Test Bank for Varcarolis' Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach, 9th Edition (Margaret Jordan Halter) | Verified Questions and Answers

Test Bank for Varcarolis' Foundations of Psychiatric-Mental Health Nursing A Clinical Approach 9th Edition by Margaret Jordan Halter Chapter 01: Mental Health and Mental Illness 2 Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 9th Edition MULTIPLE CHOICE 1. A staff nursing practitioner completes orientation to a psychiatric unit. This nursing practitioner may expect an advanced practice nursing practitioner to perform which additional intervention? a.Conduct mental health assessments. b. Prescribe psychotropic medication. c. Establish therapeutic relationships. d. Individualize nursing care plans. CORRECT ANSWER: B In most states, prescriptive privileges are granted to master‘s-prepared nursing practitioner practitioners and clinical nursing practitioner specialists who have taken special courses on prescribing medication. The nursing practitioner prepared at the basic level is permitted to perform mental health assessments, establish relationships, and provide individualized care planning. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-23 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 2. A nursing student expresses concerns that mental health nurses ―lose all their clinical nursing skills.‖ Select the best response by the mental health nurse. a. ―Psychiatric nurses practice in safer environments than other specialties. Nurse-to-client ratios must be better because of the nature of the clients‘ problems.‖ b. ―Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.‖ c. ―That‘s a misconception. Psychiatric nurses frequently use high technology monitoring equipment and manage complex intravenous therapies.‖ d. ―Psychiatric nurses do not have to deal with as much pain and suffering as medical– surgical nurses do. That appeals to me.‖ CORRECT ANSWER: B The practice of psychiatric nursing requires a different set of skills than medical–surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients with medical as well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical pain and suffering PTS: 1 DIF: Cognitive Level: Apply (Application) 3 REF: Pages 1-2, 21 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care EnvironmentWhen a new bill introduced in Congress reduces funding for care of persons diagnosed with mental illness, a group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Recovery b. Attending c. Advocacy d. Evidence-based practice CORRECT ANSWER: C An advocate defends or asserts another‘s cause, particularly when the other person lacks the ability to do that for self. Examples of individual advocacy include helping clients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the human condition. Since funding is necessary to deliver quality programming for persons with mental illness, the letter-writing campaign advocates for that cause on behalf of clients who are unable to articulate their own needs. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-26 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment 3. A family has a long history of conflicted relationships among the members. Which family member‘s comment best reflects a mentally healthy perspective? a. ―I‘ve made mistakes but everyone else in this family has also.‖ b. ―I remember joy and mutual respect from our early years together.‖ c. ―I will make some changes in my behavior for the good of the family.‖ d. ―It‘s best for me to move away from my family. Things will never change.‖ CORRECT ANSWER: C The correct response demonstrates the best evidence of a healthy recognition of the importance of relationships. Mental health includes rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a higher level of mental health. The other incorrect responses show blaming and avoidance. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 4. Which assessment finding most clearly indicates that a client may be experiencing a mental illness? The client a. reports occasional sleeplessness and anxiety. b. reports a consistently sad, discouraged, and hopeless mood. c. is able to describe the difference between ―as if‖ and ―for real.‖ 4 d. perceives difficulty making a decision about whether to change jobs. CORRECT ANSWER: B The correct response describes a mood alteration, which reflects mental illness. The distracters describe behaviors that are mentally healthy or within the usual scope of human experience. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-2 to 4 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 5. Which finding best indicates that the goal “Demonstrate mentally healthy behavior‖ was achieved for an adult client? The client a. sees self as capable of achieving ideals and meeting demands. b. behaves without considering the consequences of personal actions. c. aggressively meets own needs without considering the rights of others. d. seeks help from others when assuming responsibility for major areas of own life. CORRECT ANSWER: A The correct response describes an adaptive, healthy behavior. The distracters describe maladaptive behaviors. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-2 to 4 TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity 6. A nursing practitioner encounters an unfamiliar psychiatric disorder on a new client‘s admission form. Which resource should the nursing practitioner consult to determine criteria used to establish this diagnosis? a. International Statistical Classification of Diseases and Related Health Problems (ICD-10) b. The ANA‟s Psychiatric-Mental Health Nursing Scope and Standards of Practice c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) d. A behavioral health reference manual CORRECT ANSWER: C The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric illness. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-18, 19 TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment 7. A nursing practitioner wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information? 5 a. Nursing Outcomes Classification (NOC) b. DSM-V c. The ANA‟s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. ICD-10 CORRECT ANSWER: B The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline for diagnosing psychiatric disorders. The other references are good resources but do not define the diagnostic criteria. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 1-18, 19 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 8. Which individual is demonstrating the highest level of resilience? One who a. is able to repress stressors. b. becomes depressed after the death of a spouse. c. lives in a shelter for 2 years after the home is destroyed by fire. d. takes a temporary job to maintain financial stability after loss of a permanent job. CORRECT ANSWER: D Resilience is closely associated with the process of adapting and helps people facing tragedies, loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources they need to support their well-being. Repression and depression are unhealthy. Living in a shelter for 2 years shows a failure to move forward after a tragedy. See related audience response question. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-5, 6 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 9. Complete this analogy. NANDA: clinical judgment: NIC: a. client outcomes. b. nursing actions. c. diagnosis. d. symptoms. CORRECT ANSWER: B Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association, identifies diagnostic statements regarding human responses to actual or potential health problems. These statements represent clinical judgments. NIC (Nursing Interventions Classification) identifies actions provided by nurses that enhance client outcomes. Nursing care activities may be direct or indirect. 6 PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-21, 22 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment 10. An adult says, ―Most of the time I‘m happy and feel good about myself. I have learned that 7 what I get out of something is proportional to the effort I put into it.‖ Which number on this mental health continuum should the nursing practitioner select? 8 Ment al Illness Mental Health 1 2 3 4 5 a. 1 b. 2 c. 3 d. 4 e. 5 CORRECT ANSWER: E The adult is generally happy and has an adequate self-concept. The statement indicates the adult is reality-oriented, works effectively, and has control over own behavior. Mental health does not mean that a person is always happy. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 11. Which disorder is an example of a culture-bound syndrome? a. Epilepsy b. Schizophrenia c. Running amok d. Major depressive disorder CORRECT ANSWER: C Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people in those cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a person (usually a male) runs around engaging in furious, almost indiscriminate violent behavior. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-7 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 12. The DSM-V classifies: a. deviant behaviors. b. present disability or distress. c. people with mental disorders. d. mental disorders people have. CORRECT ANSWER: D The DSM-V classifies disorders people have rather than people themselves. The terminology of the tool reflects this distinction by referring to individuals with a disorder rather than as a 9 ―schizophrenic‖ or ―alcoholic,‖ for example. Deviant behavior is not generally considered a mental disorder. Present disability or distress is only one aspect of the diagnosis. 10 PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 1-18, 19 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 13. A citizen at a community health fair asks the nurse, ―What is the most prevalent mental disorder in the United States?‖ Select the nurse‘s correct response. a. Schizophrenia b. Bipolar disorder c. Dissociative fugue d. Alzheimer‘s disease CORRECT ANSWER: D The 12-month prevalence for Alzheimer‘s disease is 10% for persons older than 65% and 50% for persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar disorder is 2.6%. Dissociative fugue is a rare disorder. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-33 (Table 1-1) TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 14. In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? One who a. describes hearing God‘s voice speaking. b. is usually pessimistic but strives to meet personal goals. c. is wealthy and gives away $20 bills to needy individuals. d. always has an optimistic viewpoint about life and having own needs met. CORRECT ANSWER: A The question asks about risk. Hearing voices is generally associated with mental illness, but in charismatic religious groups, hearing the voice of God or a prophet is a desirable event. Cultural norms vary, which makes it more difficult to make an accurate diagnosis. The individuals described in the other options are less likely to be labeled mentally ill. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-3, 4 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 15. A client‘s relationships are intense and unstable. The client initially idealizes the significant other and then devalues him or her, resulting in frequent feelings of emptiness. This client will benefit from interventions to develop which aspect of mental health? a. Effectiveness in work b. Communication skills c. Productive activities d. Fulfilling relationships 11 CORRECT ANSWER: D The information given centers on relationships with others that are described as intense and unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially 12 integrated. Data are not present to describe work effectiveness, communication skills, or activities. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-32 (Figure 1-1) TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity 16. Which belief will best support a nurse‘s efforts to provide client advocacy during a multidisciplinary client care planning session? a. All mental illnesses are culturally determined. b. Schizophrenia and bipolar disorder are cross-cultural disorders. c. Symptoms of mental disorders are unchanged from culture to culture. d. Assessment findings in mental illness reflect a person‘s cultural patterns. CORRECT ANSWER: D Symptoms must be understood in terms of a person‘s cultural background. A nursing practitioner who understands that a client‘s symptoms are influenced by culture will be able to advocate for the client to a greater degree than a nursing practitioner who believes that culture is of little relevance. The distracters are untrue statements. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-27 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 17. A nursing practitioner is part of a multidisciplinary team working with groups of depressed clients. One group of clients receives supportive interventions and antidepressant medication. The other group receives only medication. The team measures outcomes for each group. Which type of study is evident? a. Incidence b. Prevalence c. Comorbidity d. Clinical epidemiology CORRECT ANSWER: D Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic screening tests, and observational and experimental studies of interventions used to treat people with the illness or symptoms. Prevalence refers to numbers of new cases. Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the number of new cases of mental disorders in a healthy population within a given period. See related audience response question. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-17 TOP: Nursing Process: Evaluation 13