Chapter 01: Mental Health and Mental Illness ANS: C
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical An advocate defends or asserts another’s cause, particularly when the other person lacks the
Approach, 9th Edition 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
MULTIPLE CHOICE 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
1. The scope of practiced for an advanced nurse practitioner would include which intervention? their own needs.
a. Conducting a mental health assessment.
b. Prescribing psychotropic medication. PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
c. Establishing a therapeutic relationship. TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
d. Individualizing a nursing care plan.
4. A family has a long history of conflicted relationships among the members. Which family
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and member’s comment best reflects a mentally healthy perspective?
a.“I’ve made mistakes but everyone else in this family has also.”
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
b.“I remember joy and mutual respect from our early years together.”
prepared at the basic level is permitted to perform mental health assessments, establish
c.“I will make some changes in my behavior for the good of the family.”
relationships, and provide individualized care planning.
d.“It’s best for me to move away from my family. Things will never change.”
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) ANS: C
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment The correct response demonstrates the best evidence of a healthy recognition of the
importance of relationships. Mental health includes rational thinking, communication skills,
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
skills.” Select the best response by the mental health nurse. be healthy, but the correct response shows a higher level of mental health. The other incorrect
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
responses show blaming and avoidance.
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 PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
to solve multidimensional problems. I am challenged by those situations.” TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
c. “That’s a misconception. Psychiatric nurses frequently use high technology
monitoring equipment and manage complex intravenous therapies.” 5. Which assessment finding most clearly indicates that a client may be experiencing a mental
d. “Psychiatric nurses do not have to deal with as much pain and suffering as illness?
medical–surgical nurses do. That appeals to me.” a. reporting occasional sleeplessness and anxiety.
b. reporting a consistently sad, discouraged, and hopeless mood.
ANS: B
c. being able to describe the difference between “as if” and “for real.”
The practice of psychiatric nursing requires a different set of skills than medical–surgical
d. experiencing difficulty making a decision about whether to change jobs.
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 ANS: B
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like The correct response describes a mood alteration, which reflects mental illness. The distracters
other specialties. Psychiatric nursing involves clinical practice, not just documentation. describe behaviors that are mentally healthy or within the usual scope of human experience.
Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with achieved for an adult client?
mental illness, a group of nurses write letters to their elected representatives in opposition to a. being willing to work towards achieving ideals and meeting demands.
the legislation. Which role have the nurses fulfilled? b. behaving without considering the consequences of personal actions.
a. Recovery c. aggressively meeting personal needs without considering the rights of others.
b. Attending d. seeking help from others to avoid assuming responsibility for major areas of own
c. Advocacy life.
d. Evidence-based practice
, ANS: A Resilience is closely associated with the process of adapting and helps people facing tragedies,
Mental health is a state of well-being in which individuals reach their own potential, cope loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources
with the normal stresses of life, work productively, and contribute to the community. Mental they need to support their well-being. Repression and protracted grief are unhealthy. Living in
health provides people with the capacity for rational thinking, communication skills, learning, a shelter for 2 years shows a failure to move forward after a tragedy. See related audience
emotional growth, resilience, and self-esteem. The correct response describes an adaptive, response question.
healthy behavior. The distracters describe maladaptive behaviors.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
10. The relationship of the North American Nursing Diagnosis Association (NANDA) is to
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. clinical judgment as Nursing Interventions Classification (NIC) is to what?
Which resource should the nurse consult to determine criteria used to establish this diagnosis? a. client outcomes.
a. International Statistical Classification of Diseases and Related Health Problems b. nursing actions.
(ICD-10) c. diagnosis.
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. symptoms.
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis
ANS: C Association, identifies diagnostic statements regarding human responses to actual or potential
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline health problems. These statements represent clinical judgments. NIC (Nursing Interventions
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a Classification) identifies actions provided by nurses that enhance client outcomes. Nursing
psychiatric illness. care activities may be direct or indirect.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource 11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that
would have the most complete information? what I get out of something is proportional to the effort I put into it.” Which number on this
a. Nursing Outcomes Classification (NOC) mental health continuum should the nurse select?
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice Mental Illness Mental Health
d. ICD-10 12345
a. 1
ANS: B
b. 2
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
c. 3
guideline for diagnosing psychiatric disorders. The other references are good resources but do
d. 4
not define the diagnostic criteria.
e. 5
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) ANS: E
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 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
9. Which individual behavior demonstrates resilience?
does not mean that a person is always happy.
a. Repress stressors associated with a divorce.
b. Continuing to grieve the death of a spouse for 5 years. PTS: 1 DIF: Cognitive Level: Apply (Application)
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
d. Taking a temporary job to maintain financial stability after loss of a permanent
job. 12. Which disorder is an example of a culture-bound syndrome?
a. Epilepsy
ANS: D
b. Schizophrenia
c. Running amok
d. Major depressive disorder
, ANS: C
PTS: 1 DIF: Cognitive Level: Apply (Application)
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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 16. A client’s relationships are intense and unstable. The client initially idealizes the significant
indiscriminate violent behavior. 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?
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) a. Effectiveness in work
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
b. Communication skills
c. Productive activities
13. What does the DSM-V classify?
d. Fulfilling relationships
a. deviant behaviors
b. present disability or distress ANS: D
c. people with mental disorders The information given centers on relationships with others that are described as intense and
d. mental disorders unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially
ANS: D
integrated. Data are not present to describe work effectiveness, communication skills, or
The DSM-V classifies disorders people have rather than people themselves. The terminology activities.
of the tool reflects this distinction by referring to individuals with a disorder rather than as a PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
“schizophrenic” or “alcoholic,” for example. Deviant behavior is not generally considered a TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity
mental disorder. Present disability or distress is only one aspect of the diagnosis.
17. Which belief will best support a nurse’s efforts to provide client advocacy during a
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) multidisciplinary client care planning session?
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
a.All mental illnesses are culturally determined.
b.Schizophrenia and bipolar disorder are cross-cultural disorders.
14. A citizen at a community health fair asks the nurse, “What is the most prevalent mental
c.Symptoms of mental disorders are unchanged from culture to culture.
disorder in the United States?” Select the nurse’s correct response.
d.Assessment findings in mental illness reflect a person’s cultural patterns.
a. Schizophrenia
b. Bipolar disorder ANS: D
c. Dissociative fugue Symptoms must be understood in terms of a person’s cultural background. A nurse who
d. Alzheimer’s disease understands that a client’s symptoms are influenced by culture will be able to advocate for the
ANS: D
client to a greater degree than a nurse who believes that culture is of little relevance. The
The 12-month prevalence for Alzheimer’s disease is 10% for persons older than 65% and 50% distracters are untrue statements.
for persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
of bipolar disorder is 2.6%. Dissociative fugue is a rare disorder. TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) 18. A nurse is part of a multidisciplinary team working with groups of depressed clients. One
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
group of clients receives supportive interventions and antidepressant medication. The other
15. In the majority culture of the United States, which individual has the greatest risk to be
group receives only medication. The team measures outcomes for each group. Which type of
labeled mentally ill? study is evident?
a. Incidence
a. One who describes hearing God’s voice speaking.
b. Prevalence
b. One who is usually pessimistic but strives to meet personal goals.
c. Comorbidity
c. One who is wealthy and gives away $20 bills to needy individuals.
d. Clinical epidemiology
d. One who always has an optimistic viewpoint about life
ANS: D
ANS: 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.
, Clinical epidemiology is a broad field that addresses studies of the natural history (or what a. All genomes are unique.
happens if there is no treatment and the problem is left to run its course) of an illness, studies b. Care is centered on the client.
of diagnostic screening tests, and observational and experimental studies of interventions used c. Healthy development is vital to mental health.
to treat people with the illness or symptoms. Prevalence refers to numbers of new cases. d. Recovery occurs on a continuum from illness to health.
Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the
ANS: B
number of new cases of mental disorders in a healthy population within a given period. See
The key areas of care promoted by QSEN are client-centered care, teamwork and
related audience response question.
collaboration, evidence-based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
19. The spouse of a client diagnosed with schizophrenia says, “I don’t understand how events
22. What is the best response for the nurse to provide to a question from another health
from childhood have anything to do with this disabling illness.” Which response by the nurse
professional regarding the difference between a diagnosis in DSM-V and a nursing diagnosis.
will best help the spouse understand the cause of this disorder? a. “There is no functional difference between the two. Both identify human
a. “Psychological stress is the basis of most mental disorders.”
b. “This illness results from developmental factors rather than stress.”
disorders.”
b. “The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes
c. “Research shows that this condition more likely has a biological basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
culture into account.”
c. “The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis
ANS: C does not explore etiology.”
Many of the most prevalent and disabling mental disorders have strong biological influences. d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis
Genetics are only one part of biological factors. Empathy does not address increasing the offers a framework for identifying interventions for issues a client is
spouse’s level of knowledge about the cause of the disorder. The other distracters are not experiencing.”
established facts.
ANS: D
PTS: 1 DIF: Cognitive Level: Apply (Application) The medical diagnosis is concerned with the client’s disease state, causes, and cures, whereas
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity the nursing diagnosis focuses on the client’s response to stress and possible caring
interventions. Both tools consider culture. The DSM-V is multiaxial. Nursing diagnoses also
20. A category 5 tornado occurred in a community of 400 people. Many homes and businesses consider potential problems.
were destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with
posttraumatic stress disorder (PTSD). Which term best applies to these newly diagnosed PTS: 1 DIF: Cognitive Level: Apply (Application)
cases? TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
a. Prevalence
23. Which nursing intervention below is part of the scope of an advanced practice
b. Comorbidity
c. Incidence
psychiatric/mental health nurse rather than a basic level registered nurse?
a. Coordination of care
d. Parity
b. Health teaching
ANS: C c. Milieu therapy
Incidence refers to the number of new cases of mental disorders in a healthy population within d. Psychotherapy
a given period of time. Prevalence describes the total number of cases, new and existing, in a
ANS: D
given population during a specific period of time, regardless of when they became ill. Parity
Psychotherapy is part of the scope of practice of an advanced practice nurse. The distracters
refers to equivalence, and legislation required insurers that provide mental health coverage to
are within a basic level registered nurse’s scope of practice.
offer annual and lifetime benefits at the same level provided for medical–surgical coverage.
Comorbidity refers to having more than one mental disorder at a time. PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning | Nursing Process: Outcomes Identification
MSC: Client Needs: Safe, Effective Care Environment MULTIPLE RESPONSE
21. Which component of treatment of mental illness is specifically recognized by Quality and
Safety Education for Nurses (QSEN)?
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical An advocate defends or asserts another’s cause, particularly when the other person lacks the
Approach, 9th Edition 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
MULTIPLE CHOICE 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
1. The scope of practiced for an advanced nurse practitioner would include which intervention? their own needs.
a. Conducting a mental health assessment.
b. Prescribing psychotropic medication. PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
c. Establishing a therapeutic relationship. TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
d. Individualizing a nursing care plan.
4. A family has a long history of conflicted relationships among the members. Which family
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and member’s comment best reflects a mentally healthy perspective?
a.“I’ve made mistakes but everyone else in this family has also.”
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
b.“I remember joy and mutual respect from our early years together.”
prepared at the basic level is permitted to perform mental health assessments, establish
c.“I will make some changes in my behavior for the good of the family.”
relationships, and provide individualized care planning.
d.“It’s best for me to move away from my family. Things will never change.”
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) ANS: C
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment The correct response demonstrates the best evidence of a healthy recognition of the
importance of relationships. Mental health includes rational thinking, communication skills,
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
skills.” Select the best response by the mental health nurse. be healthy, but the correct response shows a higher level of mental health. The other incorrect
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
responses show blaming and avoidance.
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 PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
to solve multidimensional problems. I am challenged by those situations.” TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
c. “That’s a misconception. Psychiatric nurses frequently use high technology
monitoring equipment and manage complex intravenous therapies.” 5. Which assessment finding most clearly indicates that a client may be experiencing a mental
d. “Psychiatric nurses do not have to deal with as much pain and suffering as illness?
medical–surgical nurses do. That appeals to me.” a. reporting occasional sleeplessness and anxiety.
b. reporting a consistently sad, discouraged, and hopeless mood.
ANS: B
c. being able to describe the difference between “as if” and “for real.”
The practice of psychiatric nursing requires a different set of skills than medical–surgical
d. experiencing difficulty making a decision about whether to change jobs.
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 ANS: B
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like The correct response describes a mood alteration, which reflects mental illness. The distracters
other specialties. Psychiatric nursing involves clinical practice, not just documentation. describe behaviors that are mentally healthy or within the usual scope of human experience.
Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with achieved for an adult client?
mental illness, a group of nurses write letters to their elected representatives in opposition to a. being willing to work towards achieving ideals and meeting demands.
the legislation. Which role have the nurses fulfilled? b. behaving without considering the consequences of personal actions.
a. Recovery c. aggressively meeting personal needs without considering the rights of others.
b. Attending d. seeking help from others to avoid assuming responsibility for major areas of own
c. Advocacy life.
d. Evidence-based practice
, ANS: A Resilience is closely associated with the process of adapting and helps people facing tragedies,
Mental health is a state of well-being in which individuals reach their own potential, cope loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources
with the normal stresses of life, work productively, and contribute to the community. Mental they need to support their well-being. Repression and protracted grief are unhealthy. Living in
health provides people with the capacity for rational thinking, communication skills, learning, a shelter for 2 years shows a failure to move forward after a tragedy. See related audience
emotional growth, resilience, and self-esteem. The correct response describes an adaptive, response question.
healthy behavior. The distracters describe maladaptive behaviors.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
10. The relationship of the North American Nursing Diagnosis Association (NANDA) is to
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. clinical judgment as Nursing Interventions Classification (NIC) is to what?
Which resource should the nurse consult to determine criteria used to establish this diagnosis? a. client outcomes.
a. International Statistical Classification of Diseases and Related Health Problems b. nursing actions.
(ICD-10) c. diagnosis.
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. symptoms.
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis
ANS: C Association, identifies diagnostic statements regarding human responses to actual or potential
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline health problems. These statements represent clinical judgments. NIC (Nursing Interventions
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a Classification) identifies actions provided by nurses that enhance client outcomes. Nursing
psychiatric illness. care activities may be direct or indirect.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource 11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that
would have the most complete information? what I get out of something is proportional to the effort I put into it.” Which number on this
a. Nursing Outcomes Classification (NOC) mental health continuum should the nurse select?
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice Mental Illness Mental Health
d. ICD-10 12345
a. 1
ANS: B
b. 2
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
c. 3
guideline for diagnosing psychiatric disorders. The other references are good resources but do
d. 4
not define the diagnostic criteria.
e. 5
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) ANS: E
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 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
9. Which individual behavior demonstrates resilience?
does not mean that a person is always happy.
a. Repress stressors associated with a divorce.
b. Continuing to grieve the death of a spouse for 5 years. PTS: 1 DIF: Cognitive Level: Apply (Application)
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
d. Taking a temporary job to maintain financial stability after loss of a permanent
job. 12. Which disorder is an example of a culture-bound syndrome?
a. Epilepsy
ANS: D
b. Schizophrenia
c. Running amok
d. Major depressive disorder
, ANS: C
PTS: 1 DIF: Cognitive Level: Apply (Application)
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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 16. A client’s relationships are intense and unstable. The client initially idealizes the significant
indiscriminate violent behavior. 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?
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) a. Effectiveness in work
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
b. Communication skills
c. Productive activities
13. What does the DSM-V classify?
d. Fulfilling relationships
a. deviant behaviors
b. present disability or distress ANS: D
c. people with mental disorders The information given centers on relationships with others that are described as intense and
d. mental disorders unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially
ANS: D
integrated. Data are not present to describe work effectiveness, communication skills, or
The DSM-V classifies disorders people have rather than people themselves. The terminology activities.
of the tool reflects this distinction by referring to individuals with a disorder rather than as a PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
“schizophrenic” or “alcoholic,” for example. Deviant behavior is not generally considered a TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity
mental disorder. Present disability or distress is only one aspect of the diagnosis.
17. Which belief will best support a nurse’s efforts to provide client advocacy during a
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) multidisciplinary client care planning session?
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
a.All mental illnesses are culturally determined.
b.Schizophrenia and bipolar disorder are cross-cultural disorders.
14. A citizen at a community health fair asks the nurse, “What is the most prevalent mental
c.Symptoms of mental disorders are unchanged from culture to culture.
disorder in the United States?” Select the nurse’s correct response.
d.Assessment findings in mental illness reflect a person’s cultural patterns.
a. Schizophrenia
b. Bipolar disorder ANS: D
c. Dissociative fugue Symptoms must be understood in terms of a person’s cultural background. A nurse who
d. Alzheimer’s disease understands that a client’s symptoms are influenced by culture will be able to advocate for the
ANS: D
client to a greater degree than a nurse who believes that culture is of little relevance. The
The 12-month prevalence for Alzheimer’s disease is 10% for persons older than 65% and 50% distracters are untrue statements.
for persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
of bipolar disorder is 2.6%. Dissociative fugue is a rare disorder. TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) 18. A nurse is part of a multidisciplinary team working with groups of depressed clients. One
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
group of clients receives supportive interventions and antidepressant medication. The other
15. In the majority culture of the United States, which individual has the greatest risk to be
group receives only medication. The team measures outcomes for each group. Which type of
labeled mentally ill? study is evident?
a. Incidence
a. One who describes hearing God’s voice speaking.
b. Prevalence
b. One who is usually pessimistic but strives to meet personal goals.
c. Comorbidity
c. One who is wealthy and gives away $20 bills to needy individuals.
d. Clinical epidemiology
d. One who always has an optimistic viewpoint about life
ANS: D
ANS: 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.
, Clinical epidemiology is a broad field that addresses studies of the natural history (or what a. All genomes are unique.
happens if there is no treatment and the problem is left to run its course) of an illness, studies b. Care is centered on the client.
of diagnostic screening tests, and observational and experimental studies of interventions used c. Healthy development is vital to mental health.
to treat people with the illness or symptoms. Prevalence refers to numbers of new cases. d. Recovery occurs on a continuum from illness to health.
Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the
ANS: B
number of new cases of mental disorders in a healthy population within a given period. See
The key areas of care promoted by QSEN are client-centered care, teamwork and
related audience response question.
collaboration, evidence-based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
19. The spouse of a client diagnosed with schizophrenia says, “I don’t understand how events
22. What is the best response for the nurse to provide to a question from another health
from childhood have anything to do with this disabling illness.” Which response by the nurse
professional regarding the difference between a diagnosis in DSM-V and a nursing diagnosis.
will best help the spouse understand the cause of this disorder? a. “There is no functional difference between the two. Both identify human
a. “Psychological stress is the basis of most mental disorders.”
b. “This illness results from developmental factors rather than stress.”
disorders.”
b. “The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes
c. “Research shows that this condition more likely has a biological basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
culture into account.”
c. “The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis
ANS: C does not explore etiology.”
Many of the most prevalent and disabling mental disorders have strong biological influences. d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis
Genetics are only one part of biological factors. Empathy does not address increasing the offers a framework for identifying interventions for issues a client is
spouse’s level of knowledge about the cause of the disorder. The other distracters are not experiencing.”
established facts.
ANS: D
PTS: 1 DIF: Cognitive Level: Apply (Application) The medical diagnosis is concerned with the client’s disease state, causes, and cures, whereas
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity the nursing diagnosis focuses on the client’s response to stress and possible caring
interventions. Both tools consider culture. The DSM-V is multiaxial. Nursing diagnoses also
20. A category 5 tornado occurred in a community of 400 people. Many homes and businesses consider potential problems.
were destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with
posttraumatic stress disorder (PTSD). Which term best applies to these newly diagnosed PTS: 1 DIF: Cognitive Level: Apply (Application)
cases? TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
a. Prevalence
23. Which nursing intervention below is part of the scope of an advanced practice
b. Comorbidity
c. Incidence
psychiatric/mental health nurse rather than a basic level registered nurse?
a. Coordination of care
d. Parity
b. Health teaching
ANS: C c. Milieu therapy
Incidence refers to the number of new cases of mental disorders in a healthy population within d. Psychotherapy
a given period of time. Prevalence describes the total number of cases, new and existing, in a
ANS: D
given population during a specific period of time, regardless of when they became ill. Parity
Psychotherapy is part of the scope of practice of an advanced practice nurse. The distracters
refers to equivalence, and legislation required insurers that provide mental health coverage to
are within a basic level registered nurse’s scope of practice.
offer annual and lifetime benefits at the same level provided for medical–surgical coverage.
Comorbidity refers to having more than one mental disorder at a time. PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning | Nursing Process: Outcomes Identification
MSC: Client Needs: Safe, Effective Care Environment MULTIPLE RESPONSE
21. Which component of treatment of mental illness is specifically recognized by Quality and
Safety Education for Nurses (QSEN)?
