Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
Chapter 1: Mental Health and Mental Illness
MULTIPLE CHOICE
1. The nurse is evaluating a client's ability to engage in adaptive stress
management. Which client statement supports the nurse's belief that the
client is successfully managing the stress of a recent divorce?
A) “Loving someone is no guarantee that they will love you
back.”
B) “I know now that we were never really meant to be
together.”
C) “It's not my fault that I loved someone who was incapable
of being faithful.”
D) “I'm a lovable person who has control over my own
happiness.”
ANS: C
Feedback: In most situations, the sense of control an individual feels over a particular stressor
determines how he or she thinks about or perceives it. Reframing is a way of restructuring our
thinking about a stressful event into one that is less disturbing and over which we can have
some control such as the belief that one is lovable and in control. The remaining options state
feelings that deflect the hurt felt or that provide a rationale for the divorce.
PTS: 1 DIF: Difficult
REF: Header: Promoting Adaptive Coping Strategies | Page: 9 OBJ: 6
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze
2. When working with a client who is grieving, which nursing action best demonstrates
understanding of the grieving process and the most effective means of facilitating the client's
ability to bring about closure and display hope for the future?
A) Using open-ended questioning techniques when communicating with the client
who is currently in the grieving process
B) Sharing with the grieving client that the client's grief is demonstrated in very
specific and personal ways that are unique to the person alone
C) Devoting time each meeting to discussing the feelings the client has described in
daily journal entries
D) Assuring the client that while the grieving process has identifiable stages, there is
no specific timetable for moving through these stages
ANS: C
, Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
Feedback: Interventions that assist individuals with the grieving process should encourage
openness and honesty about their feelings, while encouraging expressions of hope for the
future and reinvestment in life interests. Journaling, that encourages the expression of grief-
related feelings, has proven to be an effective intervention in this process. Open-ended
questioning focuses on effective information gathering especially related to the assessment of
the grieving client. It is true that the grieving process is an experience that is unique to each
individual and not bound by specific timetables; sharing this information with the client does
not facilitate the expression of feelings so necessary to the successful management of acute
grief.
PTS: 1 DIF: Difficult
REF: Header: Coping with Grief and Loss | Page: 13 OBJ: 9
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply
3. When considering the various aspects of stress, which statement would accurately describe
eustress?
A) “I often feel stressed by the end of a very hectic shift here at the clinic.”
B) “When I'm really stressed, I usually get a severe headache.”
C) “I generally do my best work when I feel some stress.”
D) “When you become a nurse, you become familiar with stress.”
ANS: C
Feedback: Eustress is positive and motivating, as shown by one's confidence in the ability to
master a challenge or stressor. Stress results when a threat or challenge to one's well-being
requires the person to adjust or adapt to the environment. Distress in response to a threat or
challenge is actually harmful to one's health. This is a negative stress and demands an
exhausting type of energy.
PTS: 1 DIF: Moderate REF: Header: Defining Stress | Page: 5
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 01 KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Analyze
4. Which client statement supports the nurse's suspicions that a client being treated for chronic
depression is experiencing severe emotional distress produced by external circumstances?
A) “I have been depressed ever since I was diagnosed with leukemia.”
B) “My doctor told me that I have to manage my stress or risk having a heart attack.”
C) “My professional life is ruined because my boss never recognizes my worth and
value.”
D) “I'm never comfortable when I know that I have to fly for my work.”
ANS: C
Feedback: It is important to recognize that many times we view external circumstances as the
cause of our stress such as in the case of the client's perception of the boss's viewpoint. The
remaining options demonstrate internal or self-perceptions and viewpoints.
PTS: 1 DIF: Difficult
REF: Header: Contributing Factors to Stress and Anxiety | Page: 8
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
, Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze
5. A young adult student recently failed a major exam. While talking with the student, which
statement by the student supports the nurse's belief that the client is using reframing to cope
with the resulting anxiety?
A) “That course is taught again next semester; if I fail, I'll take it over then.”
B) “I've decided to transfer to another section that's taught by an easier teacher.”
C) “That exam wasn't really that important. I'll do better on the next one.”
D) “I've arranged to join a study group so I'll do better on the next exam.”
ANS: D
Feedback: Reframing is a way of restructuring our thinking about a stressful event into one
that is less disturbing and over which we can have some control such as deciding on a plan to
improve their next exam grade. Reframing does not involve minimization, transference, or
denial of the problem.
PTS: 1 DIF: Difficult
REF: Header: Promoting Adaptive Coping Strategies | Page: 9 OBJ: 6
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply
6. A college student is very anxious about auditioning for the school's famous chorale. Which
coping strategy implemented by the student would the nurse recognize as being maladaptive?
A) Arranging for private voice lessons
B) Practicing the songs used in the audition
C) Repeatedly telling friends it's okay to fail
D) Singing with a group of friends who are also auditioning
ANS: C
Feedback: Maladaptive and dysfunctional strategies usually do not result in a positive
outcome. The individual who does not attempt to reduce the anxiety or solve the problem is
considered to have dysfunctional coping in response to the stressor and the emotional
response. In this scenario, the student does not attempt to reduce the anxiety of auditioning
but rather decides that failing will be acceptable. The other options demonstrate some positive
action directed toward preparing for the audition and so reducing anxiety.
PTS: 1 DIF: Moderate REF: Header: Coping Strategies | Page: 8
OBJ: 6 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze
7. A nurse is preparing to assist a client in dealing with the grief associated with the death of a
loved one. Which interventions would the nurse do first?
A) Use open-ended questions to explore the client's feelings about grief and encourage
communication.
B) Help the client identify the members of the client's support system and the
importance of their assistance.
, Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
C) Engage in self-reflection regarding personal beliefs and values associated with
death and dying.
D) Assist the client in creating a letter to the deceased in order to facilitate closure for
the relationship.
ANS: C
Feedback: To deal effectively with the client experiencing grief, the nurse must face the
reality of his or her own mortality and concept of death. While all the remaining options are
appropriate interventions, the process must begin with the nurse working toward an
understanding of his or her personal grief beliefs and the ability to provide unbiased support
to the client.
PTS: 1 DIF: Moderate
REF: Header: Coping with Grief and Loss | Page: 13 OBJ: 9
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Caring BLM: Cognitive Level: Apply
8. The nurse suspects a client is demonstrating signs of dysfunctional grief. Which question
would the nurse most likely use to help assess for that disorder?
A) “How would you define grief?”
B) “What gives your life meaning?”
C) “Have you ever thought about hurting yourself?”
D) “When did you first notice the feelings of grief?”
ANS: B
Feedback: Dysfunctional grief is a failure to complete the grieving process and cope
successfully with a loss. If the person experiences a prolonged and intensified reaction, life
may become meaningless and a mere existence centered on longing for that which is lost.
While the assessment should attempt to identify when the symptoms began and how the client
views their condition, this information will not necessarily support a diagnosis of
dysfunctional grief. Assessing for suicidal ideations is appropriate for clients experiencing a
variety of mental health disorders.
PTS: 1 DIF: Moderate REF: Header: Dysfunctional Grief | Page: 13
OBJ: 8 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply
9. A nurse is gathering information about a client who has experienced a loss. Which
information would the nurse identify as indicating that the client is experiencing chronic
sorrow?
A) Twelve continuous months of coping with a loss
B) Inability to complete the coping process after a loss
C) A loss that causes suicidal ideations
D) Prolonged and intensified reaction to a loss
ANS: D
Chapter 1: Mental Health and Mental Illness
MULTIPLE CHOICE
1. The nurse is evaluating a client's ability to engage in adaptive stress
management. Which client statement supports the nurse's belief that the
client is successfully managing the stress of a recent divorce?
A) “Loving someone is no guarantee that they will love you
back.”
B) “I know now that we were never really meant to be
together.”
C) “It's not my fault that I loved someone who was incapable
of being faithful.”
D) “I'm a lovable person who has control over my own
happiness.”
ANS: C
Feedback: In most situations, the sense of control an individual feels over a particular stressor
determines how he or she thinks about or perceives it. Reframing is a way of restructuring our
thinking about a stressful event into one that is less disturbing and over which we can have
some control such as the belief that one is lovable and in control. The remaining options state
feelings that deflect the hurt felt or that provide a rationale for the divorce.
PTS: 1 DIF: Difficult
REF: Header: Promoting Adaptive Coping Strategies | Page: 9 OBJ: 6
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze
2. When working with a client who is grieving, which nursing action best demonstrates
understanding of the grieving process and the most effective means of facilitating the client's
ability to bring about closure and display hope for the future?
A) Using open-ended questioning techniques when communicating with the client
who is currently in the grieving process
B) Sharing with the grieving client that the client's grief is demonstrated in very
specific and personal ways that are unique to the person alone
C) Devoting time each meeting to discussing the feelings the client has described in
daily journal entries
D) Assuring the client that while the grieving process has identifiable stages, there is
no specific timetable for moving through these stages
ANS: C
, Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
Feedback: Interventions that assist individuals with the grieving process should encourage
openness and honesty about their feelings, while encouraging expressions of hope for the
future and reinvestment in life interests. Journaling, that encourages the expression of grief-
related feelings, has proven to be an effective intervention in this process. Open-ended
questioning focuses on effective information gathering especially related to the assessment of
the grieving client. It is true that the grieving process is an experience that is unique to each
individual and not bound by specific timetables; sharing this information with the client does
not facilitate the expression of feelings so necessary to the successful management of acute
grief.
PTS: 1 DIF: Difficult
REF: Header: Coping with Grief and Loss | Page: 13 OBJ: 9
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply
3. When considering the various aspects of stress, which statement would accurately describe
eustress?
A) “I often feel stressed by the end of a very hectic shift here at the clinic.”
B) “When I'm really stressed, I usually get a severe headache.”
C) “I generally do my best work when I feel some stress.”
D) “When you become a nurse, you become familiar with stress.”
ANS: C
Feedback: Eustress is positive and motivating, as shown by one's confidence in the ability to
master a challenge or stressor. Stress results when a threat or challenge to one's well-being
requires the person to adjust or adapt to the environment. Distress in response to a threat or
challenge is actually harmful to one's health. This is a negative stress and demands an
exhausting type of energy.
PTS: 1 DIF: Moderate REF: Header: Defining Stress | Page: 5
OBJ: 4 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 01 KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Analyze
4. Which client statement supports the nurse's suspicions that a client being treated for chronic
depression is experiencing severe emotional distress produced by external circumstances?
A) “I have been depressed ever since I was diagnosed with leukemia.”
B) “My doctor told me that I have to manage my stress or risk having a heart attack.”
C) “My professional life is ruined because my boss never recognizes my worth and
value.”
D) “I'm never comfortable when I know that I have to fly for my work.”
ANS: C
Feedback: It is important to recognize that many times we view external circumstances as the
cause of our stress such as in the case of the client's perception of the boss's viewpoint. The
remaining options demonstrate internal or self-perceptions and viewpoints.
PTS: 1 DIF: Difficult
REF: Header: Contributing Factors to Stress and Anxiety | Page: 8
OBJ: 5 NAT: Client Needs: Psychosocial Integrity
, Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze
5. A young adult student recently failed a major exam. While talking with the student, which
statement by the student supports the nurse's belief that the client is using reframing to cope
with the resulting anxiety?
A) “That course is taught again next semester; if I fail, I'll take it over then.”
B) “I've decided to transfer to another section that's taught by an easier teacher.”
C) “That exam wasn't really that important. I'll do better on the next one.”
D) “I've arranged to join a study group so I'll do better on the next exam.”
ANS: D
Feedback: Reframing is a way of restructuring our thinking about a stressful event into one
that is less disturbing and over which we can have some control such as deciding on a plan to
improve their next exam grade. Reframing does not involve minimization, transference, or
denial of the problem.
PTS: 1 DIF: Difficult
REF: Header: Promoting Adaptive Coping Strategies | Page: 9 OBJ: 6
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply
6. A college student is very anxious about auditioning for the school's famous chorale. Which
coping strategy implemented by the student would the nurse recognize as being maladaptive?
A) Arranging for private voice lessons
B) Practicing the songs used in the audition
C) Repeatedly telling friends it's okay to fail
D) Singing with a group of friends who are also auditioning
ANS: C
Feedback: Maladaptive and dysfunctional strategies usually do not result in a positive
outcome. The individual who does not attempt to reduce the anxiety or solve the problem is
considered to have dysfunctional coping in response to the stressor and the emotional
response. In this scenario, the student does not attempt to reduce the anxiety of auditioning
but rather decides that failing will be acceptable. The other options demonstrate some positive
action directed toward preparing for the audition and so reducing anxiety.
PTS: 1 DIF: Moderate REF: Header: Coping Strategies | Page: 8
OBJ: 6 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Analyze
7. A nurse is preparing to assist a client in dealing with the grief associated with the death of a
loved one. Which interventions would the nurse do first?
A) Use open-ended questions to explore the client's feelings about grief and encourage
communication.
B) Help the client identify the members of the client's support system and the
importance of their assistance.
, Test Bank For Introductory Mental Health Nursing, 4th Edition Donna M. Womble
C) Engage in self-reflection regarding personal beliefs and values associated with
death and dying.
D) Assist the client in creating a letter to the deceased in order to facilitate closure for
the relationship.
ANS: C
Feedback: To deal effectively with the client experiencing grief, the nurse must face the
reality of his or her own mortality and concept of death. While all the remaining options are
appropriate interventions, the process must begin with the nurse working toward an
understanding of his or her personal grief beliefs and the ability to provide unbiased support
to the client.
PTS: 1 DIF: Moderate
REF: Header: Coping with Grief and Loss | Page: 13 OBJ: 9
NAT: Client Needs: Psychosocial Integrity TOP: Chapter 01
KEY: Integrated Process: Caring BLM: Cognitive Level: Apply
8. The nurse suspects a client is demonstrating signs of dysfunctional grief. Which question
would the nurse most likely use to help assess for that disorder?
A) “How would you define grief?”
B) “What gives your life meaning?”
C) “Have you ever thought about hurting yourself?”
D) “When did you first notice the feelings of grief?”
ANS: B
Feedback: Dysfunctional grief is a failure to complete the grieving process and cope
successfully with a loss. If the person experiences a prolonged and intensified reaction, life
may become meaningless and a mere existence centered on longing for that which is lost.
While the assessment should attempt to identify when the symptoms began and how the client
views their condition, this information will not necessarily support a diagnosis of
dysfunctional grief. Assessing for suicidal ideations is appropriate for clients experiencing a
variety of mental health disorders.
PTS: 1 DIF: Moderate REF: Header: Dysfunctional Grief | Page: 13
OBJ: 8 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 01
KEY: Integrated Process: Clinical Problem-Solving Process (Nursing Process)
BLM: Cognitive Level: Apply
9. A nurse is gathering information about a client who has experienced a loss. Which
information would the nurse identify as indicating that the client is experiencing chronic
sorrow?
A) Twelve continuous months of coping with a loss
B) Inability to complete the coping process after a loss
C) A loss that causes suicidal ideations
D) Prolonged and intensified reaction to a loss
ANS: D
