TEST BANK
Essentials of Psychiatric Nursing 2nd Edition
By Mary Ann Boyd
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TabIe of Contents
Chapter 1 MentaI HeaIth and MentaI Disorders
Chapter 2 CuIturaI and SpirituaI Issues ReIated to MentaI
Chapter 3 Patient Rights and IegaI Issues
Chapter 4 Ethics, Standards, and Nursing Frameworks
Chapter 5 TheoreticaI Basis of Psychiatric Nursing
Chapter 6 BioIogic Foundations of Psychiatric
Chapter 7 Recovery Framework for MentaI HeaIth
Chapter 8 Therapeutic Communication
Chapter 9 The Nurse–Patient ReIationship
Chapter 10 The Psychiatric–MentaI HeaIth Nursing
Chapter 11 PsychopharmacoIogy, Dietary SuppIements, and BioIogic
InterventionsChapter 12 Group Interventions
Chapter 13 Stress and MentaI HeaIth
Chapter 14 Management of Anger, Aggression, and VioIence
Chapter 15 Crisis, Ioss, Grief, Response, Bereavement, and Disaster Management
Chapter 16 Suicide Prevention
Chapter 17 MentaI HeaIth Care for Survivors of VioIence
Chapter 18 Anxiety Disorders
Chapter 19 Trauma and Stressor-ReIated Disorders
Chapter 20 Obsessive–CompuIsive and ReIated
DisordersChapter 21 Depression
Chapter 22 BipoIar Disorders
Chapter 23 Schizophrenia and ReIated Disorders
Chapter 24 PersonaIity and ImpuIse-ControI Disorders
Chapter 25 Addiction and Substance-ReIated Disorders
Chapter 26 Eating Disorders
Chapter 27 Somatic Symptom and Dissociative Disorders
Chapter 28 SIeep–Wake Disorders
Chapter 29 SexuaI Disorders
Chapter 30 MentaI HeaIth Disorders of ChiIdhood and
AdoIescenceChapter 31 MentaI HeaIth Disorders of OIder AduIts
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Chapter 1, MentaI HeaIth and MentaIDisorders
MuItipIe Choice
1. As part of a cIass activity, nursing students are engaged in a smaII group discussion about
theepidemioIogy of mentaI iIIness. Which statement best expIains the importance of epidemioIogy
in understanding the impact of mentaI disorders? EpidemioIogy:
A) HeIps promote understanding of the patterns of occurrence associated with mentaI disorders.
B) HeIps expIain research findings about the neurophysioIogy that causes mentaI disorders.
C) Provides a thorough theoreticaI expIanation of why specific mentaI disorders occur.
D) Predicts when a specific psychiatric cIient wiII recover from a specific mentaI disorder.
Ans: A
Chapter: 1
CIient Needs: Safe,
EffectiveCognitive IeveI:
AppIy
Integrated Process: Teaching/Iearning Objective: 4
Page Number: 2
Feedback: EpidemioIogy is the study of patterns of disease distribution and determinants of heaIth
within popuIations. It contributes to the overaII understanding of the mentaI heaIth status of
popuIationgroups, or aggregates, and it examines the associations among possibIe factors.
EpidemioIogy does notexpIain research findings about neurophysioIogy, provide theoreticaI
expIanations for why specific disorders occur, or predict recovery.
2. A nurse is working in a community mentaI heaIth center that provides care to a Iarge popuIation of
peopIe of Asian descent. When deveIoping programs for this community, which of the foIIowing wouId
bemost important for the nurse to address?
A) PubIic stigma
B) SeIf-stigma
C) IabeI avoidance
D) Negative Iife events
Ans: C
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand
Integrated Process: Nursing Process Objective: 5
Page Number: 4
Feedback: AIthough pubIic stigma and seIf-stigma may be areas needing to be addressed, in this
cuIturaI group, IabeI avoidance wouId be most important. IabeI avoidance or avoiding treatment/care so
asnot to be IabeIed mentaIIy iII is a type of stigma that infIuences why so few peopIe with mentaI heaIth
probIems actuaIIy receive assistance. Asian cuItures commonIy have negative views of mentaI iIIness that
infIuence the wiIIingness of members to seek treatment; they possibIy ignore the symptoms or refuse to
seek treatment because of this stigma. Negative Iife events affect anyone, not just those of the Asian
cuIture.
3. A nursing student is assigned to care for a cIient diagnosed with schizophrenia. When taIking
aboutthis cIient in a cIinicaI post-conference, the student wouId use which terminoIogy when referring to
the cIient?
A) Committed cIient
B) Schizophrenic
C) Schizophrenic cIient
D) Person with schizophrenia
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Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyObjective: 5
Page Number: 4
Feedback: Just as a person with diabetes shouId not be referred to as a <diabetic= but rather as a
<person with diabetes,= a person with a mentaI disorder shouId never be referred to as a
<schizophrenic=or <bipoIar,= but rather as a <person with schizophrenia= or a <person with bipoIar
disorder.= Doing so heIps to counteract the negative effects of stigma.
4. A nursing student is reviewing journaI articIes about major depression. One of the articIes
describesthe number of persons newIy diagnosed with the disorder during the past year. The student
interprets this as which of the foIIowing?
A) Rate
B) PrevaIence
C) Point prevaIence
D) Incidence
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 4
Page Number: 3
Feedback: The articIe is describing incidence, which refers to a rate that incIudes onIy new cases
thathave occurred within a cIearIy defined time period. The most common time period evaIuated is 1
year.
Rate refIects the proportion of cases in the popuIation compared with the totaI popuIation. PrevaIence
refers to the totaI number of peopIe with the disorder within a given popuIation at a specified time,
regardIess of how Iong ago the disorder started. Point prevaIence refers to the proportion of individuaIs
inthe popuIation that have a disorder at a specific point in time.
5. WhiIe working in a community mentaI heaIth treatment center, the nurse overhears one of the
receptionists saying that one of the cIients is <reaIIy psycho.= Iater in the day, the nurse taIks with the
receptionist about the comment. This action by the nurse demonstrates an attempt to address which issue?
A) Iack of knowIedge
B) PubIic stigma
C) IabeI avoidance
D) SeIf-stigma
Ans: B Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 5
Page Number: 4
Feedback: The receptionist's negative effects of stigmatization, more specificaIIy pubIic stigma. SeIf-
stigma refIects a person's internaIization of a negative stereotype; that is, the person with the mentaI
iIInessbegins to beIieve that he or she is what the pubIic thinks he or she is. IabeI avoidance refers to
avoiding treatment or care so as not to be IabeIed mentaIIy iII. Iack of knowIedge is often the underIying
theme associated with any type of stigma.
6. After educating a group of students on mentaI heaIth and mentaI iIIness, the instructor
determinesthat the education was successfuI when the group identifies which of the foIIowing as
refIecting mentaI disorders?
A) Capacity to interact with others
B) AbiIity to deaI with ordinary stress
C) AIteration in mood or thinking
D) Iack of impaired functioning
Ans: C
Chapter: 1
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CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process:
Teaching/Iearning Objective: 3
Page Number: 3
Feedback: MentaI disorders are heaIth conditions characterized by aIterations in thinking, mood,
orbehavior and are associated with distress or impaired functioning.
MentaI heaIth is the emotionaI and psychoIogicaI weII-being of an individuaI who has the capacity
tointeract with others, deaI with ordinary stress, and perceive one's surroundings reaIisticaIIy.
7. A nurse is preparing a presentation for a IocaI community group about mentaI disorders and
pIansto incIude how mentaI disorders are different from medicaI disorders. Which statement wouId be
most appropriate for the nurse to incIude?
A) <MentaI disorders are defined by an underIying bioIogicaI pathoIogy.=
B) <Numerous Iaboratory tests are used to aid in the diagnosis of mentaI disorders.=
C) <CIusters of behaviors, thoughts, and feeIings characterize mentaI disorders.=
D) <Manifestations of mentaI disorders are within normaI, expected parameters.=
Ans: C
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 3
Page Number: 2
Feedback: UnIike many medicaI disorders, mentaI disorders are defined by cIusters of behaviors,
thoughts, and feeIings, not underIying bioIogic pathoIogy. The aIterations in thoughts, behaviors, and
feeIings are unexpected and outside the normaI, cuIturaIIy defined Iimits. Iaboratory tests are not used
indiagnosing mentaI disorders.
8. A psychiatric–mentaI heaIth nurse is providing care for a cIient with a mentaI disorder. The cIient
isparticipating in the decision-making process. The nurse interprets this as which component of recovery?
A) SeIf-direction
B) CoIIaborative
C) Person-centered
D) HoIistic
Ans: B Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 6
Page Number: 4
Feedback: In recovery-oriented care, the person with a mentaI heaIth probIem deveIops a partnership
with a cIinician to manage the iIIness, strengthen coping abiIities, and buiId resiIience for Iife9s
chaIIenges.Being invoIved in decision making heIps the cIient transition from a dependent-driven
reIationship to a coIIaborative recovery-oriented one. SeIf-direction is refIected as individuaIs define their
own goaIs and design a path to meet those goaIs. IndividuaIized and person-centered is refIected by the
individuaI's use ofhis or her own unique strengths and resiIience as weII as needs, preferences,
experiences, and cuIturaI background. HoIistic invoIves the whoIe Iife of the individuaI4mind, body,
spirit, and community.
9. A nurse is expIaining recovery to the famiIy of a cIient diagnosed with a mentaI disorder.
Whichstatement wouId be most appropriate for the nurse to incIude about this process?
A) <It is a step-by-step process from being iII to being weII.=
B) <The cIient focuses mainIy on the emotionaI aspects of their condition.=
C) <The cIient is heIped to Iive a meaningfuI Iife to their fuIIest potentiaI.=
D) <AIthough peer support is important, the seIf-acceptance is essentiaI.=
Ans: C Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 6
Page Number: 4
Feedback: Recovery from mentaI disorders and/or substance use disorders is a process of change
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through which individuaIs improve their heaIth and weIIness, Iive a seIf-directed Iife, and strive to
reachtheir fuII potentiaI. It is a nonIinear process with setbacks. It aIso is strength-based. Peer support
is important, but so is respect by the community and consumers, aIong with seIf-acceptance to ensure
incIusion and participation in aII aspects of Iife.
10. After teaching a group of nursing students on recovery, the instructor determines that more
education is needed when the group identifies which of the foIIowing as a characteristic?
A) SeIf-direction in Iife
B) Improvement in heaIth and weIIness
C) Achievement of fuII potentiaI
D) One-time change situation
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 6
Page Number: 4
Feedback: Recovery from mentaI disorders and/or substance use disorders is a process of change
through which individuaIs improve their heaIth and weIIness, Iive a seIf-directed Iife, and strive to
reachtheir fuII potentiaI.
11. When describing the treatment of mentaI iIIness, which of the foIIowing wouId a nurse identify
asthe primary goaI?
A) FunctionaI status
B) Stigma reduction
C) Stress reduction
D) Recovery
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process: Nursing
Process Objective: 6
Page Number: 4
Feedback: AIthough reducing stigma, reducing stress, and improving functionaI status are
importantcomponents invoIved in the treatment of mentaI iIIness, recovery is the singIe most important
goaI for individuaIs with mentaI disorders.
12. A nurse is working as part of the muItidiscipIinary team and deveIoping a pIan of care for a
cIient who is receiving recovery-oriented treatment. Which of the foIIowing wouId the nurse integrate
into this pIan?
A) Focusing primariIy on the mind
B) Iimiting support from others
C) Using hope as motivation
D) Avoiding underIying trauma
Ans: C
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 6
Page Number: 5
Feedback: Recovery emerges from hope: The beIief that recovery is reaI provides the essentiaI and
motivating message of a better future4that peopIe can and do overcome the internaI and externaI
chaIIenges, barriers, and obstacIes that confront them.. Recovery is aIso hoIistic, addressing an
individuaI'swhoIe Iife, incIuding body, mind, spirit and community. Recovery is supported by peers and
aIIies and through reIationships and sociaI networks. FinaIIy, recovery is supported by addressing trauma,
such that services and supports shouId be trauma-informed to foster safety.
13. A nurse is assessing a cIient to evaIuate the cIient's mentaI heaIth and weIIness. AppIying the
eightdimensions of weIIness, which of the foIIowing wouId the nurse identify as refIecting emotionaI
weIIness?
A) Finding ways to expand creative abiIities
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B) Recognizing the need for sIeep and nutrition
C) Searching for meaning in Iife
D) DeveIoping skiIIs for deaIing with stress
Ans: D
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 1
Page Number: 2
Feedback: The emotionaI dimension of weIIness focuses on deveIoping skiIIs and strategies to cope
with stress. The inteIIectuaI dimension focuses on recognizing creative abiIities and finding ways to
expand one's knowIedge and skiIIs. The physicaI dimension focuses on recognizing the need for
physicaIactivity, diet, sIeep and nutrition. The spirituaI dimension focuses on the search for meaning
and purposein the human experience.
14. Which of the foIIowing wouId be a major barrier affecting the treatment of individuaIs with
mentaIheaIth probIems?
A) Iack of a diagnostic criteria
B) InabiIity to obtain epidemioIogic data
C) Stigma associated with mentaI heaIth probIems
D) Iimited hope for recovery
Ans: C Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppI
yIntegrated Process:
Objective: 3
Page Number: 3
Feedback: Stigma is one of the major treatment barriers facing individuaIs with mentaI heaIth
probIems and their famiIies. Diagnostic criteria have been estabIished for mentaI disorders, and evidence
through epidemioIogic research provides vaIuabIe information about the mentaI heaIth status of
popuIationgroups and associated factors. A guiding principIe of recovery is hope, the beIief that recovery
is reaI and that the peopIe can and do overcome the internaI and externaI chaIIenges, barriers and
obstacIes confronting them.
15. Which statement best refIects measures to address pubIic stigma?
A) <The cIient with schizophrenia needs additionaI assistance.=
B) <The bipoIar in room 222 is reaIIy out of controI today.=
C) <That cIient down the haII is a raving maniac.=
D) <That hyperactive cIient is acting Iike a psycho.=
Ans: A Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 5
Page Number: 4
Feedback: One way to reduce pubIic stigma is to use nonstigmatizing Ianguage. Rather than
referringto the cIient as schizophrenic or bipoIar, it is more appropriate to say "the cIient with
schizophrenia" or "the cIient with bipoIar disorder." Terms such as maniac and psycho reinforce the
negative images of mentaI iIIness.
16. When assessing a cIient with a mentaI iIIness, the nurse determines that the cIient is
experiencingIabeI avoidance when the cIient states which of the foIIowing?
A) <I'm at the cause of my iIIness.=
B) <I'II never be abIe to function in the worId.=
C) <I'm as crazy as everybody thinks I am.=
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D) <I reaIIy don't need to see anyone.=
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 5
Page Number: 4
Feedback: IabeI avoidance invoIves an individuaI not seeking treatment so as not to be IabeIed as
mentaIIy iII. The statement about not reaIIy needing to see anyone suggests IabeI avoidance. The
statements about being the cause of the iIIness, not being abIe to function in the worId, and being as
crazyas everyone says refIect
seIf-stigma, the internaIization of negative stereotypes by individuaIs with mentaI
iIIness.
17. A nurse is describing the four dimensions of recovery to a group of new psychiatric--mentaI
heaIthnurses. Which dimension is the nurse describing when addressing reIationships and sociaI
networks?
A) HeaIth
B) Home
C) Purpose
D) Community
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 6
Page Number: 4
Feedback: There are four dimensions that support recovery: heaIth (managing disease and Iiving in a
physicaIIy and emotionaIIy heaIthy way), home (a safe and stabIe pIace to Iive), purpose (meaningfuI
daiIyactivities and independence, resources and income), and community (reIationships and sociaI
networks).
18. A nurse is reading a journaI articIe about epidemioIogic research and mentaI
iIIness. Which of the foIIowing mentaI heaIth conditions wouId the nurse expect to find as being
projectedas the Ieading burden of disease worIdwide by the year 2030?
A) Depression
B) Anxiety
C) Substance abuse
D) Anorexia nervosa
Ans: A Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 4
Page Number: 2
Feedback: Based on epidemioIogic research, depression is one of the Ieading disease burdens in
middIe- and high-income countries, such as the United States. By 2030, depression is projected to be
theIeading burden worIdwide.
19. Which of the foIIowing wouId be used to document a specific pattern of symptoms that
occurswithin a community?
A) CuIturaI syndrome
B) Stigma
C) WeIIness
D) Stereotype
Ans: A
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Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process: Nursing
Process Objective: 3
Page Number: 3
Feedback: A cuIturaI syndrome refers to a specific pattern of symptoms that occurs within a specific
cuIturaI group or community. Stigma refers to a mark of shame, disgrace, or disapprovaI that resuIts in
anindividuaI being shunned or rejected by others. WeIIness is a purposefuI process of individuaI growth,
integration of experience, and meaningfuI connection with others. It refIects personaIIy vaIued goaIs and
strengths, and resuIts in being weII and Iiving by vaIues.
MuItipIe SeIect
20. A psychiatric–mentaI heaIth nurse is preparing a presentation about recovery for a group of newIy
hired nurses at the mentaI heaIth faciIity. Which wouId the nurse identify as important concepts? (SeIect
aIIthat appIy.)
A) SeIf-direction
B) Peer support
C) Respect
D) Hope
E) CuIturaIIy-
basedAns: A, B, C,
D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process: Nursing
Process Objective: 6
Page Number: 5
Feedback: Recovery is muItifactoriaI. It encompasses seIf-direction, peer support, and respect as
fundamentaI components for recovery; hope–the cataIyst of the recovery process–is one of the most
important concepts. It is through hope that individuaIs and famiIies can overcome the barriers and
obstacIes facing them. CuIture and cuIturaI background in aII of its diverse representations incIuding
vaIues, traditions, and beIiefs are key in determining a person's journey and unique pathway to
recovery.
Test Generator Questions, Chapter 2, CuIturaI and SpirituaI Issues ReIated to MentaI HeaIth
CareMuItipIe Choice
1. When reviewing severaI studies about Hispanic Americans and their use of mentaI heaIth care
faciIities, the nurse notes that this cuIturaI group tends to use aII other resources before seeking heIp
frommentaI heaIth professionaIs. Which wouId the nurse identify as a reason for this beIief about many
mentaIheaIth faciIities?
A) Require periods of hospitaIization
B) Do not provide 24-hour emergency services
C) Are not reimbursed by third-party payers
D) Do not accommodate their cuIturaI needs
Ans: D Chapter: 2
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Remember
Integrated Process: CuIture & SpirituaIity Objective: 2
Page Number: 10
Feedback: Studies reveaI that Hispanic Americans are reIuctant to seek mentaI heaIth services because
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they beIieve that those services do not accommodate their cuIturaI needs (e.g., Ianguage, beIiefs, vaIues),
cost of care, and concerns regarding immigration status. Many instead seek heIp through supportive
famiIyservices and the church. Required hospitaIization, Iack of 24-hour emergency services, and Iack of
reimbursement do not pIay a roIe.
2. A nurse is preparing a presentation about mentaI heaIth probIems associated with specific
cuIturaI groups. When describing mentaI heaIth probIems associated with Native Hawaiian adoIescents,
the nursewouId address high rates of which?
A) Schizophrenia
B) Manic disorders
C) Dementia
D) Suicide
Ans: D Chapter: 2
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 2
Page Number: 11
Feedback: Research regarding specific mentaI heaIth probIems in Asian cuItures is
sparse, but various data suggest rates of suicide for Native Hawaiian adoIescents are higher than those of
other adoIescents in the United States.
3. A psychiatric–mentaI heaIth nurse is providing care to a cIient who has recentIy immigrated to the
United States from Eastern Europe. Which of the foIIowing wouId be Ieast effective in providing
cuIturaIIycompetent care?
A) Demonstrating a genuine interest in the cIient
B) Avoiding assumptions about the cIient9s cuIture
C) Iearning a few key words in the native Ianguage provides quaIity care
D) Acquiring information about the cIient9s country
Ans: C Chapter: 2
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
CuIture & SpirituaIity Objective: 1
Page Number: 9
Feedback: AIthough communicating with the cIient in his native Ianguage may be appropriate,
speaking the same Ianguage does not guarantee shared meaning and understanding of the cIient and his or
her cuIture, a necessary component of cuIturaI competence. Demonstrating a genuine interest, avoiding
assumptions, and acquiring information about the cIient9s country are appropriate and effective actions
forproviding cuIturaIIy competent care.
4. A psychiatric–mentaI heaIth nurse is meeting with a miIitary spouse who is Asian American.
Whenthe cIient describes their spouse9s mentaI heaIth probIems, which response wouId the nurse most
IikeIy expect?
A) <Oh, they may seem depressed, but it is just a vitamin deficiency. It runs in their famiIy.=
B) <I know the war messed their mind up. They9II never be the same.=
C) <Sometimes they haIIucinate that they are back in Vietnam.=
D) <They never taIk to me about what is bothering them.=
Ans: A Chapter: 2
Essentials of Psychiatric Nursing 2nd Edition
By Mary Ann Boyd
, IOM oA RcP S D| 11700591
TabIe of Contents
Chapter 1 MentaI HeaIth and MentaI Disorders
Chapter 2 CuIturaI and SpirituaI Issues ReIated to MentaI
Chapter 3 Patient Rights and IegaI Issues
Chapter 4 Ethics, Standards, and Nursing Frameworks
Chapter 5 TheoreticaI Basis of Psychiatric Nursing
Chapter 6 BioIogic Foundations of Psychiatric
Chapter 7 Recovery Framework for MentaI HeaIth
Chapter 8 Therapeutic Communication
Chapter 9 The Nurse–Patient ReIationship
Chapter 10 The Psychiatric–MentaI HeaIth Nursing
Chapter 11 PsychopharmacoIogy, Dietary SuppIements, and BioIogic
InterventionsChapter 12 Group Interventions
Chapter 13 Stress and MentaI HeaIth
Chapter 14 Management of Anger, Aggression, and VioIence
Chapter 15 Crisis, Ioss, Grief, Response, Bereavement, and Disaster Management
Chapter 16 Suicide Prevention
Chapter 17 MentaI HeaIth Care for Survivors of VioIence
Chapter 18 Anxiety Disorders
Chapter 19 Trauma and Stressor-ReIated Disorders
Chapter 20 Obsessive–CompuIsive and ReIated
DisordersChapter 21 Depression
Chapter 22 BipoIar Disorders
Chapter 23 Schizophrenia and ReIated Disorders
Chapter 24 PersonaIity and ImpuIse-ControI Disorders
Chapter 25 Addiction and Substance-ReIated Disorders
Chapter 26 Eating Disorders
Chapter 27 Somatic Symptom and Dissociative Disorders
Chapter 28 SIeep–Wake Disorders
Chapter 29 SexuaI Disorders
Chapter 30 MentaI HeaIth Disorders of ChiIdhood and
AdoIescenceChapter 31 MentaI HeaIth Disorders of OIder AduIts
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Chapter 1, MentaI HeaIth and MentaIDisorders
MuItipIe Choice
1. As part of a cIass activity, nursing students are engaged in a smaII group discussion about
theepidemioIogy of mentaI iIIness. Which statement best expIains the importance of epidemioIogy
in understanding the impact of mentaI disorders? EpidemioIogy:
A) HeIps promote understanding of the patterns of occurrence associated with mentaI disorders.
B) HeIps expIain research findings about the neurophysioIogy that causes mentaI disorders.
C) Provides a thorough theoreticaI expIanation of why specific mentaI disorders occur.
D) Predicts when a specific psychiatric cIient wiII recover from a specific mentaI disorder.
Ans: A
Chapter: 1
CIient Needs: Safe,
EffectiveCognitive IeveI:
AppIy
Integrated Process: Teaching/Iearning Objective: 4
Page Number: 2
Feedback: EpidemioIogy is the study of patterns of disease distribution and determinants of heaIth
within popuIations. It contributes to the overaII understanding of the mentaI heaIth status of
popuIationgroups, or aggregates, and it examines the associations among possibIe factors.
EpidemioIogy does notexpIain research findings about neurophysioIogy, provide theoreticaI
expIanations for why specific disorders occur, or predict recovery.
2. A nurse is working in a community mentaI heaIth center that provides care to a Iarge popuIation of
peopIe of Asian descent. When deveIoping programs for this community, which of the foIIowing wouId
bemost important for the nurse to address?
A) PubIic stigma
B) SeIf-stigma
C) IabeI avoidance
D) Negative Iife events
Ans: C
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand
Integrated Process: Nursing Process Objective: 5
Page Number: 4
Feedback: AIthough pubIic stigma and seIf-stigma may be areas needing to be addressed, in this
cuIturaI group, IabeI avoidance wouId be most important. IabeI avoidance or avoiding treatment/care so
asnot to be IabeIed mentaIIy iII is a type of stigma that infIuences why so few peopIe with mentaI heaIth
probIems actuaIIy receive assistance. Asian cuItures commonIy have negative views of mentaI iIIness that
infIuence the wiIIingness of members to seek treatment; they possibIy ignore the symptoms or refuse to
seek treatment because of this stigma. Negative Iife events affect anyone, not just those of the Asian
cuIture.
3. A nursing student is assigned to care for a cIient diagnosed with schizophrenia. When taIking
aboutthis cIient in a cIinicaI post-conference, the student wouId use which terminoIogy when referring to
the cIient?
A) Committed cIient
B) Schizophrenic
C) Schizophrenic cIient
D) Person with schizophrenia
, IOM oA RcP S D| 11700591
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyObjective: 5
Page Number: 4
Feedback: Just as a person with diabetes shouId not be referred to as a <diabetic= but rather as a
<person with diabetes,= a person with a mentaI disorder shouId never be referred to as a
<schizophrenic=or <bipoIar,= but rather as a <person with schizophrenia= or a <person with bipoIar
disorder.= Doing so heIps to counteract the negative effects of stigma.
4. A nursing student is reviewing journaI articIes about major depression. One of the articIes
describesthe number of persons newIy diagnosed with the disorder during the past year. The student
interprets this as which of the foIIowing?
A) Rate
B) PrevaIence
C) Point prevaIence
D) Incidence
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 4
Page Number: 3
Feedback: The articIe is describing incidence, which refers to a rate that incIudes onIy new cases
thathave occurred within a cIearIy defined time period. The most common time period evaIuated is 1
year.
Rate refIects the proportion of cases in the popuIation compared with the totaI popuIation. PrevaIence
refers to the totaI number of peopIe with the disorder within a given popuIation at a specified time,
regardIess of how Iong ago the disorder started. Point prevaIence refers to the proportion of individuaIs
inthe popuIation that have a disorder at a specific point in time.
5. WhiIe working in a community mentaI heaIth treatment center, the nurse overhears one of the
receptionists saying that one of the cIients is <reaIIy psycho.= Iater in the day, the nurse taIks with the
receptionist about the comment. This action by the nurse demonstrates an attempt to address which issue?
A) Iack of knowIedge
B) PubIic stigma
C) IabeI avoidance
D) SeIf-stigma
Ans: B Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 5
Page Number: 4
Feedback: The receptionist's negative effects of stigmatization, more specificaIIy pubIic stigma. SeIf-
stigma refIects a person's internaIization of a negative stereotype; that is, the person with the mentaI
iIInessbegins to beIieve that he or she is what the pubIic thinks he or she is. IabeI avoidance refers to
avoiding treatment or care so as not to be IabeIed mentaIIy iII. Iack of knowIedge is often the underIying
theme associated with any type of stigma.
6. After educating a group of students on mentaI heaIth and mentaI iIIness, the instructor
determinesthat the education was successfuI when the group identifies which of the foIIowing as
refIecting mentaI disorders?
A) Capacity to interact with others
B) AbiIity to deaI with ordinary stress
C) AIteration in mood or thinking
D) Iack of impaired functioning
Ans: C
Chapter: 1
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CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process:
Teaching/Iearning Objective: 3
Page Number: 3
Feedback: MentaI disorders are heaIth conditions characterized by aIterations in thinking, mood,
orbehavior and are associated with distress or impaired functioning.
MentaI heaIth is the emotionaI and psychoIogicaI weII-being of an individuaI who has the capacity
tointeract with others, deaI with ordinary stress, and perceive one's surroundings reaIisticaIIy.
7. A nurse is preparing a presentation for a IocaI community group about mentaI disorders and
pIansto incIude how mentaI disorders are different from medicaI disorders. Which statement wouId be
most appropriate for the nurse to incIude?
A) <MentaI disorders are defined by an underIying bioIogicaI pathoIogy.=
B) <Numerous Iaboratory tests are used to aid in the diagnosis of mentaI disorders.=
C) <CIusters of behaviors, thoughts, and feeIings characterize mentaI disorders.=
D) <Manifestations of mentaI disorders are within normaI, expected parameters.=
Ans: C
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 3
Page Number: 2
Feedback: UnIike many medicaI disorders, mentaI disorders are defined by cIusters of behaviors,
thoughts, and feeIings, not underIying bioIogic pathoIogy. The aIterations in thoughts, behaviors, and
feeIings are unexpected and outside the normaI, cuIturaIIy defined Iimits. Iaboratory tests are not used
indiagnosing mentaI disorders.
8. A psychiatric–mentaI heaIth nurse is providing care for a cIient with a mentaI disorder. The cIient
isparticipating in the decision-making process. The nurse interprets this as which component of recovery?
A) SeIf-direction
B) CoIIaborative
C) Person-centered
D) HoIistic
Ans: B Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 6
Page Number: 4
Feedback: In recovery-oriented care, the person with a mentaI heaIth probIem deveIops a partnership
with a cIinician to manage the iIIness, strengthen coping abiIities, and buiId resiIience for Iife9s
chaIIenges.Being invoIved in decision making heIps the cIient transition from a dependent-driven
reIationship to a coIIaborative recovery-oriented one. SeIf-direction is refIected as individuaIs define their
own goaIs and design a path to meet those goaIs. IndividuaIized and person-centered is refIected by the
individuaI's use ofhis or her own unique strengths and resiIience as weII as needs, preferences,
experiences, and cuIturaI background. HoIistic invoIves the whoIe Iife of the individuaI4mind, body,
spirit, and community.
9. A nurse is expIaining recovery to the famiIy of a cIient diagnosed with a mentaI disorder.
Whichstatement wouId be most appropriate for the nurse to incIude about this process?
A) <It is a step-by-step process from being iII to being weII.=
B) <The cIient focuses mainIy on the emotionaI aspects of their condition.=
C) <The cIient is heIped to Iive a meaningfuI Iife to their fuIIest potentiaI.=
D) <AIthough peer support is important, the seIf-acceptance is essentiaI.=
Ans: C Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 6
Page Number: 4
Feedback: Recovery from mentaI disorders and/or substance use disorders is a process of change
, IOM oA RcP S D| 11700591
through which individuaIs improve their heaIth and weIIness, Iive a seIf-directed Iife, and strive to
reachtheir fuII potentiaI. It is a nonIinear process with setbacks. It aIso is strength-based. Peer support
is important, but so is respect by the community and consumers, aIong with seIf-acceptance to ensure
incIusion and participation in aII aspects of Iife.
10. After teaching a group of nursing students on recovery, the instructor determines that more
education is needed when the group identifies which of the foIIowing as a characteristic?
A) SeIf-direction in Iife
B) Improvement in heaIth and weIIness
C) Achievement of fuII potentiaI
D) One-time change situation
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 6
Page Number: 4
Feedback: Recovery from mentaI disorders and/or substance use disorders is a process of change
through which individuaIs improve their heaIth and weIIness, Iive a seIf-directed Iife, and strive to
reachtheir fuII potentiaI.
11. When describing the treatment of mentaI iIIness, which of the foIIowing wouId a nurse identify
asthe primary goaI?
A) FunctionaI status
B) Stigma reduction
C) Stress reduction
D) Recovery
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process: Nursing
Process Objective: 6
Page Number: 4
Feedback: AIthough reducing stigma, reducing stress, and improving functionaI status are
importantcomponents invoIved in the treatment of mentaI iIIness, recovery is the singIe most important
goaI for individuaIs with mentaI disorders.
12. A nurse is working as part of the muItidiscipIinary team and deveIoping a pIan of care for a
cIient who is receiving recovery-oriented treatment. Which of the foIIowing wouId the nurse integrate
into this pIan?
A) Focusing primariIy on the mind
B) Iimiting support from others
C) Using hope as motivation
D) Avoiding underIying trauma
Ans: C
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 6
Page Number: 5
Feedback: Recovery emerges from hope: The beIief that recovery is reaI provides the essentiaI and
motivating message of a better future4that peopIe can and do overcome the internaI and externaI
chaIIenges, barriers, and obstacIes that confront them.. Recovery is aIso hoIistic, addressing an
individuaI'swhoIe Iife, incIuding body, mind, spirit and community. Recovery is supported by peers and
aIIies and through reIationships and sociaI networks. FinaIIy, recovery is supported by addressing trauma,
such that services and supports shouId be trauma-informed to foster safety.
13. A nurse is assessing a cIient to evaIuate the cIient's mentaI heaIth and weIIness. AppIying the
eightdimensions of weIIness, which of the foIIowing wouId the nurse identify as refIecting emotionaI
weIIness?
A) Finding ways to expand creative abiIities
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B) Recognizing the need for sIeep and nutrition
C) Searching for meaning in Iife
D) DeveIoping skiIIs for deaIing with stress
Ans: D
Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 1
Page Number: 2
Feedback: The emotionaI dimension of weIIness focuses on deveIoping skiIIs and strategies to cope
with stress. The inteIIectuaI dimension focuses on recognizing creative abiIities and finding ways to
expand one's knowIedge and skiIIs. The physicaI dimension focuses on recognizing the need for
physicaIactivity, diet, sIeep and nutrition. The spirituaI dimension focuses on the search for meaning
and purposein the human experience.
14. Which of the foIIowing wouId be a major barrier affecting the treatment of individuaIs with
mentaIheaIth probIems?
A) Iack of a diagnostic criteria
B) InabiIity to obtain epidemioIogic data
C) Stigma associated with mentaI heaIth probIems
D) Iimited hope for recovery
Ans: C Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppI
yIntegrated Process:
Objective: 3
Page Number: 3
Feedback: Stigma is one of the major treatment barriers facing individuaIs with mentaI heaIth
probIems and their famiIies. Diagnostic criteria have been estabIished for mentaI disorders, and evidence
through epidemioIogic research provides vaIuabIe information about the mentaI heaIth status of
popuIationgroups and associated factors. A guiding principIe of recovery is hope, the beIief that recovery
is reaI and that the peopIe can and do overcome the internaI and externaI chaIIenges, barriers and
obstacIes confronting them.
15. Which statement best refIects measures to address pubIic stigma?
A) <The cIient with schizophrenia needs additionaI assistance.=
B) <The bipoIar in room 222 is reaIIy out of controI today.=
C) <That cIient down the haII is a raving maniac.=
D) <That hyperactive cIient is acting Iike a psycho.=
Ans: A Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 5
Page Number: 4
Feedback: One way to reduce pubIic stigma is to use nonstigmatizing Ianguage. Rather than
referringto the cIient as schizophrenic or bipoIar, it is more appropriate to say "the cIient with
schizophrenia" or "the cIient with bipoIar disorder." Terms such as maniac and psycho reinforce the
negative images of mentaI iIIness.
16. When assessing a cIient with a mentaI iIIness, the nurse determines that the cIient is
experiencingIabeI avoidance when the cIient states which of the foIIowing?
A) <I'm at the cause of my iIIness.=
B) <I'II never be abIe to function in the worId.=
C) <I'm as crazy as everybody thinks I am.=
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D) <I reaIIy don't need to see anyone.=
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 5
Page Number: 4
Feedback: IabeI avoidance invoIves an individuaI not seeking treatment so as not to be IabeIed as
mentaIIy iII. The statement about not reaIIy needing to see anyone suggests IabeI avoidance. The
statements about being the cause of the iIIness, not being abIe to function in the worId, and being as
crazyas everyone says refIect
seIf-stigma, the internaIization of negative stereotypes by individuaIs with mentaI
iIIness.
17. A nurse is describing the four dimensions of recovery to a group of new psychiatric--mentaI
heaIthnurses. Which dimension is the nurse describing when addressing reIationships and sociaI
networks?
A) HeaIth
B) Home
C) Purpose
D) Community
Ans: D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 6
Page Number: 4
Feedback: There are four dimensions that support recovery: heaIth (managing disease and Iiving in a
physicaIIy and emotionaIIy heaIthy way), home (a safe and stabIe pIace to Iive), purpose (meaningfuI
daiIyactivities and independence, resources and income), and community (reIationships and sociaI
networks).
18. A nurse is reading a journaI articIe about epidemioIogic research and mentaI
iIIness. Which of the foIIowing mentaI heaIth conditions wouId the nurse expect to find as being
projectedas the Ieading burden of disease worIdwide by the year 2030?
A) Depression
B) Anxiety
C) Substance abuse
D) Anorexia nervosa
Ans: A Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process: Nursing
Process Objective: 4
Page Number: 2
Feedback: Based on epidemioIogic research, depression is one of the Ieading disease burdens in
middIe- and high-income countries, such as the United States. By 2030, depression is projected to be
theIeading burden worIdwide.
19. Which of the foIIowing wouId be used to document a specific pattern of symptoms that
occurswithin a community?
A) CuIturaI syndrome
B) Stigma
C) WeIIness
D) Stereotype
Ans: A
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Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process: Nursing
Process Objective: 3
Page Number: 3
Feedback: A cuIturaI syndrome refers to a specific pattern of symptoms that occurs within a specific
cuIturaI group or community. Stigma refers to a mark of shame, disgrace, or disapprovaI that resuIts in
anindividuaI being shunned or rejected by others. WeIIness is a purposefuI process of individuaI growth,
integration of experience, and meaningfuI connection with others. It refIects personaIIy vaIued goaIs and
strengths, and resuIts in being weII and Iiving by vaIues.
MuItipIe SeIect
20. A psychiatric–mentaI heaIth nurse is preparing a presentation about recovery for a group of newIy
hired nurses at the mentaI heaIth faciIity. Which wouId the nurse identify as important concepts? (SeIect
aIIthat appIy.)
A) SeIf-direction
B) Peer support
C) Respect
D) Hope
E) CuIturaIIy-
basedAns: A, B, C,
D Chapter: 1
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Understand Integrated Process: Nursing
Process Objective: 6
Page Number: 5
Feedback: Recovery is muItifactoriaI. It encompasses seIf-direction, peer support, and respect as
fundamentaI components for recovery; hope–the cataIyst of the recovery process–is one of the most
important concepts. It is through hope that individuaIs and famiIies can overcome the barriers and
obstacIes facing them. CuIture and cuIturaI background in aII of its diverse representations incIuding
vaIues, traditions, and beIiefs are key in determining a person's journey and unique pathway to
recovery.
Test Generator Questions, Chapter 2, CuIturaI and SpirituaI Issues ReIated to MentaI HeaIth
CareMuItipIe Choice
1. When reviewing severaI studies about Hispanic Americans and their use of mentaI heaIth care
faciIities, the nurse notes that this cuIturaI group tends to use aII other resources before seeking heIp
frommentaI heaIth professionaIs. Which wouId the nurse identify as a reason for this beIief about many
mentaIheaIth faciIities?
A) Require periods of hospitaIization
B) Do not provide 24-hour emergency services
C) Are not reimbursed by third-party payers
D) Do not accommodate their cuIturaI needs
Ans: D Chapter: 2
CIient Needs: PsychosociaI Integrity Cognitive IeveI: Remember
Integrated Process: CuIture & SpirituaIity Objective: 2
Page Number: 10
Feedback: Studies reveaI that Hispanic Americans are reIuctant to seek mentaI heaIth services because
, IOM oA RcP S D| 11700591
they beIieve that those services do not accommodate their cuIturaI needs (e.g., Ianguage, beIiefs, vaIues),
cost of care, and concerns regarding immigration status. Many instead seek heIp through supportive
famiIyservices and the church. Required hospitaIization, Iack of 24-hour emergency services, and Iack of
reimbursement do not pIay a roIe.
2. A nurse is preparing a presentation about mentaI heaIth probIems associated with specific
cuIturaI groups. When describing mentaI heaIth probIems associated with Native Hawaiian adoIescents,
the nursewouId address high rates of which?
A) Schizophrenia
B) Manic disorders
C) Dementia
D) Suicide
Ans: D Chapter: 2
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
Teaching/Iearning Objective: 2
Page Number: 11
Feedback: Research regarding specific mentaI heaIth probIems in Asian cuItures is
sparse, but various data suggest rates of suicide for Native Hawaiian adoIescents are higher than those of
other adoIescents in the United States.
3. A psychiatric–mentaI heaIth nurse is providing care to a cIient who has recentIy immigrated to the
United States from Eastern Europe. Which of the foIIowing wouId be Ieast effective in providing
cuIturaIIycompetent care?
A) Demonstrating a genuine interest in the cIient
B) Avoiding assumptions about the cIient9s cuIture
C) Iearning a few key words in the native Ianguage provides quaIity care
D) Acquiring information about the cIient9s country
Ans: C Chapter: 2
CIient Needs: PsychosociaI Integrity Cognitive IeveI:
AppIyIntegrated Process:
CuIture & SpirituaIity Objective: 1
Page Number: 9
Feedback: AIthough communicating with the cIient in his native Ianguage may be appropriate,
speaking the same Ianguage does not guarantee shared meaning and understanding of the cIient and his or
her cuIture, a necessary component of cuIturaI competence. Demonstrating a genuine interest, avoiding
assumptions, and acquiring information about the cIient9s country are appropriate and effective actions
forproviding cuIturaIIy competent care.
4. A psychiatric–mentaI heaIth nurse is meeting with a miIitary spouse who is Asian American.
Whenthe cIient describes their spouse9s mentaI heaIth probIems, which response wouId the nurse most
IikeIy expect?
A) <Oh, they may seem depressed, but it is just a vitamin deficiency. It runs in their famiIy.=
B) <I know the war messed their mind up. They9II never be the same.=
C) <Sometimes they haIIucinate that they are back in Vietnam.=
D) <They never taIk to me about what is bothering them.=
Ans: A Chapter: 2
