lOMoAR cPSD| 8510046
, lOMoAR cPSD| 8510046
Chapter01:ScienceandtheTherapeuticUseofSelfinPsychiatricMentalHealth
Nursing
Varcarolis:EssentialsofPsychiatricMentalHealthNursing:ACommunication
ApproachtoEvidence-BasedCare,4thEdition
MULTIPLECHOICE
1. Whichoutcome,focusedonrecovery,wouldbeexpectedintheplanofcareforapatientlivinginthec
ommunityanddiagnosedwithseriousandpersistentmentalillness?Within3months,thepatientw
illdemonstratewhatbehavior?
a. Denyingsuicidalideation
b. Reportingasenseofwell-being
c. Takingmedicationsasprescribed
d. Attendingclinicappointmentsontime
ANS:B
Recoveryemphasizesmanagingsymptoms,reducingpsychosocialdisability,andimprovingrolepe
rformance.Thegoalofrecoveryistoempowertheindividualwithmentalillnesstoachieveasenseofm
eaningandsatisfactioninlifeandtofunctionatthehighestpossiblelevelofwellness.Theincorrectopti
onsfocusontheclassicmedicalmodelratherthanrecovery.
DIF:
CognitiveLevel:Application(Applying)TOP:
NursingProcess:OutcomesIdentificationMSC:NCL
EX:HealthPromotionandMaintenance
2. Apatientishospitalizedfordepressionandsuicidalideationaftertheirspouseasksforadivorce.
Selectthenurse’smostcaringcomment.
a. “Let’sdiscusshealthymeansofcopingwhenyouhavesuicidalfeelings.”
b. “Iunderstandwhyyou’resodepressed.WhenIgotdivorced,Iwasdevastatedtoo.”
c. “Youshouldforgetaboutyourmarriageandmoveonwithyourlife.”
d. “Howdidyougetsodepressedthathospitalizationwasnecessary?”
ANS:A
Thenurse’scommunicationshouldevidencecaringandacommitmenttoworkwiththepatient.Thisc
ommitmentletsthepatientknowthenursewillhelp.Probingandadvicearenothelpfulfortherapeutici
nterventions.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:PsychosocialIntegrity
3. Intheshift-changereport,anoff-
goingnursecriticizesapatientwhowearsextremelyheavymakeup.Whichcommentbythenursewh
oreceivesthereportbestdemonstratesadvocacy?
a. “Thisisapsychiatrichospital,soweexpectourpatientstobehavebizarrely.”
b. “Let’sallshowacceptanceofthispatientbywearinglotsofmakeuptoo.”
c. “Yourcommentsareinconsiderateandinappropriate.Keepthereportobjective.”
d. “Ourpatientsneedourhelptolearnbehaviorsthatwillhelpthemgetalonginsociety.”
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ANS:D
Acceptingpatients’needsforself-
expressionandseekingtoteachskillsthatwillcontributetotheirwell-
beingdemonstraterespectandareimportantpartsofadvocacy.Theon-
comingnurseneedstotakeactiontoensurethatothersarenotprejudicedagainstthepatient.Humorcan
beappropriatewithintheprivacyofashiftreportbutnotattheexpenseofrespectforpatients.Judgingth
eoff-goingnurseinacriticalwaywillcreateconflict.Nursesmustshowcompassionforeachother.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:Safe,EffectiveCareEnvironment
4. Anurseassessesanewlyadmittedpatientdiagnosedwithmajordepressivedisorder.Whichstatem
entisanexampleof“attending”?
a. “Weallhavestressinlife.Beinginapsychiatrichospitalisnottheendoftheworld.”
b. “Tellmewhyyoufeltyouhadtobehospitalizedtoreceivetreatmentforyour
depression.”
c. “Youwillfeelbetterafterwegetsomeantidepressantmedicationstartedforyou.”
d. “I’dliketositwithyouforawhile,soyoumayfeelmorecomfortabletalkingwithme.”
ANS:D
Attendingisatechniquethatdemonstratesthenurse’scommitmenttotherelationshipandreducesf
eelingsofisolation.Thistechniqueshowsrespectforthepatientanddemonstratescaring.Generali
zations,probing,andfalsereassurancesarenontherapeutic.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:PsychosocialIntegrity
5. ApatientshowsthenurseanarticlefromtheInternetaboutahealthproblem.Whichcharacteristicoft
hewebsite’saddressmostalertsthenursethatthesitemayhavebiasedandprejudicedinformation?
a. Addressendsin“.org.”
b. Addressendsin“.com.”
c. Addressendsin“.gov.”
d. Addressendsin“.net.”
ANS:B
Financialinfluencesonasiteareacluethattheinformationmaybebiased.“.com”attheendoftheaddre
ssindicatesthatthesiteisacommercialone.“.gov”indicatesthatthesiteismaintainedbyagovernmen
tentity.“.org”indicatesthatthesiteisnonproprietary;thesitemayormaynothavereliableinformatio
n,butitdoesnotprofitfromitsactivities.“.net”canhavemultiplemeanings.
DIF: CognitiveLevel:Comprehension(Understanding)
TOP:NursingProcess:EvaluationMSC:NCLEX:HealthPromotionandMaintenance
6. Anursesays,“WhenIwasinschool,Ilearnedtocallupsetpatientsbynametogettheirattention;ho
wever,Ireadadescriptiveresearchstudythatsaysthatthisapproachdoesnotwork.Iplantostopcall
ingpatientsbyname.”Whichstatementisthebestappraisalofthisnurse’scomment?
a. Onedescriptiveresearchstudyrarelyprovidesenoughevidencetochangepractice.
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, lOMoAR cPSD| 8510046
b. Staffnursesapplynewresearchfindingsonlywiththehelpfromclinicalnursespecial
ists.
c. Newresearchfindingsshouldbeincorporatedintoclinicalalgorithmsbeforeusingthemi
npractice.
d. Thenursemisinterpretedtheresultsofthestudy.Classictenetsofpracticedonotchange.
ANS:A
Descriptiveresearchfindingsprovideevidenceforpracticebutmustbeviewedinrelationtootherstud
iesbeforepracticechanges.Onestudyisnotenough.Descriptivestudiesarelowonthehierarchyofevi
dence.Clinicalalgorithmsuseflowchartstomanageproblemsanddonotspecifyoneresponsetoaclin
icalproblem.Classictenetsofpracticeshouldchangeasresearchfindingsprovideevidenceforchang
e.
DIF: CognitiveLevel:Analysis(Analyzing)
TOP:NursingProcess:EvaluationMSC:NCLEX:HealthPromotionandMaintenance
7. Twonursingstudentsdiscusscareerplansaftergraduation.Onestudentwantstoenterpsychiatricnu
rsing.Theotherstudentasks,“Whywouldyouwanttobeapsychiatricnurse?Alltheydoistalk.Youw
illloseyourskills.”Selectthebestresponsebythestudentinterestedinpsychiatricnursing.
a. “Psychiatricnurses’practiceinsaferenvironmentsthanotherspecialtiesandnurse
-to-patientratiosarebetterbecauseofthenatureofpatients’problems.”
b. “Psychiatricnursesusecomplexcommunicationskills,aswellascriticalthinking,
tosolvemultidimensionalproblems.I’mchallengedbythosesituations.”
c. “IthinkIwillbegoodinthementalhealthfield.Idonotlikeclinicalrotationsin
school,soIdonotwanttocontinuethemafterIgraduate.”
d. “Psychiatricnursesdonothavetodealwithasmuchpainandsufferingas
medical-surgicalnurses.Thatappealstome.”
ANS:B
Thepracticeofpsychiatricnursingrequiresadifferentsetofskillsthanmedical-
surgicalnursing,althoughsubstantialoverlapdoesexist.Psychiatricnursesmustbeabletohelppati
entswithmedicalandmentalhealthproblems,reflectingtheholisticperspectivethesenursesmusth
ave.Nurse–
patientratiosandworkloadsinpsychiatricsettingshaveincreased,similartootherspecialties.Psyc
hiatricnursinginvolvesclinicalpractice,notsimplydocumentation.Psychosocialpainisrealandca
ncauseasmuchsufferingasphysicalpain.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:Safe,EffectiveCareEnvironment
8. Whichresearchevidencewouldmostinfluenceagroupofnursestochangetheirpractice?
a. Expertcommitteereportofrecommendationsforpractice
b. Systematicreviewofrandomizedcontrolledtrials
c. Nonexperimentaldescriptivestudy
d. Criticalpathway
ANS:B
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, lOMoAR cPSD| 8510046
Chapter01:ScienceandtheTherapeuticUseofSelfinPsychiatricMentalHealth
Nursing
Varcarolis:EssentialsofPsychiatricMentalHealthNursing:ACommunication
ApproachtoEvidence-BasedCare,4thEdition
MULTIPLECHOICE
1. Whichoutcome,focusedonrecovery,wouldbeexpectedintheplanofcareforapatientlivinginthec
ommunityanddiagnosedwithseriousandpersistentmentalillness?Within3months,thepatientw
illdemonstratewhatbehavior?
a. Denyingsuicidalideation
b. Reportingasenseofwell-being
c. Takingmedicationsasprescribed
d. Attendingclinicappointmentsontime
ANS:B
Recoveryemphasizesmanagingsymptoms,reducingpsychosocialdisability,andimprovingrolepe
rformance.Thegoalofrecoveryistoempowertheindividualwithmentalillnesstoachieveasenseofm
eaningandsatisfactioninlifeandtofunctionatthehighestpossiblelevelofwellness.Theincorrectopti
onsfocusontheclassicmedicalmodelratherthanrecovery.
DIF:
CognitiveLevel:Application(Applying)TOP:
NursingProcess:OutcomesIdentificationMSC:NCL
EX:HealthPromotionandMaintenance
2. Apatientishospitalizedfordepressionandsuicidalideationaftertheirspouseasksforadivorce.
Selectthenurse’smostcaringcomment.
a. “Let’sdiscusshealthymeansofcopingwhenyouhavesuicidalfeelings.”
b. “Iunderstandwhyyou’resodepressed.WhenIgotdivorced,Iwasdevastatedtoo.”
c. “Youshouldforgetaboutyourmarriageandmoveonwithyourlife.”
d. “Howdidyougetsodepressedthathospitalizationwasnecessary?”
ANS:A
Thenurse’scommunicationshouldevidencecaringandacommitmenttoworkwiththepatient.Thisc
ommitmentletsthepatientknowthenursewillhelp.Probingandadvicearenothelpfulfortherapeutici
nterventions.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:PsychosocialIntegrity
3. Intheshift-changereport,anoff-
goingnursecriticizesapatientwhowearsextremelyheavymakeup.Whichcommentbythenursewh
oreceivesthereportbestdemonstratesadvocacy?
a. “Thisisapsychiatrichospital,soweexpectourpatientstobehavebizarrely.”
b. “Let’sallshowacceptanceofthispatientbywearinglotsofmakeuptoo.”
c. “Yourcommentsareinconsiderateandinappropriate.Keepthereportobjective.”
d. “Ourpatientsneedourhelptolearnbehaviorsthatwillhelpthemgetalonginsociety.”
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
ANS:D
Acceptingpatients’needsforself-
expressionandseekingtoteachskillsthatwillcontributetotheirwell-
beingdemonstraterespectandareimportantpartsofadvocacy.Theon-
comingnurseneedstotakeactiontoensurethatothersarenotprejudicedagainstthepatient.Humorcan
beappropriatewithintheprivacyofashiftreportbutnotattheexpenseofrespectforpatients.Judgingth
eoff-goingnurseinacriticalwaywillcreateconflict.Nursesmustshowcompassionforeachother.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:Safe,EffectiveCareEnvironment
4. Anurseassessesanewlyadmittedpatientdiagnosedwithmajordepressivedisorder.Whichstatem
entisanexampleof“attending”?
a. “Weallhavestressinlife.Beinginapsychiatrichospitalisnottheendoftheworld.”
b. “Tellmewhyyoufeltyouhadtobehospitalizedtoreceivetreatmentforyour
depression.”
c. “Youwillfeelbetterafterwegetsomeantidepressantmedicationstartedforyou.”
d. “I’dliketositwithyouforawhile,soyoumayfeelmorecomfortabletalkingwithme.”
ANS:D
Attendingisatechniquethatdemonstratesthenurse’scommitmenttotherelationshipandreducesf
eelingsofisolation.Thistechniqueshowsrespectforthepatientanddemonstratescaring.Generali
zations,probing,andfalsereassurancesarenontherapeutic.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:PsychosocialIntegrity
5. ApatientshowsthenurseanarticlefromtheInternetaboutahealthproblem.Whichcharacteristicoft
hewebsite’saddressmostalertsthenursethatthesitemayhavebiasedandprejudicedinformation?
a. Addressendsin“.org.”
b. Addressendsin“.com.”
c. Addressendsin“.gov.”
d. Addressendsin“.net.”
ANS:B
Financialinfluencesonasiteareacluethattheinformationmaybebiased.“.com”attheendoftheaddre
ssindicatesthatthesiteisacommercialone.“.gov”indicatesthatthesiteismaintainedbyagovernmen
tentity.“.org”indicatesthatthesiteisnonproprietary;thesitemayormaynothavereliableinformatio
n,butitdoesnotprofitfromitsactivities.“.net”canhavemultiplemeanings.
DIF: CognitiveLevel:Comprehension(Understanding)
TOP:NursingProcess:EvaluationMSC:NCLEX:HealthPromotionandMaintenance
6. Anursesays,“WhenIwasinschool,Ilearnedtocallupsetpatientsbynametogettheirattention;ho
wever,Ireadadescriptiveresearchstudythatsaysthatthisapproachdoesnotwork.Iplantostopcall
ingpatientsbyname.”Whichstatementisthebestappraisalofthisnurse’scomment?
a. Onedescriptiveresearchstudyrarelyprovidesenoughevidencetochangepractice.
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
b. Staffnursesapplynewresearchfindingsonlywiththehelpfromclinicalnursespecial
ists.
c. Newresearchfindingsshouldbeincorporatedintoclinicalalgorithmsbeforeusingthemi
npractice.
d. Thenursemisinterpretedtheresultsofthestudy.Classictenetsofpracticedonotchange.
ANS:A
Descriptiveresearchfindingsprovideevidenceforpracticebutmustbeviewedinrelationtootherstud
iesbeforepracticechanges.Onestudyisnotenough.Descriptivestudiesarelowonthehierarchyofevi
dence.Clinicalalgorithmsuseflowchartstomanageproblemsanddonotspecifyoneresponsetoaclin
icalproblem.Classictenetsofpracticeshouldchangeasresearchfindingsprovideevidenceforchang
e.
DIF: CognitiveLevel:Analysis(Analyzing)
TOP:NursingProcess:EvaluationMSC:NCLEX:HealthPromotionandMaintenance
7. Twonursingstudentsdiscusscareerplansaftergraduation.Onestudentwantstoenterpsychiatricnu
rsing.Theotherstudentasks,“Whywouldyouwanttobeapsychiatricnurse?Alltheydoistalk.Youw
illloseyourskills.”Selectthebestresponsebythestudentinterestedinpsychiatricnursing.
a. “Psychiatricnurses’practiceinsaferenvironmentsthanotherspecialtiesandnurse
-to-patientratiosarebetterbecauseofthenatureofpatients’problems.”
b. “Psychiatricnursesusecomplexcommunicationskills,aswellascriticalthinking,
tosolvemultidimensionalproblems.I’mchallengedbythosesituations.”
c. “IthinkIwillbegoodinthementalhealthfield.Idonotlikeclinicalrotationsin
school,soIdonotwanttocontinuethemafterIgraduate.”
d. “Psychiatricnursesdonothavetodealwithasmuchpainandsufferingas
medical-surgicalnurses.Thatappealstome.”
ANS:B
Thepracticeofpsychiatricnursingrequiresadifferentsetofskillsthanmedical-
surgicalnursing,althoughsubstantialoverlapdoesexist.Psychiatricnursesmustbeabletohelppati
entswithmedicalandmentalhealthproblems,reflectingtheholisticperspectivethesenursesmusth
ave.Nurse–
patientratiosandworkloadsinpsychiatricsettingshaveincreased,similartootherspecialties.Psyc
hiatricnursinginvolvesclinicalpractice,notsimplydocumentation.Psychosocialpainisrealandca
ncauseasmuchsufferingasphysicalpain.
DIF: CognitiveLevel:Application(Applying)
TOP:NursingProcess:Implementation MSC:NCLEX:Safe,EffectiveCareEnvironment
8. Whichresearchevidencewouldmostinfluenceagroupofnursestochangetheirpractice?
a. Expertcommitteereportofrecommendationsforpractice
b. Systematicreviewofrandomizedcontrolledtrials
c. Nonexperimentaldescriptivestudy
d. Criticalpathway
ANS:B
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