,Chapter 01: Mental Health and Mental Illness
c c c c c c
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical
c c c c c c c c
Approach, 9th Edition
c c c
MULTIPLE CHOICE c
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
c c c c c c c c c c c c
a. Conducting a mental health assessment. c c c c
b. Prescribing psychotropic medication. c c
c. Establishing a therapeutic relationship. c c c
d. Individualizing a nursing care plan. c c c c
ANS: B c
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
c c c c c c c c c c c
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
c c c c c c c c c c c c c
prepared at the basic level is permitted to perform mental health assessments, establish
c c c c c c c c c c c c c
relationships, and provide individualized care planning.
c c c c c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
c c c c c c c c c c c c c
c skills.” Select the best response by the mental health nurse.
c c c c c c c c c
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to- c c c c c c c c c
c client ratios must be better because of the nature of the clients’ problems.”
c c c c c c c c c c c c
b. “Psychiatric nurses use complex communication skills as well as critical thinking c c c c c c c c c c
c to solve multidimensional problems. I am challenged by those situations.”
c c c c c c c c c
c. “That’s a misconception. Psychiatric nurses frequently use high technology
c c c c c c c c
c monitoring equipment and manage complex intravenous therapies.” c c c c c c
d. “Psychiatric nurses do not have to deal with as much pain and suffering as c c c c c c c c c c c c c
c medical–surgical nurses do. That appeals to me.” c c c c c c
ANS: B c
The practice of psychiatric nursing requires a different set of skills than medical–surgical
c c c c c c c c c c c c
nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients
c c c c c c c c c c c c c c
with medical as well as mental health problems, reflecting the holistic perspective these nurses
c c c c c c c c c c c c c c
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like
c c c c c c c c c c c c c
other specialties. Psychiatric nursing involves clinical practice, not just documentation.
c c c c c c c c c c
Psychosocial pain and suffering are as real as physical pain and suffering. c c c c c c c c c c c
PTS: c c 1 DIF: Cognitive Level: Apply (Application) c c c
TOP: c Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
c c c c c c c c c c c c c c
cmental illness, a group of nurses write letters to their elected representatives in opposition to
c c c c c c c c c c c c c c
cthe legislation. Which role have the nurses fulfilled?
c c c c c c c
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice c
, ANS: C c
An advocate defends or asserts another’s cause, particularly when the other person lacks the
c c c c c c c c c c c c c
ability to do that for self. Examples of individual advocacy include helping clients understand
c c c c c c c c c c c c c c
their rights or make decisions. On a community scale, advocacy includes political activity,
c c c c c c c c c c c c c
public speaking, and publication in the interest of improving the human condition. Since
c c c c c c c c c c c c c
funding is necessary to deliver quality programming for persons with mental illness, the letter-
c c c c c c c c c c c c c c
writing campaign advocates for that cause on behalf of clients who are unable to articulate
c c c c c c c c c c c c c c c
their own needs.
c c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
4. A family has a long history of conflicted relationships among the members. Which family
c c c c c c c c c c c c c
cmember’s comment best reflects a mentally healthy perspective?
c c c c c c c
a. “I’ve made mistakes but everyone else in this family has also.”
c c c c c c c c c c
b. “I remember joy and mutual respect from our early years together.”
c c c c c c c c c c
c. “I will make some changes in my behavior for the good of the family.”
c c c c c c c c c c c c c
d. “It’s best for me to move away from my family. Things will never change.”
c c c c c c c c c c c c c
ANS: C c
The correct response demonstrates the best evidence of a healthy recognition of the
c c c c c c c c c c c c
importance of relationships. Mental health includes rational thinking, communication skills,
c c c c c c c c c c
learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
c c c c c c c c c c c c c
be healthy, but the correct response shows a higher level of mental health. The other incorrect
c c c c c c c c c c c c c c c c
responses show blaming and avoidance.
c c c c c
PTS: c c 1 DIF: Cognitive Level: Analyze (Analysis) c c c
TOP: c Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
c c c c c c
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
c c c c c c c c c c c c c
cillness?
a. reporting occasional sleeplessness and anxiety. c c c c
b. reporting a consistently sad, discouraged, and hopeless mood. c c c c c c c
c. being able to describe the difference between “as if” and “for real.”
c c c c c c c c c c c
d. experiencing difficulty making a decision about whether to change jobs. c c c c c c c c c
ANS: B c
The correct response describes a mood alteration, which reflects mental illness. The distracters
c c c c c c c c c c c c
describe behaviors that are mentally healthy or within the usual scope of human experience.
c c c c c c c c c c c c c c
PTS: c c 1 DIF: Cognitive Level: Apply (Application) c c c
TOP: c Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
c c c c c c
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
c c c c c c c c c c c
c achieved for an adult client? c c c c
a. being willing to work towards achieving ideals and meeting demands.
c c c c c c c c c
b. behaving without considering the consequences of personal actions.
c c c c c c c
c. aggressively meeting personal needs without considering the rights of others. c c c c c c c c c
d. seeking help from others to avoid assuming responsibility for major areas of own
c c c c c c c c c c c c
life. c
, ANS: A c
Mental health is a state of well-being in which individuals reach their own potential, cope
c c c c c c c c c c c c c c
with the normal stresses of life, work productively, and contribute to the community. Mental
c c c c c c c c c c c c c c
health provides people with the capacity for rational thinking, communication skills, learning,
c c c c c c c c c c c c
emotional growth, resilience, and self-esteem. The correct response describes an adaptive,
c c c c c c c c c c c
healthy behavior. The distracters describe maladaptive behaviors.
c c c c c c c
PTS: c c 1 DIF: Cognitive Level: Apply (Application) c c c
TOP: c Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
c c c c c c
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form.
c c c c c c c c c c c c
c Which resource should the nurse consult to determine criteria used to establish this diagnosis?
c c c c c c c c c c c c c
a. International Statistical Classification of Diseases and Related Health Problems
c c c c c c c c
c (ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c c c c c c c c c
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) c c c c c c c
d. A behavioral health reference manual
c c c c
ANS: C c
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline
c c c c c c c c c c c c c c c
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
c c c c c c c c c c c c c
psychiatric illness.
c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
c c c c c c c c c c c c c c
cwould have the most complete information?
c c c c c
a. Nursing Outcomes Classification (NOC) c c c
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c c c c c c c c c
d. ICD-10
ANS: B c
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
c c c c c c c c c c c c c
guideline for diagnosing psychiatric disorders. The other references are good resources but do
c c c c c c c c c c c c c
not define the diagnostic criteria.
c c c c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
9. Which individual behavior demonstrates resilience?
c c c c
a. Repress stressors associated with a divorce. c c c c c
b. Continuing to grieve the death of a spouse for 5 years. c c c c c c c c c c
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
c c c c c c c c c c c c c c c
d. Taking a temporary job to maintain financial stability after loss of a permanent
c c c c c c c c c c c c
c job.
ANS: D c
c c c c c c
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical
c c c c c c c c
Approach, 9th Edition
c c c
MULTIPLE CHOICE c
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
c c c c c c c c c c c c
a. Conducting a mental health assessment. c c c c
b. Prescribing psychotropic medication. c c
c. Establishing a therapeutic relationship. c c c
d. Individualizing a nursing care plan. c c c c
ANS: B c
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
c c c c c c c c c c c
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
c c c c c c c c c c c c c
prepared at the basic level is permitted to perform mental health assessments, establish
c c c c c c c c c c c c c
relationships, and provide individualized care planning.
c c c c c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
c c c c c c c c c c c c c
c skills.” Select the best response by the mental health nurse.
c c c c c c c c c
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to- c c c c c c c c c
c client ratios must be better because of the nature of the clients’ problems.”
c c c c c c c c c c c c
b. “Psychiatric nurses use complex communication skills as well as critical thinking c c c c c c c c c c
c to solve multidimensional problems. I am challenged by those situations.”
c c c c c c c c c
c. “That’s a misconception. Psychiatric nurses frequently use high technology
c c c c c c c c
c monitoring equipment and manage complex intravenous therapies.” c c c c c c
d. “Psychiatric nurses do not have to deal with as much pain and suffering as c c c c c c c c c c c c c
c medical–surgical nurses do. That appeals to me.” c c c c c c
ANS: B c
The practice of psychiatric nursing requires a different set of skills than medical–surgical
c c c c c c c c c c c c
nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients
c c c c c c c c c c c c c c
with medical as well as mental health problems, reflecting the holistic perspective these nurses
c c c c c c c c c c c c c c
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like
c c c c c c c c c c c c c
other specialties. Psychiatric nursing involves clinical practice, not just documentation.
c c c c c c c c c c
Psychosocial pain and suffering are as real as physical pain and suffering. c c c c c c c c c c c
PTS: c c 1 DIF: Cognitive Level: Apply (Application) c c c
TOP: c Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
c c c c c c c c c c c c c c
cmental illness, a group of nurses write letters to their elected representatives in opposition to
c c c c c c c c c c c c c c
cthe legislation. Which role have the nurses fulfilled?
c c c c c c c
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice c
, ANS: C c
An advocate defends or asserts another’s cause, particularly when the other person lacks the
c c c c c c c c c c c c c
ability to do that for self. Examples of individual advocacy include helping clients understand
c c c c c c c c c c c c c c
their rights or make decisions. On a community scale, advocacy includes political activity,
c c c c c c c c c c c c c
public speaking, and publication in the interest of improving the human condition. Since
c c c c c c c c c c c c c
funding is necessary to deliver quality programming for persons with mental illness, the letter-
c c c c c c c c c c c c c c
writing campaign advocates for that cause on behalf of clients who are unable to articulate
c c c c c c c c c c c c c c c
their own needs.
c c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
4. A family has a long history of conflicted relationships among the members. Which family
c c c c c c c c c c c c c
cmember’s comment best reflects a mentally healthy perspective?
c c c c c c c
a. “I’ve made mistakes but everyone else in this family has also.”
c c c c c c c c c c
b. “I remember joy and mutual respect from our early years together.”
c c c c c c c c c c
c. “I will make some changes in my behavior for the good of the family.”
c c c c c c c c c c c c c
d. “It’s best for me to move away from my family. Things will never change.”
c c c c c c c c c c c c c
ANS: C c
The correct response demonstrates the best evidence of a healthy recognition of the
c c c c c c c c c c c c
importance of relationships. Mental health includes rational thinking, communication skills,
c c c c c c c c c c
learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
c c c c c c c c c c c c c
be healthy, but the correct response shows a higher level of mental health. The other incorrect
c c c c c c c c c c c c c c c c
responses show blaming and avoidance.
c c c c c
PTS: c c 1 DIF: Cognitive Level: Analyze (Analysis) c c c
TOP: c Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
c c c c c c
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
c c c c c c c c c c c c c
cillness?
a. reporting occasional sleeplessness and anxiety. c c c c
b. reporting a consistently sad, discouraged, and hopeless mood. c c c c c c c
c. being able to describe the difference between “as if” and “for real.”
c c c c c c c c c c c
d. experiencing difficulty making a decision about whether to change jobs. c c c c c c c c c
ANS: B c
The correct response describes a mood alteration, which reflects mental illness. The distracters
c c c c c c c c c c c c
describe behaviors that are mentally healthy or within the usual scope of human experience.
c c c c c c c c c c c c c c
PTS: c c 1 DIF: Cognitive Level: Apply (Application) c c c
TOP: c Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
c c c c c c
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
c c c c c c c c c c c
c achieved for an adult client? c c c c
a. being willing to work towards achieving ideals and meeting demands.
c c c c c c c c c
b. behaving without considering the consequences of personal actions.
c c c c c c c
c. aggressively meeting personal needs without considering the rights of others. c c c c c c c c c
d. seeking help from others to avoid assuming responsibility for major areas of own
c c c c c c c c c c c c
life. c
, ANS: A c
Mental health is a state of well-being in which individuals reach their own potential, cope
c c c c c c c c c c c c c c
with the normal stresses of life, work productively, and contribute to the community. Mental
c c c c c c c c c c c c c c
health provides people with the capacity for rational thinking, communication skills, learning,
c c c c c c c c c c c c
emotional growth, resilience, and self-esteem. The correct response describes an adaptive,
c c c c c c c c c c c
healthy behavior. The distracters describe maladaptive behaviors.
c c c c c c c
PTS: c c 1 DIF: Cognitive Level: Apply (Application) c c c
TOP: c Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
c c c c c c
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form.
c c c c c c c c c c c c
c Which resource should the nurse consult to determine criteria used to establish this diagnosis?
c c c c c c c c c c c c c
a. International Statistical Classification of Diseases and Related Health Problems
c c c c c c c c
c (ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c c c c c c c c c
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) c c c c c c c
d. A behavioral health reference manual
c c c c
ANS: C c
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline
c c c c c c c c c c c c c c c
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
c c c c c c c c c c c c c
psychiatric illness.
c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
c c c c c c c c c c c c c c
cwould have the most complete information?
c c c c c
a. Nursing Outcomes Classification (NOC) c c c
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c c c c c c c c c
d. ICD-10
ANS: B c
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
c c c c c c c c c c c c c
guideline for diagnosing psychiatric disorders. The other references are good resources but do
c c c c c c c c c c c c c
not define the diagnostic criteria.
c c c c c
PTS: c c 1 DIF: Cognitive Level: Understand (Comprehension) c c c
TOP: c Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c c
9. Which individual behavior demonstrates resilience?
c c c c
a. Repress stressors associated with a divorce. c c c c c
b. Continuing to grieve the death of a spouse for 5 years. c c c c c c c c c c
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
c c c c c c c c c c c c c c c
d. Taking a temporary job to maintain financial stability after loss of a permanent
c c c c c c c c c c c c
c job.
ANS: D c
