a clinical 9th edition by margaret jordan halter
.
Chapter01: MentalHealthand MentalIllness
Halter:Varcarolis’Foundationsof Psychiatric-MentalHealthNursing:A Clinical Approach, 9th
Edition
MULTIPLE CHOICE
1. The scopeof practicedfor an advancednursepractitionerwouldincludewhich intervention?
a. Conducting a mentalhealthassessment.
b. Prescribingpsychotropicmedication.
c. Establishinga therapeuticrelationship.
d. Individualizing a nursing careplan.
ANS: B
In most states,prescriptive privileges
aregrantedto master’s- preparednursepractitionersand
clinical nursespecialistswho havetakenspecialcourseson prescribingmedication.The nurse
prepared at the basic level is permitted to perform mental health assessments, establish relationship
and provide individualized care planning.
PTS: 1 DIF: CognitiveLevel:Understand(Comprehension)
TOP: Nursing Process:Implementation MSC: Client Needs:Safe,EffectiveCare Environment
2. A nursing studentexpressesconcernsthatmentalhealthnurses“loseall theirclinical nursing skills.”
Select the best response by the mental health nurse.
a. “Psychiatricnursespracticein saferenvironmentsthanotherspecialties.Nurse-to- client
ratios must be better because of the nature of the clients’
problems.”
b. “Psychiatricnursesusecomplexcommunicationskills as wellas critical thinking to
solve multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception.Psychiatricnursesfrequentlyusehigh technology
monitoring equipment and manage complex intravenous therapies.”
d. “Psychiatricnursesdo not haveto dealwith as much pain and sufferingas
medical–surgical nurses do. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical
–surgical nursing,
though there is substantial overlap. Psychiatric nurses must be able to help clientsmedical
with as
wellas mentalhealthproblems,reflectingtheholisticperspectivethesenurses must have. Nurse –
client ratios and workloads in psychiatric settings have increased, just like other specialties.
Psychiatric nursing involves clinical practice, not just documentation.
Psychosocialpain and sufferingareas realas physicalpain and suffering.
PTS: 1 DIF: CognitiveLevel:Apply (Application)
TOP: Nursing Process:Implementation MSC: Client Needs:Safe,EffectiveCare Environment
3. When a newbill introducedin Congressreducesfunding for careof personsdiagnosedwith mental
,illness,a groupof nurseswritelettersto theirelectedrepresentatives
in oppositionto the legislation.
Which role have the nurses fulfilled?
a. Recovery
b. Attending
c. Advocacy
d. Evidence-basedpractice
, ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the ability t
do that for self. Examples of individual advocacy include helping clients understand their rights or
make decisions. On a community scale, advocacy includes political activity, public speaking, and
publication in the interest of improving the human condition. Since funding
is necessaryto deliver
qualityprogrammingfor personswith mentalillness,theletter- writing campaign advocates for that
cause on behalf of clients who are unable to articulate their own needs.
PTS: 1 DIF: CognitiveLevel:Understand(Comprehension)
TOP: Nursing Process:Evaluation MSC: Client Needs:Safe,EffectiveCare Environment
4. A family has a long historyof conflictedrelationshipsamongthemembers.Which family
member’s comment best reflects a mentally healthy perspective?
a. “I’ve mademistakesbut everyoneelsein this family has also.”
b. “I rememberjoy and mutualrespectfrom our earlyyearstogether.”
c. “I will makesomechangesin my behaviorfor thegoodof thefamily.”
d. “It’s bestfor me to moveawayfrom my family.Things will neverchange.”
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the importance of
relationships. Mental health includes rational thinking, communication skills, learning,
emotional
growth,resilience,and self-esteem.Recallingjoy from earlierin life may behealthy,but thecorrect
responseshowsa higherlevelof mentalhealth.The otherincorrect responses show blaming and
avoidance.
PTS: 1 DIF: CognitiveLevel:Analyze(Analysis)
TOP: Nursing Process:Assessment MSC: Client Needs:PsychosocialIntegrity
5. Which assessmentfinding mostclearlyindicatesthata clientmay be experiencinga mentalillness?
a. reportingoccasionalsleeplessnessand anxiety.
b. reportinga consistentlysad,discouraged,and hopelessmood.
c. beingableto describethedifferencebetween“as if” and “for real.”
d. experiencingdifficultymaking a decisionaboutwhetherto changejobs.
ANS: B
The correctresponsedescribesa moodalteration,which reflectsmentalillness.The distracters
describe behaviors that are mentally healthy or within the usual scope of human experience.
PTS: 1 DIF: CognitiveLevel:Apply (Application)
TOP: Nursing Process:Assessment MSC: Client Needs:PsychosocialIntegrity
6. Which finding bestindicatesthatthegoal “Demonstratementallyhealthybehavior” was
achieved for an adult client?
a. beingwilling to work towardsachievingidealsand meetingdemands.
b. behavingwithoutconsideringtheconsequencesof personalactions.
c. aggressivelymeetingpersonalneedswithoutconsideringtherightsof others.
d. seekinghelp from othersto avoid assumingresponsibilityfor majorareasof own life.
, ANS: A
Mental health is a state of well
-being in which individuals reach their own potential, cope with the
normal stresses of life, work productively, and contribute to the community. Mentalprovides
health
peoplewith thecapacityfor rationalthinking, communicationskills, learning, emotional growth,
resilience, and self
-esteem. The correct response describes an adaptive, healthy behavior. The
distracters describe maladaptive behaviors.
PTS: 1 DIF: CognitiveLevel:Apply (Application)
TOP: Nursing Process:Evaluation MSC: Client Needs:PsychosocialIntegrity
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Which
resourceshouldthenurseconsultto determinecriteriausedto establishthis diagnosis?
a. InternationalStatisticalClassificationof Diseasesand RelatedHealthProblems(ICD -
10)
b. The ANA’s Psychiatric-MentalHealthNursingScopeand Standardsof Practice
c. Diagnosticand StatisticalManualof MentalDisorders(DSM-V)
d. A behavioralhealthreferencemanual
ANS: C
The DSM-V givesthecriteriausedto diagnoseeachmentaldisorder.It is theofficialguideline for
diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric
illness.
PTS: 1 DIF: CognitiveLevel:Understand(Comprehension)
TOP: Nursing Process:Assessment MSC: Client Needs:Safe,EffectiveCare Environment
8. A nursewantsto find a descriptionof diagnosticcriteriafor anxietydisorders.Which resource would
have the most complete information?
a. NursingOutcomesClassification(NOC)
b. DSM-V
c. The ANA’s Psychiatric-MentalHealthNursingScopeand Standardsof Practice
d. ICD -10
ANS: B
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline
for diagnosingpsychiatricdisorders.The otherreferencesaregoodresourcesbut do not define the
diagnostic criteria.
PTS: 1 DIF: CognitiveLevel:Understand(Comprehension)
TOP: Nursing Process:Implementation MSC: Client Needs:Safe,EffectiveCare Environment
9. Which individual behaviordemonstratesresilience?
a. Repressstressorsassociatedwith a divorce.
b. Continuing to grievethedeathof a spousefor 5 years.
c. Continuing to live in a shelterfor 2 yearsafterthehomeis destroyedby fire.
d. Taking a temporaryjob to maintainfinancialstabilityafterloss of a permanentjob.
ANS: D