, Table of Contents
Table of Contents 1
Chapter 01. The Concept of Stress Adaptation 2
Chapter 02. Mental Health/Mental Illness: Historical and Theoretical Concepts 9
Chapter 03. Psychopharmacology 20
Chapter 04. Concepts of Psychobiology 28
Chapter 05. Ethical and Legal Issues in Psychiatric/Mental Health Nursing 37
Chapter 06. Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing
47
Chapter 07. Relationship Development 54
Chapter 08. Therapeutic Communication 62
Chapter 09. The Nursing Process in Psychiatric/Mental Health Nursing 74
Chapter 10. Therapeutic Groups 85
Chapter 11. Intervention With Families 93
Chapter 12. Milieu Therapy - The Therapeutic Community 99
Chapter 13. Crisis Intervention 104
Chapter 14. Assertiveness Training 109
Chapter 15. Promoting Self-Esteem 117
Chapter 16. Anger/Aggression Management 123
Chapter 17. The Suicidal Client 130
Chapter 18. Behavior Therapy 139
Chapter 19. Cognitive Therapy 146
Chapter 20. Electroconvulsive Therapy 155
Chapter 21. The Recovery Model 162
Chapter 22. Neurocognitive Disorders 169
Chapter 23. Substance-Related and Addictive Disorders 175
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders 186
Chapter 25. Depressive Disorders 197
Chapter 26. Bipolar and Related Disorders 208
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders 219
Chapter 28: Trauma and Stressor-Related Disorders 230
Chapter 29. Somatic Symptom and Dissociative Disorders 238
Chapter 30. Issues Related to Human Sexuality and Gender Dysphoria 244
Chapter 31. Eating Disorders 249
Chapter 32. Personality Disorders 257
Chapter 33. Children and Adolescents 269
Chapter 34. The Aging Individual 279
Chapter 35. Survivors of Abuse or Neglect 284
Chapter 36. Community Mental Health Nursing 290
Chapter 37. The Bereaved Individual 297
Chapter 38. Military Families 302
,Chapter 01. The Concept of Stress Adaptation
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unemployed.
This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should
the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of
stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of
coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the
Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500
or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social support
can limit susceptibility to stress-related illnesses.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a
nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the
nurse characterize the clients appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.
ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent
learning appropriate coping skills and can prevent access to needed support systems.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When
this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage
ANS: C
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been
depleted. Diseases of adaptation occur more frequently in this stage.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The
clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing
response?
A. Teenagers! They dont know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a
physiological change.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
Psychosocial Integrity
6. A bright student confides in the school nurse about conflicts related to attending college or working to add
needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend
to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANS: B
The student must assess his or her situation and determine the best course of action. Problem-solving training,
by providing structure and objectivity, can assist in decision making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
Psychosocial Integrity
Table of Contents 1
Chapter 01. The Concept of Stress Adaptation 2
Chapter 02. Mental Health/Mental Illness: Historical and Theoretical Concepts 9
Chapter 03. Psychopharmacology 20
Chapter 04. Concepts of Psychobiology 28
Chapter 05. Ethical and Legal Issues in Psychiatric/Mental Health Nursing 37
Chapter 06. Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing
47
Chapter 07. Relationship Development 54
Chapter 08. Therapeutic Communication 62
Chapter 09. The Nursing Process in Psychiatric/Mental Health Nursing 74
Chapter 10. Therapeutic Groups 85
Chapter 11. Intervention With Families 93
Chapter 12. Milieu Therapy - The Therapeutic Community 99
Chapter 13. Crisis Intervention 104
Chapter 14. Assertiveness Training 109
Chapter 15. Promoting Self-Esteem 117
Chapter 16. Anger/Aggression Management 123
Chapter 17. The Suicidal Client 130
Chapter 18. Behavior Therapy 139
Chapter 19. Cognitive Therapy 146
Chapter 20. Electroconvulsive Therapy 155
Chapter 21. The Recovery Model 162
Chapter 22. Neurocognitive Disorders 169
Chapter 23. Substance-Related and Addictive Disorders 175
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders 186
Chapter 25. Depressive Disorders 197
Chapter 26. Bipolar and Related Disorders 208
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders 219
Chapter 28: Trauma and Stressor-Related Disorders 230
Chapter 29. Somatic Symptom and Dissociative Disorders 238
Chapter 30. Issues Related to Human Sexuality and Gender Dysphoria 244
Chapter 31. Eating Disorders 249
Chapter 32. Personality Disorders 257
Chapter 33. Children and Adolescents 269
Chapter 34. The Aging Individual 279
Chapter 35. Survivors of Abuse or Neglect 284
Chapter 36. Community Mental Health Nursing 290
Chapter 37. The Bereaved Individual 297
Chapter 38. Military Families 302
,Chapter 01. The Concept of Stress Adaptation
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unemployed.
This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should
the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of
stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of
coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the
Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500
or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social support
can limit susceptibility to stress-related illnesses.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a
nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the
nurse characterize the clients appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.
ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent
learning appropriate coping skills and can prevent access to needed support systems.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When
this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage
ANS: C
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been
depleted. Diseases of adaptation occur more frequently in this stage.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The
clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing
response?
A. Teenagers! They dont know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a
physiological change.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
Psychosocial Integrity
6. A bright student confides in the school nurse about conflicts related to attending college or working to add
needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend
to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANS: B
The student must assess his or her situation and determine the best course of action. Problem-solving training,
by providing structure and objectivity, can assist in decision making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
Psychosocial Integrity
