, Chapter 01: Mental Health and Mental Illness
x@ x@ x@ x@ x@ x@ x@
Halter: Varcarolis’ Foundations of Psychiatric-
x@ x@ x@ x@
Mental Health Nursing: A Clinical Approach, 9th Edition
x@ x@ x@ x@ x@ x@ x@
MULTIPLE CHOICE x@
1. The scope of practiced for an advanced nurse practitioner would include which intervent
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ion?
a. Conducting a mental health assessment. x@ x@ x@ x@
b. Prescribing psychotropic medication. x@ x@
c. Establishing a therapeutic relationship. x@ x@ x@
d. Individualizing a nursing care plan. x@ x@ x@ x@
ANS: x @ B
In most states, prescriptive privileges are granted to master‘s-
x@ x@ x@ x@ x@ x@ x@ x@
prepared nurse practitioners and clinical nurse specialists who have taken special courses
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
on prescribing medication. The nurse prepared at the basic level is permitted to perfor
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
m mental health assessments, establish relationships, and provide individualized care pla
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
nning.
PTS: x @ x @ 1 DIF: Cognitive Level: Understand (Comprehension) x@ x@ x@
TOP: x @ Nursing Process: Implementation
x@ x@
MSC: Client Needs: Safe, Effective Care Environmen x @ x@ x@ x@ x@ x@
t
2. A nursing student expresses concerns that mental health nurses ―lose all their clinical n
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ursing skills.‖ Select the best response by the mental health nurse.
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
a. ―Psychiatric nurses practice in safer environments than other specialties. Nurs
x@ x@ x@ x@ x@ x@ x@ x@ x@
e-to-
client ratios must be better because of the nature of the clients‘ problems.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
b. ―Psychiatric nurses use complex communication skills as well as critical thi
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
nking to solve multidimensional problems. I am challenged by those situati
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ons.‖
c. ―That‘s a misconception. Psychiatric nurses frequently use high technol
x@ x@ x@ x@ x@ x@ x@ x@
ogy monitoring equipment and manage complex intravenous therapies.
x@ x@ x@ x@ x@ x@ x@
‖
d. ―Psychiatric nurses do not have to deal with as much pain and suffer
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ing as medical–surgical nurses do. That appeals to me.‖
x@ x@ x@ x@ x@ x@ x@ x@
ANS: x @ B
The practice of psychiatric nursing requires a different set of skills than medical–
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x
@help clients with medical as well as mental health problems, reflecting the holistic pers
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
pective these nurses must have. Nurse–
x@ x@ x@ x@ x@
client ratios and workloads in psychiatric settings have increased, just like other special
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ties. Psychiatric nursing involves clinical practice, not just documentation.
x@ x@ x@ x@ x@ x@ x@ x@
Psychosocial pain and suffering are as real as physical pain and suffering.
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
PTS: x @ x @ 1 DIF: Cognitive Level: Apply (Application) x@ x@ x@
TOP: x @ Nursing Process: Implementation
x@ x@
MSC: Client Needs: Safe, Effective Care Environmen x @ x@ x@ x@ x@ x@
t
3. When a new bill introduced in Congress reduces funding for care of persons diagnos
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
,ed with mental illness, a group of nurses write letters to their elected representatives i
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
n opposition to the legislation. Which role have the nurses fulfilled?
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
x@
, ANS: x @ C
An advocate defends or asserts another‘s cause, particularly when the other person lack
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
s the ability to do that for self. Examples of individual advocacy include helping client
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
s understand their rights or make decisions. On a community scale, advocacy includes
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
political activity, public speaking, and publication in the interest of improving the huma
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
n condition. Since funding is necessary to deliver quality programming for persons with
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x
@mental illness, the letter-
x@ x@ x@
writing campaign advocates for that cause on behalf of clients who are unable to artic
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ulate their own needs.
x@ x@ x@
PTS: x @ x @ 1 DIF: Cognitive Level: Understand (Comprehension) x@ x@ x@
TOP: x @ Nursing Process: Evaluation
x@ x@
MSC: Client Needs: Safe, Effective Care Environmen x @ x@ x@ x@ x@ x@
t
4. A family has a long history of conflicted relationships among the members. Which
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
family member‘s comment best reflects a mentally healthy perspective?
x@ x@ x@ x@ x@ x@ x@ x@
a. ―I‘ve made mistakes but everyone else in this family has also.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
b. ―I remember joy and mutual respect from our early years together.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
c. ―I will make some changes in my behavior for the good of the family.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
d. ―It‘s best for me to move away from my family. Things will never change.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ANS: x @ C
The correct response demonstrates the best evidence of a healthy recognition of the i
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
mportance of relationships. Mental health includes rational thinking, communication ski
x@ x@ x@ x@ x@ x@ x@ x@ x@
lls, learning, emotional growth, resilience, and self-
x@ x@ x@ x@ x@ x@
esteem. Recalling joy from earlier in life may be healthy, but the correct response sho
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ws a higher level of mental health. The other incorrect responses show blaming and av
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
oidance.
PTS: x @ x @ 1 DIF: Cognitive Level: Analyze (Analysis) x@ x@ x@
TOP: x @ Nursing Process: Assessment
x@ MSC: Client Needs: Psychosocial Integrity
x@ x @ x@ x@ x@
5. Which assessment finding most clearly indicates that a client may be experiencing a
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
mental illness? x@
a. reporting occasional sleeplessness and anxiety.
x@ x@ x@ x@
b. reporting a consistently sad, discouraged, and hopeless mood.
x@ x@ x@ x@ x@ x@ x@
c. being able to describe the difference between ―as if‖ and ―for real.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
d. experiencing difficulty making a decision about whether to change jobs.
x@ x@ x@ x@ x@ x@ x@ x@ x@
ANS: x @ B
The correct response describes a mood alteration, which reflects mental illness. The distr
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
acters describe behaviors that are mentally healthy or within the usual scope of human
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x
@experience.
PTS: x @ x @ 1 DIF: Cognitive Level: Apply (Application) x@ x@ x@
TOP: x @ Nursing Process: Assessment
x@ MSC: Client Needs: Psychosocial Integrity
x@ x @ x@ x@ x@
6. Which finding best indicates that the goal ―Demonstrate mentally healthy behavior
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
‖ was achieved for an adult client?
x@ x@ x@ x@ x@ x@
a. being willing to work towards achieving ideals and meeting demands.
x@ x@ x@ x@ x@ x@ x@ x@ x@
b. behaving without considering the consequences of personal actions.
x@ x@ x@ x@ x@ x@ x@
c. aggressively meeting personal needs without considering the rights of others.
x@ x@ x@ x@ x@ x@ x@ x@ x@
d. seeking help from others to avoid assuming responsibility for major areas o
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
f own life. x@ x@
x@ x@ x@ x@ x@ x@ x@
Halter: Varcarolis’ Foundations of Psychiatric-
x@ x@ x@ x@
Mental Health Nursing: A Clinical Approach, 9th Edition
x@ x@ x@ x@ x@ x@ x@
MULTIPLE CHOICE x@
1. The scope of practiced for an advanced nurse practitioner would include which intervent
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ion?
a. Conducting a mental health assessment. x@ x@ x@ x@
b. Prescribing psychotropic medication. x@ x@
c. Establishing a therapeutic relationship. x@ x@ x@
d. Individualizing a nursing care plan. x@ x@ x@ x@
ANS: x @ B
In most states, prescriptive privileges are granted to master‘s-
x@ x@ x@ x@ x@ x@ x@ x@
prepared nurse practitioners and clinical nurse specialists who have taken special courses
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
on prescribing medication. The nurse prepared at the basic level is permitted to perfor
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
m mental health assessments, establish relationships, and provide individualized care pla
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
nning.
PTS: x @ x @ 1 DIF: Cognitive Level: Understand (Comprehension) x@ x@ x@
TOP: x @ Nursing Process: Implementation
x@ x@
MSC: Client Needs: Safe, Effective Care Environmen x @ x@ x@ x@ x@ x@
t
2. A nursing student expresses concerns that mental health nurses ―lose all their clinical n
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ursing skills.‖ Select the best response by the mental health nurse.
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
a. ―Psychiatric nurses practice in safer environments than other specialties. Nurs
x@ x@ x@ x@ x@ x@ x@ x@ x@
e-to-
client ratios must be better because of the nature of the clients‘ problems.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
b. ―Psychiatric nurses use complex communication skills as well as critical thi
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
nking to solve multidimensional problems. I am challenged by those situati
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ons.‖
c. ―That‘s a misconception. Psychiatric nurses frequently use high technol
x@ x@ x@ x@ x@ x@ x@ x@
ogy monitoring equipment and manage complex intravenous therapies.
x@ x@ x@ x@ x@ x@ x@
‖
d. ―Psychiatric nurses do not have to deal with as much pain and suffer
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ing as medical–surgical nurses do. That appeals to me.‖
x@ x@ x@ x@ x@ x@ x@ x@
ANS: x @ B
The practice of psychiatric nursing requires a different set of skills than medical–
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x
@help clients with medical as well as mental health problems, reflecting the holistic pers
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
pective these nurses must have. Nurse–
x@ x@ x@ x@ x@
client ratios and workloads in psychiatric settings have increased, just like other special
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ties. Psychiatric nursing involves clinical practice, not just documentation.
x@ x@ x@ x@ x@ x@ x@ x@
Psychosocial pain and suffering are as real as physical pain and suffering.
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
PTS: x @ x @ 1 DIF: Cognitive Level: Apply (Application) x@ x@ x@
TOP: x @ Nursing Process: Implementation
x@ x@
MSC: Client Needs: Safe, Effective Care Environmen x @ x@ x@ x@ x@ x@
t
3. When a new bill introduced in Congress reduces funding for care of persons diagnos
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
,ed with mental illness, a group of nurses write letters to their elected representatives i
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
n opposition to the legislation. Which role have the nurses fulfilled?
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
x@
, ANS: x @ C
An advocate defends or asserts another‘s cause, particularly when the other person lack
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
s the ability to do that for self. Examples of individual advocacy include helping client
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
s understand their rights or make decisions. On a community scale, advocacy includes
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
political activity, public speaking, and publication in the interest of improving the huma
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
n condition. Since funding is necessary to deliver quality programming for persons with
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x
@mental illness, the letter-
x@ x@ x@
writing campaign advocates for that cause on behalf of clients who are unable to artic
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ulate their own needs.
x@ x@ x@
PTS: x @ x @ 1 DIF: Cognitive Level: Understand (Comprehension) x@ x@ x@
TOP: x @ Nursing Process: Evaluation
x@ x@
MSC: Client Needs: Safe, Effective Care Environmen x @ x@ x@ x@ x@ x@
t
4. A family has a long history of conflicted relationships among the members. Which
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
family member‘s comment best reflects a mentally healthy perspective?
x@ x@ x@ x@ x@ x@ x@ x@
a. ―I‘ve made mistakes but everyone else in this family has also.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
b. ―I remember joy and mutual respect from our early years together.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
c. ―I will make some changes in my behavior for the good of the family.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
d. ―It‘s best for me to move away from my family. Things will never change.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ANS: x @ C
The correct response demonstrates the best evidence of a healthy recognition of the i
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
mportance of relationships. Mental health includes rational thinking, communication ski
x@ x@ x@ x@ x@ x@ x@ x@ x@
lls, learning, emotional growth, resilience, and self-
x@ x@ x@ x@ x@ x@
esteem. Recalling joy from earlier in life may be healthy, but the correct response sho
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
ws a higher level of mental health. The other incorrect responses show blaming and av
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
oidance.
PTS: x @ x @ 1 DIF: Cognitive Level: Analyze (Analysis) x@ x@ x@
TOP: x @ Nursing Process: Assessment
x@ MSC: Client Needs: Psychosocial Integrity
x@ x @ x@ x@ x@
5. Which assessment finding most clearly indicates that a client may be experiencing a
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
mental illness? x@
a. reporting occasional sleeplessness and anxiety.
x@ x@ x@ x@
b. reporting a consistently sad, discouraged, and hopeless mood.
x@ x@ x@ x@ x@ x@ x@
c. being able to describe the difference between ―as if‖ and ―for real.‖
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
d. experiencing difficulty making a decision about whether to change jobs.
x@ x@ x@ x@ x@ x@ x@ x@ x@
ANS: x @ B
The correct response describes a mood alteration, which reflects mental illness. The distr
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
acters describe behaviors that are mentally healthy or within the usual scope of human
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x
@experience.
PTS: x @ x @ 1 DIF: Cognitive Level: Apply (Application) x@ x@ x@
TOP: x @ Nursing Process: Assessment
x@ MSC: Client Needs: Psychosocial Integrity
x@ x @ x@ x@ x@
6. Which finding best indicates that the goal ―Demonstrate mentally healthy behavior
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
‖ was achieved for an adult client?
x@ x@ x@ x@ x@ x@
a. being willing to work towards achieving ideals and meeting demands.
x@ x@ x@ x@ x@ x@ x@ x@ x@
b. behaving without considering the consequences of personal actions.
x@ x@ x@ x@ x@ x@ x@
c. aggressively meeting personal needs without considering the rights of others.
x@ x@ x@ x@ x@ x@ x@ x@ x@
d. seeking help from others to avoid assuming responsibility for major areas o
x@ x@ x@ x@ x@ x@ x@ x@ x@ x@ x@
f own life. x@ x@
