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OpenStax Psychiatric-Mental Health Nursing Instructor Answer Guide
OpenStax Psychiatric-Mental Health
Nursing Instructor Answer Guide
Chapter 1: Foundations of Psychiatric-Mental Health Nursing ...................................................... 3
Chapter 2: Fundamentals of Theories and Therapies..................................................................... 9
Chapter 3: Communication, Perception, and Assessment ........................................................... 18
Chapter 4: Neurology and Pharmacology Standards ................................................................... 23
Chapter 5: Therapeutic Settings ................................................................................................... 30
Chapter 6: Therapeutic Relationships........................................................................................... 37
Chapter 7: Interprofessional Care................................................................................................. 42
Chapter 8: Cultural Considerations ............................................................................................... 57
Chapter 9: Social and Emotional Concerns ................................................................................... 65
Chapter 10: Legal and Ethical Guidelines ..................................................................................... 74
Chapter 11: Court Involvement .................................................................................................... 79
Chapter 12: Self-Determination and Advocacy ............................................................................ 89
Chapter 13: Clinical Guidelines and Practice ................................................................................ 98
Chapter 14: Neurocognitive Disorders ....................................................................................... 114
Chapter 15: Schizophrenia Spectrum Disorder and Other Psychotic Disorders ........................ 121
Chapter 16: Mood Disorders and Suicide ................................................................................... 126
Chapter 17: Anxiety, OCD, and Trauma-Stressor Disorders ....................................................... 134
Chapter 18: Personality Disorders .............................................................................................. 145
Chapter 19: Substance Use and Misuse ..................................................................................... 151
Chapter 20: Eating Disorders ...................................................................................................... 158
Chapter 21: Somatic Symptom Disorders ................................................................................... 165
Chapter 22: Sexual Dysfunction and Gender Dysphoria ............................................................ 171
Chapter 23: Children and Adolescents ....................................................................................... 178
Chapter 24: Older Adults ............................................................................................................ 187
Chapter 25: Community Mental Health Treatment ................................................................... 194
Chapter 26: Adjuncts to Treatments .......................................................................................... 201
Chapter 27: Current Trends and Growing Needs ....................................................................... 207
Chapter 28: Critical Thinking in Psychiatric-Mental Health Nursing .......................................... 214
2
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Chapter 1: Foundations of Psychiatric-Mental Health Nursing
Review Questions
1. Nurse Jon is caring for a client with severe anxiety. Their anxiety has recently increased so
much that the client is unable to go to work. Nurse Jon realizes that according to the mental
health to mental illness continuum, this client is in the category of:
a. emotional problems or concerns
b. well-being
c. mental illness
d. between well-being and emotional problems
[Answer: C]
2. Student nurse DeShawna just began clinical on a behavioral health unit. The nursing
instructor realizes that DeShawna needs assistance when DeShawna states:
a. “I have completed all parts of the nursing assessment.”
b. “This client seems fine so I did not complete a mental status exam.”
c. “I have gathered the names of all the medications this client takes.”
d. “I have assessed for suicidal ideation.”
[Answer: B]
3. What is the scope of psychiatric-mental health nursing practice?
a. assessment, education, medication administration, and screening for suicide risk
b. assessment, medical diagnosis, giving orders, writing prescriptions, admitting, and
discharging
c. assisting providers, assisting with ADLs, monitoring clients, offering support, promoting
safety
d. assessment, counseling, teaching coping skills, giving advice, listening
[Answer: A]
4. A psychiatric nurse is working in a community mental health center. They are completing an
assessment on a 32-year-old pregnant woman presenting with depression. They note that
the client has not answered the questions about alcohol and tobacco use. Why is it
important to gather this information?
a. This information is not a pertinent part of the assessment process for a community
mental health client.
b. This information will help the health-care team in all aspects of caring for the client,
especially since she is pregnant.
c. This information is not important as it will have no long-term effects on the client’s
unborn child.
d. This information is optional in relation to mental health care.
[Answer: B]
5. A client of the local mental health clinic arrives for their appointment out of breath, hair a
mess, and clothing askew. The receptionist tells the client, “You are fifteen minutes late. I
will have to see if the doctor can still see you.” The client responds, “I know I am late. I can
3
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OpenStax Psychiatric-Mental Health Nursing Instructor Answer Guide
explain, my mother-in-law had a bad night. She lives with my husband and me. I am just so
tired of taking care of her.” This example falls under which category of risk factors?
a. genetic comorbidities
b. psychological factors
c. social factors
d. victimization
[Answer: C]
6. Nurse Simon has just completed a psychosocial assessment of his client Juan. During the
assessment, Nurse Simon listens to Juan and tries to make Juan feel respected by showing
compassion and empathy. Nurse Simon is utilizing
a. the therapeutic relationship
b. risk assessment
c. spiritual awareness
d. resilience strategy
[Answer: A]
7. To keep the plan of care client-centered, what important assessment should the nurse do
after identifying several risk factors for substance abuse in a client?
a. contact a rehab center for an intake assessment
b. perform a client strengths assessment
c. ask the psychiatrist to screen for depression
d. complete a health assessment
[Answer: B]
8. A nurse is teaching a therapeutic group about reducing the stigma of taking psychiatric
medications. One of the participants raises his hand and states, “I don’t want to take
medication because I am afraid what other people will think of me.” What is an appropriate
response by the nurse?
a. “Why do you care what other people think?”
b. “You don’t need to tell anyone you are taking medication.”
c. “Medication to help your brain is just as important as it is for any other body part.”
d. “People can be really mean sometimes, can’t they?”
[Answer: C]
9. A person with mental illness does not want to seek care because of the shame they feel for
being sick. What type of stigma is this related to?
a. self-stigma
b. caregiver stigma
c. institutional stigma
d. public stigma
[Answer: A]
10. A 45-year-old man with schizophrenia has been denied the rental of an apartment due to
his mental health. Besides being illegal, what is this most closely related to?
a. stigma
b. prejudice
4
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OpenStax Psychiatric-Mental Health Nursing Instructor Answer Guide
OpenStax Psychiatric-Mental Health
Nursing Instructor Answer Guide
Chapter 1: Foundations of Psychiatric-Mental Health Nursing ...................................................... 3
Chapter 2: Fundamentals of Theories and Therapies..................................................................... 9
Chapter 3: Communication, Perception, and Assessment ........................................................... 18
Chapter 4: Neurology and Pharmacology Standards ................................................................... 23
Chapter 5: Therapeutic Settings ................................................................................................... 30
Chapter 6: Therapeutic Relationships........................................................................................... 37
Chapter 7: Interprofessional Care................................................................................................. 42
Chapter 8: Cultural Considerations ............................................................................................... 57
Chapter 9: Social and Emotional Concerns ................................................................................... 65
Chapter 10: Legal and Ethical Guidelines ..................................................................................... 74
Chapter 11: Court Involvement .................................................................................................... 79
Chapter 12: Self-Determination and Advocacy ............................................................................ 89
Chapter 13: Clinical Guidelines and Practice ................................................................................ 98
Chapter 14: Neurocognitive Disorders ....................................................................................... 114
Chapter 15: Schizophrenia Spectrum Disorder and Other Psychotic Disorders ........................ 121
Chapter 16: Mood Disorders and Suicide ................................................................................... 126
Chapter 17: Anxiety, OCD, and Trauma-Stressor Disorders ....................................................... 134
Chapter 18: Personality Disorders .............................................................................................. 145
Chapter 19: Substance Use and Misuse ..................................................................................... 151
Chapter 20: Eating Disorders ...................................................................................................... 158
Chapter 21: Somatic Symptom Disorders ................................................................................... 165
Chapter 22: Sexual Dysfunction and Gender Dysphoria ............................................................ 171
Chapter 23: Children and Adolescents ....................................................................................... 178
Chapter 24: Older Adults ............................................................................................................ 187
Chapter 25: Community Mental Health Treatment ................................................................... 194
Chapter 26: Adjuncts to Treatments .......................................................................................... 201
Chapter 27: Current Trends and Growing Needs ....................................................................... 207
Chapter 28: Critical Thinking in Psychiatric-Mental Health Nursing .......................................... 214
2
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Chapter 1: Foundations of Psychiatric-Mental Health Nursing
Review Questions
1. Nurse Jon is caring for a client with severe anxiety. Their anxiety has recently increased so
much that the client is unable to go to work. Nurse Jon realizes that according to the mental
health to mental illness continuum, this client is in the category of:
a. emotional problems or concerns
b. well-being
c. mental illness
d. between well-being and emotional problems
[Answer: C]
2. Student nurse DeShawna just began clinical on a behavioral health unit. The nursing
instructor realizes that DeShawna needs assistance when DeShawna states:
a. “I have completed all parts of the nursing assessment.”
b. “This client seems fine so I did not complete a mental status exam.”
c. “I have gathered the names of all the medications this client takes.”
d. “I have assessed for suicidal ideation.”
[Answer: B]
3. What is the scope of psychiatric-mental health nursing practice?
a. assessment, education, medication administration, and screening for suicide risk
b. assessment, medical diagnosis, giving orders, writing prescriptions, admitting, and
discharging
c. assisting providers, assisting with ADLs, monitoring clients, offering support, promoting
safety
d. assessment, counseling, teaching coping skills, giving advice, listening
[Answer: A]
4. A psychiatric nurse is working in a community mental health center. They are completing an
assessment on a 32-year-old pregnant woman presenting with depression. They note that
the client has not answered the questions about alcohol and tobacco use. Why is it
important to gather this information?
a. This information is not a pertinent part of the assessment process for a community
mental health client.
b. This information will help the health-care team in all aspects of caring for the client,
especially since she is pregnant.
c. This information is not important as it will have no long-term effects on the client’s
unborn child.
d. This information is optional in relation to mental health care.
[Answer: B]
5. A client of the local mental health clinic arrives for their appointment out of breath, hair a
mess, and clothing askew. The receptionist tells the client, “You are fifteen minutes late. I
will have to see if the doctor can still see you.” The client responds, “I know I am late. I can
3
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OpenStax Psychiatric-Mental Health Nursing Instructor Answer Guide
explain, my mother-in-law had a bad night. She lives with my husband and me. I am just so
tired of taking care of her.” This example falls under which category of risk factors?
a. genetic comorbidities
b. psychological factors
c. social factors
d. victimization
[Answer: C]
6. Nurse Simon has just completed a psychosocial assessment of his client Juan. During the
assessment, Nurse Simon listens to Juan and tries to make Juan feel respected by showing
compassion and empathy. Nurse Simon is utilizing
a. the therapeutic relationship
b. risk assessment
c. spiritual awareness
d. resilience strategy
[Answer: A]
7. To keep the plan of care client-centered, what important assessment should the nurse do
after identifying several risk factors for substance abuse in a client?
a. contact a rehab center for an intake assessment
b. perform a client strengths assessment
c. ask the psychiatrist to screen for depression
d. complete a health assessment
[Answer: B]
8. A nurse is teaching a therapeutic group about reducing the stigma of taking psychiatric
medications. One of the participants raises his hand and states, “I don’t want to take
medication because I am afraid what other people will think of me.” What is an appropriate
response by the nurse?
a. “Why do you care what other people think?”
b. “You don’t need to tell anyone you are taking medication.”
c. “Medication to help your brain is just as important as it is for any other body part.”
d. “People can be really mean sometimes, can’t they?”
[Answer: C]
9. A person with mental illness does not want to seek care because of the shame they feel for
being sick. What type of stigma is this related to?
a. self-stigma
b. caregiver stigma
c. institutional stigma
d. public stigma
[Answer: A]
10. A 45-year-old man with schizophrenia has been denied the rental of an apartment due to
his mental health. Besides being illegal, what is this most closely related to?
a. stigma
b. prejudice
4
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