Chapter 01: Mental Health and Mental Illness
A This client is demonstrating deviant behavior. This client demonstrates undersocialized, aggressive behavior such as a repetitive and persistent pattern of aggressive conduct in which the basic rights of others are violated. REF: Pages 2-3
A 14-year-old belongs to a neighborhood gang, engages in sexually promiscuous behavior, and has a history of school truancy but reports that her parents are just old- fashioned and don't understand her. The assessment data supports that the client a. is displaying deviant behavior. b. cannot accurately appraise reality. c. is seriously and persistently mentally ill. d. should be considered for group home placement.
C Incidence refers to the number of new cases of mental disorders in a healthy population within a given period of time. Prevalence describes the total number of cases, new and existing, in a given population during a specific period of time, regardless of when they became ill. Parity refers to equivalence, and legislation required insurers that provide mental health coverage to offer annual and lifetime benefits at the same level provided for medical/surgical coverage. Co-morbidity refers to having more than one mental disorder at a time. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 9-10 TOP: Nursing Process: Planning/Outcomes Identification MSC: Client Needs: Safe, Effective Care Environment
A category 5 tornado occurred in a community of 400 people resulting in destruction of many homes and businesses. In the 2 years after this disaster, 140 individuals were diagnosed with posttraumatic stress disorder (PTSD). Which term best applies to these newly diagnosed cases? a. Prevalence c. Incidence b. Co-morbidity d. Parity
D The 12-month prevalence for Alzheimer's disease is 10% for persons older than 65 and 50% for persons older than 85. The prevalence of schizophrenia is 1.1% per year. The prevalence of bipolar disorder is 2.6%. Dissociative fugue is a rare disorder. See related audience response question. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 9-10 (Table 1-1) TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
A citizen at a community health fair asks the nurse, "What is the most prevalent mental disorder in the United States?" Select the nurse's best response. a. Schizophrenia c. Dissociative fugue b. Bipolar disorder d. Alzheimer's disease
B The appraisal of reality is lacking for this client. The client does not have a picture of what is happening around himself or herself. REF: Pages 2-3
A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking? a. Control over behavior b. Appraisal of reality c. Effectiveness in work d. Healthy self-concept
E The student is happy and has an adequate self-concept. The student is reality-oriented, works effectively, and has control over own behavior. Mental health does not mean that a person is always happy. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 2-3 (Figure 1-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
A college student said, "Most of the time I'm happy and feel good about myself. I have learned that what I get out of something is proportional to the effort I put into it." Which number on this mental health continuum should the nurse select? Mental Illness 1 2 3 4 5 Mental Health a. 1 b. 2 c. 3 d. 4 e. 5
B The DSM-5 gives the criteria used to diagnose each mental disorder. The distracters may not contain diagnostic criteria for a psychiatric illness. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 3-4 TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
A nurse encounters an unfamiliar psychiatric disorder on a new patient's admission form. Which resource should the nurse consult to determine criteria used to establish this diagnosis? a. International Statistical Classification of Diseases and Related Health Problems (ICD-10) b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) c. A behavioral health reference manual d. Wikipedia
D Clinical epidemiology is a broad field that addresses studies of the natural history (or what happens if there is no treatment and the problem is left to run its course) of an illness, studies of diagnostic screening tests, and observational and experimental studies of interventions used to treat people with the illness or symptoms. Prevalence refers to numbers of new cases. Co-morbidity refers to having more than one mental disorder at a time. Incidence refers to the number of new cases of mental disorders in a healthy population within a given period. See related audience response question. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 9-10 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients receive supportive interventions and antidepressant medication. The other half receives only medication. The team measures outcomes for each group. Which type of study is evident? a. Incidence c. Co-morbidity b. Prevalence d. Clinical epidemiology
B The DSM-5 details the diagnostic criteria for psychiatric clinical conditions. The other references are good resources but do not define the diagnostic criteria. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 10-12 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information? a. Nursing Outcomes Classification (NOC) b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) c. The ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice d. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
B Nurses who are aware of legislative concerns and who are active in organizations that promote mental health awareness and appropriate and equal treatment for mental illness help achieve the goal of parity, or equality of treatment for mentally ill individuals. Becoming active in politics may be a personal goal but does not directly or necessarily reduce stigma or encourage treatment equality. The other options are undesirable outcomes. Cognitive Level: Analyze (Analysis) Nursing Process: Implementation NCLEX: Safe and Effective Care Environment Text page: 16
A nurse who is active in local consumer mental health groups and in local and state mental health associations and who keeps aware of state and national legislation affecting mental illness treatment may positively affect the climate for treatment by: a. becoming active in politics leading to a potential political career. b. reducing the stigma of mental illness and advocating for equality in treatment. c. encouraging laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons. d. advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions.
D A psychiatric mental health nurse has specialized nursing skills and implements the nursing process to manage and deliver nursing care to the mentally ill. The remaining options either do not effectively answer the client's question or assume that the question is the result of the client's paranoia.
A nurse's identification badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "What does that title mean?" The nurse responds best by answering: a. "Don't be afraid; it means I'm here to help, not hurt, you." b. "Psychiatric mental health nurses care for people with mental illnesses." c. "We have the specialized skills needed to care for those with mental illnesses." d. "The nurses who work in mental health facilities have that title."
C Nursing diagnoses provide the framework for identifying appropriate nursing interventions for dealing with the phenomena a client with a mental health disorder is experiencing. REF: Pages 13-14
A nursing diagnosis for a client with a psychiatric disorder serves the purpose of a. justifying the use of certain psychotropic medication. b. providing data essential for insurance reimbursement. c. providing a framework for selecting appropriate interventions. d. completing the medical diagnostic statement.
D
A nursing student new to psychiatric mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be: a. Nursing Intervention Classification (NIC) b. Nursing Outcomes Classification (NOC) c. NANDA-I nursing diagnoses d. DSM-5
B, C, E The aspects of mental health of greatest concern are the patient's appraisal of and control over behavior. The appraisal of reality is inaccurate. There are auditory hallucinations, delusions of persecution, and delusions of grandeur. In addition, the patient's control over behavior is tenuous, as evidenced by the plan to stab anyone who seems threatening. A healthy self-concept is lacking, as evidenced by the delusion of grandeur. Data are not present to suggest that the other aspects of mental health (happiness and effectiveness in work) are of immediate concern. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 2-4 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
A patient in the emergency department says, "Voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat." Which aspects of the patient's mental health have the greatest and most immediate concern to the nurse? Select all that apply. a. Happiness b. Appraisal of reality c. Control over behavior d. Effectiveness in work e. Healthy self-concept
D The information given centers on relationships with others that are described as intense and unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data are not present to describe work effectiveness, communication skills, or activities. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 2-3 (Figure 1-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
A patient's relationships are intense and unstable. The patient initially idealizes the significant other and then devalues him or her, resulting in frequent feelings of emptiness. This patient will benefit from interventions to develop which aspect of mental health? a. Effectiveness in work c. Productive activities b. Communication skills d. Fulfilling relationships
B In most states, prescriptive privileges are granted to master's-prepared nurse practitioners who have taken special courses on prescribing medication. The nurse prepared at the basic level is permitted to perform mental health assessments, establish relationships, and provide individualized care planning. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 15 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which additional intervention? a. Conduct mental health assessments. c. Establish therapeutic relationships. b. Prescribe psychotropic medication. d. Individualize nursing care plans.
A The DSM-5 states there is evidence to suggest that mental illness is influenced by cultural and ethnic factors. The DSM-5 does not state that there is evidence that occupation, birth order, or sexual preference affect mental illness. Cognitive Level: Understand (Comprehension) Nursing Process: Diagnosis NCLEX: Psychosocial Integrity Text page: 10-12
According to the DSM-5, there is evidence that symptoms and causes of mental illness are influenced by: a. cultural and ethnic factors. b. occupation and status. c. birth order. d. sexual preference.
A, B Evidence-based practice involves using research findings and standards of care to provide the most effective nursing care. Evidence is continuously emerging, so nurses cannot rely solely on experience. The effective nurse also maintains respect for each patient as an individual. Overgeneralization compromises that perspective. Intuition and trial and error are unsystematic approaches to care. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 7-9 TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Safe, Effective Care Environment
An experienced nurse says to a new graduate, "When you've practiced as long as I have, you instantly know how to take care of psychotic patients." What information should the new graduate consider when analyzing this comment? Select all that apply. a. The experienced nurse may have lost sight of patients' individuality, which may compromise the integrity of practice. b. New research findings should be integrated continuously into a nurse's practice to provide the most effective care. c. Experience provides mental health nurses with the essential tools and skills needed for effective professional practice. d. Experienced psychiatric nurses have learned the best ways to care for mentally ill patients through trial and error. e. An intuitive sense of patients' needs guides effective psychiatric nurses.
D One myth about mental illness is that to be mentally ill is to be different and odd. Another misconception is that to be healthy, a person must be logical and rational. Everyone dreams "irrational" dreams at night, and "irrational" emotions are universal human experiences and are essential to a fulfilling life. Some people who show extremely abnormal behavior and are characterized as mentally ill are far more like the rest of us than different from us. No obvious and consistent line between mental illness and mental health exists. REF: Pages 2-3
An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports that he is a. demonstrating symptoms of bipolar disorder. b. socially deviant. c. egocentric. d. not demonstrating any definitive signs of mental illness.
B Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association, identifies diagnostic statements regarding human responses to actual or potential health problems. These statements represent clinical judgments. NIC (Nursing Interventions Classification) identifies actions provided by nurses that enhance patient outcomes. Nursing care activities may be direct or indirect. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Page 13-14 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
Complete this analogy. NANDA: clinical judgment: NIC : _________________ a. patient outcomes c. diagnosis b. nursing actions d. symptoms
A The biologically influenced illnesses include schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress disorder, and autism. Therefore many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Psychological trauma, learned behaviors, and faulty patterns of nurturance may contribute to some forms of mental illness, but they are not major factors in most disabling mental disorders.
Current information suggests that the most disabling mental disorders are the result of a. biological influences. b. psychological trauma. c. learned ways of behaving. d. faulty patterns of early nurturance.
C
Epidemiological studies contribute to improvements in care for individuals with mental disorders by: a. Providing information about effective nursing techniques. b. Identifying risk factors that contribute to the development of a disorder. c. Identifying who in the general population will develop a specific disorder. d. Identifying which individuals will respond favorably to a specific treatment.
B One approach to differentiating mental health from mental illness is to consider what a particular culture regards as acceptable or unacceptable. In this view, the mentally ill are those who violate social norms and thus threaten (or make anxious) those observing them. For example, traditional Japanese may consider suicide to be an act of honor, and Middle Eastern "suicide bombers" are considered holy warriors or martyrs. Contrast these viewpoints with Western culture, where people who attempt or complete suicides are nearly always considered mentally ill. REF: Pages 4-5
In order to best differentiate whether an Asian client is demonstrating a mental illness when attempting suicide is to a. ask the client whether he views himself as being depressed. b. identify his culture's view regarding suicide. c. explain to him that suicide is often regarded as a desperate act. d. assess the client for other examples of depressive behaviors.
A The question asks about risk. Hearing voices is generally associated with mental illness, but in charismatic religious groups, hearing the voice of God or a prophet is a desirable event. Cultural norms vary, which makes it more difficult to make an accurate diagnosis. The individuals described in the other options are less likely to be labeled mentally ill. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Page 4-5 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? One who: a. describes hearing God's voice speaking. b. is usually pessimistic but strives to meet personal goals. c. is wealthy and gives away $20 bills to needy individuals. d. always has an optimistic viewpoint about life and having own needs met.
B Resilience is a characteristic that helps individuals cope with loss and trauma that may occur in life. Dependence is described as being dependent on others for decision making and care. Pessimism is a life philosophy that things are more likely to go wrong than right. Altruism is described as putting others before yourself. Cognitive Level: Understand (Comprehension) Nursing Process: Assessment NCLEX: Psychosocial Integrity Text page: 3
One characteristic of mental health that allows people to adapt to tragedies, trauma, and loss is: a. dependence. b. resilience. c. pessimism. d. altruism.
D The medical diagnosis is concerned with the patient's disease state, causes, and cures, whereas the nursing diagnosis focuses on the patient's response to stress and possible caring interventions. Both tools consider culture. The DSM-5 is multiaxial. Nursing diagnoses also consider potential problems. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 10-14 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
Select the best response for the nurse who receives a question from another health professional seeking to understand the difference between a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis and a nursing diagnosis. a. "There is no functional difference between the two. Both identify human disorders." b. "The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis takes culture into account. c. The DSM-5 diagnosis describes causes of disorders whereas a nursing diagnosis does not explore etiology." d. "The DSM-5 diagnosis guides medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for issues a patient is experiencing."
D The DSM-5 classifies disorders people have rather than people themselves. The terminology of the tool reflects this distinction by referring to individuals with a disorder rather than as a "schizophrenic" or "alcoholic," for example. Deviant behavior is not generally considered a mental disorder. Present disability or distress is only one aspect of the diagnosis. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 10-12 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies: a. deviant behaviors. c. people with mental disorders. b. present disability or distress. d. mental disorders people have.
B
The intervention that can be practiced by an advanced practice registered nurse in psychiatric mental health but cannot be practiced by a basic level registered nurse is: a. Advocacy b. Psychotherapy c. Coordination of care d. Community-based care
C Many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Therefore, these disorders can be regarded as "diseases." Visualizing these disorders along the mental health continuum is helpful. REF: Pages 3-4
The mental health status of a particular client can best be assessed by considering a. the degree of conformity of the individual to society's norms. b. the degree to which an individual is logical and rational. c. placement on a continuum from health to illness. d. the rate of intellectual and emotional growth.
A Nurses are expected to evaluate clients with mental health issues for their strengths and their areas of high functioning. You will find many attributes of mental health in some of your clients with mental health issues. These strengths should be built upon and encouraged. REF: Pages 6
The nurse planning care for a mentally ill client bases interventions on the concept that the client a. has areas of strength on which to build. b. has right that must be respected. c. comes with experiences that contribute to their problem. d. share fears that are similar to those of all mentally healthy individuals.
D Statistics show that the prevalence rate over a 12-month period for major depressive disorder is 6.7%, and the lifetime prevalence rate for generalized anxiety is 3.1%.
The prevalence rate over a 12-month period for major depressive disorder is a. lower than the prevalence rate for panic disorders. b. greater than the prevalence rate for psychotic disorders. c. equal to the prevalence rate for psychotic disorders. d. greater than the prevalence rate for generalized anxiety.
C Epidemiology is the quantitative study of the distribution of mental disorders in human populations. Mortality refers to deaths. Prevalence refers to the proportion of a population with a mental disorder at a given time. Clinical epidemiology deals with what happens to people with illnesses who are seen by providers of care.
The quantitative study of the distribution of mental disorders in human populations is called a. mortality. b. prevalence. c. epidemiology. d. clinical epidemiology.
C Many of the most prevalent and disabling mental disorders have strong biological influences. Genetics are only one part of biological factors. Empathy does not address increasing the spouse's level of knowledge about the cause of the disorder. The other distracters are not established facts. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 6-7 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
The spouse of a patient diagnosed with schizophrenia says, "I don't understand how events from childhood have anything to do with this disabling illness." Which response by the nurse will best help the spouse understand the cause of this disorder? a. "Psychological stress is the basis of most mental disorders." b. "This illness results from developmental factors rather than stress." c. "Research shows that this condition more likely has a biological basis." d. "It must be frustrating for you that your spouse is sick so much of the time."
B Worldwide studies indicate that both schizophrenia and bipolar disorder are recognized cross-culturally.
These severe mental illnesses are recognized across cultures: a. antisocial and borderline personality disorders. b. schizophrenia and bipolar disorder. c. bulimia and anorexia nervosa. d. amok and social phobia.
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 patients with medical as well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical pain and suffering. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 10 | Page 13-14 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
When a nursing student expresses concerns about how mental health nurses "lose all their nursing skills," the best response by the mental health nurse is: a. "Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be better because of the nature of the patients' problems." b."Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations." c. "That's a misconception. Psychiatric nurses frequently use high technology monitoring equipment and manage complex intravenous therapies." d. "Psychiatric nurses do not have to deal with as much pain and suffering as medical-surgical nurses do. That appeals to me."
B The correct response describes a mood alteration, which reflects mental illness. The distracters describe behaviors that are mentally healthy or within the usual scope of human experience. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 2-3 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The patient: a. reports occasional sleeplessness and anxiety. b. reports a consistently sad, discouraged, and hopeless mood. c. is able to describe the difference between "as if" and "for real." d. perceives difficulty making a decision about whether to change jobs.
D A nurse who understands that a patient's symptoms are influenced by culture will be able to advocate for the patient to a greater degree than a nurse who believes that culture is of little relevance. The distracters are untrue statements. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 4-5 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
Which belief will best support a nurse's efforts to provide patient advocacy during a multidisciplinary patient care planning session? a. All mental illnesses are culturally determined. b. Schizophrenia and bipolar disorder are cross-cultural disorders. c. Symptoms of mental disorders are unchanged from culture to culture. d. Assessment findings in mental disorders reflect a person's cultural patterns.
C Clinical epidemiology represents a broad field that addresses what happens to people with illnesses who are seen by providers of clinical care. Studies use traditional epidemiological methods and are conducted in groups that are usually defined by illness or symptoms or by diagnostic procedures or treatments given for the illness or symptoms. REF: Pages 9-10
Which branch of epidemiology is the nurse involved in when seeking outcomes for patients whose depression was treated with electroconvulsive therapy (ECT)? a. experimental b. descriptive c. clinical d. analytic
C Caring evidences empathetic understanding as well as competency. It helps change pain and suffering into a shared experience, creating a human connection that alleviates feelings of isolation. The distracters give examples of statements that demonstrate advocacy or giving advice. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 7 |Page 10 TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
Which comment best indicates that a patient perceived the nurse was caring? "My nurse: a. always asks me which type of juice I want to help me swallow my medication." b. explained my treatment plan to me and asked for my ideas about how to make it better." c. spends time listening to me talk about my problems. That helps me feel like I am not alone." d. told me that if I take all the medicines the doctor prescribes, then I will get discharged sooner."
B The key areas of care promoted by QSEN are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 8-9 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
Which component of treatment of mental illness is specifically recognized by Quality and Safety Education for Nurses (QSEN)? a. All genomes are unique. b. Care is centered on the patient. c. Healthy development is vital to mental health. d. Recovery occurs on a continuum from illness to health.
C Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people in those cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a person (usually a male) runs around engaging in furious, almost indiscriminate violent behavior. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 5-6 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
Which disorder is a culture-bound syndrome? a. Epilepsy c. Running amok b. Schizophrenia d. Major depression
A The correct response describes an adaptive, healthy behavior. The distracters describe maladaptive behaviors. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 2-3 TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
Which finding best indicates that the goal "Demonstrate mentally healthy behavior" was achieved? A patient: a. sees self as capable of achieving ideals and meeting demands. b. behaves without considering the consequences of personal actions. c. aggressively meets own needs without considering the rights of others. d. seeks help from others when assuming responsibility for major areas of own life.
A, D, E Mental health is a state of well-being in which each individual is able to realize his or her own potential, cope with the normal stresses of life, work productively, and make a contribution to the community. Mental health provides people with the capacity for rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 2-3 (Figure 1-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
Which findings are signs of a person who is mentally healthy? Select all that apply. a. Says, "I have some weaknesses, but I feel I'm important to my family and friends." b. Adheres strictly to religious beliefs of parents and family of origin. c. Spends all holidays alone watching old movies on television. d. Considers past experiences when deciding about the future. e. Experiences feelings of conflict related to changing jobs.
D Resilience is closely associated with the process of adapting and helps people facing tragedies, loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources they need to support their well-being. Repression and depression are unhealthy. Living in a shelter for two years shows a failure to move forward after a tragedy. See related audience response question. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 3-4 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
Which individual is demonstrating the highest level of resilience? One who: a. is able to repress stressors. b. becomes depressed after the death of a spouse. c. lives in a shelter for two years after the home is destroyed by fire. d. takes a temporary job to maintain financial stability after loss of a permanent job.
D Psychotherapy is part of the scope of practice of an advanced practice nurse. The distracters are within a staff nurse's scope of practice. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 14-15 (Table 1-2) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
Which nursing intervention below is part of the scope of an advanced practice psychiatric/mental health nurse only? a. Coordination of care c. Milieu therapy b. Health teaching d. Psychotherapy
C Parity refers to equivalence that requires insurers who provide mental health coverage to offer annual and lifetime benefits at the same level provided for medical/surgical coverage. REF: Pages 9-10
Which of the following best demonstrates parity related to mental health care? a. The client is admitted for a 72-hour mental hygiene evaluation. b. Advance practice nurse can be certified as psychiatric nurse specialist. c. A client's mental health coverage is equal to his medical/surgical coverage. d. A client who has attempted suicide is hospitalized for a mental health evaluation.
B Every society has its own view of health and illness and the types of behavior categorized as mental illness. Culture also influences the symptoms of a particular disorder. For example, individuals of certain cultures are more likely to express depression through somatic symptoms than through affect and feeling tone. The five axes system was abandoned in this edition of the DSM-5.
Which statement about diagnosis of a mental disorder is true? a. The symptoms of each disorder are common among all cultures. b. Culture may cause variations in symptoms for each clinical disorder. c. All mental disorders listed in the DSM-5 are seen in all other cultures. d. Psychiatric diagnoses are listed in separately from other physical disorders in a five axes system.
C
Which statement about mental illness is true? a. Mental illness is a matter of individual nonconformity with societal norms. b. Mental illness is present when individual irrational and illogical behavior occurs. c. Mental illness changes with culture, time in history, political systems, and the groups defining it. d. Mental illness is evaluated solely by considering individual control over behavior and appraisal of reality.
C
Which statement best describes a major difference between a DSM-5 diagnosis and a nursing diagnosis? a. There is no functional difference between the two; both serve to identify a human deviance. b. The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis takes culture into account. c. The DSM-5 is associated with present symptoms, whereas a nursing diagnosis considers past, present, and potential responses to actual mental health problems. d. The DSM-5 diagnosis impacts the choice of medical treatment, whereas the nursing diagnosis offers a framework for identifying multidisciplinary interventions.
A The DSM-5 is a classification of mental disorders that includes descriptions and criteria of diagnoses.
Which statement best describes the DSM-5? a. It is a medical psychiatric assessment system. b. It is a compendium of treatment modalities. c. It offers a complete list of nursing diagnoses. d. It suggests common interventions for mental disorders.
A By letting the provider know that the patient does not want the treatment the provider is prescribing, you have advocated for the patient and her right to make decisions regarding her treatment. The other selections do not describe patient advocacy. Cognitive Level: Analyze (Analysis) Nursing Process: Implementation NCLEX: Safe and Effective Care Environment Text page: 16
You are caring for Kiley, a 29-year-old female patient who is being admitted following a suicide attempt. Which of the following illustrates the concept of patient advocacy? a. "Dr. Raye, I notice you ordered Prozac for Kiley. She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed." b. "Dr. Raye, during her admissions interview Kiley stated that she has had three other suicide attempts in the past." c. "Kiley, can you tell me more about your depression and your suicide attempt?" d. "Kiley, I will take you on a tour of the unit and orient you to the rules."
C Basic level RNs cannot perform psychotherapy. The other options are all appropriate expectations of a patient's schedule on a psychiatric unit. Cognitive Level: Analyze (Analysis) Nursing Process: Planning NCLEX: Safe and Effective Care Environment Text page: 14-15
You have graduated with your BSN degree and have taken your first job on a psychiatric unit after becoming a licensed Registered Nurse. You are providing teaching to Mason, a newly admitted patient on the psychiatric unit, regarding his daily schedule. Which of the following would not be an appropriate teaching statement? a. "You will participate in unit activities and groups daily." b. "You will be given a schedule daily of the groups we would like you to attend." c. "You will attend a psychotherapy group that I lead." d. "You will see your provider daily in a one-to-one session."