Psychiatric Mental Health Nursing 8th Edition, Wanda K. Mohr Test Bank

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Psychiatric Mental Health Nursing 8th Edition, Wanda K. Mohr Test Bank


Test Bank Psychiatric Mental Health Nursing 8th Edition, Wanda Mohr

Chapter 01- Introduction to Psychiatric-Mental Health Nursing
1. A nurse is giving a presentation about preventing mental illness to college freshmen. A student asks, What does it mean to be mentally healthy? Which of the following potential responses by the nurse is best?
A) Mental health is difficult to define and depends on cultural norms.
B) Mental health is marked by productivity, fulfilling relationships, and adaptability.
C) Mental health is characterized by the absence of mental illness.
D) Mental health is the performance of behavior that is accepted as normal.
2. A 48-year-old independent, successful woman is recovering from a modified radical mastectomy. She states she was grateful that during the first few weeks after surgery her mother stayed with her and did everything for her. Which element of mental health does this reflect?
A) Reality orientation
B) Mastery of the environment
C) Self-governance
D) Tolerance of the unknown
3. Why is the document Mental Health: A Report of the Surgeon General (1999) most significant?
A) Because it states clearly that there are effective treatments for mental illness
B) Because it allocates research money to psychiatric facilities
C) Because it sets new guidelines for use of restraints
D) Because it establishes reimbursement guidelines for third-party payers
4. While a nurse is performing an admission assessment for a mental health client, the client states that all of his problems have been caused by his parents. The nurse knows that psychological factors that can influence mental health include which of the following?
A) Neuroanatomy
B) Emotional developmental level
C) Values and beliefs
D) Religion
5. What is the primary purpose of the five-axis system used in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR)?
A) To separate the various mental disorders into five related categories
B) To give a comprehensive picture of client functioning
C) To improve prognostic ability
D) To provide a decision-making algorithm for pharmacologic treatment
6. One limitation of the DSM relates to diagnostic labels given to children. The most problematic issue caused by applying adult categories to children is which of the following?
A) It prevents the proper treatment of childhood disorders.
B) The criteria for diagnosis of a disorder are flexible for an adult, but not for children.
C) Categories are based on manifestations of adult disorders, not research in children.
D) The DSM was written before childhood psychological conditions were recognized.
7. Which of the following represents a problem complicating the treatment of people with mental illness?
A) Insurers reimbursement decisions
B) Increased responsibility for care by state mental hospitals
C) Overuse of the well-coordinated mental health care system
D) Lack of effective treatments
8. Julie, a 47-year-old woman, missed 1 week of work when she was hospitalized with bipolar disorder. She was placed on medication and was able to return to work. When asked about her absence, Julie informed coworkers that she was suffering from influenza. What is the most likely reason Julie lied about her illness?
A) This is a sign that the medication is not effectively treating her illness.
B) Fear of rejection, isolation, and discrimination based on her mental health diagnosis
C) Due to workplace policies that encourage the firing of those with mental illnesses
D) To avoid eliciting sympathy among her coworkers
9. A 22-year-old man with a history of a recent suicide attempt is being treated for depression. Prior to becoming depressed, the client attended a prestigious art school and enjoyed many social and leisure activities. Of the following long-term goals for this client, which is consistent with an overarching recovery goal for all clients with mental disorders?
A) The client will not injure himself.
B) The clients symptoms will be reduced.
C) The client will show interest in social and leisure activities.
D) The client will resume pre-illness functioning.
10. Which of the following approaches to care best reflects cultural competence?
A) Always assign nurses of a specific ethnic background to clients with the same ethnic background.
B) Learn the behaviors and values associated with people of specific ethnic backgrounds.
C) Assess the culturally mediated beliefs of each client.
D) Believe that people are more alike than they are different.

Chapter 02- Neuroscience-Biology and Behavior
1. The basic units of structure and function in the nervous system are called which of the following?
A) Glial cells
B) Neurons
C) Axons
D) Dendrites
2. The structure and function of a neuron form the basis for the overall function of the nervous system. What are the components of a neuron?
A) A glial cell, nucleus, organelles, dendrites, and axons
B) A glial cell, nucleus, dendrites, and synapses
C) A cell body, nucleus, organelles, dendrites, and axons
D) A cell body, nucleus, axon, and synapses
3. A patient has researched the role of neurotransmitters in her mental illness. What is the role of neurotransmitters?
A) Excite the receptor cell located inside the synaptic cleft.
B) Inhibit the receptor cell found inside of glial cells.
C) Communicate information within the receptor cell.
D) Communicate information from one cell or cell group to another.
4. Because neurotransmitters are responsible for immediately transmitting impulses between nerve cells, they are known as which of the following?
A) First messengers
B) Second messengers
C) Receptors
D) Synapses
5. A nurse is caring for a patient who is addicted to alcohol and drugs and is discussing the pathway of the brain responsible for this behavior. The nurse should know that the pathway of the brain thought to be involved in pleasurable sensations and the euphoria resulting from use of drugs is called the:
A) Tuberinfundibular dopamine pathway
B) Nigrostriatal dopamine pathway
C) Mesocortical dopamine pathway
D) Mesolimbic dopamine pathway
6. A client lives with acquired deficits in emotional control, memory, and learning. What part of this clients brain is most likely affected?
A) Basal ganglia
B) Brainstem
C) Limbic system
D) Cerebellum
7. You are caring for a mental health client who has developed difficulty with balance and muscle tone after a car accident that involved a head injury. Based on this information, what area of the brain was most likely injured in the accident?
A) Diencephalon
B) Brainstem
C) Cerebellum
D) Pons
8. A client who experiences dysfunction in the hypothalamus is most likely to have
A) Maintaining homeostasis
B) Processing sensory input
C) Secreting melatonin
D) Integrating motor activities
9. Sensory deprivation in infancy and childhood has adversely affected a boys brain development. Which characteristic of the brain was most directly involved in this process?
A) Neuroplasticity
B) Reactive plasticity
C) Adaptive plasticity
D) Synaptic plasticity
10. Rather than being 100%, concordance rates for schizophrenia in monozygotic twins are only 50%. Which of the following statements best explains this phenomenon?
A) Genetic predisposition to disease is frequently overstated.
B) One twin is inherently more vulnerable in every case.
C) Environmental experiences affect gene expression.
D) The genetic pathway responsible for vulnerability is unrelated to being a twin.

Chapter 03- Conceptual Frameworks and Theories
1. A psychiatricmental health nurse is aware of the importance of theories in the development and delivery of care. Which of the following is the best definition of a theory?
A) A group of related concepts or ideas
B) A persons or groups beliefs about how something happens or works
C) A prediction about two or more concepts
D) A researchable question related to health care
2. Which of the following explains why theories are important to psychiatricmental health nursing?
A) Theories provide more treatment options for clients.
B) Theories add professionalism to health care.
C) Theories simplify treatment decisions for most clients.
D) Theories lead to the expansion of knowledge.
3. A client has been told by a psychologist that memories in his unconscious are contributing to his depression. This reasoning implies that the psychologist ascribes to what theory?
A) Psychoanalytic theory
B) Behavior theory
C) Cognitivebehavioral theory
D) The humanistic perspective
4. A clients current plan of care includes interventions that are rooted in the concepts of reinforcement. Which theory of human behavior is being prioritized during this clients care?
A) Humanistic theory
B) Sociocultural theory
C) Behavioral theory
D) Psychoanalytic theory
5. A client and her therapist have been discussing the notion that her psychopathology results from the blocking or distortion of personal growth, excessive stress, and unfavorable social conditions. This discussion is congruent with what theory?
A) Humanistic theory
B) Interpersonal theory
C) Biophysiological theory
D) Sociocultural theory
6. During marital counseling, a man complains that his wife often bombards him with problems as soon as he settles down at home after work, which results in a prolonged argument. The wife admits that she does this but states she feels neglected and that her husband does not take the family problems seriously. She doesnt want her marriage to turn out like her parents marriage. The wife admits that she sometimes provokes an argument in order to gain her husbands attention. How would a behaviorist most likely explain the wifes actions?
A) She has repressed painful memories about her emotionally distant father and is working out her anger at the parent in the marital relationship.
B) Her thoughts about her parents unhappy marriage are a justification for her behavior.
C) She has an underlying anxiety disorder.
D) The long argument in which she and her husband participate positively reinforces her behavior.
7. An adult man recalls that he was teased as a child about his inability to participate in sports. He began to avoid situations in which others might evaluate his behavior. He seeks treatment now because he is an accomplished musician but cannot perform for an audience. According to behavioral theory, his behavior is an example of which of the following concepts?
A) Discrimination
B) Modeling
C) Generalization
D) Shaping
8. The nurse is working with a client who admits to having low self-esteem. The care team has determined that cognitive restructuring will likely enhance the clients self-esteem. Which of the following best describes the goals of this intervention?
A) Avoid negative self-talk
B) Replace negative self-talk with positive statements
C) Change distorted thinking and the subsequent behaviors
D) Use adaptive defense mechanisms
9. A 55-year-old woman is being treated for narcissistic personality disorder. The therapist demonstrates caring and appropriate regard for the client. The therapists behavior is an example of which concept of behavior theory?
A) Shaping
B) Discrimination
C) Modeling
D) Conditioning
10. In a group therapy session, group members confront a 35-year-old woman about her abuse of prescription pain medications. The woman states that, because a physician has prescribed her medication, she is not a drug addict. The nurse identifies this as an example of which of the following defense mechanisms?
A) Regression
B) Projection
C) Denial
D) Sublimation

Chapter 04- Evidence-Based Practice
1. The nurse demonstrates a commitment to the health, safety, and welfare of people by providing evidence-based practice. What does the term evidence-based practice mean?
A) Care that integrates research and clinical expertise with the clients characteristics, culture, and preferences
B) Care that bases decision making on established clinical protocols
C) Care based on prior outcomes from the nurses practice
D) Care based on outcomes and research conducted by the practitioner
2. Many pseudoscientific practitioners function openly and market themselves as mainstream therapists. Why does the public often respond favorably to unconventional therapies?
A) Pseudoscientific therapies are frequently more effective than conventional therapies.
B) Further advancements can be made in effective pseudoscientific treatments with continued practice.
C) Malpractice is minimized because pseudoscientific treatments are not empirically supported.
D) Some clients and families are disenchanted with the outcomes of professionally approved treatments.
3. Nursing is both an art and a science. Which statement best represents how evidence-based practice encompasses these two aspects of nursing?
A) The art of nursing has been replaced by evidence-based practice.
B) Multiple theoretical perspectives no longer guide evidence-based nursing care.
C) The art of nursing is demonstrated through carrying out the science of nursing in a skillful, knowledgeable, intelligent, and ethical manner.
D) The artful side of nursing is of less value to positive patient outcomes than is the science of nursing.
4. Evidence-based practice is based on the scientific method and empirical evidence. Which of the following is a principle of empirical evidence?
A) Scientific observations are subjective inferences made by the knowledgeable nurse researcher.
B) Empirical studies may be designed to report the physical and mental effects of subjective experiences.
C) Empirical evidence is not appropriate in the field of mental health because cognitions and emotions are subjective and unpredictable.
D) Empirical knowledge is verifiable only with valid and reliable measurement instruments.
5. The nurse is part of team conducting a research study that involves controlled observations. Controlled observations involve which of the following activities?
A) Putting information together to form a new understanding
B) Watching something carefully and noting events
C) Testing a hypothesis or prediction
D) Determining whether data are reliable and supportive
6. Two patients with schizophrenia have consented to be involved in clinical trials to determine the efficacy of a new antipsychotic medication. The researcher administers the new drug to one subject and a sugar pill to another subject. The patient who received the sugar pill received a treatment that is considered which of the following?
A) Sham treatment
B) Unethical treatment
C) Placebo
D) Supplemental therapy
7. A research team has been formed to study a new medication and its effects on depression. The researcher wants to use a design where neither the clients nor the research staff will know who is receiving the medication or the placebo. What type of study is this group conducting?
A) An empirical study
B) An evidence-based study
C) A case-control study
D) A double-blind study
8. A researcher is determining whether data that were obtained in a psychiatric nursing study are reliable and whether the data support the study hypothesis. In what part of the scientific process is the researcher functioning?
A) Experimentation
B) Analysis
C) Synthesis
D) Prediction
9. The nurse is working with a 42-year-old female patient who is mildly overweight. The patient expresses a desire to tone up before summer and is interested in trying an over-the-counter weight loss remedy. The nurse should perform health education related to what subject?
A) To be wary of any product that claims rapid or effortless results without exercise
B) The relatively low risk of using natural remedies
C) The small amount of active ingredient in most over-the-counter treatments
D) To choose a product that reports data indicating a high degree of effectiveness
10. Many people get health care information from the Internet. Hence, evidence-based health care can be threatened by the proliferation of pseudoscientific information available to the public. Which measure is currently being taken to prevent the misinformation of the healthcare consumer?
A) Evidence-based knowledge is currently only disseminated in professional journals and publications.
B) The Food and Drug Administration (FDA) has been denied the jurisdiction to prosecute unscrupulous internet marketers.
C) Public education is being performed by the Federal Trade Commission (FTC) through a campaign called Operation Cure All.
D) Websites publicizing misinformation on the Internet are being screened and blocked.

Chapter 05- Legal and Ethical Aspects
1. A psychiatricmental health nurse has been consistently aware of the need to adhere to standards of practice during interactions with clients and their families. What is a standard of nursing practice?
A) The body of text in the state nurse practice act
B) A document outlining minimum expectations for safe nursing practice
C) Unwritten but traditional practices that constitute safe nursing care
D) Part of the federal nurse practice act
2. Nursing students are reviewing the nurse practice act in the state where they reside. A states nurse practice act has which of the following functions?
A) Makes recommendations for how nurses should practice
B) Defines the scope and limit of nursing practice
C) Defines specific situations that constitute malpractice
D) Follows federal laws about nursing practice
3. A psychiatricmental health nurse has been named in a malpractice suit in which certain criteria have to be demonstrated by the clients legal team. Which of the following lists includes the correct criteria?
A) Duty of care, professional performance, injury related to the nurses action, action foreseeably could have caused the injury, and proven injury
B) Duty of care, professional performance, injury related to the nurses action, failure to document injury, and proven injury
C) Professional performance, injury related to the nurses action, action foreseeably could have caused the injury, and proven injury
D) Duty of care, professional performance, injury related to the nurses action, and action foreseeably could have caused the injury
4. A class of nursing students are learning how to protect themselves from liability for malpractice. How can the students best do this once they begin providing care for clients?
A) Know and follow the statutory and professional standards.
B) Avoid documenting incriminating information.
C) Carry individual malpractice insurance.
D) Request legal consultation from their employers.
5. A physician would like to include a client with schizophrenia in a research study testing a new medication. What is the nurses primary obligation in this situation?
A) Ensure the client knows what he or she is agreeing to when providing consent.
B) Help the client with revoking consent once the study has started.
C) Obtain informed consent when the primary provider cannot be present.
D) Persuade the client to consent, because the new drug has shown promising results.
6. An adolescent client has refused to wash or change his clothes for several days. He smells and looks filthy. Three male staff members approach him to escort him to the shower. The client resists and becomes combative when staff members insist. They place the client in seclusion and restraints and tell him that they will release him when he is calm and willing to shower. The clients rights have been which of the following?
A) Not been violated, because a degree of cleanliness is important
B) Been violated, primarily because he should not be forced to shower
C) Been violated, primarily because of the inappropriate use of restraints
D) Not been violated, because his combative behavior warranted seclusion and restraint to protect others
7. A client was admitted to a psychiatric facility because he was found walking around the street naked and talking incoherently. He has no known next of kin and has been adjudicated incompetent for the first time following a thorough assessment. He refuses any antipsychotic medications but has not been harmful to himself or others. What action should the facility take?
A) Initiate court proceedings to have a guardian named
B) Convince the client of his need for care
C) Continue custodial care
D) Contact social services to find outpatient housing
8. A client with a diagnosis of depression has been admitted to the health care facility. From a legal standpoint, clients hospitalized as voluntary admissions differ from other types of admissions in which of the following ways?
A) They can dictate their own plan of care independently.
B) They are considered legally competent.
C) They are considered a danger to themselves or others.
D) They cannot refuse treatment.
9. A 25-year-old man is seen standing on a rooftop. His employer calls the police and tells them the man had been behaving strangely. When the police arrive, the man states that he has special healing powers and no harm will come to him. The man believes the police have been provided to him as a courtesy, and he willingly accompanies them to a psychiatric facility. His admission is considered what?
A) Involuntary admission
B) Legal admission
C) Coerced admission
D) Emergency admission
10. A client with persistent depression is considering electroconvulsive therapy (ECT). The nurse has seen ECT be effective in other cases. When the client expresses fear and doubt about undergoing ECT, the nurse tries to talk him into taking it, truly believing it will help him. Which two ethical concepts are in conflict?
A) Beneficence and fidelity
B) Fidelity and paternalism
C) Paternalism and autonomy
D) Beneficence and autonomy

Chapter 06- Culture
1. A nurse who provides care in a diverse, urban center is aware of the importance of culture in the planning and delivery of psychiatricmental health care. Which of the following statements is the best brief definition of culture?
A) Culture refers to a persons racial background.
B) Culture refers to a persons religious and spiritual beliefs.
C) Culture is a shared structure for living.
D) Culture is a societys particular social norms.
2. A nurse has conducted a thorough assessment of a new clients cultural context prior to creating a care plan. Why is understanding a clients cultural context most important to a mental health worker?
A) Because it influences perceptions of health and illness
B) Because it influences the adoption of traditional gender roles
C) Because it helps the care provider avoid offending the client
D) Because it helps the care provider determine the clients prognosis
3. Long-term planning is taking place in a large, multisite health care system. Planning must reflect current demographics while anticipating future changes. If demographic predictions are accurate, which cultural group will constitute approximately 25% of the U.S. population by 2050?
A) White European Americans
B) African Americans
C) Hispanic Americans
D) Asian Americans
4. A group of psychiatricmental health nurses have completed an educational session on strategies for fostering cultural congruence. Cultural congruence is defined as:
A) Agreement between and among people of different cultural backgrounds
B) Assimilation of a minority culture into the dominant culture
C) Feelings of belonging despite cultural differences
D) The expression of personal and cultural validation
5. A nurse working in an urban clinic is gathering data about the use of preventive mental health services by the clinics clientele. The nurse is surprised to learn that more than 80% of the clients using this service are white, while the areas residents are predominantly African American and Asian American. Which of the following statements most likely explains the data?
A) The clinics white clients may value mental health services more than members of the other groups.
B) African Americans and Asian Americans may consider seeking mental health care to be a sign of weakness.
C) African Americans and Asian Americans may distrust the predominantly white mental healthcare system.
D) The clinics African Americans and Asian Americans may require mental health services less frequently than do their white counterparts.
6. An occupational health nurse is asked to see a Muslim employee, who is a recent immigrant to the United States. The client has been sent to the nurse because she appears weak. Her supervisor states that for several days the client has not eaten lunch with other employees as she had done formerly and refuses to join them despite repeatedly being asked to do so. The nurse suspects a cultural reason for the clients condition. Which step should the nurse take next?
A) Contact the clients husband for an explanation.
B) Ask the client if she is participating in a religious or cultural ritual.
C) Offer the client food to eat in the privacy of the nurses office.
D) Ask the client if she has been receiving treatment from a traditional healer.
7. A nurse previously set a goal of fostering transcultural nursing knowledge to provide better care for clients. Which of the following represents an action associated with the third phase of the development of transcultural nursing knowledge as defined by Leininger?
A) Developing a research study about the influence of religious beliefs on health-seeking behaviors
B) Implementing a different assessment tool in a mental health clinic after reading a research study about cultural barriers to thorough assessment
C) Assessing the culturally mediated beliefs of each client
D) Reading about Muslim and Hispanic cultures
8. Nurses cannot possibly learn all the variations that exist in culturally mediated beliefs. Which of the following approaches would be most helpful when caring for clients from other cultures?
A) Focus on the clients own constructs for health and illness.
B) Teach each client about the diversity of cultures that exists in the region.
C) Explain ones own cultural beliefs or the cultural expectations of the health care environment.
D) Allow the client to practice his or her religious rituals.
9. A psychiatricmental health nurse has become acutely aware that there are significant differences between Western psychiatric treatment modalities and those of other cultures. Which factor sets Western health care practices apart from the practices of other cultures?
A) A holistic approach to care
B) Reliance on technology
C) Belief in stress as the cause of most illnesses
D) A higher rate of successful treatment
10. A female nurse enters the room of a male client who is about to undergo a procedure. The client is a Cambodian monk, and the nurse knows that he is forbidden to be touched by a woman. When the nurse tries to apply cardiac monitoring leads to his chest, the client recoils in horror. The nurse is angry and insulted. Which of the following statements best explains the nurses reaction?
A) The nurse is demonstrating a lack of self-knowledge.
B) The nurse understands she has made a mistake.
C) The nurse is justified, because the client also should be aware of his own cultural beliefs.
D) The nurse is justified, because some touching during the delivery of care is unavoidable.

Chapter 07- Spirituality in Psychiatric Care
1. A psychiatric nurse has facilitated a patients recent attendance at a church service and has arranged for another to attend his nephews bar mitzvah. These are examples of:
A) Religious practices
B) Spiritual beliefs
C) Cultural values
D) Social customs
2. Different individuals and groups conceptualize spirituality in different ways. What is a central component of a definition of spirituality?
A) The belief in eternal life
B) The belief in God
C) The belief in a power apart from ones own existence
D) The connection between spirituality and religion
3. A nurses colleague has questioned the objective usefulness of spirituality and religious practices. Which of the following statements best describes a connection between religious involvement and health that the nurse could cite?
A) There is little or no relationship between religious involvement and improved health.
B) Religion is related to better mental health but has no effect on physical health.
C) Better physical and mental health and a healthier lifestyle are associated with religious practice.
D) There are better subjective feelings of health but no demonstrable effects on longevity.
4. A team of psychiatric nursing researchers have encountered difficulty while attempting to plan a research study addressing patients and clients spirituality. Which of the following factors would have the most influence on improving the research into spiritual and religious effects on health?
A) More rigorous study design
B) Increased research funding
C) Better control of confounding variables
D) Consistent definition of terms
5. A psychiatricmental health nurse is aware that spiritually based interventions must be carefully matched with individual clients. For which of the following clients would spiritual interventions be most appropriate?
A) A client who has a difficult relationship with her parents and who has indicated a willingness to seek change
B) A client who believes God is speaking to him in an audible voice throughout the day
C) A client with a diagnosis of schizophrenia who believes he is all-powerful
D) A client with postpartum depression who believes her children are in danger of becoming possessed by demons
6. The nurse is interviewing a client who states that she lives alone and follows no religion. The nurse contemplates how lonely the client must be, living by herself and having no religious community for support. The nurses thoughts reflect what?
A) Empathy
B) Lack of self-awareness
C) Prejudice
D) Compassion
7. A client is his early 30s has just experienced the end of a 2-year relationship with a woman he planned to marry. The client states that he is confused about his life and feels hopeless about his future. Which of the following nursing responses would be most therapeutic?
A) Suggest he give himself time to get over the failed relationship
B) Ask him what is most important to him in his life
C) Tell him many other women are available and that he will meet someone when the time is right
D) Suggest that the client explore the possibility of antidepressant medication
8. The nurse is assessing a client with depression. Which of the following questions will be most helpful in determining if the client has spiritual needs?
A) How is religion or spirituality important to you in this illness?
B) Do you attend church regularly?
C) Would you like to discuss your religious beliefs?
D) What religious rituals are important to you?
9. A female psychiatricmental health nurse has asked whether the client has a deep faith. The nurse states that people with strong religious beliefs have better health outcomes and suggests that the client return to the religious practices of his childhood. Are the nurses comments a cause for ethical concern?
A) No, because she has not tried to force her own religious views on the client
B) No, because her suggestions are within the scope of nursing practice
C) Yes, because she is not an expert in the area, yet her professional status implies that her advice is expert
D) Yes, because her views are paternalistic
10. A client who is receiving care on an inpatient basis tells the nurse he would like to develop his spiritual self. He asks the nurse how he can do so. Which of the following responses is best?
A) Would you like to speak with a chaplain?
B) Some people pray, read religious texts, or keep a journal to gain spiritual insight. You might start by keeping a journal.
C) The concepts of repentance and forgiveness are useful. Would you like to try that?
D) I suggest you use meditation to help you gain spiritual insight. You dont have to be any particular religion to do it.

Chapter 08- Nursing Values, Attitudes, and Self Awareness
1. After caring for a psychiatricmental health client suffering from schizophrenia, a nurse begins to analyze his attitudes and assumptions about individuals with this condition. This nurse is attempting to achieve a higher level of what?
A) Self-awareness
B) Client bias
C) Self-actualization
D) Client awareness
2. It is not uncommon for new psychiatricmental health students to be fearful of interacting with individuals suffering from mental illness. The fear and misunderstanding of those with mental illness are known as which of the following?
A) Discrimination
B) Bias
C) Prejudice
D) Stigma
3. A group of recent nursing graduates are discussing the numerous sources of stigmatization of those with mental illness. Which of the following has contributed most significantly to this phenomenon?
A) The psychotic symptoms displayed in the community by those who suffer from phobias
B) Intense media coverage about mental illness and the accurate portrayal of symptoms experienced by those with mental illness
C) Films that show what the experience of visual hallucinations can be like for someone who is mentally ill
D) Dramatic and inaccurate depictions of individuals with mental illness in movies and literature
4. A public health campaign has been launched to address some of the myths surrounding mental illness. What are shared values, norms, or beliefs that bind groups together and that may underlie myths?
A) Essentials
B) Ideologies
C) Belief systems
D) Global morals
5. A community health nurse has been asked to develop a plan to improve the local communitys negative attitudes toward those suffering from mental illness. Which of the following would best assist the nurse in accomplishing this goal?
A) Read a book about people who suffer from mental illness and try to understand the clients perspective.
B) Interview clients suffering from various mental illnesses.
C) Identify myths underlying the negative attitudes in the community and improve factual information about mental illness.
D) Read descriptions of mental illness from the Diagnostic and Statistical Manual (DSM) to individuals in the community.
6. While completing a rotation in a mental health facility, you are observing a client who is becoming increasingly agitated. He begins yelling at other clients and then picks up a chair and throws it against a wall. You are asked to document what you witnessed. Which of the following would be the most appropriate documentation?
A) Client is engaging in attention-seeking behavior and is argumentative and disruptive.
B) Client is acting crazy by yelling at other clients and throwing objects.
C) Client is displaying aggression including yelling at other clients and throwing a chair.
D) Client is a psycho, is argumentative, aggressive, and disruptive.
7. After having a conversation with a depressed client, a nurse is thinking about possible factors that may explain why the client is depressed. This nurses thinking exemplifies which of the following?
A) Attribution theory
B) Assumption theory
C) Dispositional theory
D) Situational theory
8. Two junior nursing students are discussing their beliefs about the root causes of mental illness. One nurse states that mental illness is caused by genetic and personality factors. Personal qualities that are cited as the cause of a behavior or action are known as which of the following?
A) Attribution factors
B) Assumption factors
C) Dispositional factors
D) Situational factors
9. The brother of a client with bipolar disorder states that he believes his brothers disorder is a result of the unhealthy interactions he had with his parents and peers while growing up. What are outside elements that influence a persons behavior called?
A) Attribution factors
B) Assumption factors
C) Dispositional factors
D) Situational factors
10. Clients who are admitted to mental health facilities are a vulnerable population. Actions that a nurse might never engage in as an individual may be demonstrated in a group setting due to perceptions of:
A) Power
B) Knowledge
C) Inferiority
D) Insight

Chapter 09- The Nursing Process in Psychiatric-Mental Health Care
1. A psychiatricmental health nurse is applying the nursing process during interactions with a client who has bipolar disorder. The nursing process is best described as:
A) A linear procedure for risk management
B) A framework for critical thinking about nursing care
C) An educational tool that enhances care and learning
D) A framework for documenting the plan of care
2. A nurse awaits the arrival of a client who is being transferred from another health care facility. The client has a history of schizophrenia and has been experiencing an exacerbation of symptoms. The nurse begins preparing the plan of care by outlining expected outcomes. How should this nurses action be interpreted?
A) It is consistent with the nursing process, because goals should be identified before interventions.
B) It is inconsistent with the nursing process, because assessment always comes first.
C) It is consistent with the nursing process, because the goals generally will be applicable to all clients with schizophrenia.
D) It is inconsistent with the nursing process, because the nurse should establish goals with the client.
3. A nurse has begun to implement the nursing process by performing a comprehensive assessment of a new client. Which of the following is the best example of assessment?
A) Monitoring behavior and mental status after administering an antipsychotic
B) Determining if the client has benefited from stress management education
C) Asking the wife of a comatose client if the client has a history of diabetes
D) Teaching the client to self-monitor heart rate with aerobic activity
4. When developing a nursing diagnosis during the care of a client, the nurse begins by considering the fundamental idea that is being addressed. What axis is this nurse considering?
A) Judgment
B) Status
C) Subject
D) Diagnostic concept
5. The client and nurse have agreed that a goal of care is for the client to manage conflict assertively. After learning assertiveness techniques, the client feels ready to practice them. The nurse correctly applies knowledge of the evaluation step of the nursing process and demonstrates skill by doing what?
A) Documenting that the goal has been met
B) Suggesting that the client attend assertiveness training classes before documenting that the goal has been met
C) Waiting to hear how the client has put the skills into practice before documenting that the goal has been met
D) Asking the client to restate the techniques before documenting that the goal has been met
6. A client relates that since the tragic death of her husband 3 years earlier, she has ceased to participate in social activities and spends much of her time looking at old photo albums. She states that thinking about enjoying herself causes her to feel guilty and anxious. Which of the following diagnoses is most applicable?
A) Anxiety related to fear of social interaction as evidenced by statements about feeling nervous and guilty
B) Impaired Social Interaction related to lack of desire for social contact as evidenced by anxiety
C) Dysfunctional Grieving related to death of husband as evidenced by reliving past experiences and feelings of guilt and anxiety
D) Spiritual Distress related to death of husband as evidenced by restricted lifestyle, anxiety, and guilt
7. A nurse develops a plan of care for a client who has been diagnosed with an eating disorder. The plan includes developing a contract with the client to modify behavior. What is the next step?
A) Implement nursing actions that have been identified.
B) Evaluate the effectiveness of the contract.
C) Diagnose the client with Ineffective Coping as evidenced by need to binge and purge to manage stress.
D) Assess the clients current weight and body mass index.
8. After completing an assessment of a new client, the psychiatricmental health nurse has identified priority nursing diagnoses. Which of the following is the most accurate definition of a nursing diagnosis?
A) A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes
B) A statement about client problems that can be treated by independent nursing interventions
C) A clinical judgment about individual, family, or community responses to actual health problems/life processes
D) A statement about client/community problems that can be treated by independent nursing interventions
9. A psychiatricmental health nurse has identified nursing diagnoses relevant to a clients care. The organization of the clients nursing diagnoses is based on groups with common factors. This organizing scheme is known as what?
A) Clusters
B) Taxonomy
C) Axes
D) Levels
10. A nurse has collaborated with a client who has schizophrenia and identified outcomes relevant to the clients care. Which of the following represents a realistic and measurable outcome for the client?
A) The client will feel better 1 month after initiating therapy.
B) The client will participate in milieu activities.
C) The client will wash daily and come to the dining hall at dinnertime.
D) The client will gain insight into his mental health issues.

Chapter 10- The Interview and Assessment Process
1. The nurse is conducting an admission interview with a psychiatricmental health client. The nurse notes that the client has a flat affect and the client reports he has been feeling depressed. What activity is the nurse engaging in?
A) Assessment
B) Planning
C) Evaluation
D) Data collection
2. After conducting an interview with a psychiatricmental health client, the nurse writes in the nurses notes that the client possesses poor insight. What activity is the nurse engaging in?
A) Assessment
B) Planning
C) Evaluation
D) Data collection
3. A recently graduated psychiatricmental health nurse is feeling highly anxious before conducting an interview with a client. This feeling of anxiety is likely to be:
A) Beneficial to the interaction by increasing the nurses focus and attention
B) Detrimental to the interaction by decreasing the nurses focus and attention
C) Beneficial to the interaction by increasing the clients self-awareness
D) Detrimental to the interaction by decreasing the clients self-awareness
4. Jillian, a psychiatricmental health nurse, has initiated a process recording after gaining the consent of the client. What is the purpose of process recording?
A) It allows the nurse to see what effect his or her communication style has on the client.
B) It allows the nurse to identify abnormalities in the clients communication techniques.
C) It allows the client to explore alternate communication techniques that can be used.
D) It allows the client to identify characteristics of his or her communication style.
5. During a particularly busy time on the psychiatric unit, the nurse has been asked to identify a location to conduct an interview with a psychiatricmental health client. What factor should the nurse prioritize when choosing a location?
A) The amount of lighting in a given location
B) The clients right to a stress-free environment
C) The clients right to privacy
D) The numbers of distracters in a given location
6. A psychiatricmental health nurse has identified a suitable location in which to conduct a client interview. Which of the following seating arrangements in the room is likely to be the least threatening to the psychiatricmental health client?
A) Sitting at an angle, 4 to 5 feet apart
B) Sitting face to face, 4 to 5 feet apart
C) Sitting at an angle, 1 to 2 feet apart
D) Sitting face to face, 1 to 2 feet apart
7. A psychiatricmental health nurse is using the PERSONS tool to collect data in the initial interview with a client. Under the first S of this tool, the nurse would assess which of the following?
A) Safety
B) Self-efficacy
C) Symptoms
D) Substance use
8. While conducting an admission interview with a client in the emergency department, the nurse suspects that the client may be a heavy user of alcohol. Which of the following assessment tools can help the nurse screen for potentially problematic alcohol use?
9. A nurse is conducting a review of systems during a comprehensive assessment of a psychiatricmental health client. Which of the following questions would most likely be included in this assessment?
A) Do you take any medications?
B) How often do you drink alcohol?
C) Do you have any numbness or tingling anywhere?
D) How would you describe your life growing up?
10. A client has been brought to the emergency department displaying symptoms that suggest the need for a mental status examination. Which of the following should the nurse include in this assessment?
A) A review of basic physiological function
B) Evaluation of the clients insight and judgment
C) Questions regarding the clients past behaviors
D) Evaluation of the clients medication compliance

Chapter 11- Therapeutic Relationships and Communication
1. A nurse learns that a distant family friend has been admitted to the inpatient psychiatric unit where the nurse works. The nurse understands that it is not acceptable to discuss this with family or neighbors, because doing so would breach the clients confidentiality. Confidentiality is a central component of what element of the therapeutic relationship?
A) Competence
B) Sympathy
C) Trust
D) Autonomy
2. The nurse provides a new client with information about the antidepressant he has been prescribed and refers him to a community support group. What essential element of a therapeutic relationship is the nurse demonstrating?
A) Empowerment
B) Fidelity
C) Professionalism
D) Recovery
3. During an assessment interview, a client frequently expresses concern about how her mental health problems will affect her grandmother. The clients grandmother, mother, and father attend a family session, during which the nurse frequently acknowledges the grandmother. In doing so, the nurse is demonstrating what?
A) Confidentiality
B) Empathy
C) Trust
D) Respect
4. The parents of a teenage client meet with the nurse for the first family session following the clients recent suicide attempt. The nurse expresses empathy with the parents about the stress and worry they have felt over the clients condition. Which of the following reasons most likely explains the nurses action?
A) The nurse wishes to show respect for the family.
B) The nurse wants to offset the mothers protective behaviors.
C) The nurse wants to take the focus off the mother.
D) The nurse is unable to create distance from the family.
5. An adult client has a history of severe psychological abuse by her mother, who has schizophrenia. The nurse plans to ask the client details about each incident of the abuse and how it has affected her sense of self-esteem. This is an example of what kind of intervention?
A) Caring
B) Excessive probing
C) An opportunity to build trust
D) A judgmental attitude
6. A male client was discharged from care several months ago after successful treatment for depression. Now, the client is back in the health care facility with severe depression, and all the former issues have returned. The nurse says to a coworker, This is unbelievable; were back at square one again. He should know better at this point. The nurses comments reflect what?
A) Countertransference
B) A judgmental attitude
C) An acceptable level of frustration
D) Her underlying concern for the client
7. A nurse is conducting a life skills program for people who have mental illness. A young adult with schizophrenia asks the nurse to call her on the weekends so she has someone to talk to who really cares about her. Which of the following actions should the nurse take?
A) Tell the client she will call once per week during office hours so that the client can practice phone skills
B) Tell the client firmly that such a request is an inappropriate violation of their professional relationship
C) Temporarily call the client once each weekend to build trust
D) Tell the client to call the office answering service in case of an emergency
8. A nurse therapist recently began meeting with a client in an effort to address some of the clients symptom-management strategies. Which of the following actions by the nurse or client represents the working phase of the therapeutic relationship?
A) Setting goals
B) Communicating interest in the client
C) Identifying past ineffective behaviors
D) Reviewing work that has been done
9. During a therapy session, the nurse states, So youre saying that youve tried many techniques for dealing with your anxiety but havent felt any better? This is an example of which of the following therapeutic communication techniques?
A) Validating
B) Paraphrasing
C) Confirming
D) Offering a broad opening
10. A client says to the nurse, Nobody cares about anything I say; even you dont! Which of the following responses is most therapeutic?
A) Why do you say I dont listen to you?
B) It sounds like youre overreacting somewhat.
C) It sounds like youre feeling ignored.
D) I listen to you.

Chapter 12- Working With the Multidisciplinary Team
1. The nurse is admitting a patient whose present health condition has led to a sharp decline in her performance of activities of daily living. After the admission assessment, the nurse collaborates with the physician and arranges for an occupational therapist to assess the patients needs. The nurse suggests this consult for which primary purpose?
A) To reduce the work load of nursing staff
B) To complete the treatment plan in a timely manner
C) To expand the nurses scope of practice
D) To enhance the clients health outcomes
2. The school nurse would most likely be involved in a team in formulating an individualized education program (IEP) for which of the following students?
A) An 8-year-old with a history of aggressive behavior toward peers
B) A 14-year-old whose father has recently been called into military service
C) A 9-year-old who has just moved to the area from out of state
D) A 10-year-old who has tested at a level of gifted intelligence
3. The nurse is part of a multidisciplinary team for a 10-year-old girl who has a history of self-mutilation. As the team members develop a behavior plan of care, the nurse should prioritize what action?
A) Encourage the girl to get involved in extracurricular activities to distract herself from self-destructive urges.
B) Take a nursing history to confirm a diagnosis of borderline personality disorder.
C) Review her academic record to document that she qualifies for extra assistance.
D) Outline a behavior contract with the girl delineating the consequences of self-destructive behavior.
4. The school nurse is meeting with a child whose grades have declined over the past several months. The boys teacher states that the child squints when looking at the whiteboard and reads at a very close distance to his books. The nurse would refer this information and submit a request for a consult with whom?
A) A social worker
B) A physical therapist
C) An occupational therapist
D) A special education teacher
5. The nurse is working in an after-school activities program for children with developmental disabilities. The nurse notes one young boy sitting out most of the exercises. The nurse learns that the child needs physical therapy, but his parents cannot afford the treatments. The nurse submits a request for a consult with which member of the multidisciplinary team?
A) The dietician
B) The social worker
C) The occupational therapist
D) The child psychologist
6. Tony, a 7-year-old boy, has been acting out in class. The school psychologist wants to determine what affective, cognitive, and environmental factors may be contributing to this. Which assessment would best achieve this goal?
A) Functional Behavioral Assessment (FBA)
B) Sensory Integration Assessment (SIA)
C) Individualized Education Assessment (IEA)
D) Service Coordination Assessment (SCA)
7. Samantha, an 8-year-old girl, has been experiencing problems in school and is demonstrating speech and language delays. She is diagnosed with sensory integration dysfunction and is scheduled to meet with an occupational therapist (OT). The OTs role will most likely include what?
A) Determining what dietary interventions will help Samantha with her condition
B) Providing Samantha with sensory information to help organize the central nervous system
C) Providing Samantha with individual counseling to address behaviors that interfere with learning
D) Promoting and enhancing Samanthas coping and problem-solving abilities
8. A 27-year-old woman has just been admitted to a drug and alcohol rehabilitation facility for abuse of prescription Oxycontin. The dietitian visits the patient during her first day of treatment for which purpose?
A) Assessing the changes in eating patterns that are symptomatic of many mental disorders
B) Assessing any nutritional factors that may be contributing to cognitive, emotional, and behavior problems
C) Changing the patients diet to match her psychotropic medication regimen
D) Planning an educational component on nutrition and health maintenance as part of the treatment and discharge plan
9. A 55-year-old client has a complex medical and psychiatric history and uses mental health services at a variety of sites. Who is the team member most often serving as a liaison, ensuring that the team is aware of the patients current needs and progress and that the necessary services are being provided?
A) Psychiatrist
B) Psychologist
C) Social worker
D) Occupational therapist
10. The home health nurse has been providing care for an elderly married couple. The wife underwent knee replacement surgery 3 weeks ago. The husband calls the nurse because he is worried that his wife has little motivation to perform her rehabilitation exercises. The husband states that his wife has also been behaving in a paranoid and emotionally erratic manner. Considering the possible impact of the wifes recent immobility and medications, the nurse notifies which member of the multidisciplinary team?
A) The psychologist
B) The psychiatrist
C) The mental health clinical nurse specialist
D) The social worker

Chapter 13- Individual Therapies and Nursing Interventions
1. A client with post-traumatic stress disorder (PTSD) has begun a course of treatment that includes psychotherapy. Psychotherapy is best described as which of the following?
A) Psychotherapy is synonymous with psychoanalysis.
B) Psychotherapy is a process of helping clients make adaptive changes in their lives.
C) Psychotherapy is a form of beneficial behavior modification that is necessary for health.
D) Psychotherapy is used solely for clients with Axis I disorders.
2. A new client is surprised to learn that his plan of care will not likely include psychoanalysis sessions, since he previously assumed that these were a cornerstone of treatment. Which of the following statements offers the most likely explanation for the decline in the use of Freudian psychoanalysis?
A) Insurers will often not cover the costs.
B) It involves too many diagnostic tests.
C) It can make clients worse.
D) It does not require a trained therapist.
3. A nurse therapist feels emotionally drained after sessions with a client. The clients passiveness reminds the therapist of a family member who led a very unhappy life. What is the term for this emotional dynamic?
A) Transference
B) Countertransference
C) Free association
D) Reaction formation
4. A client has recently completed her first session of cognitive therapy. Within this treatment modality, the term cognition refers to what?
A) The neurological deficits that result in her abnormal behavior
B) How a client thinks about herself and her world
C) The clients ability, or inability, to process stimuli
D) Dysfunctional ways of responding to situations
5. An APRN-PMH is participating in cognitive therapy with a client who has a diagnosis of obsessive-compulsive disorder. The nurse is aware of Becks cognitive triad when working with this client. Becks cognitive triad consists of which of the following?
A) Self, the world, and the future
B) Others, the past, and the future
C) Self, others, and the present
D) Self, the world, and the present
6. A client states that she is anxious about leaving a group home because she has not worked in many years. Using Becks cognitive triad, the nurse understands that the client is concerned primarily about what?
A) Threats from the world
B) Threats to her self
C) Threats about her future
D) Threats from her past
7. A 37-year-old woman who is counseling characterizes her life as an abject failure, despite the fact that she has a healthy, stable family and has built a successful business with her husband. What does this womans thinking represent?
A) Rationalization
B) Cognitive distortion
C) Delusional thinking
D) Self-aggrandizement
8. A client grew up in an isolated subculture that had a rigid understanding of religious belief and expression. The accumulation of this persons learning and experience that results in core beliefs is known as what?
A) Schema
B) Culture
C) Endowment
D) Worldview
9. A client in therapy has been postponing speaking to her mother about a traumatic event in her childhood. The client cries when she thinks about bringing this up, saying, Ill fall apart, and it will kill her. Which of the following responses by the nurse is most appropriate?
A) What evidence do you have that that will happen?
B) What is the worst thing that could happen if you spoke to her?
C) What other options do you realistically have at this point?
D) Falling apart about this may be a turning point for you.
10. During dialectical-pharmacologic behavior therapy (DBT), the therapist is actively listening and is accurately reflecting the clients spoken and unspoken feelings. What is this core strategy of DBT known as?
A) Criticism
B) Validation
C) Client acceptance
D) Contradiction

Chapter 14- Groups and Group Interventions
1. A nurse recognizes that individuals typically belong to several different groups simultaneously. A group that a person voluntarily joins because of common interests with the other members is:
A) A formal group
B) A secondary group
C) A primary group
D) An informal group
2. An ongoing support group for new mothers of children with autism has been meeting for several months. A new member comments that she does not have time to come to a group just to talk. Other members meet the womans comments with silence. Which of the following statements best explains this situation?
A) The new member is insecure.
B) The group is closed to outsiders.
C) The new member has violated group norms.
D) The group has not accepted the new member.
3. Which of the following statements would be associated with autocratic leadership?
A) Id like you all to develop an action plan and send it to me on Friday.
B) Lets go around the table and hear everyones input on this problem.
C) Those are the issues; let me know when you have a plan to deal with it.
D) How do you all think that we should best deal with this?
4. A nurse therapist is forming a support group for the family members of clients who have schizophrenia. The therapist understands that group dynamics will result in various members assuming certain roles. Which of the following are the three major categories of group roles?
A) Building and maintenance, task, and individual
B) Harmonizer, gatekeeper, and follower
C) Aggressor, recognition seeker, and blocker
D) Information giver, coordinator, and information seeker
5. A therapy group is in session, and one member shares that she feels hopeless about her future. Another member responds by saying, I felt hopeless once, but then I went back to school to better myself. It was hard; sometimes I dont know how I did it. But I got great grades, the kids turned out well, and I have a well-paying job. Anyone who wants to can do it. This group member is playing what role?
A) Group task role
B) Group building role
C) Individual role
D) Group maintenance role
6. One member of a substance-abuse recovery group consistently performs an individual role during the groups meetings. Individual roles typically have what effect on group functioning?
A) Disrupt group functioning
B) Enhance group functioning
C) Encourage the contributions of others
D) Have no effect on group functioning
7. A group of women recovering from intravenous drug use meets weekly. One member, who has been a powerful presence, has missed several consecutive meetings. When she returns, she explains her prolonged absence in vague terms. Another group member suspects she is using drugs, but does not share this with the group. Instead, she appears mildly disinterested in the other members explanation. This is an example of what type of communication?
A) Content communication
B) Latent communication
C) Manifest communication
D) Indirect communication
8. In group, Rosario talks about how stressful and important her job is. Debbie comments that Rosario seems to think she is better than the rest of us. Another member rushes to defend Rosario and says she does not understand why everyone wants to tear Rosario apart. This dynamic illustrates what phenomenon?
A) Content communication
B) Group process
C) Transference
D) Countertransference
9. The nurses on a psychiatric unit are informed that their manager will be leaving for a few weeks because she requires medical care. The manager typically makes the schedule, fills in if needed, and handles all conflicts or unit difficulties. The nurse administrator calls a meeting of the staff nurses and asks them to come up with a plan for how to handle the unit in the managers absence. Which of the following group reactions suggests that the group is in the mature stage of development?
A) The nurses discuss various options. Although there is conflict, everyone tries to cooperate.
B) The nurses are unsure how to proceed and ask their manager what she would like them to do.
C) The nurses are upset about their managers illness and the consequences of it but are supportive. Initially, they feel disorganized but then begin developing a plan.
D) The nurses begin trying to problem solve. They realize they cannot reach a decision how to proceed and inform the nurse administrator.
10. A group of nursing students have been assigned the task of teaching a module on mental health assessment during their problem-based learning class. Which of the fo

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