(Test Bank) Essentials Of Psychiatric Mental Health Nursing: Concepts Of Care In Evidence-Based Practice

Townsend,Morgan, 7

Nursing

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7th Edition

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Test Bank for Essentials Of Psychiatric Mental Health Nursing: Concepts Of Care In Evidence-Based Practice, The downloadable file consists of 421 pages, and the total size of the file is 10.75 MB. Purchase now only for highly discounted price.

Author(s): Townsend, Morgan

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Copyright © 2017 F. A. Davis Compa ny Chapter 1: Mental Health and Mental Illness Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client’s appetite, sleep patterns, an d daily routine have not changed. How should the nurse interpret the client’s behaviors? 1. The client’s behaviors demonstrate mental illness in the form of depression. 2. The client’ s behaviors are extensive, which indicates the presence of mental illness. 3. The client’s behaviors are not congruent with cultural norms. 4. The client’ s behaviors demonstrate no functional impairment, indicating no mental illness. ____ 2. At what point should the nurse determine that a client is at risk for developing a mental illness? 1. When thoughts, feelings, and behaviors are not reflective of th e DSM -5 criteria. 2. When maladaptive responses to stress are coupled with interference in daily functioning. 3. When a client communicates significant distress. 4. When a client uses defense mechanisms as ego protection. ____ 3. A nurse is assessing a set of 15 -year-old identical twins who respond very differently to stress. One twin becomes anxious and irri table, and the other withdraws and cries. How should the nurse explain these different stress responses to the parents? 1. Reactions to stress are relative rather than absolute; individual responses to stress vary. 2. It is abnormal for identical twins to react differently to similar stressors. 3. Identical tw ins should share the same temperament and respond similarly to stress. 4. Environmental influences to stress weigh more heavily than genetic influences. ____ 4. Which client should the nurse anti cipate to be most receptive to psychiatric treatment? 1. A Jewish, female social worker. 2. A Baptist, homeless male. 3. A Catholic, black male. 4. A Protestant, Swedish business executive. ____ 5. A psychiatric nurse intern states, “This client’s us e of defense mechanisms should be eliminated.” Which is a correct evaluation of this nurse’s statement? 1. Defense mechanisms can be appropriate responses to stress and need not be eliminated. 2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. 3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not eliminated. 4. Defense mechanisms cause disintegration o f the ego and should be fostered and encouraged. Copyright © 2017 F. A. Davis Compa ny ____ 6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best response? 1. “It is just a routine part of our assessment . All cl ients are asked these same questions.” 2. “Why are you concerned about these types of questions?” 3. “Psychological factors, like excessive stress, have been found to affect medical conditions.” 4. “We can skip these questions, if you like. It i sn’t imperative that we complete this section.” ____ 7. An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee? 1. The employee assertively confronts the boss. 2. The employee leaves the staff meeting to work ou t in the gym. 3. The employee criticizes a coworker. 4. The employee takes the boss out to lunch. ____ 8. A fourth -grade boy teases and makes jokes about a cute girl in his class. This behavio r should be identified by a nurse as indicative of which defense mechanism? 1. Displacement 2. Projection 3. Reaction formation 4. Sublimation ____ 9. Which nursing statement about the concept of neurosis is most accurate? 1. An individual experienci ng neurosis is unaware that he or she is experiencing distress. 2. An individual experiencing neurosis feels helpless to change his or her situation. 3. An individual experiencing neurosis is aware of the psychological causes of his or her behavior. 4. An individual experiencing neurosis has a loss of contact with reali ty. ____ 10. Which nursing statement regarding the concept of psychosis is most accurate? 1. Individuals experiencing psychoses are aware that their behaviors are maladaptive. 2. Indiv iduals experiencing psychoses experience little distress. 3. Individuals experiencing psychoses are aware of experiencing psychological problems. 4. Individuals e xperiencing psychoses are based in reality. ____ 11. When under stress, a client routinel y uses alcohol to excess. Finding her drunk, her husband yells at the client about her chronic alcohol abuse. Which action alerts the nurse to the client’s use of t he defense mechanism of denial? 1. The client hides liquor bottles in a closet. 2. The clie nt yells at her son for slouching in his chair. 3. The client burns dinner on purpose. 4. The client says to the spouse, “I don’t drink too much!” Copyright © 2017 F. A. Davis Compa ny ____ 12. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief? 1. “If only we could have tried again, things might have worked out.” 2. “I am so mad that the children and I had to put up with him as long as we did.” 3. “Yes, it was a difficult relationship, but I think I have learned from the experience.” 4. “I still don’t have any appetite and continue to lose weight.” ____ 13. A nurse is performing a mental health assessment on an adult client. According to Maslow’s hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health? 1. Maintaining a long -term, faithful, intimate relationship 2. Achieving a sense of self -confidence 3. Possessing a feeling of self -fulfillment and realizing full potential 4. Developing a sense of purpose and the ability to direct activities ____ 14. According to Maslow’s hierarchy of needs, which situation on an inpatient psychiatric unit would requir e priority intervention by a nurse? 1. A client rudely complaining about limited visiting hours 2. A client exhibiting aggressive behavior toward another client 3. A client stating that no one cares 4. A client verbalizing feelings of failure ____ 15. How would a nurse best complete the new DSM -5 definition of a mental disorder? “A health condition characterized by significant dysfunction in an individual’s cognitions, or behaviors that reflect a dist urbance in …” which of the following? 1. Psychosocial, biological, or developmental process underlying mental functioning 2. Psychological, cognitive, or developmental process underlying mental functioning 3. Psychological, biological, or developmental process underlying mental functioning 4. Psychological, biological, or psychosocial process underlying mental functioning Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 16. A nurse is assessing a client who appears to be experiencing some anxiety during questioning. Which symptoms might the client demonstrate that would indicate an xiety? ( Select all that apply. ) 1. Fidgeting 2. Laughing inappropriately 3. Palpitations 4. Nail biting 5. Limited attention span Completion Complete each statement. 17. _______________________ i s a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness. Copyright © 2017 F. A. Davis Compa ny 18. _______________________ is a subjective state of emotional, physical, and social responses to the loss of a val ued entity.Copyright © 2017 F. A. Davis Compa ny Chapter 1: M ental Health and Mental Illness Answer Section MULTIPLE CHOICE 1. ANS: 4 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Discuss cultural elements that influence attitudes toward mental health and mental illness. Page: 9 Heading: Grief Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Grief and Loss Difficulty: Easy Feedback 1 The client’s behaviors are to be expected in a time of grief. 2 The client’ s behaviors are not presented as being extensive. 3 The client’s behaviors are to be expected after a loss. 4 The nurse should assess that the client’s daily functioning is not impaired. The client who experiences feelings of sadness after the loss of a pet is respondi ng within normal expectations. PTS: 1 CON: Grief and Loss 2. ANS: 2 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Define mental health and mental illness. Page: 3 Heading: Mental Illness Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback 1 The client with a mental illness would have symptoms that reflect the DSM -5. 2 The nurse should determine that the client is at risk for m ental illness when responses to stress are maladaptive and interfere with daily functioning. The DSM -5 indicates that in order to be diagnosed with a mental illness, daily functioning must be significantly impaired. 3 The client’s ability to communicate d istress would be considered a positive attribute. 4 The use of defense mechanisms does not indicate that the client is at risk for mental illness. Copyright © 2017 F. A. Davis Compa ny PTS: 1 CON: Stress 3. ANS: 1 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological responses to stress. Page: 7 Heading: Physical and Psychological Responses to Stress > Mild Anxiety Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Growth and Developm ent Difficulty: Easy Feedback 1 The nur se should explain to the parents that, although the twins have identical DNA, there are several other factors that affect reactions to stress. 2 It is considered normal for twins to react differently to stress. 3 Identical twins do not necessarily respond similarly to stress, due to differences in temperament and personality. 4 Environmental influences and temperament can affect stress reactions. PTS: 1 CON: Growth and Development 4. ANS: 1 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Discuss cultural elements that influence attitudes toward mental health and mental illness. Page: 4 Heading: Box 1 -1 Cultural Aspects of Mental Illness Integrated Processes: Nursing Process Client Need: Psych osocial Integrity Cognitive Level: Ap plication [Applying] Concept: Culture Difficulty: Easy Feedback 1 The nurse should anticipate that the client of Jewish culture would place a high importance on preventative health care and would consider mental healt h as equally important to physical health. 2 The homeless client may have difficulty accessing health ca re and may not place a high emphasis on mental health treatment. 3 Women are more likely to seek treatment for mental health problems than men. 4 This client is not typically as receptive to psychiatric treatment as the client of Jewish culture. PTS: 1 CON: Culture 5. ANS: 1 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological responses to stress. Copyright © 2017 F. A. Davis Compa ny Page: 7 Heading : Physi cal and Psychological Responses to Stress > Mild Anxiety Cognitive Level: Application [Applying] Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Concept: Stress Difficulty: Moderate Feedback 1 The nurse should determine t hat defense mechanisms can be appropriate during times of stress. 2 Defense mechanisms are not maladaptive attempts of the ego to manage anxiety. 3 Defense mechanisms are a normal part of coping with stress. They are not used by individuals with weak ego integrity. They should not be discouraged and eliminated. 4 Defense mechanisms are normal and are used by all individuals in some way during times of stress; they do not cause disintegrat ion of the ego. PTS: 1 CON: Stress 6. ANS: 3 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological responses to stress. Page: 9 Heading: Physical and Psychological Responses to Stress > Severe Anxiety Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback 1 This statement is not therapeutic to the client. 2 This statement is not therapeutic and may anger the client further. 3 The nurse should attempt to educate the client on the ne gative effects of excessive stress on medical conditions. 4 It is not appro priate to skip physiological and psychosocial questions, as this would lead to an inaccurate assessment. PTS: 1 CON: Stress 7. ANS: 3 Chapter: Chapter 1, Mental Health and Men tal Illness Objective: Identify physiological responses to stress. Page: 7 Heading: Table 1 -1 Ego Defense Mechanisms > Displacement Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Str ess Copyright © 2017 F. A. Davis Compa ny Difficul ty: Easy Feedback 1 Confronting others is not a behavior consistent with displacement. 2 Leaving the staff meeting is not a behavior consistent with displacement. 3 The nurse should expect that the cli ent using the defense mechanism displac ement would criticize a coworker after being confronted by the boss. 4 Taking the boss out to lunch is not a behavior consistent with displacement. PTS: 1 CON: Stress 8. ANS: 3 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological responses to stress. Page: 7 Heading: Table 1 -1 Ego Defense Mechanisms > Reaction Formation Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback 1 Displacement refers to transferring feelings from one target to another. 2 Projection refers to the attribution of unacceptable feelings or behaviors to another person. 3 The nurse should identify that the boy is using reaction formation as a d efense mechanism. Reaction formation is the attempt to prevent undesirable thoughts from being expressed by expressing opposite thoughts or behaviors. 4 Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable ac tivities. PTS: 1 CON: Stress 9. ANS: 2 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological responses to stress. Page: 9 Heading: Physical and Psychological Responses to Stress > Severe Anxiety Integrated Processes: N ursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback 1 The client is aware tha t he or she is experiencing distress. 2 The client feels helpless to change his or her situatio n. 3 The client is unaware of the psychological causes of the distress. 4 The client experiences no loss of contact with reality. Copyright © 2017 F. A. Davis Compa ny PTS: 1 CON: Stress 10. ANS: 2 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological r esponses to stress. Page: 6 Heading: Physical and Physiological Responses to Stress > Anxiety Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback 1 The client with psychosis is unaware that his or her behavior is maladaptive. 2 The nurse should understand that the client with psychosis experiences little distress owing to his or her lack of awareness of reality. 3 The client with psychosis is unawar e he or she has a psychological problem. 4 The client experiencing psychosis has a lack of awareness of reality. PTS: 1 CON: Stress 11. ANS: 4 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Identify physiological responses to stress. Page: 7 Heading: Table 1 -1 Ego Defense Mechanisms > Denial Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Addiction and Behav iors Difficulty: Easy Feedback 1 This behavior does not indicate denial. 2 Yelling at family members does not indicate denial. 3 Burning dinner on purpose is not an action that indicates denial. 4 The client’s statement “I don’t drink too much!” alerts the nurse to the use of the defense mechanism of den ial. The client is refusing to acknowledge the existence of a real situation an d the feelings associated with it. PTS: 1 CON: Addiction and Behaviors 12. ANS: 3 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Discuss the concepts of an xiety and grief as psychological responses to stress. Page: 10 Heading: Stages of Grief Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Copyright © 2017 F. A. Davis Compa ny Cognitive Level: Analysis [Analyzing] Concept: Grief and Loss Difficulty: Easy Feedback 1 This statement indicates denial. 2 This statement indicates anger. 3 The nurse should evaluate that the client is in the acceptance stage of grief because during this stage of the grief process, the client would be able to focus on the reality of the loss and its meaning in relation to life. 4 This statement indicates prol onged grieving. PTS: 1 CON: Grief and Loss 13. ANS: 3 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Define mental health and mental illness. Page: 3 Heading: Ment al Health Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Self Difficulty: Easy Feedback 1 This option is not the highest level on Maslow’s hierarchy of needs. 2 While this opti on is important, it is not the highest level on Maslow’s hierarchy of needs. 3 The nurse should identify that the client who possesses a feeling of self - fulfillment and realizes his or her full potential has achieved self -actualization, the highest level on Maslow’s hierarchy of needs. 4 This option is important for the development of the client, but is not the most important on Maslow’s hierarchy of needs. PTS: 1 CON: Self 14. ANS: 2 Chapter: Chapter 1, Mental Health and Mental Illness Objective: De fine mental health and mental illness. Page: 3 Heading: Mental Health Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Lev el: Analysis [Analyzing] Concept: Stress Difficulty: Easy Feedba ck Copyright © 2017 F. A. Davis Compa ny 1 Clients who complain are struggling with higher -level needs, such as the need for love and belonging or the need for self -esteem. 2 The nurse should immediately intervene when a client exhibits aggressive behavior toward another client. Safety and securi ty are considered lower -level needs according to Maslow’s hierarchy of needs and must be fulfilled before other higher -level needs can be met. 3 Clients who state that no one cares are struggling with higher -level needs such as the need for love and belon ging or the need for self -esteem. 4 Clients who have feelings of failure are struggling with higher -level needs, such as the need for love and belonging or the need for self -esteem. PTS: 1 CON: Stress 15. ANS: 3 Chapter: Chapter 1, Mental Hea lth and Mental Illness Objective: Define mental health and mental illness. Page: 4 Heading: Mental Illness Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Patient -Centered Care Difficulty: Easy Feedback 1 This option in not part of the DSM -5 definition of a mental disorder. 2 This option does not define the DSM -5’s mental disorder definition. 3 The new DSM -5 definition of a mental disorder is “A health condition characterized by significant dysfunction in an individual’s cognitions, or behaviors that reflect a disturbance in the psychological, biological, or develo pmental process underlying mental functioning.” 4 This option is incorrect, because it does not meet the definition set by the DSM - 5 for mental health disorders. PTS: 1 CON: Patient -Centered Care MULTIPLE RESPONSE 16. ANS: 1, 2, 4 Chapter: Chapter 1, Mental Health and Mental Illness Objective: Discuss the concepts of anxiety and grief as psychological responses to stress. Page: 7 Heading: Physical and Physiological Responses to Stress > Mild Anxiety Integrated Processes: Nursing Pro cess Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Copyright © 2017 F. A. Davis Compa ny Feedback 1. This symptom is a sign of anxiety. 2. This is a sympt om that the nurse would expect in a client experiencing anxiety. 3. The nurse would not expect the client to have palpitations. 4. This option indicates anxiety. 5. Limited attention span does not indi cate anxiety. PTS: 1 CON: Stress COMPLETION 17. ANS: Anxiety Chapter: Chapter 1, Mental Health and Mental Illness Objective: Discuss the concepts of anxiety and grief as psychological responses to stress. Page: 6 Heading: Core Concept > Anxiety Integrated Processes: Teaching and Learni ng Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback: The definition of anxiety is a diffuse apprehension that is vague in nature and is associated wi th feelings of uncertainty and helplessness. Townsend considers this a core concept. PTS: 1 CON: Stress 18. ANS: Grief Chapter: Chapter 1, Mental Health and Mental Illness Objective: Discuss the concepts of anxiety and grief as psychological responses to stress. Page: 9 Heading: Physical and Psychological Responses to Stress > Psychological Responses Integrated Processes: Nursing Process Client Need : Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Grief and Loss Difficulty: Easy Feedback: The definition of grief is a subjective state of emotional, physical, and social responses to the loss of a valued entity. Townsend considers this a core concept. PTS: 1 CON: Grief and Loss Copyright © 2017 F. A. Davis Company Chapter 2: Biological Implications Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A depressed client states, “I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again.” Which nursi ng response is appropriate? 1. “Medications only address biological factors. Environmental and interpersonal factors must also be considered.” 2. “Because biological f actors are the sole cause of depress ion, medications will improve your mood.” 3. “Environmental factors have been shown to exert the most influence in the development of depression.” 4. “Researchers have been unabl e to demonstrate a link between nature (biology and genetics) and nurture (e nvironment).” ____ 2. A client diagnosed with major depressive disorder asks, “What part of my brain controls my emotions?” Which nursing response is appropriate? 1. “The occipi tal lobe governs perceptions, judging them as positive or negative.” 2. “The parietal lobe has been linked to depression.” 3. “The medulla regulates key biological and psychological activities.” 4. “The limbic system is largely responsible for one’s emotional state.” ____ 3. Which part of the nervous system should a nurse id entify as playing a major role during stressful situations? 1. Peripheral nervous system 2. Somatic nervous system 3. Sympat hetic nervous system 4. Parasympathetic nervous system ____ 4. Which client statement reflects an understanding of circadian r hythms in psychopathology? 1. “When I dream about my mother’ s horrible train accident, I become hysterical.” 2. “I get really irritable during my menstrual cycle.” 3. “I’m a morning person. I get my best work done before noon.” 4. “Every February, I ten d to experience periods of sadness.” ____ 5. Which types of adoption studies should a nurse recognize as providing useful information for the psychiatric community? 1. Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy 2. Studies i n which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill 3. Studies in which monozygotic twins from mentally ill parents were raised separately by differ ent adoptive parents 4. Studies in which monozy gotic twins were raised together by mentally ill biological parents Copyright © 2017 F. A. Davis Company 5. All of the above ____ 6. Six months after her hu sband and children were killed in a car accident, a client is diagnosed with ulcerati ve colitis. The nurse should recognize that this situation validates which study perspective? 1. Neuroendocrinology 2. Psychoneuroimmunology 3. Diagnostic technology 4. Neurophysiology ____ 7. A withdrawn client, diagnosed with schizophrenia, express es little emotion and refuses to attend group therapy. What altered component of the nervous system should a nurse recognize as being responsible for this behavior? 1. Dendrites 2. Axons 3. Neurotr ansmitters 4. Synapses ____ 8. An instructor is teach ing nursing students about neurotransmitters. Which best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron? 1. Regeneration 2. Reuptake 3. Recycling 4. Retransmissio n ____ 9. A nurse c oncludes that a restless, agitated client is manifesting a fight -or-flight response. The nurse should associate this response with which neurotransmitter? 1. Acetylcholine 2. Dopamine 3. Serotonin 4. Norepinephrine ____ 10. A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client’s neurotransmitters should a nurse expect to be elevated? 1. Serotonin 2. Dopamine 3. Gamma -aminobutyric acid (GABA) 4. Histamine ____ 11. A client’s wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client’s therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist’s recommend ations? 1. The therapist is usi ng an interpersonal approach. 2. The client has an alteration in neurotransmitters. 3. It is routine practice to remind clients about nutrition, exercise, and rest. 4. The client is susceptible to illness because of effect s of stress on the immune syste m. ____ 12. Which mental illness should a nurse identify as being associated with an increase in prolactin hormone level?