,Chapter 01: Mental Health and Mental Illness
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Halter: Varcarolis’ Foundations of Psychiatric-
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Mental Health Nursing: A Clinical Approach, 10th Edition
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MULTIPLE CHOICE rx
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
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a. Conducting a mental health assessment. rx rx rx rx
b. Prescribing psychotropic medication. rx rx
c. Establishing a therapeutic relationship. rx rx rx
d. Individualizing a nursing care plan. rx rx rx rx
ANS: B r x
In most states, prescriptive privileges are granted to master’s-
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prepared nurse practitioners and clinical nurse specialists who have taken special courses on p
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rescribing medication. The nurse prepared at the basic level is permitted to perform mental he
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alth assessments, establish relationships, and provide individualized care planning.
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PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
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2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
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xskills.” Select the best response by the mental health nurse.
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a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
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client ratios must be better because of the nature of the clients’ problems.”
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b. “Psychiatric nurses use complex communication skills as well as critical thinking
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to solve multidimensional problems. I am challenged by those situations.”
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c. “That’s a misconception. Psychiatric nurses frequently use high technology
rx rx rx rx rx rx rx rx r
monitoring equipment and manage complex intravenous therapies.”
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d. “Psychiatric nurses do not have to deal with as much pain and suffering as
rx rx rx rx rx rx rx rx rx rx rx rx rx
medical–surgical nurses do. That appeals to me.”
rx rx rx rx rx rx rx
ANS: B r x
The practice of psychiatric nursing requires a different set of skills than medical–
rx rx rx rx rx rx rx rx rx rx rx rx
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help c
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
lients with medical as well as mental health problems, reflecting the holistic perspective these
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nurses must have. Nurse– rx rx rx
client ratios and workloads in psychiatric settings have increased, just like other specialties. P
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sychiatric nursing involves clinical practice, not just documentation.
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Psychosocial pain and suffering are as real as physical pain and suffering.
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PTS: r x r x 1 DIF: Cognitive Level: Apply (Application) rx rx rx
TOP: r x Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed wit
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h mental illness, a group of nurses write letters to their elected representatives in opposition
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
to the legislation. Which role have the nurses fulfilled?
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a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice rx
, ANS: C r x
An advocate defends or asserts another’s cause, particularly when the other person lacks the
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ability to do that for self. Examples of individual advocacy include helping clients understand
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their rights or make decisions. On a community scale, advocacy includes political activity, p
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
ublic speaking, and publication in the interest of improving the human condition. Since fundi
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ng is necessary to deliver quality programming for persons with mental illness, the letter-
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writing campaign advocates for that cause on behalf of clients who are unable to articulate t
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heir own needs. rx rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
4. A family has a long history of conflicted relationships among the members. Which family
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member’s comment best reflects a mentally healthy perspective?
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a. “I’ve made mistakes but everyone else in this family has also.”
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b. “I remember joy and mutual respect from our early years together.”
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c. “I will make some changes in my behavior for the good of the family.”
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d. “It’s best for me to move away from my family. Things will never change.”
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ANS: C r x
The correct response demonstrates the best evidence of a healthy recognition of the importa
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nce of relationships. Mental health includes rational thinking, communication skills, learning
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, emotional growth, resilience, and self-
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esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a hi
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gher level of mental health. The other incorrect responses show blaming and avoidance.
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PTS: r x r x 1 DIF: Cognitive Level: Analyze (Analysis) rx rx rx
TOP: r x Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
rx rx r x rx rx rx
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
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illness?
rx
a. reporting occasional sleeplessness and anxiety. rx rx rx rx
b. reporting a consistently sad, discouraged, and hopeless mood. rx rx rx rx rx rx rx
c. being able to describe the difference between “as if” and “for real.”
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d. experiencing difficulty making a decision about whether to change jobs. rx rx rx rx rx rx rx rx rx
ANS: B r x
The correct response describes a mood alteration, which reflects mental illness. The distracters
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describe behaviors that are mentally healthy or within the usual scope of human experience.
x rx rx rx rx rx rx rx rx rx rx rx rx rx
PTS: r x r x 1 DIF: Cognitive Level: Apply (Application) rx rx rx
TOP: r x Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
rx rx r x rx rx rx
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
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rx achieved for an adult client? rx rx rx rx
a. being willing to work towards achieving ideals and meeting demands.
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b. behaving without considering the consequences of personal actions.
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c. aggressively meeting personal needs without considering the rights of others. rx rx rx rx rx rx rx rx rx
d. seeking help from others to avoid assuming responsibility for major areas of own
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life. rx
, ANS: A r x
Mental health is a state of well- rx rx rx rx rx rx
being in which individuals reach their own potential, cope with the normal stresses of life, w
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
ork productively, and contribute to the community. Mental health provides people with the c
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apacity for rational thinking, communication skills, learning, emotional growth, resilience, an
rx rx rx rx rx rx rx rx rx rx
d self-
rx
esteem. The correct response describes an adaptive, healthy behavior. The distracters describ
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e maladaptive behaviors.
rx rx
PTS: r x r x 1 DIF: Cognitive Level: Apply (Application) rx rx rx
TOP: r x Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
rx rx r x rx rx rx
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Whi
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ch resource should the nurse consult to determine criteria used to establish this diagnosis?
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a. International Statistical Classification of Diseases and Related Health Problems
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x (ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
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c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) rx rx rx rx rx rx rx
d. A behavioral health reference manual
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ANS: C r x
The DSM- rx
V gives the criteria used to diagnose each mental disorder. It is the official guideline for diagn
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
osing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatr
rx rx rx rx rx rx rx rx rx rx rx rx
ic illness.
rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
would have the most complete information?
rx rx rx rx rx rx
a. Nursing Outcomes Classification (NOC) rx rx rx
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
rx rx rx rx rx rx rx rx rx
d. ICD-10
ANS: B r x
The DSM- rx
V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline f
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
or diagnosing psychiatric disorders. The other references are good resources but do not define
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
the diagnostic criteria.
rx rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
9. Which individual behavior demonstrates resilience?
rx rx rx rx
a. Repress stressors associated with a divorce. rx rx rx rx rx
b. Continuing to grieve the death of a spouse for 5 years. rx rx rx rx rx rx rx rx rx rx
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
d. Taking a temporary job to maintain financial stability after loss of a permanent
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x job.
ANS: D r x
rx rx rx rx rx rx
Halter: Varcarolis’ Foundations of Psychiatric-
rx rx rx rx
Mental Health Nursing: A Clinical Approach, 10th Edition
rx rx rx rx rx rx rx
MULTIPLE CHOICE rx
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
rx rx rx rx rx rx rx rx rx rx rx rx
a. Conducting a mental health assessment. rx rx rx rx
b. Prescribing psychotropic medication. rx rx
c. Establishing a therapeutic relationship. rx rx rx
d. Individualizing a nursing care plan. rx rx rx rx
ANS: B r x
In most states, prescriptive privileges are granted to master’s-
rx rx rx rx rx rx rx rx
prepared nurse practitioners and clinical nurse specialists who have taken special courses on p
rx rx rx rx rx rx rx rx rx rx rx rx rx
rescribing medication. The nurse prepared at the basic level is permitted to perform mental he
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
alth assessments, establish relationships, and provide individualized care planning.
rx rx rx rx rx rx rx rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
rx rx rx rx rx rx rx rx rx rx rx rx rx r
xskills.” Select the best response by the mental health nurse.
rx rx rx rx rx rx rx rx rx
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
rx rx rx rx rx rx rx rx rx
client ratios must be better because of the nature of the clients’ problems.”
rx rx rx rx rx rx rx rx rx rx rx rx rx
b. “Psychiatric nurses use complex communication skills as well as critical thinking
rx rx rx rx rx rx rx rx rx rx
to solve multidimensional problems. I am challenged by those situations.”
rx rx rx rx rx rx rx rx rx rx
c. “That’s a misconception. Psychiatric nurses frequently use high technology
rx rx rx rx rx rx rx rx r
monitoring equipment and manage complex intravenous therapies.”
x rx rx rx rx rx rx
d. “Psychiatric nurses do not have to deal with as much pain and suffering as
rx rx rx rx rx rx rx rx rx rx rx rx rx
medical–surgical nurses do. That appeals to me.”
rx rx rx rx rx rx rx
ANS: B r x
The practice of psychiatric nursing requires a different set of skills than medical–
rx rx rx rx rx rx rx rx rx rx rx rx
surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help c
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
lients with medical as well as mental health problems, reflecting the holistic perspective these
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
nurses must have. Nurse– rx rx rx
client ratios and workloads in psychiatric settings have increased, just like other specialties. P
rx rx rx rx rx rx rx rx rx rx rx rx rx
sychiatric nursing involves clinical practice, not just documentation.
rx rx rx rx rx rx rx
Psychosocial pain and suffering are as real as physical pain and suffering.
rx rx rx rx rx rx rx rx rx rx rx
PTS: r x r x 1 DIF: Cognitive Level: Apply (Application) rx rx rx
TOP: r x Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed wit
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
h mental illness, a group of nurses write letters to their elected representatives in opposition
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
to the legislation. Which role have the nurses fulfilled?
rx rx rx rx rx rx rx rx
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice rx
, ANS: C r x
An advocate defends or asserts another’s cause, particularly when the other person lacks the
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
ability to do that for self. Examples of individual advocacy include helping clients understand
rx rx rx rx rx rx rx rx rx rx rx rx rx
their rights or make decisions. On a community scale, advocacy includes political activity, p
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
ublic speaking, and publication in the interest of improving the human condition. Since fundi
rx rx rx rx rx rx rx rx rx rx rx rx rx
ng is necessary to deliver quality programming for persons with mental illness, the letter-
rx rx rx rx rx rx rx rx rx rx rx rx rx
writing campaign advocates for that cause on behalf of clients who are unable to articulate t
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
heir own needs. rx rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
4. A family has a long history of conflicted relationships among the members. Which family
rx rx rx rx rx rx rx rx rx rx rx rx rx
member’s comment best reflects a mentally healthy perspective?
rx rx rx rx rx rx rx rx
a. “I’ve made mistakes but everyone else in this family has also.”
rx rx rx rx rx rx rx rx rx rx
b. “I remember joy and mutual respect from our early years together.”
rx rx rx rx rx rx rx rx rx rx
c. “I will make some changes in my behavior for the good of the family.”
rx rx rx rx rx rx rx rx rx rx rx rx rx
d. “It’s best for me to move away from my family. Things will never change.”
rx rx rx rx rx rx rx rx rx rx rx rx rx
ANS: C r x
The correct response demonstrates the best evidence of a healthy recognition of the importa
rx rx rx rx rx rx rx rx rx rx rx rx rx
nce of relationships. Mental health includes rational thinking, communication skills, learning
rx rx rx rx rx rx rx rx rx rx
, emotional growth, resilience, and self-
rx rx rx rx rx
esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a hi
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
gher level of mental health. The other incorrect responses show blaming and avoidance.
rx rx rx rx rx rx rx rx rx rx rx rx
PTS: r x r x 1 DIF: Cognitive Level: Analyze (Analysis) rx rx rx
TOP: r x Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
rx rx r x rx rx rx
5. Which assessment finding most clearly indicates that a client may be experiencing a mental
rx rx rx rx rx rx rx rx rx rx rx rx rx
illness?
rx
a. reporting occasional sleeplessness and anxiety. rx rx rx rx
b. reporting a consistently sad, discouraged, and hopeless mood. rx rx rx rx rx rx rx
c. being able to describe the difference between “as if” and “for real.”
rx rx rx rx rx rx rx rx rx rx rx
d. experiencing difficulty making a decision about whether to change jobs. rx rx rx rx rx rx rx rx rx
ANS: B r x
The correct response describes a mood alteration, which reflects mental illness. The distracters
rx rx rx rx rx rx rx rx rx rx rx rx r
describe behaviors that are mentally healthy or within the usual scope of human experience.
x rx rx rx rx rx rx rx rx rx rx rx rx rx
PTS: r x r x 1 DIF: Cognitive Level: Apply (Application) rx rx rx
TOP: r x Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
rx rx r x rx rx rx
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
rx rx rx rx rx rx rx rx rx rx rx
rx achieved for an adult client? rx rx rx rx
a. being willing to work towards achieving ideals and meeting demands.
rx rx rx rx rx rx rx rx rx
b. behaving without considering the consequences of personal actions.
rx rx rx rx rx rx rx
c. aggressively meeting personal needs without considering the rights of others. rx rx rx rx rx rx rx rx rx
d. seeking help from others to avoid assuming responsibility for major areas of own
rx rx rx rx rx rx rx rx rx rx rx rx
life. rx
, ANS: A r x
Mental health is a state of well- rx rx rx rx rx rx
being in which individuals reach their own potential, cope with the normal stresses of life, w
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
ork productively, and contribute to the community. Mental health provides people with the c
rx rx rx rx rx rx rx rx rx rx rx rx rx
apacity for rational thinking, communication skills, learning, emotional growth, resilience, an
rx rx rx rx rx rx rx rx rx rx
d self-
rx
esteem. The correct response describes an adaptive, healthy behavior. The distracters describ
rx rx rx rx rx rx rx rx rx rx rx
e maladaptive behaviors.
rx rx
PTS: r x r x 1 DIF: Cognitive Level: Apply (Application) rx rx rx
TOP: r x Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity
rx rx r x rx rx rx
7. A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Whi
rx rx rx rx rx rx rx rx rx rx rx rx rx
ch resource should the nurse consult to determine criteria used to establish this diagnosis?
rx rx rx rx rx rx rx rx rx rx rx rx rx
a. International Statistical Classification of Diseases and Related Health Problems
rx rx rx rx rx rx rx rx r
x (ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
rx rx rx rx rx rx rx rx rx
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) rx rx rx rx rx rx rx
d. A behavioral health reference manual
rx rx rx rx
ANS: C r x
The DSM- rx
V gives the criteria used to diagnose each mental disorder. It is the official guideline for diagn
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
osing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatr
rx rx rx rx rx rx rx rx rx rx rx rx
ic illness.
rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
would have the most complete information?
rx rx rx rx rx rx
a. Nursing Outcomes Classification (NOC) rx rx rx
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
rx rx rx rx rx rx rx rx rx
d. ICD-10
ANS: B r x
The DSM- rx
V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline f
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
or diagnosing psychiatric disorders. The other references are good resources but do not define
rx rx rx rx rx rx rx rx rx rx rx rx rx rx
the diagnostic criteria.
rx rx
PTS: r x r x 1 DIF: Cognitive Level: Understand (Comprehension) rx rx rx
TOP: r x Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
rx rx r x rx rx rx rx rx
9. Which individual behavior demonstrates resilience?
rx rx rx rx
a. Repress stressors associated with a divorce. rx rx rx rx rx
b. Continuing to grieve the death of a spouse for 5 years. rx rx rx rx rx rx rx rx rx rx
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
rx rx rx rx rx rx rx rx rx rx rx rx rx rx rx
d. Taking a temporary job to maintain financial stability after loss of a permanent
rx rx rx rx rx rx rx rx rx rx rx rx r
x job.
ANS: D r x
