,Chapter 1. Mental Health and Mental
IllnessMultiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
because of therecent death of a beloved pet. The clients appetite, sleep patterns, and
daily routine have not changed. How should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mental
illness.
ANSWER: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
clientwho experiences feelings of sadness after the loss of a pet is responding within
normal expectations. Without significant impairment, the clients distress does not indicate
a mental illness.
Cognitive Level: Analysis
Integrated Process:
Assessment
2. At what point should the nurse determine that a client is at risk for developing a
mentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the 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.
ANSWER: 2
Rationale: The nurse should determine that the client is at risk for mental illness when
responsesto stress are maladaptive and interfere with daily functioning. The DSM-5
indicates that in orderto be diagnosed with a mental illness, daily functioning must be
significantly impaired. The clients ability to communicate distress would be considered a
positive attribute.
Cognitive Level: Application Integrated
Process:
Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently
to stress.One twin becomes anxious and irritable, 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 twins should share the same temperament and respond similarly to stress.
4. Environmental influences to stress weigh more heavily than genetic influences.
, ANSWER: 1
Rationale: The nurse should explain to the parents that, although the twins have identical
DNA,there are several other factors that affect reactions to stress. Mental health is a state
of being thatis relative to the individual client. Environmental influences and
temperament can affect stress reactions.
Cognitive Level: Application Integrated
Process:
Implementation
4. Which client should the nurse anticipate 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.
ANSWER: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a high
importance on preventative health care and would consider mental health as equally
important asphysical health. Women are also more likely to seek treatment for mental
health problems than men.
Cognitive Level:
ApplicationIntegrated
Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
eliminated.Which is a correct evaluation of this nurses 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 shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged andnot eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.
ANSWER: 1
IllnessMultiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of sadness
because of therecent death of a beloved pet. The clients appetite, sleep patterns, and
daily routine have not changed. How should the nurse interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no mental
illness.
ANSWER: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
clientwho experiences feelings of sadness after the loss of a pet is responding within
normal expectations. Without significant impairment, the clients distress does not indicate
a mental illness.
Cognitive Level: Analysis
Integrated Process:
Assessment
2. At what point should the nurse determine that a client is at risk for developing a
mentalillness?
1. When thoughts, feelings, and behaviors are not reflective of the 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.
ANSWER: 2
Rationale: The nurse should determine that the client is at risk for mental illness when
responsesto stress are maladaptive and interfere with daily functioning. The DSM-5
indicates that in orderto be diagnosed with a mental illness, daily functioning must be
significantly impaired. The clients ability to communicate distress would be considered a
positive attribute.
Cognitive Level: Application Integrated
Process:
Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very differently
to stress.One twin becomes anxious and irritable, 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 twins should share the same temperament and respond similarly to stress.
4. Environmental influences to stress weigh more heavily than genetic influences.
, ANSWER: 1
Rationale: The nurse should explain to the parents that, although the twins have identical
DNA,there are several other factors that affect reactions to stress. Mental health is a state
of being thatis relative to the individual client. Environmental influences and
temperament can affect stress reactions.
Cognitive Level: Application Integrated
Process:
Implementation
4. Which client should the nurse anticipate 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.
ANSWER: 1
Rationale: The nurse should anticipate that the client of Jewish culture would place a high
importance on preventative health care and would consider mental health as equally
important asphysical health. Women are also more likely to seek treatment for mental
health problems than men.
Cognitive Level:
ApplicationIntegrated
Process: Planning
5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
eliminated.Which is a correct evaluation of this nurses 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 shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged andnot eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.
ANSWER: 1
