NUR 405 EXAM 1 QUESTIONS AND ANSWERS
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, and daily routine have not changed. How
should the nurse interpret the client's behaviors?
A. The client's behaviors demonstrate mental illness in the form of depression.
B. The client's behaviors are extensive, which indicates the presence of mental illness.
C. The client's behaviors are not congruent with cultural norms.
D. The client's behaviors demonstrate no functional impairment, indicating no mental illness. - CORRECT
ANSWER✅✅ANS: D
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 responding within normal expectations. Without significant
impairment, the client's distress does not indicate a mental illness.
2. At what point should the nurse determine that a client is at risk for developing a mental disorder?
A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B. When maladaptive responses to stress are coupled with interference in daily functioning
C. When the client communicates significant distress
D. When the client uses defense mechanisms as ego protection - CORRECT ANSWER✅✅ANS: B
The nurse should determine that the client is at risk for mental disorder when responses to stress are
maladaptive and interfere with daily functioning. The DSM-5 indicates that in order to be diagnosed
with a mental disorder, there must be significant disturbance in cognition, emotion, regulation, or
behavior that reflects a dysfunction in the psychological, biological or developmental processes
underlying mental functioning. These disorders are usually associated with significant distress or
disability in social, occupational, or other important activities. The client's ability to communicate
distress would be considered a positive attribute
3. A nurse is assessing 15-year-old identical twins who respond very differently to stress. One twin
becomes anxious and irritable, while the other withdraws and cries. How should the nurse explain these
different responses to stress to the parents?
A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
B. It is abnormal for identical twins to react differently to similar stressors.
C. Identical twins should share the same temperament and respond similarly to stress.
,D. Environmental influences weigh more heavily than genetic influences on reactions to stress. -
CORRECT ANSWER✅✅ANS: A
Responses to stress are variable among individuals and may be influenced by perception, past
experience, and environmental factors in addition to genetic factors.
4. A client has a history of excessive drinking, which has led to multiple arrests for driving under the
influence (DUI). The client states, "I work hard to provide for my family. I don't see why I can't drink to
relax." The nurse recognizes the use of which defense mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation - CORRECT ANSWER✅✅ANS: B
The nurse should recognize that the client is using rationalization, a common defense mechanism. The
client is attempting to make excuses and create logical reasons to justify unacceptable feelings or
behaviors.
5. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
A. A Jewish, female journalist
B. A Baptist, homeless male
C. A Catholic, black male
D. A Protestant, Swedish business executive - CORRECT ANSWER✅✅ANS: A
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 as physical health.
Women are also more likely than men to seek treatment for mental health problems.
6. A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated."
Which is a correct evaluation of this nurse's statement?
A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be
eliminated.
C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not
eliminated.
, D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged. -
CORRECT ANSWER✅✅ANS: A
The nurse should know that defense mechanisms serve the purpose of reducing anxiety during times of
stress. A client with no defense mechanisms may have a lower tolerance for stress, predisposing him or
her to anxiety disorders. Defense mechanisms should be confronted when they impede the client from
developing healthy coping skills.
7. 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?
A. "It's just a routine part of our assessment. All clients are asked these same questions."
B. "Why are you concerned about these types of questions?"
C. "Psychological factors, like excessive stress, have been found to affect medical conditions."
D. "We can skip these questions, if you like. It isn't imperative that we complete this section." - CORRECT
ANSWER✅✅ANS: C
The nurse should attempt to educate the client on the negative effects of excessive stress on medical
conditions. It is not appropriate to skip either physiological or psychosocial questions, as this would lead
to an inaccurate assessment.
8. Which statement reflects a student nurse's accurate understanding of the concepts of mental health
and mental illness?
A. "The concepts are rigid and religiously based."
B. "The concepts are multidimensional and culturally defined."
C. "The concepts are universal and unchanging."
D. "The concepts are unidimensional and fixed." - CORRECT ANSWER✅✅ANS: B
The student nurse should understand that mental health and mental illness are multidimensional and
culturally defined. It is important for nurses to be aware of cultural norms when evaluating a client's
mental state.
9. A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a
patient?" Which of these responses by the nurse would be most accurate?
A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental
Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
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, and daily routine have not changed. How
should the nurse interpret the client's behaviors?
A. The client's behaviors demonstrate mental illness in the form of depression.
B. The client's behaviors are extensive, which indicates the presence of mental illness.
C. The client's behaviors are not congruent with cultural norms.
D. The client's behaviors demonstrate no functional impairment, indicating no mental illness. - CORRECT
ANSWER✅✅ANS: D
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 responding within normal expectations. Without significant
impairment, the client's distress does not indicate a mental illness.
2. At what point should the nurse determine that a client is at risk for developing a mental disorder?
A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B. When maladaptive responses to stress are coupled with interference in daily functioning
C. When the client communicates significant distress
D. When the client uses defense mechanisms as ego protection - CORRECT ANSWER✅✅ANS: B
The nurse should determine that the client is at risk for mental disorder when responses to stress are
maladaptive and interfere with daily functioning. The DSM-5 indicates that in order to be diagnosed
with a mental disorder, there must be significant disturbance in cognition, emotion, regulation, or
behavior that reflects a dysfunction in the psychological, biological or developmental processes
underlying mental functioning. These disorders are usually associated with significant distress or
disability in social, occupational, or other important activities. The client's ability to communicate
distress would be considered a positive attribute
3. A nurse is assessing 15-year-old identical twins who respond very differently to stress. One twin
becomes anxious and irritable, while the other withdraws and cries. How should the nurse explain these
different responses to stress to the parents?
A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
B. It is abnormal for identical twins to react differently to similar stressors.
C. Identical twins should share the same temperament and respond similarly to stress.
,D. Environmental influences weigh more heavily than genetic influences on reactions to stress. -
CORRECT ANSWER✅✅ANS: A
Responses to stress are variable among individuals and may be influenced by perception, past
experience, and environmental factors in addition to genetic factors.
4. A client has a history of excessive drinking, which has led to multiple arrests for driving under the
influence (DUI). The client states, "I work hard to provide for my family. I don't see why I can't drink to
relax." The nurse recognizes the use of which defense mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation - CORRECT ANSWER✅✅ANS: B
The nurse should recognize that the client is using rationalization, a common defense mechanism. The
client is attempting to make excuses and create logical reasons to justify unacceptable feelings or
behaviors.
5. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
A. A Jewish, female journalist
B. A Baptist, homeless male
C. A Catholic, black male
D. A Protestant, Swedish business executive - CORRECT ANSWER✅✅ANS: A
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 as physical health.
Women are also more likely than men to seek treatment for mental health problems.
6. A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated."
Which is a correct evaluation of this nurse's statement?
A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be
eliminated.
C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not
eliminated.
, D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged. -
CORRECT ANSWER✅✅ANS: A
The nurse should know that defense mechanisms serve the purpose of reducing anxiety during times of
stress. A client with no defense mechanisms may have a lower tolerance for stress, predisposing him or
her to anxiety disorders. Defense mechanisms should be confronted when they impede the client from
developing healthy coping skills.
7. 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?
A. "It's just a routine part of our assessment. All clients are asked these same questions."
B. "Why are you concerned about these types of questions?"
C. "Psychological factors, like excessive stress, have been found to affect medical conditions."
D. "We can skip these questions, if you like. It isn't imperative that we complete this section." - CORRECT
ANSWER✅✅ANS: C
The nurse should attempt to educate the client on the negative effects of excessive stress on medical
conditions. It is not appropriate to skip either physiological or psychosocial questions, as this would lead
to an inaccurate assessment.
8. Which statement reflects a student nurse's accurate understanding of the concepts of mental health
and mental illness?
A. "The concepts are rigid and religiously based."
B. "The concepts are multidimensional and culturally defined."
C. "The concepts are universal and unchanging."
D. "The concepts are unidimensional and fixed." - CORRECT ANSWER✅✅ANS: B
The student nurse should understand that mental health and mental illness are multidimensional and
culturally defined. It is important for nurses to be aware of cultural norms when evaluating a client's
mental state.
9. A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a
patient?" Which of these responses by the nurse would be most accurate?
A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental
Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
