Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based Practice
10th Edition Townsend Test Bank
TABLE OF CONTENT
UNIT I. BASIC CONCEPTS IN PSYCHIATRIC-MENTAL HEALTH NURSING
Chapter 1. The Concept of Stress Adaptation
Chapter 2. Mental Health and Mental Illness: Historical and Theoretical Concepts
UNIT II. FOUNDATIONS FOR PSYCHIATRIC-MENTAL HEALTH NURSING
Chapter 3. Concepts of Psychobiology
Chapter 4. Psychopharmacology
Chapter 5. Ethical and Legal Issues
UNIT III. THERAPEUTIC APPROACHES IN PSYCHIATRIC NURSING CARE
Chapter 6. Relationship Development
Chapter 7. Therapeutic Communication
Chapter 8. The Nursing Process in Psychiatric-Mental Health Nursing
Chapter 9. Therapeutic Groups
Chapter 10. Intervention with Families
Chapter 11. Milieu Therapy--The Therapeutic Community
Chapter 12. Crisis Intervention
Chapter 13. Assertiveness Training
Chapter 14. Promoting Self Esteem
Chapter 15. Anger and Aggression Management
Chapter 16. Suicide Prevention
Chapter 17. Behavior Therapy
Chapter 18. Cognitive Behavioral Therapy
Chapter 19. Electroconvulsive Therapy
Chapter 20. The Recovery Model
UNIT IV. NURSING CARE OF PATIENTS WITH ALTERATIONS IN PSYCHOSOCIAL
ADAPTATION
Chapter 21. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice
Settings
Chapter 22. Neurocognitive Disorders
Chapter 23. Substance-Related and Addictive Disorders
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders
Chapter 25. Depressive Disorders
Chapter 26. Bipolar and Related Disorders
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders
Chapter 28. Trauma and Stressor-Related Disorders
Chapter 29. Somatic Symptom and Dissociative Disorders
Chapter 30. Eating Disorders
Chapter 31. Personality Disorders
,UNIT V. PSYCHIATRIC/MENTAL HEALTH NURSING OF SPECIAL POPULATIONS
Chapter 32. Children and Adolescents
Chapter 33. The Aging Individual
Chapter 34. Survivors of Abuse or Neglect
Chapter 35. Community Mental Health Nursing
Chapter 36. The Bereaved Individual
Chapter 37. Military Families
Chapter 38. Theoretical Models of Personality Development
Chapter 39. Cultural and Spiritual Concepts Relevant to Psychiatric Mental Health Nursing
Chapter 40. Complementary and Psychosocial Therapies
Chapter 41. Relaxation Therapy
Chapter 42. Issues Related to Human Sexuality and Gender Dysphoria
Chapter 43. Forensic Nursing
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
1. A client has experienced the death of a close family member and at the same time
becomes unemployed. The client’s 6-month score on the Recent Life Changes
Questionnaire is 110. The nurse:
A. Understands the client is at risk for significant stress-related illness.
B. Determines the client is not at risk for significant stress-related illness.
C. Needs further assessment of the client’s coping skills to determine susceptibility to
stress-related illness.
D. Recognizes the client may view the losses as challenges and perceive them as
opportunities.
ANS: C
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 5–6
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process:
, Evaluation Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Moderate
Feedback
A This is incorrect. Assessment is the first step of the nursing process. The nurse should
assess the client’s coping skills and available support before determining susceptibility
to stress-related physical and psychological illness. The Recent Life Changes
Questionnaire is an expanded version of the Schedule of Recent Experiences and the
Rahe- Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a
year-score total of 500 or more, indicates high stress in a client’s life and susceptibility
to stress-related illnesses.
B This is incorrect. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining the client’s
perception of the current stresses. A 6-month score of 300 or a year-score of 500 or
more on the Recent Life Changes Questionnaire indicates high stress in a client’s life
and susceptibility to stress-related physical and
psychological illness.
C This is correct. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining susceptibility
to stress- related physical and psychological illness. A 6-month score of 300 or a year-
score of 500 or more indicates high stress in a client’s life and risk for significant
stress-related physical
and psychological illness.
D This is incorrect. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining
susceptibility to stress-related illness. A 6-month score of 300 or a year-score of 500
or more on the Recent Life Changes Questionnaire indicates high stress in a client’s
life is susceptible to significant stress-related physical and
psychological illness.
PTS: 1CON: Stress
2. A physically and emotionally healthy client has just been fired. During a routine
office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll
consider pursuing an art degree.” The nurse determines the client perceives the
stressor of his job loss as:
A. Irrelevant.
B. Harm/loss.
C. A threat.
D. A challenge.
ANS: D
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management
of stress.
Page: 7
Heading: Individual’s Perception of the Event > Primary
, Appraisal Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. The client’s statement
indicates he perceives the loss of his job as a challenge and an opportunity for
growth.
B This is incorrect. The client’s statement indicates he perceives the loss of his job
as a
challenge and an opportunity for growth.
C This is incorrect. The client’s statement
indicates he perceives the loss of his job as a challenge and an opportunity for
growth.
D This is correct. The client’s statement indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
PTS: 1CON: Stress
3. Which client statement alerts the nurse that the client may be responding
maladaptively to stress?
A. “Avoiding contact with others helps me cope.”
B. “I really enjoy journaling; it’s my private time.”
C. “I signed up for a yoga class this week.”
D. “I made an appointment to meet with a therapist.”
ANS: A
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management
of stress.
Page: 8–9
Heading: Stress Management
Integrated Processes: Nursing Process:
Evaluation Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Easy
, Feedback
A This is correct. Reliance on social isolation as a coping mechanism is a maladaptive
method to relieve stress. It can prevent learning appropriate coping skills and can
prevent access to needed support systems.
B This is incorrect. Journaling is not considered a maladaptive coping method.
C This is incorrect. Group exercise is not considered a maladaptive coping method.
D This is incorrect. Seeing a therapist is not considered a maladaptive coping method.
PTS: 1CON: Stress
4. A nursing student comes down with a sinus infection toward the end
of every semester. Which stage of stress is the student most likely experiencing
when this occurs?
A. Alarm reaction
B. Resistance
C. Exhaustion
D. Fight or flight
ANS: C
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 9
Heading: Stress as a Biological Response > Stage of Exhaustion
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension
[Understanding] Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. At the alarm reaction stage, physiological responses of the fight-
or-flight syndrome are initiated.
B This is incorrect. At the stage of resistance, the individual uses the physiological
responses of the first stage as a defense in the attempt to adapt to the stressor.
Physiological symptoms may disappear.
C This is correct. At the stage of exhaustion, the student’s exposure to stress has been
prolonged and adaptive energy has been depleted. Diseases of adaptation occur
more frequently in this stage.
D This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
, PTS: 1CON: Stress
5. A school nurse is assessing a female high-school student who is overly concerned
about her appearance. The client’s mother states, “That’s not something to be stressed
about!” Which response by the nurse is best?
A. “Teenagers! They don’t know a thing about real stress.”
B. “Psychological or physical stress occur only when there is a loss.”
C. “Poor physical condition can interfere with psychological well-being.”
D. “A threat to self-esteem can result in psychological stress.”
ANS: D
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Describe the core concept of stress as an environmental
event.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Moderate
Feedback
A This is incorrect. This response is judgmental
and nontherapeutic.
B This is incorrect. Physical and psychological stress can be precipitated by events
other than
loss.
C This is incorrect. Stress can be physical or psychological in nature. A perceived
threat to self-esteem can be as stressful as a
physiological change.
D This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation, which is an individual’s evaluation of the
personal significance of the event or occurrence. Stress can be physical or
psychological in nature. A perceived threat to self-esteem can be as
stressful as a physiological change.
PTS: 1CON: Stress
6. A student confides in the school nurse that he is “stressed out” about deciding
10th Edition Townsend Test Bank
TABLE OF CONTENT
UNIT I. BASIC CONCEPTS IN PSYCHIATRIC-MENTAL HEALTH NURSING
Chapter 1. The Concept of Stress Adaptation
Chapter 2. Mental Health and Mental Illness: Historical and Theoretical Concepts
UNIT II. FOUNDATIONS FOR PSYCHIATRIC-MENTAL HEALTH NURSING
Chapter 3. Concepts of Psychobiology
Chapter 4. Psychopharmacology
Chapter 5. Ethical and Legal Issues
UNIT III. THERAPEUTIC APPROACHES IN PSYCHIATRIC NURSING CARE
Chapter 6. Relationship Development
Chapter 7. Therapeutic Communication
Chapter 8. The Nursing Process in Psychiatric-Mental Health Nursing
Chapter 9. Therapeutic Groups
Chapter 10. Intervention with Families
Chapter 11. Milieu Therapy--The Therapeutic Community
Chapter 12. Crisis Intervention
Chapter 13. Assertiveness Training
Chapter 14. Promoting Self Esteem
Chapter 15. Anger and Aggression Management
Chapter 16. Suicide Prevention
Chapter 17. Behavior Therapy
Chapter 18. Cognitive Behavioral Therapy
Chapter 19. Electroconvulsive Therapy
Chapter 20. The Recovery Model
UNIT IV. NURSING CARE OF PATIENTS WITH ALTERATIONS IN PSYCHOSOCIAL
ADAPTATION
Chapter 21. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice
Settings
Chapter 22. Neurocognitive Disorders
Chapter 23. Substance-Related and Addictive Disorders
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders
Chapter 25. Depressive Disorders
Chapter 26. Bipolar and Related Disorders
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders
Chapter 28. Trauma and Stressor-Related Disorders
Chapter 29. Somatic Symptom and Dissociative Disorders
Chapter 30. Eating Disorders
Chapter 31. Personality Disorders
,UNIT V. PSYCHIATRIC/MENTAL HEALTH NURSING OF SPECIAL POPULATIONS
Chapter 32. Children and Adolescents
Chapter 33. The Aging Individual
Chapter 34. Survivors of Abuse or Neglect
Chapter 35. Community Mental Health Nursing
Chapter 36. The Bereaved Individual
Chapter 37. Military Families
Chapter 38. Theoretical Models of Personality Development
Chapter 39. Cultural and Spiritual Concepts Relevant to Psychiatric Mental Health Nursing
Chapter 40. Complementary and Psychosocial Therapies
Chapter 41. Relaxation Therapy
Chapter 42. Issues Related to Human Sexuality and Gender Dysphoria
Chapter 43. Forensic Nursing
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
1. A client has experienced the death of a close family member and at the same time
becomes unemployed. The client’s 6-month score on the Recent Life Changes
Questionnaire is 110. The nurse:
A. Understands the client is at risk for significant stress-related illness.
B. Determines the client is not at risk for significant stress-related illness.
C. Needs further assessment of the client’s coping skills to determine susceptibility to
stress-related illness.
D. Recognizes the client may view the losses as challenges and perceive them as
opportunities.
ANS: C
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 5–6
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process:
, Evaluation Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Moderate
Feedback
A This is incorrect. Assessment is the first step of the nursing process. The nurse should
assess the client’s coping skills and available support before determining susceptibility
to stress-related physical and psychological illness. The Recent Life Changes
Questionnaire is an expanded version of the Schedule of Recent Experiences and the
Rahe- Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a
year-score total of 500 or more, indicates high stress in a client’s life and susceptibility
to stress-related illnesses.
B This is incorrect. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining the client’s
perception of the current stresses. A 6-month score of 300 or a year-score of 500 or
more on the Recent Life Changes Questionnaire indicates high stress in a client’s life
and susceptibility to stress-related physical and
psychological illness.
C This is correct. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining susceptibility
to stress- related physical and psychological illness. A 6-month score of 300 or a year-
score of 500 or more indicates high stress in a client’s life and risk for significant
stress-related physical
and psychological illness.
D This is incorrect. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining
susceptibility to stress-related illness. A 6-month score of 300 or a year-score of 500
or more on the Recent Life Changes Questionnaire indicates high stress in a client’s
life is susceptible to significant stress-related physical and
psychological illness.
PTS: 1CON: Stress
2. A physically and emotionally healthy client has just been fired. During a routine
office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll
consider pursuing an art degree.” The nurse determines the client perceives the
stressor of his job loss as:
A. Irrelevant.
B. Harm/loss.
C. A threat.
D. A challenge.
ANS: D
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management
of stress.
Page: 7
Heading: Individual’s Perception of the Event > Primary
, Appraisal Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. The client’s statement
indicates he perceives the loss of his job as a challenge and an opportunity for
growth.
B This is incorrect. The client’s statement indicates he perceives the loss of his job
as a
challenge and an opportunity for growth.
C This is incorrect. The client’s statement
indicates he perceives the loss of his job as a challenge and an opportunity for
growth.
D This is correct. The client’s statement indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
PTS: 1CON: Stress
3. Which client statement alerts the nurse that the client may be responding
maladaptively to stress?
A. “Avoiding contact with others helps me cope.”
B. “I really enjoy journaling; it’s my private time.”
C. “I signed up for a yoga class this week.”
D. “I made an appointment to meet with a therapist.”
ANS: A
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management
of stress.
Page: 8–9
Heading: Stress Management
Integrated Processes: Nursing Process:
Evaluation Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Easy
, Feedback
A This is correct. Reliance on social isolation as a coping mechanism is a maladaptive
method to relieve stress. It can prevent learning appropriate coping skills and can
prevent access to needed support systems.
B This is incorrect. Journaling is not considered a maladaptive coping method.
C This is incorrect. Group exercise is not considered a maladaptive coping method.
D This is incorrect. Seeing a therapist is not considered a maladaptive coping method.
PTS: 1CON: Stress
4. A nursing student comes down with a sinus infection toward the end
of every semester. Which stage of stress is the student most likely experiencing
when this occurs?
A. Alarm reaction
B. Resistance
C. Exhaustion
D. Fight or flight
ANS: C
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 9
Heading: Stress as a Biological Response > Stage of Exhaustion
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension
[Understanding] Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. At the alarm reaction stage, physiological responses of the fight-
or-flight syndrome are initiated.
B This is incorrect. At the stage of resistance, the individual uses the physiological
responses of the first stage as a defense in the attempt to adapt to the stressor.
Physiological symptoms may disappear.
C This is correct. At the stage of exhaustion, the student’s exposure to stress has been
prolonged and adaptive energy has been depleted. Diseases of adaptation occur
more frequently in this stage.
D This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
, PTS: 1CON: Stress
5. A school nurse is assessing a female high-school student who is overly concerned
about her appearance. The client’s mother states, “That’s not something to be stressed
about!” Which response by the nurse is best?
A. “Teenagers! They don’t know a thing about real stress.”
B. “Psychological or physical stress occur only when there is a loss.”
C. “Poor physical condition can interfere with psychological well-being.”
D. “A threat to self-esteem can result in psychological stress.”
ANS: D
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Describe the core concept of stress as an environmental
event.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application
[Applying] Concept: Stress
Difficulty: Moderate
Feedback
A This is incorrect. This response is judgmental
and nontherapeutic.
B This is incorrect. Physical and psychological stress can be precipitated by events
other than
loss.
C This is incorrect. Stress can be physical or psychological in nature. A perceived
threat to self-esteem can be as stressful as a
physiological change.
D This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation, which is an individual’s evaluation of the
personal significance of the event or occurrence. Stress can be physical or
psychological in nature. A perceived threat to self-esteem can be as
stressful as a physiological change.
PTS: 1CON: Stress
6. A student confides in the school nurse that he is “stressed out” about deciding
