BANK
Chapter 1
• The nurse is assessing the factors contributing to the well-being of a newly admitted
patient. Which of the following would the nurse identify as having a positive impact on the
individual's mental health?
• Not needing others for companionship
• The ability to effectively manage stress
• A family history of mental illness
• Striving for total self-relianceAns: B
Feedback:
Individual factors influencing mental health include biologic makeup, autonomy, independence,
self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or
hardiness, sense of belonging, reality orientation, and coping or stress management abilities.
Interpersonal factors such as intimacy and a balance of separateness and connectedness are both
needed for good mental health, and therefore a healthy person would need others for
companionship. A family history of mental illness could relate to the biologic makeup of an
individual, which may have a negative impact on an individual's mental health, as well as a
negative impact on an individual's interpersonal and socialñcultural factors of health. Total self-
reliance is not possible, and a positive social/cultural factor is access to adequate resources.
• Which of the following statements about mental illness are true? Select all that apply.
• Mental illness can cause significant distress, impaired functioning, or both.
• Mental illness is only due to social/cultural factors.
• Social/cultural factors that relate to mental illness include excessive dependency on or
withdrawal from relationships.
• Individuals suffering from mental illness are usually able to cope effectively with daily
life.
• Individuals suffering from mental illness may experience dissatisfaction with
relationships and self.
Ans: A, D, E
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental illness may
be related to individual, interpersonal, or social/cultural factors. Excessive dependency on or
withdrawal from relationships are interpersonal factors that relate to mental illness. Individuals
suffering from mental illness can feel overwhelmed with daily life. Individuals suffering from
mental illness may experience dissatisfaction with relationships and self.
• Which of the following are true regarding mental health and mental illness?
• Behavior that may be viewed as acceptable in one culture is always unacceptable in other
cultures.
• It is easy to determine if a person is mentally healthy or mentally ill.
,• In most cases, mental health is a state of emotional, psychological, and social wellness
evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-
concept, and emotional stability.
• Persons who engage in fantasies are mentally ill. Ans: C
Feedback:
What one society may view as acceptable and appropriate behavior, another society may see that
as maladaptive, and inappropriate. Mental health and mental illness are difficult to define
precisely. In most cases, mental health is a state of emotional, psychological, and social wellness
evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-
concept, and emotional stability. Persons who engagein fantasies may be mentally healthy, but
the inability to distinguish reality from fantasyis an individual factor that may contribute to
mental illness.
• A patient grieving the recent loss of her husband asks if she is becoming mentally ill
because she is so sad. The nurse's best response would be,
• ìYou may have a temporary mental illness because you are experiencing so much pain.î
• ìYou are not mentally ill. This is an expected reaction to the loss you have experienced.î
• ìWere you generally dissatisfied with your relationship before your husband's death?î
• ìTry not to worry about that right now. You never know what the future brings.î Ans: B
Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships, ineffective
coping, and lack of personal growth. Additionally the behavior must not be culturally expected.
Acute grief reactions are expected and therefore not considered mental illness. False reassurance
or overanalysis does not accurately address the patient'sconcerns.
• The nurse consults the DSM for which of the following purposes?
• To devise a plan of care for a newly admitted patient
• To predict the patient's prognosis of treatment outcomes
• To document the appropriate diagnostic code in the patient's medical record
• To serve as a guide for patient assessment Ans: D
Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and identifies
underlying causes of mental disorders. It does not provide care plans or prognostic outcomes of
treatment. Diagnosis of mental illness is not within the generalist RN's scope of practice, so
documenting the code in the medical record would be inappropriate.
• Which would be a reason for a student nurse to use the DSM?
• Identifying the medical diagnosis
• Treat patients
• Evaluate treatments
• Understand the reason for the admission and the nature of psychiatric illnesses. Ans: D
Feedback:
, Although student nurses do not use the DSM to diagnose patients, they will find it a helpful
resource to understand the reason for the admission and to begin building knowledge about the
nature of psychiatric illnesses. Identifying the medical diagnosis, treating, and evaluating
treatments are not a part of the nursing process.
• The legislation enacted in 1963 was largely responsible for which of the following shifts
in care for the mentally ill?
• The widespread use of community-based services
• The advancement in pharmacotherapies
• Increased access to hospitalization
• Improved rights for patients in long-term institutional care Ans: A
Feedback:
The Community Mental Health Centers Construction Act of 1963 accomplished the release of
individuals from long-term stays in state institutions, the decrease in admissions to hospitals, and
the development of community-based services as an alternative to hospital care.
• Which one of the following is a result of federal legislation?
• Making it easier to commit people for mental health treatment against their will.
• Making it more difficult to commit people for mental health treatment against their will.
• State mental institutions being the primary source of care for mentally ill persons.
• Improved care for mentally ill persons. Ans: B
Feedback:
Commitment laws changed in the early 1970s, making it more difficult to commit people for
mental health treatment against their will. Deinstitutionalization accomplished the release of
individuals from long-term stays in state institutions. Deinstitutionalization also had negative
effects in that some mentally ill persons are subjected to the revolving door effect, which may
limit care for mentally ill persons.
• The goal of the 1963 Community Mental Health Centers Act was to
• ensure patients' rights for the mentally ill.
• deinstitutionalize state hospitals.
• provide funds to build hospitals with psychiatric units.
• treat people with mental illness in a humane fashion. Ans: B
Feedback:
The 1963 Community Mental Health Centers Act intimated the movement toward treating those
with mental illness in a less restrictive environment. This legislation resulted in the shift of
patients with mental illness from large state institutions to care based in the community. Answer
choices A, C, and D were not purposes of the 1963 Community Mental Health Centers Act.
• The creation of asylums during the 1800s was meant to
• improve treatment of mental disorders.