,Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 1
Table . of . Contents
Table . of 1
. Contents
Chapter .01: .Practicing .the .Science .and .the .Art .of .Psychiatric .Nursing 2
.Chapter .02: .Mental .Health .and .Mental .Illness 7
Chapter . 03: . Theories . and . Therapies 12
Chapter .04: .Biological .Basis .for .Understanding .Psychopharmacology 20
.Chapter .05: .Settings .for .Psychiatric .Care 28
Chapter . 06: . Legal . and . Ethical . Basis . for . Practice 35
Chapter .07: .Nursing .Process .and .QSEN: .The .Foundation .for .Safe .and .Effective 43
.Care .Chapter .08: .Communication .Skills: .Medium .for .All .Nursing .Practice 51
Chapter .09: .Therapeutic .Relationships .and .the .Clinical .Interview 58
.Chapter .10: .Trauma .and .Stress-Related .Disorders 67
Chapter .11: .Anxiety, .Anxiety .Disorders, .and .Obsessive-Compulsive .Disorders 74
.Chapter .12: .Somatic .System .Disorders .and .Dissociative .Disorders 85
Chapter .13: .Personality .Disorders 94
.Chapter .14: .Eating .Disorders 103
Chapter .15: .Mood .Disorders: 111
.Depression .Chapter .16: .Bipolar 121
.Spectrum .Disorders 131
Chapter .17: .Schizophrenia .Spectrum .Disorders .and .Other .Psychotic .Disorders 142
.Chapter .18: .Neurocognitive .Disorders 151
Chapter .19: .Substance-Related .and .Addictive .Disorders 163
.Chapter .20: .Crisis .and .Mass .Disaster 171
Chapter .21: .Child, .Partner, .and .Elder .Violence 179
.Chapter .22: .Sexual .Violence 186
Chapter .23: .Suicidal .Thoughts .and .Behavior 195
.Chapter .24: .Anger, .Aggression, .and .Violence 204
Chapter .25: .Care .for .the .Dying .and .Those .Who .Grieve 213
.Chapter .26: .Children .and .Adolescents 221
Chapter .27: .Adults 230
.Chapter .28: .Older .Adults
,Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2
Chapter . 01: . Practicing . the . Science . and . the . Art . of . Psychiatric . Nursing
MULTIPLE . CHOICE
1. Which .outcome, .focused .on .recovery, .would .be .expected .in .the .plan .of .care .for .a .patient .living .in
.the .community . and . diagnosed . with . serious . and . persistent . mental . illness? . Within . 3 . months, . the
. patient . will:
a. deny . suicidal . ideation.
b. report . a . sense . of . well-being.
c. take . medications . as . prescribed.
d. attend . clinic . appointments . on . time.
ANS: . B
Recovery .emphasizes .managing .symptoms, .reducing .psychosocial .disability, .and .improving .role
.performance. . The .goal .of .recovery .is .to .empower .the .individual .with .mental .illness .to .achieve .a .sense
.of .meaning .and .satisfaction .in .life .and .to .function .at .the .highest .possible .level .of .wellness. .The .incorrect
.options .focus .on .the . classic .medical .model .rather .than .recovery.
DIF: .Cognitive .Level: .Application .(Applying) .REF:
.2 .TOP: . Nursing . Process: . Outcomes . Identification
.MSC: .NCLEX: .Health .Promotion .and .Maintenance
2. In .the .shift-change .report, .an .off-going .nurse .criticizes .a .patient .who .wears .heavy .makeup. .Which
.comment . by .the .nurse .who .receives .the .report .best .demonstrates .advocacy?
a. This . is . a . psychiatric . hospital. . Craziness . is . what . we .are . all . about.
b. Lets . all . show . acceptance . of . this . patient . by . wearing . lots . of . makeup . too.
c. Your . comments . are . inconsiderate . and . inappropriate. . Keep . the . report . objective.
d. Our . patients . need . our . help . to . learn . behaviors . that . will . help . them . get .along . in . society.
ANS: . D
Accepting .patients .needs .for .self-expression .and .seeking .to .teach .skills .that .will .contribute .to .their .well-
being .demonstrate .respect .and .are .important .parts .of .advocacy. .The .on-coming .nurse .needs .to .take .action
.to .ensure . that .others .are .not .prejudiced .against .the .patient. .Humor .can .be .appropriate .within .the .privacy
.of .a .shift .report . but .not .at .the .expense .of .respect .for .patients. .Judging .the .off-going .nurse .in .a .critical
.way .will .create .conflict. . Nurses .must .show .compassion .for .each .other.
DIF: . Cognitive . Level: . Application . (Applying) . REF: . 8
TOP: . Nursing . Process: . Implementation . MSC: . NCLEX: . Safe, . Effective . Care . Environment
3. A .nurse .assesses .a .newly .admitted .patient .diagnosed .with .major .depressive .disorder. .Which .statement .is
.an .example .of .attending?
a. We . all .have . stress . in . life. .Being . in .a . psychiatric . hospital . isnt . the . end .of . the . world.
b. Tell . me . why . you . felt . you . had . to . be .hospitalized . to . receive . treatment . for . your . depression.
c. You . will . feel . better . after . we . get . some . antidepressant . medication . started . for . you.
d. Id . like . to . sit . with . you . a . while . so . you . may . feel . more . comfortable . talking . with . me.
ANS: . D
Attending .is .a .technique .that .demonstrates .the .nurses .commitment .to .the .relationship .and .reduces .feelings
.of .isolation. .This .technique .shows .respect .for .the .patient .and .demonstrates .caring. .Generalizations,
.probing, .and .false .reassurances .are .non-therapeutic.
DIF: . Cognitive . Level: . Application . (Applying) . REF: . 8
TOP: . Nursing . Process: . Implementation . MSC: . NCLEX: . Psychosocial . Integrity
4. A .patient .is .hospitalized .for .depression .and .suicidal .ideation .after .their .spouse .asks .for .a .divorce. .Select
.the .nurses .most .caring .comment.
a. Lets . discuss . some . means . of . coping . other . than . suicide . when . you . have . these . feelings.
b. I . understand . why . youre . so . depressed. . When . I . got . divorced, . I . was . devastated . too.
c. You . should . forget . about . your . marriage . and . move . on . with . your . life.
d. How . did . you . get . so . depressed . that . hospitalization . was . necessary?
, Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 3
ANS: . A
The .nurses .communication .should .evidence .caring .and .a .commitment .to .work .with .the .patient. .This
.commitment .lets .the .patient .know .the .nurse .will .help. .Probing .and .advice .are .not .helpful .or .therapeutic
.interventions.
DIF: . Cognitive . Level: . Application . (Applying) . REF: . 6
TOP: . Nursing . Process: . Implementation . MSC: . NCLEX: . Psychosocial . Integrity
5. A .patient .shows .the .nurse .an .article .from .the .Internet .about .a .health .problem. .Which .characteristic .of
.the .web .sites .address .most .alerts .the .nurse .that .the .site .may .have .biased .and .prejudiced .information?
a. Address . ends . in . .org.
b. Address . ends . in . .com.
c. Address . ends . in . .gov.
d. Address . ends . in . .net.
ANS: . B
Financial .influences .on .a .site .are .a .clue .that .the .information .may .be .biased. ..com .at .the .end .of .the
.address .indicates . that . the . site . is . a . commercial . one. . .gov . indicates . that . the . site . is . maintained . by . a
. government . entity.
.org .indicates .that .the .site .is .nonproprietary; .the .site .may .or .may .not .have .reliable .information, .but .it .does
.not . profit .from .its .activities. ..net .can .have .multiple .meanings.
DIF: . Cognitive . Level: . Comprehension . (Understanding) . REF: . 5
TOP: . Nursing . Process: . Evaluation . MSC: . NCLEX: . Health . Promotion . and . Maintenance
6. A .nurse .says, .When .I .was .in .school, .I .learned .to .call .upset .patients .by .name .to .get .their .attention;
.however, .I . read .a .descriptive .research .study .that .says .that .this .approach .does .not .work. .I .plan .to .stop
.calling .patients .by . name. .Which .statement .is .the .best .appraisal .of .this .nurses .comment?
a. One . descriptive . research . study . rarely . provides . enough . evidence . to . change . practice.
b. Staff . nurses . apply . new . research . findings . only . with . the . help . from . clinical . nurse . specialists.
c. New . research . findings . should . be . incorporated . into . clinical . algorithms . before . using . them . in . practice.
d. The . nurse . misinterpreted . the . results . of . the . study. . Classic . tenets . of . practice . do . not . change.
ANS: . A
Descriptive .research .findings .provide .evidence .for .practice .but .must .be .viewed .in .relation .to .other .studies
. before .practice .changes. .One .study .is .not .enough. .Descriptive .studies .are .low .on .the .hierarchy .of
.evidence. . Clinical .algorithms .use .flow .charts .to .manage .problems .and .do .not .specify .one .response .to .a
.clinical .problem. . Classic .tenets .of .practice .should .change .as .research .findings .provide .evidence .for
.change.
DIF: . Cognitive . Level: . Analysis . (Analyzing) . REF: . 3
TOP: . Nursing . Process: . Evaluation . MSC: . NCLEX: . Health . Promotion . and . Maintenance
7. Two .nursing .students .discuss .career .plans .after .graduation. .One .student .wants .to .enter .psychiatric
.nursing. .The .other .student .asks, .Why .would .you .want .to .be .a .psychiatric .nurse? .All .they .do .is .talk. .You
.will .lose .your .skills. .Select .the .best .response .by .the .student .interested .in .psychiatric .nursing.
a. Psychiatric .nurses .practice .in .safer .environments .than .other .specialties. .Nurse-to-patient .ratios .must
.be .better .because .of .the .nature .of .patients .problems.
b. Psychiatric .nurses .use .complex .communication .skills, .as .well .as .critical .thinking, .to .solve
.multidimensional .problems. .Im .challenged .by .those .situations.
c. I .think .I .will .be .good .in .the .mental .health .field. .I .do .not .like .clinical .rotations .in .school, .so .I .do .not
.want .to .continue .them .after .I .graduate.
d. Psychiatric .nurses .do .not .have .to .deal .with .as .much .pain .and .suffering .as .medical .surgical .nurses.
.That .appeals .to .me.
ANS: . B
The .practice .of .psychiatric .nursing .requires .a .different .set .of .skills .than .medical .surgical .nursing, .although
.substantial .overlap .does .exist. .Psychiatric .nurses .must .be .able .to .help .patients .with .medical .and .mental .health
.problems, .reflecting .the .holistic .perspective .these .nurses .must .have. .Nurse-patient .ratios .and .workloads .in
.psychiatric . settings . have . increased, . similar . to . other . specialties. . Psychiatric . nursing . involves . clinical
. practice,
Table . of . Contents
Table . of 1
. Contents
Chapter .01: .Practicing .the .Science .and .the .Art .of .Psychiatric .Nursing 2
.Chapter .02: .Mental .Health .and .Mental .Illness 7
Chapter . 03: . Theories . and . Therapies 12
Chapter .04: .Biological .Basis .for .Understanding .Psychopharmacology 20
.Chapter .05: .Settings .for .Psychiatric .Care 28
Chapter . 06: . Legal . and . Ethical . Basis . for . Practice 35
Chapter .07: .Nursing .Process .and .QSEN: .The .Foundation .for .Safe .and .Effective 43
.Care .Chapter .08: .Communication .Skills: .Medium .for .All .Nursing .Practice 51
Chapter .09: .Therapeutic .Relationships .and .the .Clinical .Interview 58
.Chapter .10: .Trauma .and .Stress-Related .Disorders 67
Chapter .11: .Anxiety, .Anxiety .Disorders, .and .Obsessive-Compulsive .Disorders 74
.Chapter .12: .Somatic .System .Disorders .and .Dissociative .Disorders 85
Chapter .13: .Personality .Disorders 94
.Chapter .14: .Eating .Disorders 103
Chapter .15: .Mood .Disorders: 111
.Depression .Chapter .16: .Bipolar 121
.Spectrum .Disorders 131
Chapter .17: .Schizophrenia .Spectrum .Disorders .and .Other .Psychotic .Disorders 142
.Chapter .18: .Neurocognitive .Disorders 151
Chapter .19: .Substance-Related .and .Addictive .Disorders 163
.Chapter .20: .Crisis .and .Mass .Disaster 171
Chapter .21: .Child, .Partner, .and .Elder .Violence 179
.Chapter .22: .Sexual .Violence 186
Chapter .23: .Suicidal .Thoughts .and .Behavior 195
.Chapter .24: .Anger, .Aggression, .and .Violence 204
Chapter .25: .Care .for .the .Dying .and .Those .Who .Grieve 213
.Chapter .26: .Children .and .Adolescents 221
Chapter .27: .Adults 230
.Chapter .28: .Older .Adults
,Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2
Chapter . 01: . Practicing . the . Science . and . the . Art . of . Psychiatric . Nursing
MULTIPLE . CHOICE
1. Which .outcome, .focused .on .recovery, .would .be .expected .in .the .plan .of .care .for .a .patient .living .in
.the .community . and . diagnosed . with . serious . and . persistent . mental . illness? . Within . 3 . months, . the
. patient . will:
a. deny . suicidal . ideation.
b. report . a . sense . of . well-being.
c. take . medications . as . prescribed.
d. attend . clinic . appointments . on . time.
ANS: . B
Recovery .emphasizes .managing .symptoms, .reducing .psychosocial .disability, .and .improving .role
.performance. . The .goal .of .recovery .is .to .empower .the .individual .with .mental .illness .to .achieve .a .sense
.of .meaning .and .satisfaction .in .life .and .to .function .at .the .highest .possible .level .of .wellness. .The .incorrect
.options .focus .on .the . classic .medical .model .rather .than .recovery.
DIF: .Cognitive .Level: .Application .(Applying) .REF:
.2 .TOP: . Nursing . Process: . Outcomes . Identification
.MSC: .NCLEX: .Health .Promotion .and .Maintenance
2. In .the .shift-change .report, .an .off-going .nurse .criticizes .a .patient .who .wears .heavy .makeup. .Which
.comment . by .the .nurse .who .receives .the .report .best .demonstrates .advocacy?
a. This . is . a . psychiatric . hospital. . Craziness . is . what . we .are . all . about.
b. Lets . all . show . acceptance . of . this . patient . by . wearing . lots . of . makeup . too.
c. Your . comments . are . inconsiderate . and . inappropriate. . Keep . the . report . objective.
d. Our . patients . need . our . help . to . learn . behaviors . that . will . help . them . get .along . in . society.
ANS: . D
Accepting .patients .needs .for .self-expression .and .seeking .to .teach .skills .that .will .contribute .to .their .well-
being .demonstrate .respect .and .are .important .parts .of .advocacy. .The .on-coming .nurse .needs .to .take .action
.to .ensure . that .others .are .not .prejudiced .against .the .patient. .Humor .can .be .appropriate .within .the .privacy
.of .a .shift .report . but .not .at .the .expense .of .respect .for .patients. .Judging .the .off-going .nurse .in .a .critical
.way .will .create .conflict. . Nurses .must .show .compassion .for .each .other.
DIF: . Cognitive . Level: . Application . (Applying) . REF: . 8
TOP: . Nursing . Process: . Implementation . MSC: . NCLEX: . Safe, . Effective . Care . Environment
3. A .nurse .assesses .a .newly .admitted .patient .diagnosed .with .major .depressive .disorder. .Which .statement .is
.an .example .of .attending?
a. We . all .have . stress . in . life. .Being . in .a . psychiatric . hospital . isnt . the . end .of . the . world.
b. Tell . me . why . you . felt . you . had . to . be .hospitalized . to . receive . treatment . for . your . depression.
c. You . will . feel . better . after . we . get . some . antidepressant . medication . started . for . you.
d. Id . like . to . sit . with . you . a . while . so . you . may . feel . more . comfortable . talking . with . me.
ANS: . D
Attending .is .a .technique .that .demonstrates .the .nurses .commitment .to .the .relationship .and .reduces .feelings
.of .isolation. .This .technique .shows .respect .for .the .patient .and .demonstrates .caring. .Generalizations,
.probing, .and .false .reassurances .are .non-therapeutic.
DIF: . Cognitive . Level: . Application . (Applying) . REF: . 8
TOP: . Nursing . Process: . Implementation . MSC: . NCLEX: . Psychosocial . Integrity
4. A .patient .is .hospitalized .for .depression .and .suicidal .ideation .after .their .spouse .asks .for .a .divorce. .Select
.the .nurses .most .caring .comment.
a. Lets . discuss . some . means . of . coping . other . than . suicide . when . you . have . these . feelings.
b. I . understand . why . youre . so . depressed. . When . I . got . divorced, . I . was . devastated . too.
c. You . should . forget . about . your . marriage . and . move . on . with . your . life.
d. How . did . you . get . so . depressed . that . hospitalization . was . necessary?
, Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 3
ANS: . A
The .nurses .communication .should .evidence .caring .and .a .commitment .to .work .with .the .patient. .This
.commitment .lets .the .patient .know .the .nurse .will .help. .Probing .and .advice .are .not .helpful .or .therapeutic
.interventions.
DIF: . Cognitive . Level: . Application . (Applying) . REF: . 6
TOP: . Nursing . Process: . Implementation . MSC: . NCLEX: . Psychosocial . Integrity
5. A .patient .shows .the .nurse .an .article .from .the .Internet .about .a .health .problem. .Which .characteristic .of
.the .web .sites .address .most .alerts .the .nurse .that .the .site .may .have .biased .and .prejudiced .information?
a. Address . ends . in . .org.
b. Address . ends . in . .com.
c. Address . ends . in . .gov.
d. Address . ends . in . .net.
ANS: . B
Financial .influences .on .a .site .are .a .clue .that .the .information .may .be .biased. ..com .at .the .end .of .the
.address .indicates . that . the . site . is . a . commercial . one. . .gov . indicates . that . the . site . is . maintained . by . a
. government . entity.
.org .indicates .that .the .site .is .nonproprietary; .the .site .may .or .may .not .have .reliable .information, .but .it .does
.not . profit .from .its .activities. ..net .can .have .multiple .meanings.
DIF: . Cognitive . Level: . Comprehension . (Understanding) . REF: . 5
TOP: . Nursing . Process: . Evaluation . MSC: . NCLEX: . Health . Promotion . and . Maintenance
6. A .nurse .says, .When .I .was .in .school, .I .learned .to .call .upset .patients .by .name .to .get .their .attention;
.however, .I . read .a .descriptive .research .study .that .says .that .this .approach .does .not .work. .I .plan .to .stop
.calling .patients .by . name. .Which .statement .is .the .best .appraisal .of .this .nurses .comment?
a. One . descriptive . research . study . rarely . provides . enough . evidence . to . change . practice.
b. Staff . nurses . apply . new . research . findings . only . with . the . help . from . clinical . nurse . specialists.
c. New . research . findings . should . be . incorporated . into . clinical . algorithms . before . using . them . in . practice.
d. The . nurse . misinterpreted . the . results . of . the . study. . Classic . tenets . of . practice . do . not . change.
ANS: . A
Descriptive .research .findings .provide .evidence .for .practice .but .must .be .viewed .in .relation .to .other .studies
. before .practice .changes. .One .study .is .not .enough. .Descriptive .studies .are .low .on .the .hierarchy .of
.evidence. . Clinical .algorithms .use .flow .charts .to .manage .problems .and .do .not .specify .one .response .to .a
.clinical .problem. . Classic .tenets .of .practice .should .change .as .research .findings .provide .evidence .for
.change.
DIF: . Cognitive . Level: . Analysis . (Analyzing) . REF: . 3
TOP: . Nursing . Process: . Evaluation . MSC: . NCLEX: . Health . Promotion . and . Maintenance
7. Two .nursing .students .discuss .career .plans .after .graduation. .One .student .wants .to .enter .psychiatric
.nursing. .The .other .student .asks, .Why .would .you .want .to .be .a .psychiatric .nurse? .All .they .do .is .talk. .You
.will .lose .your .skills. .Select .the .best .response .by .the .student .interested .in .psychiatric .nursing.
a. Psychiatric .nurses .practice .in .safer .environments .than .other .specialties. .Nurse-to-patient .ratios .must
.be .better .because .of .the .nature .of .patients .problems.
b. Psychiatric .nurses .use .complex .communication .skills, .as .well .as .critical .thinking, .to .solve
.multidimensional .problems. .Im .challenged .by .those .situations.
c. I .think .I .will .be .good .in .the .mental .health .field. .I .do .not .like .clinical .rotations .in .school, .so .I .do .not
.want .to .continue .them .after .I .graduate.
d. Psychiatric .nurses .do .not .have .to .deal .with .as .much .pain .and .suffering .as .medical .surgical .nurses.
.That .appeals .to .me.
ANS: . B
The .practice .of .psychiatric .nursing .requires .a .different .set .of .skills .than .medical .surgical .nursing, .although
.substantial .overlap .does .exist. .Psychiatric .nurses .must .be .able .to .help .patients .with .medical .and .mental .health
.problems, .reflecting .the .holistic .perspective .these .nurses .must .have. .Nurse-patient .ratios .and .workloads .in
.psychiatric . settings . have . increased, . similar . to . other . specialties. . Psychiatric . nursing . involves . clinical
. practice,
