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EssentialsnofnPsychiatricnM entalnHealthnNursing:nAnCommunicationnApproachntonEvidence-
BasednCare,n4thnEdition
WWWPRIM
.THENUR
ESXINAM
GMA.CO
STER
MY.COM
, lOMoARcPSD|8510046
Chapter n01:nScience nandnthenTherapeutic nUsenofnSelfninnPsychiatric nMentalnHealthn
Nursing
Varcarolis: nEssentials nofnPsychiatric nMentalnHealthnNursing: nAnCommunicationn
ApproachntonEvidence-BasednCare,n4thnEdition
MULTIPLEnCHOICE
1. Whichn outcome,n focused n onn recovery,n wouldn benexpectedninn then plann ofn carenfornan patient n livi
ngn inn then communityn and n diagnosed nwithn seriousn and n persistent n mentaln illness?n Withinn 3nmon
ths,n then patient n willn demonstraten what n behavior?
a. Denyingnsuicidaln ideation
b. Reportingn an sensen of n well-being
c. Takingnmedicationsn asn prescribed
d. Attendingn clinicn appointmentsn onn time
ANS:n B
Recoveryn emphasizesn managingn symptoms,n reducingn psychosocialn disability,n and n improvingn ro
len performance.n Then goaln of n recoveryn isn ton empowern then individualn withn mentaln illnessn ton achiev
en an sensen of n meaningn and nsatisfactionn innlifen andn tonfunctionn at nthen highest npossiblen levelnof n welln
ess.n Then incorrect n optionsn focusn onn then classicn medicaln modeln rathern thann recovery.
DIF:
Cognitiven Level:nApplicationn (Applying)nTO
P:n Nursingn Process:nOutcomesnIdentificationn MSC:n
NCLEX:n Health n Promotion nand n Maintenance
2. A n patient n isn hospitalized n forndepressionn and n suicidaln ideationn afterntheirn spousen asksn forn and
ivorce.n Select n then nurse’sn mostncaringn comment.
a. “Let’sn discussn healthynmeansn of n copingnwhenn youn haven suicidaln feelings.”
b. “I n understand nwhynyou’ren son depressed.nWhenn In gotndivorced,n Inwasn devastated nt
oo.”
c. “Youn should n forget n about n yourn marriagen and n moven onn withn yourn life.”
d. “How ndid n youn get n son depressed nthat n hospitalizationn wasn necessary?”
ANS:n A
Then nurse’sn communicationn should n evidencen caringn and n an commitment n ton worknwithnthen patient
.n Thisn commitment n letsn then patient n know n then nursen willn help.n Probingn and nadvicen aren not nhelpfulnf
orn therapeuticn interventions.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Psychosocialn Integrity
3. Inn then shift-changen report,n ann off-
goingn nursen criticizesn an patient n whon wearsn extremelyn heavynmakeup.n Whichn comment n bynthen n
ursen whon receivesn then report n best n demonstratesn advocacy?
a. “Thisn isn an psychiatricn hospital,n son wen expect n ourn patientsn ton behaven bizarrely.”
b. “Let’sn alln show n acceptancen of n thisn patient n bynwearingn lotsn of n makeupn too.”
c. “Yourncommentsn areninconsideraten and n inappropriate.n Keepn then report n objective.”
d. “Ourn patientsn need n ourn helpn tonlearnn behaviorsn that n willn helpn themn get n alongn inns
ociety.”
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ANS:n D
Acceptingn patients’n needsn forn self-
expressionn and n seekingn ton teachn skillsn that n willn contributen tont heirn well-
beingn demonstraten respect n and n aren important n partsn of n advocacy.n Then on-
comingn nursen needsn ton taken actionntonensuren thatn othersn aren notn prejudicedn against nthen patient.n H
umorn cann ben appropriaten withinn then privacyn of n anshiftn report nbut nnot natn then expensen ofnrespect n forn
patients.n Judgingn then off-
goingn nursen inn an criticaln wayn willn createn conflict.n Nursesn must n shown compassionn forn eachn other.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Safe,n Effective n Caren Environment
4. A n nursen assessesn an newlyn admitted npatient ndiagnosed nwithnmajorn depressiven disorder.n Whichns
tatement n isn ann examplen of n “attending”?
a. “Wen alln haven stressn inn life.n Beingn inn an psychiatricn hospitaln isn not n then end n of n then
world.”
b. “Telln men whyn youn felt n youn had n ton ben hospitalized n ton receiven treatment n forn your
depression.”
c. “Younwilln feeln bettern aftern wen get n somen antidepressant n medicationn started n forn you.”
d. “I’d n liken ton sit n withn youn forn an while,n son youn mayn feeln moren comfortablen talkingn withn
me.”
ANS:n D
Attendingn isn an techniquen thatn demonstratesn thennurse’sn commitment n ton then relationshipn and nre
ducesn feelingsn of n isolation.n Thisn techniquen showsn respect n fornthenpatient nandn demonstratesncar
ing.n Generalizations,n probing,n and n falsen reassurancesn aren nontherapeutic.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Psychosocialn Integrity
5. A n patient n showsn thennursen annarticlen fromn thenInternet n about n an healthn problem.n Whichn characte
risticn of n then website’sn addressn most n alertsn thennursen thatn then sitenmayn haven biased n and nprejudice
d n information?
a. Addressn endsn inn “.org.”
b. Addressn endsn inn “.com.”
c. Addressn endsn inn “.gov.”
d. Addressn endsn inn “.net.”
ANS:n B
Financialn influencesn onn an siten aren an cluen that n then informationn mayn benbiased.n“.com”n at nthen end no
f n then addressn indicatesn thatnthensiten isn ancommercialn one.n “.gov”n indicatesn that nthen siten isn maintai
ned n byn an government n entity.n “.org”n indicatesn that nthensiten isn nonproprietary;n then sitenmayn orn may
n not n haven reliablen information,n but n it n doesn notnprofit nfromn itsnactivities.n “.net”ncann haven multiple
n meanings.
DIF: CognitivenLevel:nComprehension n(Understanding)
TOP:n NursingnProcess:n Evaluation nMSC:n NCLEX:n Health n Promotion n and n Maintenance
6. A n nursen says,n “Whenn I n wasninn school,n I nlearned ntoncalln upset n patientsn bynnamen tonget ntheirn atte
ntion;n however,n I n read n andescriptiven researchn studynthatn saysn that nthisn approachn doesn not nwork
.n I n plann ton stopn callingn patientsn bynname.”n Whichn statement n isn then best n appraisaln of n thisnnurse’
sn comment?
a. Onendescriptiven researchn studynrarelynprovidesn enoughn evidencen ton changen practice.
PRIMEXAM.COM
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b. Staff n nursesn applyn new n researchn findingsn onlyn withn then helpn fromn clinicaln nursens
pecialists.
c. New n researchn findingsn should n benincorporated n inton clinicaln algorithmsn beforen usingnt
hemn inn practice.
d. Then nursen misinterpreted n then resultsn of n then study.n Classicn tenetsn ofn practicen donnotnc
hange.
ANS:n A
Descriptiven researchn findingsn providen evidencen forn practicen butn must nben viewedninn relationn tonot
hern studiesn beforen practicen changes.n Onen studyn isn notnenough.n Descriptiven studiesn aren lownonnthen
hierarchyn of n evidence.n Clinicaln algorithmsn usen flowchartsn ton managen problemsn and n don notn speci
fyn onen responsen ton an clinicaln problem.n Classicn tenetsn of n practicen shouldn changen asn researchn findi
ngsn providen evidencen forn change.
DIF: CognitivenLevel:n Analysisn(Analyzing)
TOP:n NursingnProcess:n Evaluation nMSC:n NCLEX:n Health n Promotion n and n Maintenance
7. Twon nursingn studentsn discussn careern plansn aftern graduation.nOnenstudent nwantsn ton entern psychi
atricn nursing.n Then othern student n asks,n “Whyn would nyounwantn ton benanpsychiatricn nurse?nAlln they
n don isn talk.n Younwilln losen yourn skills.”n Select n then best n responsen bynthenstudentn interestedninn psyc
hiatricn nursing.
a. “Psychiatricn nurses’n practicen inn safern environmentsn thann othern specialtiesn and nn
urse-to-patient n ratiosn aren bettern becausen of n then naturen of n patients’n problems.”
b. “Psychiatricn nursesn usen complexn communicationn skills,n asn welln asn criticaln thinking,
ton solven multidimensionaln problems.n I’mn challenged n bynthosen situations.”
c. “I n thinkn I n willn ben good n inn then mentaln healthn field.n I n don not n liken clinicaln rotationsn in
school,n son I ndon not n want n ton continuen themn aftern I n graduate.”
d. “Psychiatricn nursesn don not n haven ton dealn withn asn muchn painn and n sufferingn as
medical-surgicaln nurses.n That n appealsn ton me.”
ANS:n B
Then practicen of n psychiatricn nursingn requiresn an different n set n of n skillsn thann medical-
surgicaln nursing,n althoughn substantialn overlapn doesn exist.n Psychiatricn nursesn must n ben ablen ton h
elpn patientsn withn medicaln and nmentaln healthn problems,n reflectingn thenholisticn perspectiven these
n nursesn must n have.n Nurse–
patient n ratiosn and n workloadsninn psychiatricn settingsn havenincreased,nsimilarn ton othern specialties.
n Psychiatricn nursingn involvesn clinicaln practice,n not n simplyn documentation.n Psychosocialn painn i
sn realn and n cann causen asn muchn sufferingnasn physicaln pain.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Safe,n Effective n Caren Environment
8. Whichn researchn evidencen would n most n influencen an groupn of n nursesn ton changen theirn practice?
a. Expert n committeen report n of n recommendationsn forn practice
b. Systematicn review n of n randomized n controlled n trials
c. Nonexperimentaln descriptiven study
d. Criticaln pathway
ANS:n B
PRIMEXAM.COM
EssentialsnofnPsychiatricnM entalnHealthnNursing:nAnCommunicationnApproachntonEvidence-
BasednCare,n4thnEdition
WWWPRIM
.THENUR
ESXINAM
GMA.CO
STER
MY.COM
, lOMoARcPSD|8510046
Chapter n01:nScience nandnthenTherapeutic nUsenofnSelfninnPsychiatric nMentalnHealthn
Nursing
Varcarolis: nEssentials nofnPsychiatric nMentalnHealthnNursing: nAnCommunicationn
ApproachntonEvidence-BasednCare,n4thnEdition
MULTIPLEnCHOICE
1. Whichn outcome,n focused n onn recovery,n wouldn benexpectedninn then plann ofn carenfornan patient n livi
ngn inn then communityn and n diagnosed nwithn seriousn and n persistent n mentaln illness?n Withinn 3nmon
ths,n then patient n willn demonstraten what n behavior?
a. Denyingnsuicidaln ideation
b. Reportingn an sensen of n well-being
c. Takingnmedicationsn asn prescribed
d. Attendingn clinicn appointmentsn onn time
ANS:n B
Recoveryn emphasizesn managingn symptoms,n reducingn psychosocialn disability,n and n improvingn ro
len performance.n Then goaln of n recoveryn isn ton empowern then individualn withn mentaln illnessn ton achiev
en an sensen of n meaningn and nsatisfactionn innlifen andn tonfunctionn at nthen highest npossiblen levelnof n welln
ess.n Then incorrect n optionsn focusn onn then classicn medicaln modeln rathern thann recovery.
DIF:
Cognitiven Level:nApplicationn (Applying)nTO
P:n Nursingn Process:nOutcomesnIdentificationn MSC:n
NCLEX:n Health n Promotion nand n Maintenance
2. A n patient n isn hospitalized n forndepressionn and n suicidaln ideationn afterntheirn spousen asksn forn and
ivorce.n Select n then nurse’sn mostncaringn comment.
a. “Let’sn discussn healthynmeansn of n copingnwhenn youn haven suicidaln feelings.”
b. “I n understand nwhynyou’ren son depressed.nWhenn In gotndivorced,n Inwasn devastated nt
oo.”
c. “Youn should n forget n about n yourn marriagen and n moven onn withn yourn life.”
d. “How ndid n youn get n son depressed nthat n hospitalizationn wasn necessary?”
ANS:n A
Then nurse’sn communicationn should n evidencen caringn and n an commitment n ton worknwithnthen patient
.n Thisn commitment n letsn then patient n know n then nursen willn help.n Probingn and nadvicen aren not nhelpfulnf
orn therapeuticn interventions.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Psychosocialn Integrity
3. Inn then shift-changen report,n ann off-
goingn nursen criticizesn an patient n whon wearsn extremelyn heavynmakeup.n Whichn comment n bynthen n
ursen whon receivesn then report n best n demonstratesn advocacy?
a. “Thisn isn an psychiatricn hospital,n son wen expect n ourn patientsn ton behaven bizarrely.”
b. “Let’sn alln show n acceptancen of n thisn patient n bynwearingn lotsn of n makeupn too.”
c. “Yourncommentsn areninconsideraten and n inappropriate.n Keepn then report n objective.”
d. “Ourn patientsn need n ourn helpn tonlearnn behaviorsn that n willn helpn themn get n alongn inns
ociety.”
PRIMEXAM.COM
, lOMoARcPSD|8510046
ANS:n D
Acceptingn patients’n needsn forn self-
expressionn and n seekingn ton teachn skillsn that n willn contributen tont heirn well-
beingn demonstraten respect n and n aren important n partsn of n advocacy.n Then on-
comingn nursen needsn ton taken actionntonensuren thatn othersn aren notn prejudicedn against nthen patient.n H
umorn cann ben appropriaten withinn then privacyn of n anshiftn report nbut nnot natn then expensen ofnrespect n forn
patients.n Judgingn then off-
goingn nursen inn an criticaln wayn willn createn conflict.n Nursesn must n shown compassionn forn eachn other.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Safe,n Effective n Caren Environment
4. A n nursen assessesn an newlyn admitted npatient ndiagnosed nwithnmajorn depressiven disorder.n Whichns
tatement n isn ann examplen of n “attending”?
a. “Wen alln haven stressn inn life.n Beingn inn an psychiatricn hospitaln isn not n then end n of n then
world.”
b. “Telln men whyn youn felt n youn had n ton ben hospitalized n ton receiven treatment n forn your
depression.”
c. “Younwilln feeln bettern aftern wen get n somen antidepressant n medicationn started n forn you.”
d. “I’d n liken ton sit n withn youn forn an while,n son youn mayn feeln moren comfortablen talkingn withn
me.”
ANS:n D
Attendingn isn an techniquen thatn demonstratesn thennurse’sn commitment n ton then relationshipn and nre
ducesn feelingsn of n isolation.n Thisn techniquen showsn respect n fornthenpatient nandn demonstratesncar
ing.n Generalizations,n probing,n and n falsen reassurancesn aren nontherapeutic.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Psychosocialn Integrity
5. A n patient n showsn thennursen annarticlen fromn thenInternet n about n an healthn problem.n Whichn characte
risticn of n then website’sn addressn most n alertsn thennursen thatn then sitenmayn haven biased n and nprejudice
d n information?
a. Addressn endsn inn “.org.”
b. Addressn endsn inn “.com.”
c. Addressn endsn inn “.gov.”
d. Addressn endsn inn “.net.”
ANS:n B
Financialn influencesn onn an siten aren an cluen that n then informationn mayn benbiased.n“.com”n at nthen end no
f n then addressn indicatesn thatnthensiten isn ancommercialn one.n “.gov”n indicatesn that nthen siten isn maintai
ned n byn an government n entity.n “.org”n indicatesn that nthensiten isn nonproprietary;n then sitenmayn orn may
n not n haven reliablen information,n but n it n doesn notnprofit nfromn itsnactivities.n “.net”ncann haven multiple
n meanings.
DIF: CognitivenLevel:nComprehension n(Understanding)
TOP:n NursingnProcess:n Evaluation nMSC:n NCLEX:n Health n Promotion n and n Maintenance
6. A n nursen says,n “Whenn I n wasninn school,n I nlearned ntoncalln upset n patientsn bynnamen tonget ntheirn atte
ntion;n however,n I n read n andescriptiven researchn studynthatn saysn that nthisn approachn doesn not nwork
.n I n plann ton stopn callingn patientsn bynname.”n Whichn statement n isn then best n appraisaln of n thisnnurse’
sn comment?
a. Onendescriptiven researchn studynrarelynprovidesn enoughn evidencen ton changen practice.
PRIMEXAM.COM
, lOMoARcPSD|8510046
b. Staff n nursesn applyn new n researchn findingsn onlyn withn then helpn fromn clinicaln nursens
pecialists.
c. New n researchn findingsn should n benincorporated n inton clinicaln algorithmsn beforen usingnt
hemn inn practice.
d. Then nursen misinterpreted n then resultsn of n then study.n Classicn tenetsn ofn practicen donnotnc
hange.
ANS:n A
Descriptiven researchn findingsn providen evidencen forn practicen butn must nben viewedninn relationn tonot
hern studiesn beforen practicen changes.n Onen studyn isn notnenough.n Descriptiven studiesn aren lownonnthen
hierarchyn of n evidence.n Clinicaln algorithmsn usen flowchartsn ton managen problemsn and n don notn speci
fyn onen responsen ton an clinicaln problem.n Classicn tenetsn of n practicen shouldn changen asn researchn findi
ngsn providen evidencen forn change.
DIF: CognitivenLevel:n Analysisn(Analyzing)
TOP:n NursingnProcess:n Evaluation nMSC:n NCLEX:n Health n Promotion n and n Maintenance
7. Twon nursingn studentsn discussn careern plansn aftern graduation.nOnenstudent nwantsn ton entern psychi
atricn nursing.n Then othern student n asks,n “Whyn would nyounwantn ton benanpsychiatricn nurse?nAlln they
n don isn talk.n Younwilln losen yourn skills.”n Select n then best n responsen bynthenstudentn interestedninn psyc
hiatricn nursing.
a. “Psychiatricn nurses’n practicen inn safern environmentsn thann othern specialtiesn and nn
urse-to-patient n ratiosn aren bettern becausen of n then naturen of n patients’n problems.”
b. “Psychiatricn nursesn usen complexn communicationn skills,n asn welln asn criticaln thinking,
ton solven multidimensionaln problems.n I’mn challenged n bynthosen situations.”
c. “I n thinkn I n willn ben good n inn then mentaln healthn field.n I n don not n liken clinicaln rotationsn in
school,n son I ndon not n want n ton continuen themn aftern I n graduate.”
d. “Psychiatricn nursesn don not n haven ton dealn withn asn muchn painn and n sufferingn as
medical-surgicaln nurses.n That n appealsn ton me.”
ANS:n B
Then practicen of n psychiatricn nursingn requiresn an different n set n of n skillsn thann medical-
surgicaln nursing,n althoughn substantialn overlapn doesn exist.n Psychiatricn nursesn must n ben ablen ton h
elpn patientsn withn medicaln and nmentaln healthn problems,n reflectingn thenholisticn perspectiven these
n nursesn must n have.n Nurse–
patient n ratiosn and n workloadsninn psychiatricn settingsn havenincreased,nsimilarn ton othern specialties.
n Psychiatricn nursingn involvesn clinicaln practice,n not n simplyn documentation.n Psychosocialn painn i
sn realn and n cann causen asn muchn sufferingnasn physicaln pain.
DIF: CognitivenLevel:nApplication n(Applying)
TOP:n Nursingn Process:n Implementation MSC:n NCLEX:n Safe,n Effective n Caren Environment
8. Whichn researchn evidencen would n most n influencen an groupn of n nursesn ton changen theirn practice?
a. Expert n committeen report n of n recommendationsn forn practice
b. Systematicn review n of n randomized n controlled n trials
c. Nonexperimentaln descriptiven study
d. Criticaln pathway
ANS:n B
PRIMEXAM.COM
