Test Bank For
Essentials Of Psychiatric Mental Health Nursing:
A Communication Approach To Evidence-Based Care, 4th Edition
Latest Edition With Complete Chapters 1-28
,Table Of Contents
Chapter 01: Science And The Therapeutic Use Of Self In Psychiatric Mental Health Nursing ..................... 3
Chapter 02: Mental Health And Mental Illness .......................................................................................... 10
Chapter 03: Theories And Therapies .......................................................................................................... 18
Chapter 04: Biological Basis For Understanding Psychopharmacology ...................................................... 31
Chapter 05: Settings For Psychiatric Care ................................................................................................... 43
Chapter 06: Legal And Ethical Basis For Practice ........................................................................................ 53
Chapter 07: The Nursing Process In Psychiatric–Mental Health Nursing ................................................... 65
Chapter 08: Communication Skills: Medium For All Nursing Practice ........................................................ 78
Chapter 09: Therapeutic Relationships And The Clinical Interview ............................................................ 88
Chapter 10: Trauma And Stress-Related Disorders And Dissociative Disorders ...................................... 101
Chapter 11: Anxiety, Anxiety Disorders, And Obsessive-Compulsive And Related Disorders.................. 112
Chapter 12: Somatic Symptom Disorders ................................................................................................. 129
Chapter 13: Personality Disorders ............................................................................................................ 143
Chapter 14: Eating Disorders .................................................................................................................... 156
Chapter 15: Mood Disorders: Depression ................................................................................................ 169
Chapter 16: Bipolar Spectrum Disorders .................................................................................................. 184
Chapter 17: Schizophrenia Spectrum Disorders And Other Psychotic Disorders ..................................... 199
Chapter 18: Neurocognitive Disorders ..................................................................................................... 216
Chapter 19: Substance-Related And Addictive Disorders ......................................................................... 230
Chapter 20: Crisis And Mass Disaster ....................................................................................................... 249
Chapter 21: Child, Partner, And Elder Violence ........................................................................................ 261
Chapter 22: Sexual Violence ..................................................................................................................... 273
Chapter 23: Suicidal Thoughts And Behavior............................................................................................ 284
Chapter 24: Anger, Aggression, And Violence .......................................................................................... 298
Chapter 25: Care For The Dying And Those Who Grieve .......................................................................... 311
Chapter 26: Children And Adolescents ..................................................................................................... 325
Chapter 27: Adults .................................................................................................................................... 336
Chapter 28: Older Adults .......................................................................................................................... 351
,Chapter 01: Science And The Therapeutic Use Of Self In Psychiatric
Mental Health Nursing
Multiple Choice
1. Which Outcome, Focused On Recovery, Would Be Expected In The Plan Of Care For A Client Living In
The Community And Diagnosed With Serious And Persistent Mental Illness? Within 3 Months, The Client
Will Demonstrate What Behavior?
A. Denying Suicidal Ideation
B. Reporting A Sense Of Well-Being
C. Taking Medications As Prescribed
D. Attending Clinic Appointments On Time
ANSWER: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)
Top: Nursing Process: Outcomes Identification
Msc: Nclex: Health Promotion And Maintenance
2. A Client Is Hospitalized For Depression And Suicidal Ideation After Their Spouse Asks For A Divorce.
Select The Caregiver’s Most Caring Comment.
A. Let’s Discuss Healthy Me Response Of Coping When You Have Suicidal Feelings.‖
B. I Understand Why You’re 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?‖
ANSWER:A
The Caregiver’s Communication Should Evidence Caring And A Commitment To Work With The Client.
This Commitment Lets The Client Know The Caregiver Will Help. Probing And Advice Are Not Helpful
For Therapeutic Interventions.
,Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation Msc: Nclex: Psychosocial Integrity
3.In The Shift-Change Report, An Off-Going Caregiver Criticizes A Client Who Wears Extremely Heavy
Makeup. Which Comment By The Caregiver Who Receives The Report Best Demonstrates Advocacy?
A. ―This Is A Psychiatric Hospital, So We Expect Our Clients To Behave Bizarrely.‖
B. ―Let‘S All Show Acceptance Of This Client By Wearing Lots Of Makeup Too.‖
C. ―Your Comments Are Inconsiderate And Inappropriate. Keep The Report Objective.‖
D. ―Our Clients Need Our Help To Learn Behaviors That Will Help Them Get Along In Society.‖
ANSWER:D
Accepting Clients‘ 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 Caregiver
Needs To Take Action To Ensure That Others Are Not Prejudiced Against The Client.
Humor Can Be Appropriate Within The Privacy Of A Shift Report But Not At The Expense Of Respect
For Clients. Judging The Off-Going Caregiver In A Critical Way Will Create Conflict. Caregivers Must
Show Compassion For Each Other.
Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation
Msc: Nclex: Safe, Effective Care Environment
4. A Caregiver Assesses A Newly Admitted Client Diagnosed With Major Depressive Disorder.
Whichstatement Is An Example Of ―Attending‖?
A. ―We All Have Stress In Life. Being In A Psychiatric Hospital Is Not 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. ―I‘D Like To Sit With You For A While, So You May Feel More Comfortable Talking With Me.‖
ANSWER:D
Attending Is A Technique That Demonstrates The Caregiver‘S Commitment To The Relationship And
Reduces Feelings Of Isolation. This Technique Shows Respect For The Client And Demonstrates Caring.
Generalizations, Probing, And False Reassurances Are Nontherapeutic.
,Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation
Msc: Nclex: Psychosocial Integrity
5. A Client Shows The Caregiver An Article From The Internet About A Health Problem. Which
Characteristic Of The Website‘S Address Most Alerts The Caregiver 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.‖
ANSWER: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)
Top: Nursing Process: Evaluation
Msc: Nclex: Health Promotion And Maintenance
6.A Caregiver Says, ―When I Was In School, I Learned To Call Upset Clients By Name To Get Their
Attention; However, I Read A Descriptive Research Study That Says That This Approach Does Notwork. I
Plan To Stop Calling Clients By Name.‖ Which Statement Is The Best Appraisal Of This Caregiver‘S
Comment?
A. One Descriptive Research Study Rarely Provides Enough Evidence To Change Practice.
B. Staff Caregivers Apply New Research Findings Only With The Help From Clinical Caregiver
Specialists.
C. New Research Findings Should Be Incorporated Into Clinical Algorithms Before Using Them In
Practice.
D. The Caregiver Misinterpreted The Results Of The Study. Classic Tenets Of Practice Do Not
Change.
ANSWER: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 Flowcharts 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)
Top: Nursing Process: Evaluation
Msc: Nclex: Health Promotion And Maintenance
7. Two Nursing Students Discuss Career Plresponse After Graduation. One Student Wants To Enter
Psychiatric Nursing. The Other Student Asks, ―Why Would You Want To Be A Psychiatric Caregiver?All
They Do Is Talk. You Will Lose Your Skills.‖ Select The Best Response By The Student Interested In
Psychiatric Nursing.
A. ―Psychiatric Caregivers‘ Practice In Safer Environments Than Other Specialties And Caregiver-
To-Client Ratios Are Better Because Of The Nature Of Clients‘
Problems.‖
B. ―Psychiatric Caregivers Use Complex Communication Skills, As Well As Critical Thinking, To
Solve Multidimensional Problems. I‘M 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 Caregivers Do Not Have To Deal With As Much Pain And Suffering As Medical-
Surgical Caregivers. That Appeals To Me.‖
ANSWER:B
The Practice Of Psychiatric Nursing Requires A Different Set Of Skills Than Medical-Surgical Nursing,
Although Substantial Overlap Does Exist. Psychiatric Caregivers Must Be Able To Help Clients With
Medical And Mental Health Problems, Reflecting The Holistic Perspective These Caregivers Must Have.
Caregiver–Client Ratios And Workloads In Psychiatric Settings Have Increased,Similar To Other
Specialties. Psychiatric Nursing Involves Clinical Practice, Not Simply Documentation. Psychosocial
Pain Is Real And Can Cause As Much Suffering As Physical Pain.
Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation
Msc: Nclex: Safe, Effective Care Environment
8. Which Research Evidence Would Most Influence A Group Of Caregivers To Change Their
Practice?
,A. Expert Committee Report Of Recommendations For Practice
B. Systematic Review Of Randomized Controlled Trials
C. Non Experimental Descriptive Study
D. Critical Pathway
ANSWER:B
Research Findings Are Graded Using A Hierarchy Of Evidence. A Systematic Review Of Randomized
Controlled Trials Is Level A And Provides The Strongest Evidence For Changing Practice. Expert
Committee Recommendations And Descriptive Studies Lend Less Powerful And Influential Evidence. A
Critical Pathway Is Not Evidence; It Incorporates Research Findings After They Have Been Analyzed.
Dif: Cognitive Level: Comprehension (Understanding) Top: Nursing Process: Planning Msc:
Nclex: Safe, Effective Care Environment
9. A Bill Introduced In Congress Would Reduce Funding For The Care Of People Diagnosed With
Mental Illnesses. A Group Of Caregivers Write Letters To Their Elected Representatives In Oppositionto
The Legislation. Which Role Have The Caregivers Fulfilled?
A. Advocacy
B. Attending
C. Recovery
D. Evidence-Based Practice
ANSWER:A
An Advocate Defends Or Asserts Another‘S Cause, Particularly When The Other Person Lacks The Ability
To Do That For Him Or Herself. Examples Of Individual Advocacy Include Helping Clients Understand
Their Rights Or Make Decisions. On A Community Scale, Advocacy Includes Political Activity, Public
Speaking, And Publication In The Interest Of Improving The Individuals With Mental Illness; The Letter-
Writing Campaign Advocates For That Cause On Behalf Of Clients Who Are Unable To Articulate Their
Own Needs.
Dif: Cognitive Level: Comprehension (Understanding)
Top: Nursing Process: Implementation Msc: Nclex: Safe, Effective Care Environment
10. An Informal Group Of Clients Discuss Their Perceptions Of Nursing Care. Which Comment Best
Indicates A Client‘S Perception That His Or Her Caregiver Is Caring?
A. ―My Caregiver Always Asks Me Which Type Of Juice I Want To Help Me Swallow My
Medication.‖
B. ―My Caregiver Explained My Treatment Plan To Me And Asked For My Ideas About How To
Make It Better.‖
,C. ―My Caregiver Told Me That If I Take All The Medicines The Doctor Prescribes, I Will Get
Discharged Soon.‖
D. ―My Caregiver Spends Time Listening To Me Talk About My Problems. That Helps Me Feel Like
I‘M Not Alone.‖
ANSWER:D
Caring Evidences Empathic Understanding As Well As Competency. It Helps Change Pain And Suffering
Into A Shared Experience, Creating A Human Connection That Alleviates Feelings Of Isolation. The
Incorrect Options Give Examples Of Statements That Demonstrate Advocacy Or Giving Advice.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Evaluation Msc: Nclex:
Psychosocial Integrity
11. A Client Who Immigrated To The United States From Honduras Was Diagnosed With
Schizophrenia. The Client Took An Antipsychotic Medication For 3 Weeks But Showed No Improvement.
Which Resource Should The Treatment Team Consult For Information On More Effective Medications
For This Client?
A. Clinical Algorithm
B. Clinical Pathway
C. Clinical Practice Guideline
D. International Statistical Classification Of Diseases And Related Health Problems
(Icd)
ANSWER:A
A Clinical Algorithm Is A Guideline That Describes Diagnostic And/Or Treatment Approaches Drawn From
Large Databases Of Information. These Guidelines Help The Treatment Team Make Decisions Cognizant
Of An Individual Client‘S Needs, Such As Ethnic Origin, Age, Or Gender. A Clinical Pathway Is A Map Of
Interventions And Treatments Related To A Specific Disorder.
Clinical Practice Guidelines Summarize Best Practices About Specific Health Problems. The Icd Classifies
Diseases.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Evaluation Msc: Nclex: Safe,
Effective Care Environment
12. A Team Of Caregivers Wants To Integrate Evidence-Based Practice Into A Facility‘S Clinical
Pathways.Which Step Should The Team Implement First?
A. Acquire Findings From Published Literature.
B. Apply The Research Findings To Clinical Practice.
,C. Assess The Outcomes Of Using New Research Findings.
D. Ask Questions To Identify Clinical Problems That Should Be Changed.
ANSWER:D
Integrating Evidence-Based Practice Is A Multistep Process Rather Than A Single Change Event. The First
Step Is To Identify Clinical Problems That Should Be Changed. Each Step Must Proceed In Order When
Integrated Into A Clinical Environment.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Planning Msc: Nclex: Safe,
Effective Care Environment
13. A Caregiver Consistently Strives To Demonstrate Caring Behaviors During Interactions With
Clients. Which Reaction Reported By A Client Indicates This Caregiver Is Most Effective?
A. Feeling Less Distrustful Of Others
B. Sensing A Connection With Others
C. Experiencing Only Minimal Uneasiness About The Future
D. Being Somewhat Encouraged With Efforts To Improve
ANSWER:B
A Client Is Likely To Respond Most To Caring With A Sense Of Connectedness With Others. The Absence
Of Caring Can Make Clients Feel Some Degree Of Distrustful, Disconnection, Unease, And
Discouragement.
Dif: Cognitive Level: Comprehension (Understanding) Top: Nursing Process: Evaluation Msc:
Nclex: Psychosocial Integrity
Multiple Response
1. An Experienced Caregiver Says To A New Graduate, ―When You‘Ve Practiced As Long As I Have,
You Will Instantly Know How To Take Care Of Psychotic Clients.‖ What Is The New Graduate‘S Best
Analysis Of This Comment? (Select All That Apply.)
A. The Experienced Caregiver May Have Lost Sight Of Clients‘ Individuality, Which Maycompromise
The Integrity Of Practice.
B. New Research Findings Must Be Continually Integrated Into A Caregiver‘S Practice To Provide
The Most Effective Care.
C. Experience Provides Mental Health Caregivers With The Tools And Skills Needed For Effective
Professional Practice.
D. Experienced Psychiatric Caregivers Have Learned The Best Ways To Care For Psychotic Clients
Through Trial And Error.
, E. Effective Psychiatric Caregivers Should Be Continually Guided By An Intuitive Sense Of Clients‘
Needs.
ANSWER:A, B
Evidence-Based Practice Involves Using Research Findings To Provide The Most Effective Nursing Care.
Evidence Is Continually Emerging; Therefore, Caregivers Cannot Rely Solely On Experience. The Effective
Caregiver Also Maintains Respect For Each Client As An Individual. Overgeneralization Compromises
That Perspective. Intuition And Trial And Error Are Unsystematic Approaches To Care.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Evaluation Msc: Nclex: Safe,
Effective Care Environment
2. Which Client Statements Identify Qualities Of Nursing Practice With High Therapeutic Value?
―My Caregiver: (Select All That Apply.)
A. ―The Caregivers Talk In Language I Can Understand.‖
B. ―The Nursing Staff Helps Me Keep Track Of My Medications.‖
C. ―My Caregiver Is Willing To Go To Social Activities With Me.‖
D. ―The Staff Lets Me Do Whatever I Choose Without Interfering.‖
E. ―My Caregivers Look At Me As A Whole Person With Different Needs.‖
ANSWER:A, B, E
Each Correct Responsewer Demonstrates Caring Is An Example Of Appropriate Nursing Foci:
Communicating At A Level Understandable To The Client, Using Holistic Principles To Guide Care,And
Providing Medication Supervision. The Incorrect Options Suggest A Laissez-Faire Attitude On The Part Of
The Caregiver When The Caregiver Should Instead Provide Thoughtful Feedback And Help Clients Test
Alternative Solutions Or Violate Boundaries.
Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation Msc: Nclex: Psychosocial Integrity
Chapter 02: Mental Health And Mental Illness
Multiple Choice
1. An 86 Year Old, Previously Healthy And Independent, Falls After An Episode Of Vertigo. Which
Statement Made By This Client Best Demonstrates Resilience?
Essentials Of Psychiatric Mental Health Nursing:
A Communication Approach To Evidence-Based Care, 4th Edition
Latest Edition With Complete Chapters 1-28
,Table Of Contents
Chapter 01: Science And The Therapeutic Use Of Self In Psychiatric Mental Health Nursing ..................... 3
Chapter 02: Mental Health And Mental Illness .......................................................................................... 10
Chapter 03: Theories And Therapies .......................................................................................................... 18
Chapter 04: Biological Basis For Understanding Psychopharmacology ...................................................... 31
Chapter 05: Settings For Psychiatric Care ................................................................................................... 43
Chapter 06: Legal And Ethical Basis For Practice ........................................................................................ 53
Chapter 07: The Nursing Process In Psychiatric–Mental Health Nursing ................................................... 65
Chapter 08: Communication Skills: Medium For All Nursing Practice ........................................................ 78
Chapter 09: Therapeutic Relationships And The Clinical Interview ............................................................ 88
Chapter 10: Trauma And Stress-Related Disorders And Dissociative Disorders ...................................... 101
Chapter 11: Anxiety, Anxiety Disorders, And Obsessive-Compulsive And Related Disorders.................. 112
Chapter 12: Somatic Symptom Disorders ................................................................................................. 129
Chapter 13: Personality Disorders ............................................................................................................ 143
Chapter 14: Eating Disorders .................................................................................................................... 156
Chapter 15: Mood Disorders: Depression ................................................................................................ 169
Chapter 16: Bipolar Spectrum Disorders .................................................................................................. 184
Chapter 17: Schizophrenia Spectrum Disorders And Other Psychotic Disorders ..................................... 199
Chapter 18: Neurocognitive Disorders ..................................................................................................... 216
Chapter 19: Substance-Related And Addictive Disorders ......................................................................... 230
Chapter 20: Crisis And Mass Disaster ....................................................................................................... 249
Chapter 21: Child, Partner, And Elder Violence ........................................................................................ 261
Chapter 22: Sexual Violence ..................................................................................................................... 273
Chapter 23: Suicidal Thoughts And Behavior............................................................................................ 284
Chapter 24: Anger, Aggression, And Violence .......................................................................................... 298
Chapter 25: Care For The Dying And Those Who Grieve .......................................................................... 311
Chapter 26: Children And Adolescents ..................................................................................................... 325
Chapter 27: Adults .................................................................................................................................... 336
Chapter 28: Older Adults .......................................................................................................................... 351
,Chapter 01: Science And The Therapeutic Use Of Self In Psychiatric
Mental Health Nursing
Multiple Choice
1. Which Outcome, Focused On Recovery, Would Be Expected In The Plan Of Care For A Client Living In
The Community And Diagnosed With Serious And Persistent Mental Illness? Within 3 Months, The Client
Will Demonstrate What Behavior?
A. Denying Suicidal Ideation
B. Reporting A Sense Of Well-Being
C. Taking Medications As Prescribed
D. Attending Clinic Appointments On Time
ANSWER: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)
Top: Nursing Process: Outcomes Identification
Msc: Nclex: Health Promotion And Maintenance
2. A Client Is Hospitalized For Depression And Suicidal Ideation After Their Spouse Asks For A Divorce.
Select The Caregiver’s Most Caring Comment.
A. Let’s Discuss Healthy Me Response Of Coping When You Have Suicidal Feelings.‖
B. I Understand Why You’re 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?‖
ANSWER:A
The Caregiver’s Communication Should Evidence Caring And A Commitment To Work With The Client.
This Commitment Lets The Client Know The Caregiver Will Help. Probing And Advice Are Not Helpful
For Therapeutic Interventions.
,Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation Msc: Nclex: Psychosocial Integrity
3.In The Shift-Change Report, An Off-Going Caregiver Criticizes A Client Who Wears Extremely Heavy
Makeup. Which Comment By The Caregiver Who Receives The Report Best Demonstrates Advocacy?
A. ―This Is A Psychiatric Hospital, So We Expect Our Clients To Behave Bizarrely.‖
B. ―Let‘S All Show Acceptance Of This Client By Wearing Lots Of Makeup Too.‖
C. ―Your Comments Are Inconsiderate And Inappropriate. Keep The Report Objective.‖
D. ―Our Clients Need Our Help To Learn Behaviors That Will Help Them Get Along In Society.‖
ANSWER:D
Accepting Clients‘ 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 Caregiver
Needs To Take Action To Ensure That Others Are Not Prejudiced Against The Client.
Humor Can Be Appropriate Within The Privacy Of A Shift Report But Not At The Expense Of Respect
For Clients. Judging The Off-Going Caregiver In A Critical Way Will Create Conflict. Caregivers Must
Show Compassion For Each Other.
Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation
Msc: Nclex: Safe, Effective Care Environment
4. A Caregiver Assesses A Newly Admitted Client Diagnosed With Major Depressive Disorder.
Whichstatement Is An Example Of ―Attending‖?
A. ―We All Have Stress In Life. Being In A Psychiatric Hospital Is Not 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. ―I‘D Like To Sit With You For A While, So You May Feel More Comfortable Talking With Me.‖
ANSWER:D
Attending Is A Technique That Demonstrates The Caregiver‘S Commitment To The Relationship And
Reduces Feelings Of Isolation. This Technique Shows Respect For The Client And Demonstrates Caring.
Generalizations, Probing, And False Reassurances Are Nontherapeutic.
,Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation
Msc: Nclex: Psychosocial Integrity
5. A Client Shows The Caregiver An Article From The Internet About A Health Problem. Which
Characteristic Of The Website‘S Address Most Alerts The Caregiver 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.‖
ANSWER: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)
Top: Nursing Process: Evaluation
Msc: Nclex: Health Promotion And Maintenance
6.A Caregiver Says, ―When I Was In School, I Learned To Call Upset Clients By Name To Get Their
Attention; However, I Read A Descriptive Research Study That Says That This Approach Does Notwork. I
Plan To Stop Calling Clients By Name.‖ Which Statement Is The Best Appraisal Of This Caregiver‘S
Comment?
A. One Descriptive Research Study Rarely Provides Enough Evidence To Change Practice.
B. Staff Caregivers Apply New Research Findings Only With The Help From Clinical Caregiver
Specialists.
C. New Research Findings Should Be Incorporated Into Clinical Algorithms Before Using Them In
Practice.
D. The Caregiver Misinterpreted The Results Of The Study. Classic Tenets Of Practice Do Not
Change.
ANSWER: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 Flowcharts 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)
Top: Nursing Process: Evaluation
Msc: Nclex: Health Promotion And Maintenance
7. Two Nursing Students Discuss Career Plresponse After Graduation. One Student Wants To Enter
Psychiatric Nursing. The Other Student Asks, ―Why Would You Want To Be A Psychiatric Caregiver?All
They Do Is Talk. You Will Lose Your Skills.‖ Select The Best Response By The Student Interested In
Psychiatric Nursing.
A. ―Psychiatric Caregivers‘ Practice In Safer Environments Than Other Specialties And Caregiver-
To-Client Ratios Are Better Because Of The Nature Of Clients‘
Problems.‖
B. ―Psychiatric Caregivers Use Complex Communication Skills, As Well As Critical Thinking, To
Solve Multidimensional Problems. I‘M 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 Caregivers Do Not Have To Deal With As Much Pain And Suffering As Medical-
Surgical Caregivers. That Appeals To Me.‖
ANSWER:B
The Practice Of Psychiatric Nursing Requires A Different Set Of Skills Than Medical-Surgical Nursing,
Although Substantial Overlap Does Exist. Psychiatric Caregivers Must Be Able To Help Clients With
Medical And Mental Health Problems, Reflecting The Holistic Perspective These Caregivers Must Have.
Caregiver–Client Ratios And Workloads In Psychiatric Settings Have Increased,Similar To Other
Specialties. Psychiatric Nursing Involves Clinical Practice, Not Simply Documentation. Psychosocial
Pain Is Real And Can Cause As Much Suffering As Physical Pain.
Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation
Msc: Nclex: Safe, Effective Care Environment
8. Which Research Evidence Would Most Influence A Group Of Caregivers To Change Their
Practice?
,A. Expert Committee Report Of Recommendations For Practice
B. Systematic Review Of Randomized Controlled Trials
C. Non Experimental Descriptive Study
D. Critical Pathway
ANSWER:B
Research Findings Are Graded Using A Hierarchy Of Evidence. A Systematic Review Of Randomized
Controlled Trials Is Level A And Provides The Strongest Evidence For Changing Practice. Expert
Committee Recommendations And Descriptive Studies Lend Less Powerful And Influential Evidence. A
Critical Pathway Is Not Evidence; It Incorporates Research Findings After They Have Been Analyzed.
Dif: Cognitive Level: Comprehension (Understanding) Top: Nursing Process: Planning Msc:
Nclex: Safe, Effective Care Environment
9. A Bill Introduced In Congress Would Reduce Funding For The Care Of People Diagnosed With
Mental Illnesses. A Group Of Caregivers Write Letters To Their Elected Representatives In Oppositionto
The Legislation. Which Role Have The Caregivers Fulfilled?
A. Advocacy
B. Attending
C. Recovery
D. Evidence-Based Practice
ANSWER:A
An Advocate Defends Or Asserts Another‘S Cause, Particularly When The Other Person Lacks The Ability
To Do That For Him Or Herself. Examples Of Individual Advocacy Include Helping Clients Understand
Their Rights Or Make Decisions. On A Community Scale, Advocacy Includes Political Activity, Public
Speaking, And Publication In The Interest Of Improving The Individuals With Mental Illness; The Letter-
Writing Campaign Advocates For That Cause On Behalf Of Clients Who Are Unable To Articulate Their
Own Needs.
Dif: Cognitive Level: Comprehension (Understanding)
Top: Nursing Process: Implementation Msc: Nclex: Safe, Effective Care Environment
10. An Informal Group Of Clients Discuss Their Perceptions Of Nursing Care. Which Comment Best
Indicates A Client‘S Perception That His Or Her Caregiver Is Caring?
A. ―My Caregiver Always Asks Me Which Type Of Juice I Want To Help Me Swallow My
Medication.‖
B. ―My Caregiver Explained My Treatment Plan To Me And Asked For My Ideas About How To
Make It Better.‖
,C. ―My Caregiver Told Me That If I Take All The Medicines The Doctor Prescribes, I Will Get
Discharged Soon.‖
D. ―My Caregiver Spends Time Listening To Me Talk About My Problems. That Helps Me Feel Like
I‘M Not Alone.‖
ANSWER:D
Caring Evidences Empathic Understanding As Well As Competency. It Helps Change Pain And Suffering
Into A Shared Experience, Creating A Human Connection That Alleviates Feelings Of Isolation. The
Incorrect Options Give Examples Of Statements That Demonstrate Advocacy Or Giving Advice.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Evaluation Msc: Nclex:
Psychosocial Integrity
11. A Client Who Immigrated To The United States From Honduras Was Diagnosed With
Schizophrenia. The Client Took An Antipsychotic Medication For 3 Weeks But Showed No Improvement.
Which Resource Should The Treatment Team Consult For Information On More Effective Medications
For This Client?
A. Clinical Algorithm
B. Clinical Pathway
C. Clinical Practice Guideline
D. International Statistical Classification Of Diseases And Related Health Problems
(Icd)
ANSWER:A
A Clinical Algorithm Is A Guideline That Describes Diagnostic And/Or Treatment Approaches Drawn From
Large Databases Of Information. These Guidelines Help The Treatment Team Make Decisions Cognizant
Of An Individual Client‘S Needs, Such As Ethnic Origin, Age, Or Gender. A Clinical Pathway Is A Map Of
Interventions And Treatments Related To A Specific Disorder.
Clinical Practice Guidelines Summarize Best Practices About Specific Health Problems. The Icd Classifies
Diseases.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Evaluation Msc: Nclex: Safe,
Effective Care Environment
12. A Team Of Caregivers Wants To Integrate Evidence-Based Practice Into A Facility‘S Clinical
Pathways.Which Step Should The Team Implement First?
A. Acquire Findings From Published Literature.
B. Apply The Research Findings To Clinical Practice.
,C. Assess The Outcomes Of Using New Research Findings.
D. Ask Questions To Identify Clinical Problems That Should Be Changed.
ANSWER:D
Integrating Evidence-Based Practice Is A Multistep Process Rather Than A Single Change Event. The First
Step Is To Identify Clinical Problems That Should Be Changed. Each Step Must Proceed In Order When
Integrated Into A Clinical Environment.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Planning Msc: Nclex: Safe,
Effective Care Environment
13. A Caregiver Consistently Strives To Demonstrate Caring Behaviors During Interactions With
Clients. Which Reaction Reported By A Client Indicates This Caregiver Is Most Effective?
A. Feeling Less Distrustful Of Others
B. Sensing A Connection With Others
C. Experiencing Only Minimal Uneasiness About The Future
D. Being Somewhat Encouraged With Efforts To Improve
ANSWER:B
A Client Is Likely To Respond Most To Caring With A Sense Of Connectedness With Others. The Absence
Of Caring Can Make Clients Feel Some Degree Of Distrustful, Disconnection, Unease, And
Discouragement.
Dif: Cognitive Level: Comprehension (Understanding) Top: Nursing Process: Evaluation Msc:
Nclex: Psychosocial Integrity
Multiple Response
1. An Experienced Caregiver Says To A New Graduate, ―When You‘Ve Practiced As Long As I Have,
You Will Instantly Know How To Take Care Of Psychotic Clients.‖ What Is The New Graduate‘S Best
Analysis Of This Comment? (Select All That Apply.)
A. The Experienced Caregiver May Have Lost Sight Of Clients‘ Individuality, Which Maycompromise
The Integrity Of Practice.
B. New Research Findings Must Be Continually Integrated Into A Caregiver‘S Practice To Provide
The Most Effective Care.
C. Experience Provides Mental Health Caregivers With The Tools And Skills Needed For Effective
Professional Practice.
D. Experienced Psychiatric Caregivers Have Learned The Best Ways To Care For Psychotic Clients
Through Trial And Error.
, E. Effective Psychiatric Caregivers Should Be Continually Guided By An Intuitive Sense Of Clients‘
Needs.
ANSWER:A, B
Evidence-Based Practice Involves Using Research Findings To Provide The Most Effective Nursing Care.
Evidence Is Continually Emerging; Therefore, Caregivers Cannot Rely Solely On Experience. The Effective
Caregiver Also Maintains Respect For Each Client As An Individual. Overgeneralization Compromises
That Perspective. Intuition And Trial And Error Are Unsystematic Approaches To Care.
Dif: Cognitive Level: Application (Applying) Top: Nursing Process: Evaluation Msc: Nclex: Safe,
Effective Care Environment
2. Which Client Statements Identify Qualities Of Nursing Practice With High Therapeutic Value?
―My Caregiver: (Select All That Apply.)
A. ―The Caregivers Talk In Language I Can Understand.‖
B. ―The Nursing Staff Helps Me Keep Track Of My Medications.‖
C. ―My Caregiver Is Willing To Go To Social Activities With Me.‖
D. ―The Staff Lets Me Do Whatever I Choose Without Interfering.‖
E. ―My Caregivers Look At Me As A Whole Person With Different Needs.‖
ANSWER:A, B, E
Each Correct Responsewer Demonstrates Caring Is An Example Of Appropriate Nursing Foci:
Communicating At A Level Understandable To The Client, Using Holistic Principles To Guide Care,And
Providing Medication Supervision. The Incorrect Options Suggest A Laissez-Faire Attitude On The Part Of
The Caregiver When The Caregiver Should Instead Provide Thoughtful Feedback And Help Clients Test
Alternative Solutions Or Violate Boundaries.
Dif: Cognitive Level: Application (Applying)
Top: Nursing Process: Implementation Msc: Nclex: Psychosocial Integrity
Chapter 02: Mental Health And Mental Illness
Multiple Choice
1. An 86 Year Old, Previously Healthy And Independent, Falls After An Episode Of Vertigo. Which
Statement Made By This Client Best Demonstrates Resilience?
