lOMoAR cPSD| 7906827
Essentials of Psychiatric Mental Health
Nursing 8th Edition Concepts of Care in
Evidence - Based Practice 8th Edition Morgan
Townsend
Chapter 1. Mental Health and
Mental Illness Multiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of
sadness because of the recent death of a beloved pet. The clients appetite,
sleep patterns, and daily routine have not changed. How should the nurse
interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of
mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no
mental illness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not
impaired. The client who experiences feelings of sadness after the loss of a
pet is responding within normal expectations. Without significant
impairment, the clients distress does not indicate a mental illness.
Cognitive Level:
Analysis Integrated
Process: Assessment
2. At what point should the nurse determine that a client is at risk for
developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5
criteria.
, lOMoAR cPSD| 7906827
2. When maladaptive responses to stress are coupled with interference in
daily functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental
illness when responses to stress are maladaptive and interfere with daily
functioning. The DSM-5 indicates that in order to be diagnosed with a
mental illness, daily functioning must be significantly impaired. The clients
ability to communicate distress would be considered a positive attribute.
Cognitive Level:
Application Integrated
Process: Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very
differently to stress. One twin becomes anxious and irritable, and the other
withdraws and cries. How should the nurse explain these different stress
responses to the parents?
1. Reactions to stress are relative rather than absolute; individual responses
to stress vary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly
to stress.
4. Environmental influences to stress weigh more heavily than genetic
influences.
, lOMoAR cPSD| 7906827
ANS: 1
Rationale: The nurse should explain to the parents that, although the twins
have identical DNA, there are several other factors that affect reactions to
stress. Mental health is a state of being that is relative to the individual
client. Environmental influences and temperament can affect stress
reactions.
Cognitive Level:
Application Integrated
Process: Implementation
4. Which client should the nurse anticipate to be most receptive to
psychiatric treatment?
1.A Jewish, female social worker.
2.A Baptist, homeless male.
3.A Catholic, black male.
4.A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture
would place a high importance on preventative health care and would
consider mental health as equally important as physical health. Women are
also more likely to seek treatment for mental health problems than men.
Cognitive Level:
Application Integrated
Process: Planning
5.A psychiatric nurse intern states, This clients use of defense mechanisms
should be eliminated. Which is a correct evaluation of this nurses
statement?
1. Defense mechanisms can be appropriate responses to stress and need not
be eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to
manage anxiety and should always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should
be discouraged and not eliminated.
, lOMoAR cPSD| 7906827
ANS: 1
4. Defense mechanisms cause disintegration of the ego and should be
fostered and encouraged.
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be
appropriate during times of stress. The client with no defense mechanisms
may have a lower tolerance for stress, thus leading to anxiety disorders.
Defense mechanisms should be confronted when they impede the client
from developing healthy coping skills.
Cognitive Level:
Application Integrated
Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and
psychosocial questions. The client angrily responds, Im here for my heart,
not my head problems. Which is the nurses best response?
1. Its just a routine part of our assessment. All clients are asked these same
questions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect
medical conditions.
4. We can skip these questions, if you like. It isnt imperative that we
complete this section.
Essentials of Psychiatric Mental Health
Nursing 8th Edition Concepts of Care in
Evidence - Based Practice 8th Edition Morgan
Townsend
Chapter 1. Mental Health and
Mental Illness Multiple Choice
1. A nurse is assessing a client who is experiencing occasional feelings of
sadness because of the recent death of a beloved pet. The clients appetite,
sleep patterns, and daily routine have not changed. How should the nurse
interpret the clients behaviors?
1. The clients behaviors demonstrate mental illness in the form of depression.
2. The clients behaviors are extensive, which indicates the presence of
mental illness.
3. The clients behaviors are not congruent with cultural norms.
4. The clients behaviors demonstrate no functional impairment, indicating no
mental illness.
ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not
impaired. The client who experiences feelings of sadness after the loss of a
pet is responding within normal expectations. Without significant
impairment, the clients distress does not indicate a mental illness.
Cognitive Level:
Analysis Integrated
Process: Assessment
2. At what point should the nurse determine that a client is at risk for
developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5
criteria.
, lOMoAR cPSD| 7906827
2. When maladaptive responses to stress are coupled with interference in
daily functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
ANS: 2
Rationale: The nurse should determine that the client is at risk for mental
illness when responses to stress are maladaptive and interfere with daily
functioning. The DSM-5 indicates that in order to be diagnosed with a
mental illness, daily functioning must be significantly impaired. The clients
ability to communicate distress would be considered a positive attribute.
Cognitive Level:
Application Integrated
Process: Assessment
3. A nurse is assessing a set of 15-year-old identical twins who respond very
differently to stress. One twin becomes anxious and irritable, and the other
withdraws and cries. How should the nurse explain these different stress
responses to the parents?
1. Reactions to stress are relative rather than absolute; individual responses
to stress vary.
2. It is abnormal for identical twins to react differently to similar stressors.
3. Identical twins should share the same temperament and respond similarly
to stress.
4. Environmental influences to stress weigh more heavily than genetic
influences.
, lOMoAR cPSD| 7906827
ANS: 1
Rationale: The nurse should explain to the parents that, although the twins
have identical DNA, there are several other factors that affect reactions to
stress. Mental health is a state of being that is relative to the individual
client. Environmental influences and temperament can affect stress
reactions.
Cognitive Level:
Application Integrated
Process: Implementation
4. Which client should the nurse anticipate to be most receptive to
psychiatric treatment?
1.A Jewish, female social worker.
2.A Baptist, homeless male.
3.A Catholic, black male.
4.A Protestant, Swedish business executive.
ANS: 1
Rationale: The nurse should anticipate that the client of Jewish culture
would place a high importance on preventative health care and would
consider mental health as equally important as physical health. Women are
also more likely to seek treatment for mental health problems than men.
Cognitive Level:
Application Integrated
Process: Planning
5.A psychiatric nurse intern states, This clients use of defense mechanisms
should be eliminated. Which is a correct evaluation of this nurses
statement?
1. Defense mechanisms can be appropriate responses to stress and need not
be eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to
manage anxiety and should always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should
be discouraged and not eliminated.
, lOMoAR cPSD| 7906827
ANS: 1
4. Defense mechanisms cause disintegration of the ego and should be
fostered and encouraged.
ANS: 1
Rationale: The nurse should determine that defense mechanisms can be
appropriate during times of stress. The client with no defense mechanisms
may have a lower tolerance for stress, thus leading to anxiety disorders.
Defense mechanisms should be confronted when they impede the client
from developing healthy coping skills.
Cognitive Level:
Application Integrated
Process: Evaluation
6. During an intake assessment, a nurse asks both physiological and
psychosocial questions. The client angrily responds, Im here for my heart,
not my head problems. Which is the nurses best response?
1. Its just a routine part of our assessment. All clients are asked these same
questions.
2. Why are you concerned about these types of questions?
3. Psychological factors, like excessive stress, have been found to affect
medical conditions.
4. We can skip these questions, if you like. It isnt imperative that we
complete this section.
