Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
Essentials of Psychiatric Mental Health Nursing 8th Edition Conce
m m m m m m m mm
pts of Care in Evidence-
m m m m
Based Practice 8th Edition Morgan Townsend Test Ba
m m mm m m m m
nk
Chapterm1.mMentalmHealthmand mMentalmIllness
MultiplemChoice
m
1. A mnursemismassessingmamclient mwhomismexperiencingmoccasionalmfeelingsmof msadnessmbecausemof mt
hemrecent mdeathmof mambeloved mpet.mThemclientsmappetite,msleepmpatterns,mand mdailymroutinemhavemn
ot mchanged.mHow mshould mthemnurseminterpret mthemclientsmbehaviors?
1. Themclientsmbehaviorsmdemonstratemmentalmillnessm inmthemformmof mdepression.
2. Themclientsmbehaviorsmaremextensive,mwhichmindicatesmthempresencemof mmentalmillness.
3. Themclientsmbehaviorsmaremnot mcongruent mwithmculturalmnorms.
4. Themclientsmbehaviorsmdemonstratemnomfunctionalmimpairment,mindicatingmnommentalmillness.
ANS:m4
Rationale:mThemnursemshould massessmthat mthemclientsmdailymfunctioningmismnot mimpaired.mThemclient
mwhomexperiencesmfeelingsmof msadnessmaftermthemlossmof mampet mismrespondingmwithinmnormalmexpec
tations.mWithout msignificant mimpairment,mthemclientsmdistressmdoesmnot mindicatemammentalmillness.
CognitivemLevel:mAnalysismInte
grated mProcess:mAssessment
2. At mwhat mpoint mshould mthemnursemdeterminemthat mamclient mismat mriskmformdevelopingmammen
talmillness?
1. Whenmthoughts,mfeelings,mand mbehaviorsmaremnot mreflectivemof mthemDSM-5mcriteria.
2. Whenmmaladaptivemresponsesmtomstressmaremcoupled mwithminterferenceminmdaily mfunctioning.
3. Whenmamclient mcommunicatesmsignificant mdistress.
4. Whenmamclient musesmdefensemmechanismsmasmegomprotection.
ANS:m2
Rationale:mThemnursemshould mdeterminemthat mthemclient mismat mriskmformmentalmillnessmwhen mrespon
sesmtomstressmaremmaladaptivemand minterferemwithmdailymfunctioning.mThemDSM-
5mindicatesmthat minmordermtombemdiagnosed mwithmammentalmillness,mdailymfunctioningmmust mbemsigni
ficantlymimpaired.mThemclientsmabilitymtomcommunicatemdistressmwould mbemconsidered mampositivem
attribute.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mAssessment
3. A mnursemismassessingmamset mof m15-year-
old midenticalmtwinsmwhomrespond mverymdifferentlymtomstress.mOnemtwinmbecomesmanxiousmand mirrit
able,mand mthemothermwithdrawsmand mcries.mHow mshould mthemnursemexplainmthesemdifferent mstressmre
sponsesmtomthemparents?
1. Reactionsmtomstressmaremrelativemrathermthanmabsolute;mindividualmresponsesmtom stressmvary.
2. It mismabnormalmformidenticalmtwinsmtomreact mdifferentlymtomsimilarmstressors.
,Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
3. Identicalmtwinsmshould msharemthemsamemtemperament mand mrespond msimilarlymtomstress.
4. Environmentalminfluencesmtomstressmweighmmoremheavilymthanmgeneticminfluences.
,Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
ANS:m1
Rationale:mThemnursemshould mexplainmtomthemparentsmthat,malthoughmthemtwinsmhavemidenticalmDN
A,mtheremaremseveralmothermfactorsmthat maffect mreactionsmtomstress.mMentalmhealthmismamstatemof mbein
gmthat mismrelativemtomthemindividualmclient.mEnvironmentalminfluencesmand mtemperament mcanmaffec
t mstressmreactions.
CognitivemLevel:mApplicationmInteg
rated mProcess:mImplementation
4.mWhichmclient mshould mthemnursemanticipatemtombemmost mreceptivemtompsychiatricmtreatment?
1. A mJewish,mfemalemsocialmworker.
2. A mBaptist,mhomelessmmale.
3. A mCatholic,mblackmmale.
4. A mProtestant,mSwedishmbusinessmexecutive.
ANS:m1
Rationale:mThemnursemshould manticipatemthat mthemclient mof mJewishmculturemwould mplacemamhighmimp
ortancemonmpreventativemhealthmcaremand mwould mconsidermmentalmhealthmasmequallymimportant masmp
hysicalmhealth.mWomenmaremalsommorem likelymtomseekmtreatment mformmental mhealthmproblemsmthanm
men.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mPlanning
5. A mpsychiatricmnurseminternmstates,mThismclientsmusemof mdefensemmechanismsmshould mbemeliminat
ed.mWhichmismamcorrect mevaluationmof mthismnursesmstatement?
1. Defensemmechanismsmcanmbemappropriatemresponsesmtomstress mand mneed mnot mbemeliminated.
2. Defensemmechanismsmaremammaladaptivemattempt mof mthemegomtommanagemanxietymand mshou
ld malwaysmbemeliminated.
3. Defensemmechanisms,mused mbymindividualsmwithmweakmegomintegrity,mshould mbemdiscouraged ma
nd mnot meliminated.
4. Defensemmechanismsmcausemdisintegrationmof mthemegomand mshould mbemfostered mand mencouraged.
ANS:m1
Rationale:mThemnursemshould mdeterminemthat mdefensemmechanismsmcanmbemappropriate mduringmtim
esmof mstress.mThemclient mwithmnomdefensemmechanismsmmaymhavemam lowermtolerancemformstress,mth
usmleadingmtomanxietymdisorders.mDefensemmechanismsmshould mbemconfronted mwhenmtheymimpede
mthemclient mfrommdevelopingmhealthymcopingmskills.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mEvaluation
6. Duringmanmintakemassessment,mamnursemasksmbothmphysiologicalmand mpsychosocial mquestions.m T
hemclient mangrilymresponds,mImmheremformmymheart,mnot mmymhead mproblems. mWhichm ismthemnursesm
best mresponse?
1. Itsmjust mamroutinempart mof mourmassessment.mAllmclientsmaremasked mthesemsamemquestions.
2. Whymaremyoumconcerned mabout mthesemtypesmof mquestions?
3. Psychologicalmfactors,mlikemexcessivemstress,mhavembeenmfound mtomaffect mmedicalmconditions.
4. Wemcanmskipmthesemquestions,mif myoumlike.mIt misnt mimperative mthat mwemcompletemthismsection.
, Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
ANS:m3
Rationale:mThemnursemshould mattempt mtomeducatemthemclient monmthemnegativemeffectsmof mexcessivems
tressmonmmedicalmconditions.mIt mismnot mappropriatemtomskipmphysiologicalmand mpsychosocialmquesti
ons,masmthismwould mlead mtomanminaccuratemassessment.
CognitivemLevel:mApplicationmInteg
rated mProcess:mImplementation
7. Anmemployeemusesmthemdefensemmechanismmof mdisplacement mwhenmthembossmopenlymdisagre
esmwithmsuggestions.mWhat mbehaviormwould mbemexpected mfrommthismemployee?
1. Thememployeemassertivelymconfrontsmthemboss.
2. Thememployeemleavesmthemstaff mmeetingmtomworkmout minmthemgym.
3. Thememployeemcriticizesmamcoworker.
4. Thememployeemtakesmthembossmout mtomlunch.
ANS:m3
Rationale:mThemnursemshould mexpect mthat mthemclient musingmthemdefensemmechanismmdisplacement m
would mcriticizemamcoworkermaftermbeingmconfronted mbymthemboss.mDisplacement mrefersmtomtransfer
ringmfeelingsmfrommonemtarget mtomamneutralmormless-threateningmtarget.
CognitivemLevel:mAnalysismInte
grated mProcess:mAssessment
8. A mfourth-
grademboymteasesmand mmakesmjokesmabout mamcutemgirlminmhismclass.m This mbehaviormshould mbemident
ified mbymamnursemasmindicativemof mwhichmdefensemmechanism?
1. Displacement
2. Projection
3. Reactionmformation
4. Sublimation
ANS:m3
Rationale:mThemnursemshould midentifymthat mthemboymismusingmreactionmformationmasmamdefensemmec
hanism.mReactionmformationmismthemattempt mtomprevent mundesirablemthoughtsmfrommbeingmexpresse
d mbymexpressingmoppositemthoughtsmormbehaviors.mDisplacement mrefersmtomtransferringmfeelingsmfro
mmonemtarget mtomanother.mRationalizationmrefersmtommakingmexcusesmtomjustifymbehavior.mProjection
mrefersmtomthemattributionmof munacceptablemfeelingsmormbehaviorsmtomanothermperson.
Sublimationmrefersmtomchannelingmunacceptablemdrivesmor mimpulsesm intommoremconstructive,maccept
ablemactivities.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mAssessment
9. Whichmnursingmstatement mabout mthemconcept mof mneurosismismmost maccurate?
1. Anmindividualmexperiencingmneurosismismunawaremthat mhemormshemis mexperiencingmdistress.
2. Anmindividualmexperiencingmneurosismfeelsmhelpless mtomchangemhismormhermsituation.
3. Anmindividualmexperiencingmneurosismismawaremof mpsychologicalmcausesmof mhis mormhermbehavior.
4. Anmindividualmexperiencingmneurosismhasmamlossmof mcontact mwithmrealit
y.mANS:m2
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
Essentials of Psychiatric Mental Health Nursing 8th Edition Conce
m m m m m m m mm
pts of Care in Evidence-
m m m m
Based Practice 8th Edition Morgan Townsend Test Ba
m m mm m m m m
nk
Chapterm1.mMentalmHealthmand mMentalmIllness
MultiplemChoice
m
1. A mnursemismassessingmamclient mwhomismexperiencingmoccasionalmfeelingsmof msadnessmbecausemof mt
hemrecent mdeathmof mambeloved mpet.mThemclientsmappetite,msleepmpatterns,mand mdailymroutinemhavemn
ot mchanged.mHow mshould mthemnurseminterpret mthemclientsmbehaviors?
1. Themclientsmbehaviorsmdemonstratemmentalmillnessm inmthemformmof mdepression.
2. Themclientsmbehaviorsmaremextensive,mwhichmindicatesmthempresencemof mmentalmillness.
3. Themclientsmbehaviorsmaremnot mcongruent mwithmculturalmnorms.
4. Themclientsmbehaviorsmdemonstratemnomfunctionalmimpairment,mindicatingmnommentalmillness.
ANS:m4
Rationale:mThemnursemshould massessmthat mthemclientsmdailymfunctioningmismnot mimpaired.mThemclient
mwhomexperiencesmfeelingsmof msadnessmaftermthemlossmof mampet mismrespondingmwithinmnormalmexpec
tations.mWithout msignificant mimpairment,mthemclientsmdistressmdoesmnot mindicatemammentalmillness.
CognitivemLevel:mAnalysismInte
grated mProcess:mAssessment
2. At mwhat mpoint mshould mthemnursemdeterminemthat mamclient mismat mriskmformdevelopingmammen
talmillness?
1. Whenmthoughts,mfeelings,mand mbehaviorsmaremnot mreflectivemof mthemDSM-5mcriteria.
2. Whenmmaladaptivemresponsesmtomstressmaremcoupled mwithminterferenceminmdaily mfunctioning.
3. Whenmamclient mcommunicatesmsignificant mdistress.
4. Whenmamclient musesmdefensemmechanismsmasmegomprotection.
ANS:m2
Rationale:mThemnursemshould mdeterminemthat mthemclient mismat mriskmformmentalmillnessmwhen mrespon
sesmtomstressmaremmaladaptivemand minterferemwithmdailymfunctioning.mThemDSM-
5mindicatesmthat minmordermtombemdiagnosed mwithmammentalmillness,mdailymfunctioningmmust mbemsigni
ficantlymimpaired.mThemclientsmabilitymtomcommunicatemdistressmwould mbemconsidered mampositivem
attribute.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mAssessment
3. A mnursemismassessingmamset mof m15-year-
old midenticalmtwinsmwhomrespond mverymdifferentlymtomstress.mOnemtwinmbecomesmanxiousmand mirrit
able,mand mthemothermwithdrawsmand mcries.mHow mshould mthemnursemexplainmthesemdifferent mstressmre
sponsesmtomthemparents?
1. Reactionsmtomstressmaremrelativemrathermthanmabsolute;mindividualmresponsesmtom stressmvary.
2. It mismabnormalmformidenticalmtwinsmtomreact mdifferentlymtomsimilarmstressors.
,Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
3. Identicalmtwinsmshould msharemthemsamemtemperament mand mrespond msimilarlymtomstress.
4. Environmentalminfluencesmtomstressmweighmmoremheavilymthanmgeneticminfluences.
,Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
ANS:m1
Rationale:mThemnursemshould mexplainmtomthemparentsmthat,malthoughmthemtwinsmhavemidenticalmDN
A,mtheremaremseveralmothermfactorsmthat maffect mreactionsmtomstress.mMentalmhealthmismamstatemof mbein
gmthat mismrelativemtomthemindividualmclient.mEnvironmentalminfluencesmand mtemperament mcanmaffec
t mstressmreactions.
CognitivemLevel:mApplicationmInteg
rated mProcess:mImplementation
4.mWhichmclient mshould mthemnursemanticipatemtombemmost mreceptivemtompsychiatricmtreatment?
1. A mJewish,mfemalemsocialmworker.
2. A mBaptist,mhomelessmmale.
3. A mCatholic,mblackmmale.
4. A mProtestant,mSwedishmbusinessmexecutive.
ANS:m1
Rationale:mThemnursemshould manticipatemthat mthemclient mof mJewishmculturemwould mplacemamhighmimp
ortancemonmpreventativemhealthmcaremand mwould mconsidermmentalmhealthmasmequallymimportant masmp
hysicalmhealth.mWomenmaremalsommorem likelymtomseekmtreatment mformmental mhealthmproblemsmthanm
men.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mPlanning
5. A mpsychiatricmnurseminternmstates,mThismclientsmusemof mdefensemmechanismsmshould mbemeliminat
ed.mWhichmismamcorrect mevaluationmof mthismnursesmstatement?
1. Defensemmechanismsmcanmbemappropriatemresponsesmtomstress mand mneed mnot mbemeliminated.
2. Defensemmechanismsmaremammaladaptivemattempt mof mthemegomtommanagemanxietymand mshou
ld malwaysmbemeliminated.
3. Defensemmechanisms,mused mbymindividualsmwithmweakmegomintegrity,mshould mbemdiscouraged ma
nd mnot meliminated.
4. Defensemmechanismsmcausemdisintegrationmof mthemegomand mshould mbemfostered mand mencouraged.
ANS:m1
Rationale:mThemnursemshould mdeterminemthat mdefensemmechanismsmcanmbemappropriate mduringmtim
esmof mstress.mThemclient mwithmnomdefensemmechanismsmmaymhavemam lowermtolerancemformstress,mth
usmleadingmtomanxietymdisorders.mDefensemmechanismsmshould mbemconfronted mwhenmtheymimpede
mthemclient mfrommdevelopingmhealthymcopingmskills.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mEvaluation
6. Duringmanmintakemassessment,mamnursemasksmbothmphysiologicalmand mpsychosocial mquestions.m T
hemclient mangrilymresponds,mImmheremformmymheart,mnot mmymhead mproblems. mWhichm ismthemnursesm
best mresponse?
1. Itsmjust mamroutinempart mof mourmassessment.mAllmclientsmaremasked mthesemsamemquestions.
2. Whymaremyoumconcerned mabout mthesemtypesmof mquestions?
3. Psychologicalmfactors,mlikemexcessivemstress,mhavembeenmfound mtomaffect mmedicalmconditions.
4. Wemcanmskipmthesemquestions,mif myoumlike.mIt misnt mimperative mthat mwemcompletemthismsection.
, Essentialsmof mPsychiatricmMentalmHealthmNursingm8thmEditionmConceptsmof mCareminmEviden
ce-mBasedmPracticem8thmEditionmMorganmTownsendmTestmBank
ANS:m3
Rationale:mThemnursemshould mattempt mtomeducatemthemclient monmthemnegativemeffectsmof mexcessivems
tressmonmmedicalmconditions.mIt mismnot mappropriatemtomskipmphysiologicalmand mpsychosocialmquesti
ons,masmthismwould mlead mtomanminaccuratemassessment.
CognitivemLevel:mApplicationmInteg
rated mProcess:mImplementation
7. Anmemployeemusesmthemdefensemmechanismmof mdisplacement mwhenmthembossmopenlymdisagre
esmwithmsuggestions.mWhat mbehaviormwould mbemexpected mfrommthismemployee?
1. Thememployeemassertivelymconfrontsmthemboss.
2. Thememployeemleavesmthemstaff mmeetingmtomworkmout minmthemgym.
3. Thememployeemcriticizesmamcoworker.
4. Thememployeemtakesmthembossmout mtomlunch.
ANS:m3
Rationale:mThemnursemshould mexpect mthat mthemclient musingmthemdefensemmechanismmdisplacement m
would mcriticizemamcoworkermaftermbeingmconfronted mbymthemboss.mDisplacement mrefersmtomtransfer
ringmfeelingsmfrommonemtarget mtomamneutralmormless-threateningmtarget.
CognitivemLevel:mAnalysismInte
grated mProcess:mAssessment
8. A mfourth-
grademboymteasesmand mmakesmjokesmabout mamcutemgirlminmhismclass.m This mbehaviormshould mbemident
ified mbymamnursemasmindicativemof mwhichmdefensemmechanism?
1. Displacement
2. Projection
3. Reactionmformation
4. Sublimation
ANS:m3
Rationale:mThemnursemshould midentifymthat mthemboymismusingmreactionmformationmasmamdefensemmec
hanism.mReactionmformationmismthemattempt mtomprevent mundesirablemthoughtsmfrommbeingmexpresse
d mbymexpressingmoppositemthoughtsmormbehaviors.mDisplacement mrefersmtomtransferringmfeelingsmfro
mmonemtarget mtomanother.mRationalizationmrefersmtommakingmexcusesmtomjustifymbehavior.mProjection
mrefersmtomthemattributionmof munacceptablemfeelingsmormbehaviorsmtomanothermperson.
Sublimationmrefersmtomchannelingmunacceptablemdrivesmor mimpulsesm intommoremconstructive,maccept
ablemactivities.
CognitivemLevel:mApplicationmI
ntegrated mProcess:mAssessment
9. Whichmnursingmstatement mabout mthemconcept mof mneurosismismmost maccurate?
1. Anmindividualmexperiencingmneurosismismunawaremthat mhemormshemis mexperiencingmdistress.
2. Anmindividualmexperiencingmneurosismfeelsmhelpless mtomchangemhismormhermsituation.
3. Anmindividualmexperiencingmneurosismismawaremof mpsychologicalmcausesmof mhis mormhermbehavior.
4. Anmindividualmexperiencingmneurosismhasmamlossmof mcontact mwithmrealit
y.mANS:m2
