Ch. 34- End of Chapter Questions

Question 1

1. Who was the English Quaker who advocated humane care and built an asylum to reflect a household?

a. Florence Nightingale
b. William Tukes
c. Sigmund Freud
d. Benjamin Rush

Answer 1

b. William Tukes

Question 2

2. Changes in the delivery of mental health care that resulted from the development of electroconvulsive therapy and psychotherapeutic drugs brought about which phenomenon in the 20th century?

a. Behavioral therapy
b. Personality disorganization
c. Deinstitutionalization
d. Brain surgery

Answer 2

c. Deinstitutionalization

Question 3

3. What is the best description of personality?

a. The level of mental health that a person attains in life
b. The relatively consistent set of attitudes and behaviors particular to an individual
c. The result of a positive self-concept and acceptable behavior
d. The ability to manage stress

Answer 3

b. The relatively consistent set of attitudes and behaviors particular to an individual

Question 4

4. The nurse is reviewing the assessment findings for a patient hospitalized with a stress disorder. What findings support the diagnosis? (Select all that apply.)

a. A vague feeling of depression
b. An assumed role to protect the ego
c. A main reason for all mental illnesses
d. A distortion of reality in response to a stressor
e. A response to any demand made upon the individual

Answer 4

d. A distortion of reality in response to a stressor
e. A response to any demand made upon the individual

Question 5

5. The nurse is caring for a patient who is currently voicing feelings of anxiety. The nurse correctly recognizes what as the best description of the feelings that the patient is experiencing?

a. A vague feeling of apprehension
b. Feelings of paranoia
c. Emotional stability
d. Concerns about the impressions that others have of her

Answer 5

a. A vague feeling of apprehension

Question 6

6. An assembly-line manager in a factory was told that he would be laid off if his line did not meet the hourly quota. He promptly went to his workers and threatened to fire anyone who was found taking even 1 minute extra on a break. What is the manager displaying?

a. Denial
b. Regression
c. Displacement
d. Identification

Answer 6

c. Displacement

Question 7

7. Punishment and abandonment were how mentally ill people were treated in medieval times. These practices continued until the 17th and 18th centuries. Which care practice that is still being used today did Dr. Philippe Pinel of France advocate?

a. Electroshock therapy for melancholy
b. Humane care with record keeping of behaviors
c. Psychoanalysis
d. Home care in the community

Answer 7

b. Humane care with record keeping of behaviors

Question 8

8. The student nurse is working on a presentation regarding OBRA.
   What was the result of this landmark legislation? (Select all that apply.)

a. Deinstitutionalization
b. Prohibition of electroshock therapy
c. Limited access to psychotropic medications
d. Approved surgical treatment for schizophrenia
e. Increased construction of state facilities for residential mental health care

Answer 8

a. Deinstitutionalization
c. Limited access to psychotropic medications

Question 9

9. A 52-year-old patient experienced cardiac arrest from a myocardial infarction. During his acute care stay in the hospital, the patient flirts with all his female nurses. When he is asked to stop, he withdraws and later complains of chest heaviness. What is a possible explanation for the patient’s behavior?

a. Boredom from restricted activity
b. Lack of motivation to recover
c. Frustration from illness
d. Threatened self-concept

Answer 9

d. Threatened self-concept

Question 10

10. A 14-year-old tells the school nurse that she is self-conscious about her recent breast development. She reports that the boys in her class are teasing her. What is the first step for the nurse to take?

a. Call her parents.
b. Ask her to describe what happened.
c. Ask who her friends are.
d. Provide her with a pamphlet outlining the changes associated with puberty.

Answer 10

b. Ask her to describe what happened.

Question 11

11. The nurse is instructing a wife to give insulin injections to her husband. The wife is unable to sit still, frequently asks to repeat parts of the instruction for understanding, and sighs often with rapid respirations. What degree of anxiety is the wife experiencing?

a. Mild
b. Moderate
c. Severe
d. Panic

Answer 11

c. Severe

Question 12

12. A 17-year-old patient was admitted to the orthopedic unit with pelvic fracture, wrist fracture, and multiple contusions and abrasions from an auto accident. She yells for the nurse every 5 minutes, refuses to use her call light, and breaks out in tears when she does not get her way. How would this behavior best be described?

a. Regression
b. Compensation
c. Denial
d. Displacement

Answer 12

a. Regression

Question 13

13. A college student is brought to the emergency department by her roommate. The roommate states that when the patient returned from her date, she was crying and said she had been raped. The patient recounts the evening’s events, cracking jokes about her date’s trouble keeping an erection, and asking if the nurse knows where she can get a replacement for her favorite outfit, which has been torn. How is this defense mechanism best described?

a. Displacement
b. Compensation
c. Denial
d. Dissociation

Answer 13

d. Dissociation

Question 14

14. A teenager wrecks the family car by rear-ending a truck turning left. The teenager says, “It wasn’t my fault. I came over the hill” and that truck was just sitting there. It was his fault for turning left.” What defense mechanism is the teenager using to deal with his situation?

a. Compensation
b. Conversion reaction
c. Projection
d. Rationalization

Answer 14

d. Rationalization

Question 15

15. After a few days of hospitalization, a patient is participating in plans to be transferred to a rehabilitation facility to continue therapies to enhance his activities of daily living. Which statement indicates the patient is beginning to adjust to his new situation and future? (Select all that apply.)

a. “I know that once I can walk without assistance, | can go back to my own home.”
b. “My wife will not be able to help take care of me until l get stronger.”
c. “I’m going to show everybody that I can make it on my own; just you wait!”
d. “I don’t know why everybody is making a big deal; I was by myself before I got sick.”
e. “I am ready to get started with therapy so I can hopefully go home soon.”

Answer 15

b. “My wife will not be able to help take care of me until l get stronger.”
e. “I am ready to get started with therapy so I can hopefully go home soon.”

Question 16

16. What factor is most predictive of the onset of a crisis for an individual?

a. The individual has no support system.
b. The individual perceives a stressor to be threatening.
c. The individual is exposed to a precipitating stressor.
d. The individual experiences a stressor and responds with ineffective coping efforts.

Answer 16

d. The individual experiences a stressor and responds with ineffective coping efforts.

Question 17

17. During crisis intervention, what is the highest priority of nursing care?

a. Managing anxiety
b. Identifying situational supports
c. Patient safety
d. Teaching specific coping skills that the patient lacks

Answer 17

c. Patient safety

Question 18

18. The leader of a self-help group is discussing the use of defense mechanisms. What information should be included about their use? (Select all that apply.)

a. Once used, they are irreversible.
b. Defense mechanisms are pathologic.
c. They are a means of managing conflict.
d. Defense mechanisms are predominantly unconscious.
e. Defense mechanisms are primarily used to blame others.

Answer 18

c. They are a means of managing conflict.
d. Defense mechanisms are predominantly unconscious.

Question 19

19. What interventions can the nurse use to enhance the assessment of an older adult patient? (Select all that apply.)

a. Identify and accommodate physical needs first.
b. Pledge complete confidentiality on all topics to the patient.
c. Interpret information with consideration of the patient’s spiritual or cultural background.
d. Adhere firmly to the sequence of questions on the standardized assessment tool.
e. Determine whether there are any sensory changes in hearing or vision before beginning the assessment.

Answer 19

a. Identify and accommodate physical needs first.
c. Interpret information with consideration of the patient’s spiritual or cultural background.
e. Determine whether there are any sensory changes in hearing or vision before beginning the assessment.

Question 20

20. The nurse manager has completed an educational program with her staff regarding patient education and improving mental illness. Which statement by a participant would indicate a need for further education? (Select all that apply.)

a. “I need to teach my patients ways to recognize and describe their levels of anxiety.”
b. “My patients will not need to worry about learning relaxation skills if they don’t want to.”
c. “Patients who use passive communication skills have better mental health than those who use assertive communication skills.”
d. “Learning problem-solving skills can help improve a person’s overall mental health.”
e. “The power of positive thinking patterns is a topic I need to discuss with my patients.”

Answer 20

b. “My patients will not need to worry about learning relaxation skills if they don’t want to.”
c. “Patients who use passive communication skills have better mental health than those who use assertive communication skills.”