Chapter 1

Question 1

The scope of practiced for an advanced nurse practitioner would include which intervention?

a. Conducting a mental health assessment.
b. Prescribing psychotropic medication.
c. Establishing a therapeutic relationship.
d. Individualizing a nursing care plan.

Answer 1

b. Prescribing psychotropic medication.

Question 2

A nursing student expresses concerns that mental health nurses “lose all their clinical nursing skills.” Select the best response by the mental health nurse.

a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-client ratios must be better because of the nature of the clients’ problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequently use high technology monitoring equipment and manage complex intravenous therapies.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as medical–surgical nurses do. That appeals to me.”

Answer 2

b. “Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.”

Question 3

When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental illness, a group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled?

a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice

Answer 3

c. Advocacy

Question 4

A family has a long history of conflicted relationships among the members. Which family member’s comment best reflects a mentally healthy perspective?

a. “I’ve made mistakes but everyone else in this family has also.”
b. “I remember joy and mutual respect from our early years together.”
c. “I will make some changes in my behavior for the good of the family.”
d. “It’s best for me to move away from my family. Things will never change.”

Answer 4

c. “I will make some changes in my behavior for the good of the family.”

Question 5

Which assessment finding most clearly indicates that a client may be experiencing a mental illness?

a. reporting occasional sleeplessness and anxiety.
b. reporting a consistently sad, discouraged, and hopeless mood.
c. being able to describe the difference between “as if” and “for real.”
d. experiencing difficulty making a decision about whether to change jobs.

Answer 5

b. reporting a consistently sad, discouraged, and hopeless mood.

Question 6

Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was achieved for an adult client?

a. being willing to work towards achieving ideals and meeting demands.
b. behaving without considering the consequences of personal actions.
c. aggressively meeting personal needs without considering the rights of others.
d. seeking help from others to avoid assuming responsibility for major areas of own life.

Answer 6

a. being willing to work towards achieving ideals and meeting demands.

Question 7

A nurse encounters an unfamiliar psychiatric disorder on a new client’s admission form. Which resource should the nurse consult to determine criteria used to establish this diagnosis?

a. International Statistical Classification of Diseases and Related Health Problems (ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual

Answer 7

c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

Question 8

A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information?

a. Nursing Outcomes Classification (NOC)
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. ICD-10

Answer 8

b. DSM-V

Question 9

Which individual behavior demonstrates resilience?

a. Repress stressors associated with a divorce.
b. Continuing to grieve the death of a spouse for 5 years.
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
d. Taking a temporary job to maintain financial stability after loss of a permanent job.

Answer 9

d. Taking a temporary job to maintain financial stability after loss of a permanent job.

Question 10

The relationship of the North American Nursing Diagnosis Association (NANDA) is to clinical judgment as Nursing Interventions Classification (NIC) is to what?

a. client outcomes.
b. nursing actions.
c. diagnosis.
d. symptoms

Answer 10

b. nursing actions.

Question 11

An adult says, “Most of the time I’m happy and feel good about myself. I have learned that what I get out of something is proportional to the effort I put into it.” Which number on this mental health continuum should the nurse select?

Mental Illness Mental Health
1 2 3 4 5

a. 1
b. 2
c. 3
d. 4
e. 5

Answer 11

e. 5

Question 12

Which disorder is an example of a culture-bound syndrome?

a. Epilepsy
b. Schizophrenia
c. Running amok
d. Major depressive disorder

Answer 12

c. Running amok

Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people in those cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a person (usually a male) runs around engaging in furious, almost indiscriminate violent behavior.

Question 13

What does the DSM-V classify?

a. deviant behaviors
b. present disability or distress
c. people with mental disorders
d. mental disorders

Answer 13

d. mental disorders

Question 14

A citizen at a community health fair asks the nurse, “What is the most prevalent mental disorder in the United States?” Select the nurse’s correct response.

a. Schizophrenia
b. Bipolar disorder
c. Dissociative fugue
d. Alzheimer’s disease

Answer 14

d. Alzheimer’s disease

Question 15

In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill?

a. One who describes hearing God’s voice speaking.
b. One who is usually pessimistic but strives to meet personal goals.
c. One who is wealthy and gives away $20 bills to needy individuals.
d. One who always has an optimistic viewpoint about life

Answer 15

a. One who describes hearing God’s voice speaking.

Question 16

A client’s relationships are intense and unstable. The client initially idealizes the significant other and then devalues him or her, resulting in frequent feelings of emptiness. This client will benefit from interventions to develop which aspect of mental health?

a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships

Answer 16

d. Fulfilling relationships

Question 17

Which belief will best support a nurse’s efforts to provide client advocacy during a multidisciplinary client care planning session?

a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental illness reflect a person’s cultural patterns

Answer 17

d. Assessment findings in mental illness reflect a person’s cultural patterns

Question 18

A nurse is part of a multidisciplinary team working with groups of depressed clients. One group of clients receives supportive interventions and antidepressant medication. The other group receives only medication. The team measures outcomes for each group. Which type of study is evident?

a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology

Answer 18

d. Clinical epidemiology

Question 19

The spouse of a client diagnosed with schizophrenia says, “I don’t understand how events from childhood have anything to do with this disabling illness.” Which response by the nurse will best help the spouse understand the cause of this disorder?

a. “Psychological stress is the basis of most mental disorders.”
b. “This illness results from developmental factors rather than stress.”
c. “Research shows that this condition more likely has a biological basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”

Answer 19

c. “Research shows that this condition more likely has a biological basis.”

Question 20

A category 5 tornado occurred in a community of 400 people. Many homes and businesses were destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with posttraumatic stress disorder (PTSD). Which term best applies to these newly diagnosed cases?

a. Prevalence
b. Comorbidity
c. Incidence
d. Parity

Answer 20

c. Incidence

Question 21

Which component of treatment of mental illness is specifically recognized by Quality and Safety Education for Nurses (QSEN)?

a. All genomes are unique.
b. Care is centered on the client.
c. Healthy development is vital to mental health.
d. Recovery occurs on a continuum from illness to health.

Answer 21

b. Care is centered on the client.

Question 22

What is the best response for the nurse to provide to a question from another health professional regarding the difference between a diagnosis in DSM-V and a nursing diagnosis.

a. “There is no functional difference between the two. Both identify human disorders.”
b. “The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes culture into account.”
c. “The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis does not explore etiology.”
d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for issues a client is experiencing.”

Answer 22

d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for issues a client is experiencing.”

Question 23

Which nursing intervention below is part of the scope of an advanced practice psychiatric/mental health nurse rather than a basic level registered nurse?

a. Coordination of care
b. Health teaching
c. Milieu therapy
d. Psychotherapy

Answer 23

d. Psychotherapy

Question 24

An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you automatically know how to take care of clients experiencing psychosis.” Which factors should the new graduate consider when analyzing this comment? (Select all that apply.)

a. The experienced nurse may have lost sight of clients’ individuality, which may compromise the integrity of practice.

b. New research findings should be integrated continuously into a nurse’s practice to provide the most effective care.

c. Experience provides mental health nurses with the essential tools and skills needed for effective professional practice.

d. Experienced psychiatric nurses have learned the best ways to care for mentally ill clients through trial and error.

e. An intuitive sense of clients’ needs guides effective psychiatric nurses.

Answer 24

a. The experienced nurse may have lost sight of clients’ individuality, which may compromise the integrity of practice.
b. New research findings should be integrated continuously into a nurse’s practice to provide the most effective care.

Question 25

Which findings are signs of a person who is mentally healthy? (Select all that apply.)

a. Says, “I have some weaknesses, but I feel I’m important to my family and friends.”
b. Adheres strictly to religious beliefs of parents and family of origin.
c. Spends all holidays alone watching old movies on television.
d. Considers past experiences when deciding about the future.
e. Experiences feelings of conflict related to changing jobs.

Answer 25

a. Says, “I have some weaknesses, but I feel I’m important to my family and friends.”
d. Considers past experiences when deciding about the future.
e. Experiences feelings of conflict related to changing jobs.

Question 26

A client in the emergency department says, “Voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat.” Which aspects of the client’s mental health have the greatest and most immediate concern to the nurse? (Select all that apply.)

a. Happiness
b. Appraisal of reality
c. Control over behavior
d. Effectiveness in work
e. Healthy self-concept

Answer 26

b. Appraisal of reality
c. Control over behavior
e. Healthy self-concept