MH final/Mental Health Exam Latest Test Bank
Contents
Chapter 01: The Concept of Stress Adaptation
Chapter 02: Mental Health/Mental Illness:
... [Show More] Historical and Theoretical Concepts
Chapter 03: Psychopharmacology
Chapter 04: Concepts of Psychobiology
Chapter 07: Relationship Development
Chapter 08: Therapeutic Communication
Chapter 09: The Nursing Process in Psychiatric/Mental Health Nursing
Chapter 10: Therapeutic Groups
Chapter 12: Milieu Therapy - The Therapeutic Community
Chapter 13: Crisis Intervention
Chapter 16: Anger/Aggression Management
Chapter 17: The Suicidal Client
Chapter 18: Behavior Therapy
Chapter 19: Cognitive Therapy
Chapter 25: Depressive Disorders
Chapter 26: Bipolar and Related Disorders
Chapter 27: Anxiety, Obsessive-Compulsive, and Related Disorders
Chapter 31: Eating Disorders
Chapter 32: Personality Disorders
Chapter 01. The Concept of Stress Adaptation
1. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope. B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing response?
A. Teenagers! They dont know a thing about real stress. B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
6. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and
has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
B. Complete the problem-solving process for the client.
C. Work through the problem-solving process with the client.
D. Encourage the client to keep a journal.
8. A school nurse is assessing a distraught female high school student who is overly concerned because her parents cant afford horseback riding lessons. How should the nurse interpret the students reaction to her perceived problem?
A. The problem is endangering her well-being. B. The problem is personally relevant to her. C. The problem is based on immaturity.
D. The problem is exceeding her capacity to cope.
9. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a nurse expect to assess?
A. An achieved state of relaxation
B. An achieved insight into ones feelings
C. A demonstration of appropriate role behaviors
D. An enhanced ability to problem-solve
10. A distraught, single, first-time mother cries and asks a nurse, How can I go to work if I cant afford childcare? What is the nurses initial action in assisting the client with the problem-solving process? A. Determine the risks and benefits for each alternative.
B. Formulate goals for resolution of the problem.
C. Evaluate the outcome of the implemented alternative.
D. Assess the facts of the situation.
11. A nursing instructor is asking students about diseases of adaptation and when they are likely to occur. Which student response indicates that learning has occurred?
A. When an individual has limited experience dealing with stress
B. When an individual inherits maladaptive genes
C. When an individual experiences existing conditions that exacerbate stress
D. When an individuals physiological and psychological resources have become depleted
12. When an individuals stress response is sustained over a long period of time, which physiological effect of the endocrine system should a nurse anticipate?
A. Decreased resistance to disease
B. Increased libido
C. Decreased blood pressure
D. Increased inflammatory response
13. Which symptom should a nurse identify as typical of the fight-or-flight response? A. Pupil constriction
B. Increased heart rate C. Increased salivation D. Increased peristalsis
14. A nurse is evaluating a clients response to stress. What would indicate to the nurse that the client is experiencing a secondary appraisal of the stressful event?
A. When the individual judges the event to be benign
B. When the individual judges the event to be irrelevant
C. When the individual judges the resources and skills needed to deal with the event
D. When the individual judges the event to be pleasurable
15. Research undertaken by Miller and Rahe in 1997 demonstrated a correlation between the effects of life change and illness. This research led to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool?
A. Specific illnesses are not identified.
B. The numerical values associated with specific life events are randomly assigned
C. Stress is viewed as only a physiological response.
D. Personal perception of the event is excluded.
16. A client who experiences stress on a regular basis asks a nurse what causes these feelings. Which is the most appropriate nursing response?
A. Genetics have nothing to do with your temperament.
B. How you reacted to past experiences influences how you feel now.
C. If youre in good physical health, your stress level will be low.
D. Stress can always be avoided if appropriate coping mechanisms are employed.
17. A nurse is interviewing a distressed client, who relates being fired after 15 years of loyal employment. Which of the following questions would best assist the nurse to determine the clients appraisal of the situation? Select all that apply.
A. What resources have you used previously in stressful situations? B. Have you ever experienced a similar stressful situation?
C. Who do you think is to blame for this situation? D. Why do you think you were fired from your job?
E. What skills do you possess that might lead to gainful employment?
18. A nurse is working with a client who has recently been under a great deal of stress. Which nursing recommendations would be most helpful when assisting the client in coping with stress? Select all that apply.
A. Enjoy a pet.
B. Spend time with a loved one. C. Listen to music.
D. Focus on the stressors.
E. Journal your feelings.
19. A nurse is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?
A. Diagnostic blood tests
B. Awareness of factors creating stress
C. Relaxation exercises
D. Identifying support systems
20. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient are common initial biological responses to stress? Select all that apply.
A. Constricted pupils
B. Watery eyes
C. Unusual food cravings
D. Increased heart rate
E. Increased respirations
Chapter 02. Mental Health/Mental Illness: Historical and Theoretical Concepts
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?
A. The clients behaviors demonstrate mental illness in the form of depression.
B. The clients behaviors are extensive, which indicates the presence of mental illness. C. The clients behaviors are not congruent with cultural norms.
D. The clients behaviors demonstrate no functional impairment, indicating no mental illness.
2. At what point should the nurse determine that a client is at risk for developing a mental disorder? A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B. When maladaptive responses to stress are coupled with interference in daily functioning
C. When the client communicates significant distress
D. When the client uses defense mechanisms as ego protection
3. A nurse is assessing 15-year-old identical twins who respond very differently to stress. One twin becomes anxious and irritable, while the other withdraws and cries. How should the nurse explain these different responses to stress to the parents?
A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
B. It is abnormal for identical twins to react differently to similar stressors.
C. Identical twins should share the same temperament and respond similarly to stress. D. Environmental influences weigh more heavily than genetic influences on reactions to stress.
4. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, I work hard to provide for my family. I dont see why I cant drink to relax. The nurse recognizes the use of which defense mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation
5. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
A. A Jewish, female journalist
B. A Baptist, homeless male
C. A Catholic, black male
D. A Protestant, Swedish business executive
6. A new psychiatric nurse states, This clients use of defense mechanisms should be eliminated. Which is a correct evaluation of this nurses statement?
A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated.
C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not eliminated.
D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
7. 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?
A. Its just a routine part of our assessment. All clients are asked these same questions.
B. Why are you concerned about these types of questions?
C. Psychological factors, like excessive stress, have been found to affect medical conditions.
D. We can skip these questions, if you like. It isnt imperative that we complete this section.
8. Which statement reflects a student nurses accurate understanding of the concepts of mental health and mental illness?
A. The concepts are rigid and religiously based.
B. The concepts are multidimensional and culturally defined.
C. The concepts are universal and unchanging. D. The concepts are unidimensional and fixed.
9. A mental health technician asks the nurse, How do psychiatrists determine which diagnosis to give a patient? Which of these responses by the nurse would be most accurate?
A. Psychiatrists use pre-established criteria from the APAs Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patients unhealthy responses and contributing factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.
10. The nurse is preparing to provide medication instruction for a patient. Which of the following understandings about anxiety will be essential to effective instruction?
A. Learning is best when anxiety is moderate to severe.
B. Learning is enhanced when anxiety is mild.
C. Panic level anxiety helps the nurse teach better.
D. Severe anxiety is characterized by intense concentration and enhances the attention span.
11. Which of the following are identified as psychoneurotic responses to severe anxiety as they appear in the DSM-5?
A. Somatic symptom disorders
B. Grief responses
C. Psychosis
D. Bipolar disorder
Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness.
12. An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?
A. The employee assertively confronts the boss
B. The employee leaves the staff meeting to work out in the gym
C. The employee criticizes a coworker
D. The employee takes the boss out to lunch
13. A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, I know she wants me. This statement reflects which defense mechanism?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
14. A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior should be identified by a nurse as indicative of which defense mechanism?
A. Displacement
B. Projection
C. Reaction formation
D. Sublimation
15. Which nursing statement about the concept of neuroses is most accurate?
A. An individual experiencing neurosis is unaware that he or she is experiencing distress.
B. An individual experiencing neurosis feels helpless to change his or her situation.
C. An individual experiencing neurosis is aware of psychological causes of his or her behavior. D. An individual experiencing neurosis has a loss of contact with reality.
16. Which nursing statement about the concept of psychoses is most accurate?
A. Individuals experiencing psychoses are aware that their behaviors are maladaptive.
B. Individuals experiencing psychoses experience little distress.
C. Individuals experiencing psychoses are aware of experiencing psychological problems. D. Individuals experiencing psychoses are based in reality.
17. When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
A. Hiding liquor bottles in a closet
B. Yelling at their son for slouching in his chair
C. Burning dinner on purpose
D. Saying to the spouse, I dont drink too much!
18. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief? A. If only we could have tried again, things might have worked out.
B. I am so mad that the children and I had to put up with him as long as we did.
C. Yes, it was a difficult relationship, but I think I have learned from the experience.
D. I still dont have any appetite and continue to lose weight.
19. A nurse is performing a mental health assessment on an adult client. According to Maslows hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health?
A. Maintaining a long-term, faithful, intimate relationship
B. Achieving a sense of self-confidence
C. Possessing a feeling of self-fulfillment and realizing full potential
D. Developing a sense of purpose and the ability to direct activities
20. According to Maslows hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?
A. A client rudely complaining about limited visiting hours
B. A client exhibiting aggressive behavior toward another client
C. A client stating that no one cares
D. A client verbalizing feelings of failure
21. Which is an example of the ego defense mechanism of regression? A. A mother blames the teacher for her childs failure in school.
B. A teenager becomes hysterical after seeing a friend killed in a car accident. C. A woman wants to marry a man exactly like her beloved father.
D. An adult throws a temper tantrum when he does not get his own way.
22. Which is the most significant consequence of the excessive use of defense mechanisms? A. The superego will be suppressed.
B. Emotions will be experienced intensely.
C. Learning and the ability to grow will be enhanced.
D. Problem-solving will be limited.
23. A husband accuses his wife of infidelity. Which situation would indicate to the nurse the husbands use of the ego defense mechanism of projection?
A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
B. The husband ignores the wifes continued absence from the home.
C. The husband has already admitted to having an affair with a coworker.
D. The husband takes out his marital frustrations through employee abuse.
24. Which should the nurse recognize as a DSM-5 disorder? A. Obesity
B. Generalized anxiety disorder
C. Hypertension
D. Grief
25. A nurse is educating a patient about the difference between mental health and mental illness. Which statement by the patient reflects an accurate understanding of mental health?
A. Mental health is the absence of any stressors.
B. Mental health is successful adaptation to stressors in the internal and external environment.
C. Mental health is incongruence between thoughts, feelings, and behavior
D. Mental health is a diagnostic category in the DSM-5.
26. Most cultures label behavior as mental illness on the basis of which of the following criteria?
A. Incomprehensibility and cultural relativity
B. Strength of character and ethics
C. Goal directedness and high energy
D. Creativity and good coping skills
27. Which should the nurse recognize as an example of the defense mechanism of repression? A. A student aware of the need to study for tomorrows test goes to a movie instead.
B. A woman whose son was killed in Iraq does not believe the military report.
C. A man who is unhappily married goes to school to become a marriage counselor.
D. A woman was raped when she was 12 and no longer remembers the incident.
28. Which of the following statements should a nurse recognize as true about defense mechanisms?
Select all that apply.
A. They are employed when there is a threat to biological or psychological integrity.
B. They are controlled by the id and deal with primal urges.
C. They are used in an effort to relieve mild to moderate anxiety.
D. They are protective devices for the superego.
E. They are mechanisms that are characteristically self-deceptive.
29. A nurse is assessing a client who appears to be experiencing moderate anxiety during questioning. Which symptoms might the client demonstrate? Select all that apply.
A. Fidgeting
B. Laughing inappropriately
C. Palpitations
D. Nail biting
E. Extremely limited attention span
30. Which of the following are cultural aspects of mental illness? Select all that apply. A. Local or cultural norms define pathological behavior.
B. The higher the social class the greater the recognition of mental illness behaviors. C. Psychiatrists typically see patients when the family can no longer deny the illness.
D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.
31. How is the DSM-5 useful in the practice of psychiatric nursing? Select all that apply. A. It informs the nurse of accurate and reliable medical diagnosis.
B. It represents progress toward a more holistic view of mindbody. C. It provides a framework for interdisciplinary communication.
D. It provides a template for nursing care plans.
E. It provides a framework for communication with the client. [Show Less]