Mental Health Quiz 2
Chapters 6, 9, 10
Chapter 6 Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing
1. An African American
... [Show More] youth, growing up in an impoverished neighborhood, presents in the emergency
department with bruises to his face, chest, and arms. He appears to be upset, is speaking in a dialect that is
difficult for the nurse to understand, and is standing within 6 inches of the nurses personal space. What
cultural consideration should a nurse identify as playing a role in this youths behavior?
A. African Americans frequently speak in different tongues when they are upset.
B. Most African Americans have learned to be aggressive when they have to see a health professional.
C. African Americans tend to use dialects and invasion of personal space to intimidate others.
D. Some African Americans speak in a dialect that is different from standard English and tend toward smaller
personal space than that of the dominant culture.
The nurse needs to recognize that a tendency toward smaller personal space and the use of dialects different
from Standard English are cultural variables and dont necessarily imply aggressive or disrespectful behavior.
2. Northern European Americans value punctuality, hard work, and the acquisition of material possessions and
status. A nurse should recognize that these values may contribute to which form of mental disorders?
A. Dissociative disorders
B. Neurocognitive disorders
C. Stress-related disorders
D. Schizophrenia spectrum disorders
Northern European American values, such as punctuality, hard work, and acquisition of material possessions,
may place this group at risk for stress-related disorders when individuals struggle to meet societal demands.
3. A community health nurse is planning a health fair at a local shopping mall. Which middle-class
socioeconomic cultural group should the nurse anticipate would most value preventive medicine and primary
health care?
A. Northern European Americans
B. Native Americans
C. Latino Americans
D. African Americans
Northern European Americans, especially those who achieve middle-class socioeconomic status, place the
most value on preventative medicine and primary health care. This value is most likely related to this groups
educational level and financial capability. Many members of the Native American, Latino American, and African
American subgroups value folk medicine practices.
4. Which rationale by a nursing instructor best explains why it is challenging to globally classify the Asian
American culture?
A. Extremes of emotional expression prevent accurate assessment of this culture.
B. Suspicion of Western civilization has resulted in minimal cultural research.
C. The small size of this subpopulation makes research virtually impossible.
D. The Asian American culture includes individuals from many different countries.
The Asian American culture includes peoples and descendents from Japan, China, Vietnam, the Philippines,
Thailand, Cambodia, Korea, Laos, India, and the Pacific Islands. Within this culture there are vast differences in
values, religious practices, languages, and attitudes.
5. A Latin American woman refuses to participate in an assertiveness training group. Which cultural belief
should a nurse identify as most likely to have influenced this clients decision?
A. Future orientation causes the client to devalue assertiveness skills.
B. Decreased emotional expression makes it difficult to be assertive.
C. Assertiveness techniques may not be aligned with the clients definition of the female role.
D. Religious prohibitions prevent the clients participation in assertiveness training.
The nurse should identify that the Latin American womans refusal to participate in an assertiveness training
group may be influenced by the Latin American cultural definition of the female role. Latin Americans place a
high value on the male-dominated family. The father usually possesses the ultimate authority.
6. A Latino American man refuses to acknowledge responsibility for hitting his wife, stating instead, It’s the
mans job to keep his wife in line. Which cultural belief may be associated with this clients behavior?
A. Traditional Latino American families are male dominated with clear malefemale role distinctions.
B. Religious tenets of Latino American culture support the use of violence within a marriage.
C. Latino American families are female dominated and the mother possesses ultimate authority.
D. Marriage dynamics are controlled by dominant females in Latin American families.
Traditional Latino American families are male dominated with clear malefemale role distinctions and may
impact the clients perception about whether or not striking his wife is physical abuse. The nurse should also
recognize that cultural beliefs do no exempt one from adhering to state and federal laws with regard to assault
and battery.
7. When working with clients of any culture, which action should a nurse avoid?
A. Maintaining eye contact, based on cultural norms
B. Assuming that all individuals who share a culture or ethnic group are similar
C. Supporting the client in participating in cultural and spiritual rituals
D. Using an interpreter to clarify communication
The nurse should avoid assuming that all individuals who share a culture or ethnic group are similar. This action
constitutes stereotyping and must be avoided. Within each culture, many variations and subcultures exist.
Clients should be treated as individuals.
8. To effectively care for Asian American clients, a nurse should be aware of which cultural norm?
A. Obesity and alcoholism are common problems.
B. Older people maintain positions of authority within the culture.
C. Milk is a staple in the Asian American diet.
D. Asian Americans are likely to seek psychiatric help.
To effectively care for clients of the Asian American culture, the nurse should be aware that older people in this
culture maintain positions of authority. Obesity and alcoholism are low among Asian Americans. Milk is seldom
consumed because a majority of Asian Americans are lactose intolerant. In the Asian culture, psychiatric illness
is often believed to be out-of-control behavior and would be considered shameful to individuals and families.
9. A Native American client is admitted to an emergency department (ED) with an ulcerated toe secondary to
uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a shaman is present. Which
nursing intervention is most appropriate?
A. Assist the client in contacting a shaman of his choice.
B. Explain to the client that voodoo medicine will not heal the ulcerated toe.
C. Ask the client to explain what the shaman can do that the physician cannot.
D. Inform the client that refusing treatment is a clients right.
The most appropriate nursing intervention would be to facilitate meeting the clients need to have a shaman
present. The nurse should understand that in the Native American culture, religion and health-care practices
are often intertwined. The shaman, a medicine man, may confer with physicians regarding the care of a client.
Research supports the importance of both health-care systems in the overall wellness of Native American
clients.
10. When planning care for a Latino American client, the nurse should be aware of which cultural influence
that may impact access to health care?
A. The root doctor may be the first contact made when illness is encountered.
B. The yin and yang practitioner may be the first contact made when illness is encountered.
C. The shaman may be the first contact made when illness is encountered.
D. The curandero may be the first contact made when illness is encountered.
The nurse should understand that some Latino Americans may initially contact a curandero when illness is
encountered. The curandero is the folk healer who is believed to have a gift from God for healing the sick.
Treatments often include supernatural rituals, prayers, magic, practical advice, and indigenous herbs.
11. In what way should a nurse expect a traditional Asian American client to view mental illness?
A. Mental illness relates to uncontrolled behaviors that bring shame to the family.
B. Mental illness is a curse from God related to immoral behaviors.
C. Mental illness is cured by home remedies based on superstitions.
D. Mental illness is cured by hot and cold herbal remedies.
The nurse should expect that traditional Asian Americans are most likely to view mental illness as uncontrolled
behavior that brings shame to the family. It is often more acceptable for mental distress to be expressed as
physical ailments.
12. Which cultural considerations should a nurse identify with Western European Americans?
A. They are present-time oriented and perceive the future as Gods will.
B. They value youth, and older adults are commonly placed in nursing homes.
C. They are at high risk for alcoholism due to a genetic predisposition.
D. They are future oriented and practice preventive health care.
The nurse should identify that most Western European Americans are present oriented and perceive the
future as Gods will. Older adults are held in positions of respect and are often cared for in the home instead of
nursing homes.
13. A nurse should recognize that clients who have a history of missed or late medical appointments are most
likely to come from which cultural group?
A. Northern European Americans
B. Asian Americans
C. Native Americans
D. Jewish Americans
The nurse should recognize that Native American clients might have a history of missed or late medical
appointments. Many Native Americans are not ruled by the clock. The concept of time is casual and focused on
the present.
14. During the first interview with a man from Syria who has just lost his son in a car accident, in sympathy for
the mans loss, the female nurse reaches out and hugs him. Which is an accurate evaluation of the nurses
action?
A. The nurses action should be evaluated as unacceptable due to breech of cultural norms.
B. The nurses action should be evaluated as empathetic, encouraging expression of feelings.
C. The nurses action should be evaluated as the technique of offering self.
D. The nurses action should be evaluated as inappropriate due to poor timing.
The nurses action should be evaluated as unacceptable due to breech of cultural norms. During
communication, Arab Americans stand close together, maintain steady eye contact, and may touch the others
hand or shoulder but only between members of the same sex.
15. A nursing instructor is teaching about cultural characteristics. Which statement by the student indicates the
need for further instruction?
A. All cultures communicate freely within their group.
B. All cultures embrace light therapeutic touch.
C. All cultures view the importance of timeliness differently.
D. All cultures display biological variations.
Not all cultures embrace light therapeutic touch. In the Native American culture, if a hand is offered to another
it may be accepted with a light touch; however, in the Asian culture, touching during communication has been
historically considered unacceptable. This student statement indicates the need for further instruction.
16. A nurse is preparing to establish a therapeutic relationship with a grieving family from China. Which
nursing intervention would be considered most appropriate?
A. Touch each member lightly, as this enhances the communication process.
B. Direct questions to the young males of the family, as they maintain positions of authority.
C. Avoid direct eye contact, as it implies rudeness.
D. Remain objective and empathetic, as Asians express feelings freely.
In the Asian culture, eye contact is often avoided, as it connotes rudeness and lack of respect.
17. Which cultural group is correctly matched with the disease process for which this group is most
susceptible?
A. African Americans are susceptible to lactose intolerance.
B. Western European Americans are susceptible to malaria.
C. Arab Americans are susceptible to sickle cell disease.
D. Jewish Americans are susceptible to thalassemia.
A number of genetic diseases are more common in the Arab American population, including sickle cell disease,
tuberculosis, malaria, trachoma, typhus, hepatitis, typhoid fever, dysentery, parasitic infestations, thalassemia,
and cardiovascular disease.
18. When interviewing a client of a different culture, which of the following questions should a nurse consider
asking? Select all that apply.
A. Would using perfume products be acceptable?
B. Who may be expected to be present during the client interview?
C. Should communication patterns be modified to accommodate this client?
D. How much eye contact should be made with the client?
E. Would hand shaking be acceptable?
When interviewing a client from a different culture, the nurse should consider who might be with the client
during the interview, modifications of communication patterns, amount of eye contact, and hand-shaking
acceptability, since these are cultural variables.
19. A female nurse is caring for a traditional Arab American male client. When planning effective care for this
client, the nurse should be aware of which of the following cultural considerations? Select all that apply.
A. Limited touch is acceptable only between members of the same sex.
B. Conversing individuals of this culture stand far apart and do not make eye contact.
C. Devout Muslim men may not shake hands with women.
D. The man is the head of the household and women take on a subordinate role.
E. In traditional culture, men are responsible for the education of their children.
When planning effective care for this client, the nurse should be aware that limited touch within this culture is
acceptable only between members of the same sex, that devout Muslim men may not shake hands with
women, and that women are subordinate to the man, who is the head of household. Conversing individuals of
this culture stand close together and maintain eye contact. Arab American women are responsible for the
education of the children.
20. Because of cultural characteristics, in which of the following cultural groups would a nurses assessment of
mood and affect be most challenging? Select all that apply.
A. Arab Americans
B. Native Americans
C. Latino Americans
D. Western European Americans
E. Asian Americans
The nurse should expect that both Native Americans and Asian Americans might be difficult to assess for mood
and affect. In both cultures, expressing emotions is difficult. Native Americans are encouraged to not
communicate private thoughts. Asian Americans may have a reserved public demeanor and may be perceived
as shy or uninterested.
Chapter 9 The Nursing Process in Psychiatric/Mental Health Nursing
1. Which data-gathering technique is employed during the assessment phase of the nursing process?
A. Asking the client to rate mood after administering an antidepressant
B. Asking the client to verbalize understanding of previously explained unit rules
C. Asking the client to describe any thoughts of self-harm
D. Asking the client if the group on assertiveness skills was helpful
The nurse should ask the client to describe any thoughts of self-harm during the assessment phase of the
nursing process. Assessment involves collecting and analyzing data about the client that may include the
following dimensions: physical, psychological, sociocultural, spiritual, cognitive, developmental, economic,
lifestyle, and functional abilities. The other three options are employed during the evaluation phase of the
nursing process.
2. Which statement is most accurate regarding the assessment of clients diagnosed with psychiatric problems?
A. Medical history is of little significance and can be eliminated from the nursing assessment.
B. Assessment provides a holistic view of the client, including biopsychosocial aspects.
C. Comprehensive assessments can be performed only by advanced practice nurses.
D. Psychosocial evaluations are gained by subjective reports rather than objective observations.
The assessment of clients diagnosed with psychiatric problems should provide a holistic view of the client. A
thorough assessment involves collecting and analyzing data from the client, significant others, and health-care
providers that may include the following dimensions: physical, psychological, sociocultural, spiritual, cognitive,
developmental, economic, lifestyle, and functional abilities.
3. Which nursing diagnosis should a nurse identify as being correctly formulated?
A. Schizophrenia R/T biochemical alterations AEB altered thought
B. Self-care deficit: hygiene R/T altered thought as AEB disheveled appearance
C. Depressed mood R/T multiple life stressors
D. Developmental disability R/T early-onset schizophrenia AEB hallucinations
The nurse should determine that the correctly written diagnosis would be Self-care deficit: hygiene R/T altered
thought AEB disheveled appearance. The nursing diagnosis should describe the unhealthy response
(inference), the contributing factors, and the data that support the inference.
4. Which expected client outcome should a nurse identify as being correctly formulated?
A. Client will feel happier by discharge.
B. Client will demonstrate two relaxation techniques.
C. Client will verbalize triggers to anger by end of session.
D. Client will initiate interaction with one peer during free time within 2 days.
The statement Client will initiate interaction with one peer during free time within 2 days is an example of a
correctly formulated expected outcome. Outcomes should be measurable, realistic, client-focused goals that
include a time frame. Appropriate nursing interventions are guided by client outcomes.
5. Which statement regarding nursing interventions should a nurse identify as accurate?
A. Nursing interventions are independent from the treatment teams goals.
B. Nursing interventions are directed solely by written physician orders.
C. Nursing interventions occur independently but in concert with overall treatment team goals.
D. Nursing interventions are standardized by policies and procedures.
The nurse should understand that nursing interventions occur independently but in concert with overall
treatment goals. Nursing interventions should be developed and implemented in collaboration with other
health-care professionals involved in the clients care.
6. Within the nurses scope of practice, which function is exclusive to the advance practice psychiatric nurse?
A. Teaching about the side effects of neuroleptic medications
B. Using psychotherapy to improve mental health status
C. Using milieu therapy to structure a therapeutic environment
D. Providing case management to coordinate continuity of health services
The advanced practice psychiatric nurse is authorized to use psychotherapy to improve mental health. This
includes individual, couples, group, and family psychotherapy. It is within the scope of practice of a registered
psychiatric mental health nurse generalist to provide education, case management, and milieu therapy.
7. A nurse charts Verbalizes understanding of the side effects of Prozac. This is an example of which category of
focused charting?
A. Data
B. Problem
C. Action
D. Response
Verbalizes understanding of the side effects of Prozac is an example of the response category of focused
charting. The response is a description of the clients reaction to any part of medical or nursing care.
8. The nurse should recognize which acronym as representing problem-oriented charting?
A. SOAPIE
B. SOLER
C. DAR
D. PQRST
The acronym SOAPIE represents problem-oriented charting, which reflects the subjective, objective,
assessment, plan, implementation, and evaluation format. This type of charting identifies nursing diagnoses
(client problems) on a written plan of care with appropriate nursing interventions described for each.
9. Which tool would be appropriate for a nurse to use when assessing mental acuity prior to and immediately
following electroconvulsive therapy (ECT)?
A. CIWA scale
B. GGT
C. MMSE
D. CAPS scale
The MMSE, or mini mental status exam, would be the appropriate tool to use to assess the mental acuity of a
client prior to and immediately following ECT. The CIWA scale, or clinical institute withdrawal assessment scale,
would be used to assess withdrawal from substances such as alcohol. The CAPS refers to the clinicianadministered PTSD scale and would be used to assess signs and symptoms of PTSD. The GGT test is used to
assess gamma-glutamyl transferase levels, which may be an indication of alcoholism.
10. What is being assessed when a nurse asks a client to identify name, date, residential address, and
situation?
A. Mood
B. Perception
C. Orientation
D. Affect
The nurse should ask the client to identify name, date, residential address, and situation to assess the clients
orientation. Assessment of the clients orientation to reality is part of a mental status evaluation. [Show Less]