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TEST BANK VARCAROLIS ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 3RD EDITION
Table of Contents
Table of Contents
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing
Chapter 02: Mental Health and Mental Illness
Chapter 03: Theories and Therapies
Chapter 04: Biological Basis for Understanding Psychopharmacology
Chapter 05: Settings for Psychiatric Care
Chapter 06: Legal and Ethical Basis for Practice
Chapter 07: Nursing Process and QSEN: The Foundation for Safe and Effective Care
Chapter 08: Communication Skills: Medium for All Nursing Practice
Chapter 09: Therapeutic Relationships and the Clinical Interview
Chapter 10: Trauma and Stress-Related Disorders
Chapter 11: Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders
Chapter 12: Somatic System Disorders and Dissociative Disorders
Chapter 13: Personality Disorders
Chapter 14: Eating Disorders
Chapter 15: Mood Disorders: Depression
Chapter 16: Bipolar Spectrum Disorders
Chapter 17: Schizophrenia Spectrum Disorders and Other Psychotic Disorders
Chapter 18: Neurocognitive Disorders
Chapter 19: Substance-Related and Addictive Disorders
Chapter 20: Crisis and Mass Disaster
Chapter 21: Child, Partner, and Elder Violence
Chapter 22: Sexual Violence
Chapter 23: Suicidal Thoughts and Behavior
Chapter 24: Anger, Aggression, and Violence
Chapter 25: Care for the Dying and Those Who Grieve
Chapter 26: Children and Adolescents
Chapter 27: Adults
Chapter 28: Older Adults
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 1
Table of Contents
Table of Contents
1
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing
2
Chapter 02: Mental Health and Mental Il ness
7
Chapter 03: Theories and Therapies
12
Chapter 04: Biological Basis for Understanding Psychopharmacology
20
Chapter 05: Settings for Psychiatric Care
28
Chapter 06: Legal and Ethical Basis for Practice
35
Chapter 07: Nursing Process and QSEN: The Foundation for Safe and Effective Care
43
Chapter 08: Communication Skil s: Medium for Al Nursing Practice
51
Chapter 09: Therapeutic Relationships and the Clinical Interview
58
Chapter 10: Trauma and Stress-Related Disorders
67
Chapter 11: Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders
74
Chapter 12: Somatic System Disorders and Dissociative Disorders
85
Chapter 13: Personality Disorders
94
Chapter 14: Eating Disorders
103
Chapter 15: Mood Disorders: Depression
111
Chapter 16: Bipolar Spectrum Disorders
121
Chapter 17: Schizophrenia Spectrum Disorders and Other Psychotic Disorders
131
Chapter 18: Neurocognitive Disorders
142
Chapter 19: Substance-Related and Addictive Disorders
151
Chapter 20: Crisis and Mass Disaster
163
Chapter 21: Child, Partner, and Elder Violence
171
Chapter 22: Sexual Violence
179
Chapter 23: Suicidal Thoughts and Behavior
186
Chapter 24: Anger, Aggression, and Violence
195
Chapter 25: Care for the Dying and Those Who Grieve
204
Chapter 26: Children and Adolescents
213
Chapter 27: Adults
221
Chapter 28: Older Adults
230
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing MULTIPLE
CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
living in the community and diagnosed with serious and persistent mental illness? Within 3
months, the patient will: a. deny suicidal ideation.
b. report a sense of well-being.
c. take medications as prescribed.
d. attend clinic appointments on time.
ANS: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
role performance.
The goal of recovery is to empower the individual with mental illness to achieve a sense of
meaning and satisfaction in life and to function at the highest possible level of wellness. The
incorrect options focus on the classic medical model rather than recovery.
DIF: Cognitive Level: Application (Applying) REF: 2
TOP: Nursing Process: Outcomes Identification
MSC: NCLEX: Health Promotion and Maintenance
2. In the shift-change report, an off-going nurse criticizes a patient who wears heavy
makeup. Which comment by the nurse who receives the report best demonstrates
advocacy?
a. This is a psychiatric hospital. Craziness is what we are all about.
b. Lets all show acceptance of this patient by wearing lots of makeup too.
c. Your comments are inconsiderate and inappropriate. Keep the report objective.
d. Our patients need our help to learn behaviors that will help them get along in society.
ANS: D
Accepting patients needs for self-expression and seeking to teach skills that will contribute
to their well-being demonstrate respect and are important parts of advocacy. The oncoming
nurse needs to take action to ensure that others are not prejudiced against the
patient. Humor can be appropriate within the privacy of a shift report but not at the
expense of respect for patients. Judging the off-going nurse in a critical way will create
conflict.
Nurses must show compassion for each other.
DIF: Cognitive Level: Application (Applying) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 3. A
nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which
statement is an example of attending?
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
c. You will feel better after we get some antidepressant medication started for you.
d. Id like to sit with you a while so you may feel more comfortable talking with me.
ANS: D
Attending is a technique that demonstrates the nurses commitment to the relationship and
reduces feelings of isolation. This technique shows respect for the patient and
demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.
DIF: Cognitive Level: Application (Applying) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 4. A patient is
hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select
the nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand why youre so depressed. When I got divorced, I was devastated too.
c. You should forget about your marriage and move on with your life.
d. How did you get so depressed that hospitalization was necessary?
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 3
ANS: A
The nurses communication should evidence caring and a commitment to work with the
patient. This commitment lets the patient know the nurse will help. Probing and advice are
not helpful or therapeutic interventions.
DIF: Cognitive Level: Application (Applying) REF: 6
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 5. A patient
shows the nurse an article from the Internet about a health problem. Which characteristic
of the web sites address most alerts the nurse that the site may have biased and prejudiced
information?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net.
ANS: B
Financial influences on a site are a clue that the information may be biased. .com at the end
of the address indicates that the site is a commercial one. .gov indicates that the site is
maintained by a government entity.
.org indicates that the site is nonproprietary; the site may or may not have reliable
information, but it does not profit from its activities. .net can have multiple meanings.
DIF: Cognitive Level: Comprehension (Understanding) REF: 5
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance 6. A
nurse says, When I was in school, I learned to call upset patients by name to get their
attention; however, I read a descriptive research study that says that this approach does not
work. I plan to stop calling patients by name. Which statement is the best appraisal of this
nurses comment?
a. One descriptive research study rarely provides enough evidence to change practice.
b. Staff nurses apply new research findings only with the help from clinical nurse
specialists.
c. New research findings should be incorporated into clinical algorithms before using them
in practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
change.
ANS: A
Descriptive research findings provide evidence for practice but must be viewed in relation
to other studies before practice changes. One study is not enough. Descriptive studies are
low on the hierarchy of evidence.
Clinical algorithms use flow charts to manage problems and do not specify one response to
a clinical problem.
Classic tenets of practice should change as research findings provide evidence for change.
DIF: Cognitive Level: Analysis (Analyzing) REF: 3
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance 7. Two
nursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing.
The other student asks, Why would you want to be a psychiatric nurse? All they do is talk.
You will lose your skills. Select the best response by the student interested in psychiatric
nursing.
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient
ratios must be better because of the nature of patients problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve
multidimensional problems. Im challenged by those situations.
c. I think I will be good in the mental health field. I do not like clinical rotations in school, so
I do not want to continue them after I graduate.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical
surgical nurses. That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical surgical
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
patients with medical and mental health problems, reflecting the holistic perspective these
nurses must have. Nurse-patient ratios and workloads in psychiatric settings have
increased, similar to other specialties. Psychiatric nursing involves clinical practice,
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 4
not simply documentation. Psychosocial pain is real and can cause as much suffering as
physical pain.
DIF: Cognitive Level: Application (Applying) REF: 3
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 8.
Which research evidence would most influence a group of nurses to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANS: B
Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is Level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful
and influential evidence. A critical pathway is not evidence; it incorporates research
findings after they have been analyzed.
DIF: Cognitive Level: Comprehension (Understanding) REF: 3
TOP: Nursing Process: Planning MSC: NCLEX: Safe, Effective Care Environment
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
mental illnesses.
A group of nurses write letters to their elected representatives in opposition to the
legislation. Which role have the nurses fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANS: A
An advocate defends or asserts anothers cause, particularly when the other person lacks
the ability to do that for himself or herself. Examples of individual advocacy include helping
patients understand their rights or make decisions. On a community scale, advocacy
includes political activity, public speaking, and publication in the interest of improving the
individuals with mental illness; the letter-writing campaign advocates for that cause on
behalf of patients who are unable to articulate their own needs.
DIF: Cognitive Level: Comprehension (Understanding) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 10.
An informal group of patients discuss their perceptions of nursing care. Which comment
best indicates a patients perception that his or her nurse is caring?
a. My nurse always asks me which type of juice I want to help me swallow my medication.
b. My nurse explained my treatment plan to me and asked for my ideas about how to make
it better.
c. My nurse told me that if I take all the medicines the doctor prescribes I will get
discharged soon.
d. My nurse spends time listening to me talk about my problems. That helps me feel like Im
not alone.
ANS: D
Caring evidences empathic understanding, as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
DIF: Cognitive Level: Application (Applying) REF: 3
TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity 11. A patient who
immigrated to the United States from Honduras was diagnosed with schizophrenia. The
patient took an antipsychotic medication for 3 weeks but showed no improvement. Which
resource should the treatment team consult for information on more effective medications
for this patient?
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 5
d. International Statistical Classification of Diseases and Related Health Problems (ICD)
ANS: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual patients needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The
ICD classifies diseases.
DIF: Cognitive Level: Application (Applying) REF: 5
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 12. Which
historical nursing leader helped focus practice to recognize the importance of science in
psychiatric nursing?
a. Abraham Maslow
b. Hildegard Peplau
c. Kris Martinsen
d. Harriet Bailey
ANS: B
Although all these leaders included science as an important component of practice,
Hildegard Peplau most influenced its development in psychiatric nursing. Maslow was not a
nurse, but his theories influence how nurses prioritize problems and care. Bailey wrote a
textbook in the 1930s on psychiatric nursing interventions.
Kris Martinsen emphasized the importance of caring in nursing practice.
DIF: Cognitive Level: Knowledge (Remembering) REF: 4
TOP: Nursing Process: N/A MSC: NCLEX: Psychosocial Integrity 13. A nurse consistently
strives to demonstrate caring behaviors during interactions with patients. Which reaction
by a patient indicates this nurse is effective? A patient reports feeling:
a. distrustful of others.
b. connected with others.
c. uneasy about the future.
d. discouraged with efforts to improve.
ANS: B
A patient is likely to respond to caring with a sense of connectedness with others. The
absence of caring can make patients feel distrustful, disconnected, uneasy, and discouraged.
DIF: Cognitive Level: Comprehension (Understanding) REF: 7
TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity MULTIPLE
RESPONSE
1. An experienced nurse says to a new graduate, When youve practiced as long as I have,
you will instantly know how to take care of psychotic patients. What is the new graduates
best analysis of this comment? Select all that apply.
a. The experienced nurse may have lost sight of patients individuality, which may
compromise the integrity of practice.
b. New research findings must be continually integrated into a nurses practice to provide
the most effective care.
c. Experience provides mental health nurses with the tools and skills needed for effective
professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for psychotic patients
through trial and error.
e. Effective psychiatric nurses should be continually guided by an intuitive sense of patients
needs.
ANS: A, B
Evidence-based practice involves using research findings to provide the most effective
nursing care. Evidence is continually emerging; therefore, nurses cannot rely solely on
experience. The effective nurse also maintains
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 6
respect for each patient as an individual. Overgeneralization compromises that perspective.
Intuition and trial and error are unsystematic approaches to care.
DIF: Cognitive Level: Application (Applying) REF: 2
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 2. Which
patient statements identify qualities of nursing practice with high therapeutic value?
(Select all that apply.) My nurse:
a. talks in language I can understand.
b. helps me keep track of my medications.
c. is willing to go to social activities with me.
d. lets me do whatever I choose without interfering.
e. looks at me as a whole person with different needs.
ANS: A, B, E
Each correct answer demonstrates caring is an example of appropriate nursing foci:
communicating at a level understandable to the patient, using holistic principles to guide
care, and providing medication supervision.
The incorrect options suggest a laissez-faire attitude on the part of the nurse, when the
nurse should instead provide thoughtful feedback and help patients test alternative
solutions or violate boundaries.
DIF: Cognitive Level: Application (Applying) REF: 6
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 7
Chapter 02: Mental Health and Mental Illness
MULTIPLE CHOICE
1. An 86-year-old, previously healthy and independent, falls after an episode of vertigo.
Which behavior by this patient best demonstrates resilience? The patient: a. says, I knew
this would happen eventually.
b. stops attending her weekly water aerobics class.
c. refuses to use a walker and says, I dont need that silly thing.
d. says, Maybe some physical therapy will help me with my balance.
ANS: D
Resiliency is the ability to recover from or adjust to misfortune and change. The correct
response indicates that the patient is hopeful and thinking positively about ways to adapt to
the vertigo. Saying I knew this would happen eventually and discontinuing healthy
activities suggest a hopeless perspective on the health change.
Refusing to use a walker indicates denial.
DIF: Cognitive Level: Comprehension (Understanding) REF: 14
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 2. A patient is
admitted to the psychiatric hospital. Which assessment finding best indicates that the
patient has a mental illness? The patient:
a. describes coping and relaxation strategies used when feeling anxious.
b. describes mood as consistently sad, discouraged, and hopeless.
c. can perform tasks attempted within the limits of own abilities.
d. reports occasional problems with insomnia.
ANS: B
A patient who reports having a consistently negative mood is describing a mood alteration.
The incorrect options describe mentally healthy behaviors and common problems that do
not indicate mental illness.
DIF: Cognitive Level: Application (Applying) REF: 11
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 3. The goal for a
patient is to increase resiliency. Which outcome should a nurse add to the plan of care?
Within 3 days, the patient will:
a. describe feelings associated with loss and stress.
b. meet own needs without considering the rights of others.
c. identify healthy coping behaviors in response to stressful events.
d. allow others to assume responsibility for major areas of own life.
ANS: C
The patients ability to identify healthy coping behaviors indicates adaptive, healthy
behavior and demonstrates an increased ability to recover from severe stress. Describing
feelings associated with loss and stress does not move the patient toward adaptation. The
remaining options are maladaptive behaviors.
DIF: Cognitive Level: Analysis (Analyzing) REF: 14
TOP: Nursing Process: Outcomes Identification
MSC: NCLEX: Psychosocial Integrity
4. Which organization actively seeks to reduce the stigma associated with mental illness
through public presentations such as In Our Own Voice (IOOV)?
a. American Psychiatric Association (APA)
b. National Alliance on Mental Illness (NAMI)
c. United States Department of Health and Human Services (USDHHS) d. North American
Nursing Diagnosis Association International (NANDA-I) ANS: B
Stigma represents the bias and prejudice commonly held regarding mental illness. NAMI
actively seeks to
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 8
dispel misconceptions about mental illness. NANDA-I defines approved nursing diagnoses.
The APA publishes the DSM 5. The USDHHS regulates and administers health policies.
DIF: Cognitive Level: Knowledge (Remembering) REF: 19
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 5. A nurse
must assess several new patients at a community mental health center. Conclusions
concerning current functioning should be made on the basis of:
a. the degree of conformity of the individual to societys norms.
b. the degree to which an individual is logical and rational.
c. a continuum from mentally healthy to unhealthy.
d. the rate of intellectual and emotional growth.
ANS: C
Because mental health and mental illness are relative concepts, assessment of functioning
is made by using a continuum. Mental health is not based on conformity; some mentally
healthy individuals do not conform to societys norms. Most individuals occasionally display
illogical or irrational thinking. The rate of intellectual and emotional growth is not the most
useful criterion to assess mental health or mental illness.
DIF: Cognitive Level: Application (Applying) REF: 11
TOP: Nursing Process: Diagnosis| Nursing Process: Analysis MSC: NCLEX: Psychosocial
Integrity
6. A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a
patients insurance form.
Which resource should the nurse consult to discern the criteria used to establish this
diagnosis?
a. A psychiatric nursing textbook
b. NANDA International (NANDA-I )
c. A behavioral health reference manual
d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ANS: D
The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses
on nursing diagnoses. A psychiatric nursing textbook or behavioral health reference manual
may not contain diagnostic criteria.
DIF: Cognitive Level: Application (Applying) REF: 12
TOP: Nursing Process: Analysis| Nursing Process: Diagnosis MSC: NCLEX: Safe, Effective
Care Environment
7. A 40-year-old adult living with parents states, Im happy but I dont socialize much. My
work is routine.
When new things come up, my boss explains them a few times to make sure I understand.
At home, my parents make decisions for me, and I go along with them. A nurse should
identify interventions to improve this patients:
a. self-concept.
b. overall happiness.
c. appraisal of reality.
d. control over behavior.
ANS: A
The patient feels the need for multiple explanations of new tasks at work and, despite being
40 years of age, allows both parents to make all decisions. These behaviors indicate a
poorly developed self-concept. Although the patient reports being happy, the subsequent
comments refute that self-appraisal. The patients comments do not indicate that he/she is
out of touch with reality. The patients needs are broader than control over own behavior.
DIF: Cognitive Level: Application (Applying) REF: 11
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity 8. A patient tells a
nurse, I have psychiatric problems and am in and out of hospitals all the time. Not one of
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 9
my friends or relatives has these problems. Select the nurses best response.
a. Comparing yourself with others has no real advantages.
b. Why do you blame yourself for having a psychiatric illness?
c. Mental illness affects 50% of the adult population in any given year.
d. It sounds like you are concerned that others dont experience the same challenges as you.
ANS: D
Mental illness affects many people at various times in their lives. No class, culture, or creed
is immune to the challenges of mental illness. The correct response also demonstrates the
use of reflection, a therapeutic communication technique. It is not true that mental illness
affects 50% of the population in any given year.
Asking patients if they blame themselves is an example of probing.
DIF: Cognitive Level: Application (Applying) REF: 11
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 9. A critical care
nurse asks a psychiatric nurse about the difference between a diagnosis in the Diagnostic
and Statistical Manual of Mental Disorders (DSM-5) and a nursing diagnosis. Select the
psychiatric nurses best response.
a. No functional difference exists between the two diagnoses. Both serve to identify a
human deviance.
b. The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural
variables.
c. The DSM-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis
considers past and present responses to actual mental health problems.
d. The DSM-5 diagnosis influences the medical treatment; the nursing diagnosis offers a
framework to identify interventions for problems a patient has or may experience.
ANS: D
The medical diagnosis, defined according to the DSM-5, is concerned with the patients
disease state, causes, and cures, whereas the nursing diagnosis focuses on the patients
response to stress and possible caring interventions. Both the DSM-5 and a nursing
diagnosis consider culture. Nursing diagnoses also consider potential problems.
DIF: Cognitive Level: Application (Applying) REF: 16
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 10.
The spouse of a patient diagnosed with schizophrenia says, I dont understand why
childhood experiences have anything to do with this disabling illness. Select the nurses
response that will best help the spouse understand this condition.
a. Psychological stress is actually at the root of most mental disorders.
b. We now know that all mental illnesses are the result of genetic factors.
c. It must be frustrating for you that your spouse is sick so much of the time.
d. Although this disorder more likely has a biological rather than psychological origin, the
support and involvement of caregivers is very important.
ANS: D
Many of the most prevalent and disabling mental disorders have been found to have strong
biological influences. Helping the spouse understand the importance of his or her role as a
caregiver is also important.
Empathy is important but does not increase the spouses level of knowledge about the cause
of the patients condition. Not all mental illnesses are the result of genetic factors.
Psychological stress is not at the root of most mental disorders.
DIF: Cognitive Level: Application (Applying) REF: 14
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
11. Which belief by a nurse supports the highest degree of patient advocacy during a
multidisciplinary patient 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 constant from culture to culture.
d. Some symptoms of mental disorders may reflect a persons cultural patterns.
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 10
ANS: D
A nurse who understands that a patients symptoms are influenced by culture will be able to
advocate for the patient to a greater degree than a nurse who believes that culture is of little
relevance. All mental illnesses are not culturally determined. Schizophrenia and bipolar
disorder are cross-cultural disorders, but this understanding has little relevance to patient
advocacy. Symptoms of mental disorders change from culture to culture.
DIF: Cognitive Level: Application (Applying) REF: 18
TOP: Nursing Process: Planning MSC: NCLEX: Safe, Effective Care Environment 12. A
patients history shows intense and unstable relationships with others. The patient initially
idealizes an individual and then devalues the person when the patients needs are not met.
Which aspect of mental health is a problem?
a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships
ANS: D
The information provided centers on relationships with others, which are described as
intense and unstable.
The relationships of mentally healthy individuals are stable, satisfying, and socially
integrated. Data are not present to describe work effectiveness, communication skills, or
activities.
DIF: Cognitive Level: Application (Applying) REF: 12
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity [Show Less]