Psychiatric-Mental Health Nursing: Evidence-Based Practice Questions, Exams of Nursing

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Chapter 01- Psychiatric-Mental Health Nursing and Evidence-

Based Practice Questions with Verified Solutions

1. A group of nursing students are reviewing information about the evolution of mental health care and are discussing the recommendations of the final report of the Joint Commission on Mental Illness and Health. The students demonstrate understanding of this information when they identify that the report recommended an increase in which of the following? A) Numbers of mental health hospitals B) State funding for mental health care C) Clinics supplemented by general hospital units D) Use of psychotherapy by psychiatrists
2. A nurse is reviewing the American Nurses Association’s Statement on Psychiatric Nursing Practice published in 1967, which sanctioned the involvement of psychiatricmental health nurses in the provision of holistic nursing care. Integrating knowledge of the various theories and views of mental health and illness, the nurse identifies which of the following as most strongly linked to this holistic approach? A) Sigmund Freud’s psychoanalytic theory B) Florence Nightingale’s Notes on Nursing C) Hildegarde D) Clifford Beers’ A Mind That Found Itself E) Peplau’s Interpersonal Relations in Nursing
3. A nursing instructor is preparing a presentation about key events and people that influenced the development of contemporary mental health and illness care. When describing the effects of World War II, which of the following would the instructor include? A) People began to view mental illness as more commonplace and acceptable. B) The biologic understanding of mental illness was almost fully developed. C) Deinstitutionalization occurred in response to the community health movement. D) Mental illnesses became categorized as psychoses or neuroses.
4. A nursing student is presenting a discussion of the history of psychiatricmental health nursing and its place within nursing history. Which of the following would be most appropriate to include? A) Certification for the psychiatricmental health nursing specialty was first emphasized by Mary Adelaide Nutting. B) Psychiatric nurses played a part in seeing that all deinstitutionalized patients got treatment at community mental health centers. C) There is a historical link between the first nursing program to admit male students and the first training school for psychiatric nursing. D) The first graduate program in psychiatric nurses was established in response to the publication of psychiatric nursing specialty journals.
5. Two nursing students are discussing psychiatricmental health nursing and the role it has played in nursing’s overall history. Which statement is most accurate? A) The importance of using therapeutic communication was stressed by Nightingale. B) The use of self-care to enhance the immune system was taught by Dorothea Dix.

C) The moral treatment of mental illness was a primary focus of deinstitutionalization. D) Peplau was the first nurse to stress the importance of therapeutic communication.

6. When reviewing the evolution of mental health and illness care, which event is associated with mental disorders beginning to be viewed as illnesses requiring treatment? A) Establishment of Pennsylvania Hospital in Philadelphia

A) Mental Health: A Report of the Surgeon General B) New Freedom Commission on Mental Health C) Action for Mental Health D) Mental Retardation Facilities and Community Mental Health Centers Construction Act

13. As part of a career day presentation to a group of nursing students, a psychiatricmental health nurse plans to describe how this specialty developed. Which individual would the nurse describe as playing a major role in the development of specialty training programs for psychiatric nurses? A) Mary Adelaide Nutting B) Hildegarde Peplau

C) Harriet Bailey D) Linda Richards

14. A psychiatricmental health nurse is asked to be a guest speaker at a community fund- raising event for mental health services. Which of the following would the nurse emphasize as the primary goal of mental health services? A) Access to affordable mental health care B) Removal of exclusions because of preexisting conditions C) Recovery from mental illness D) Effective treatment for mental health care needs
15. A psychiatricmental health nurse is implementing evidence-based practice. The nurse understands that this approach is developed by doing which of the following first? A) Conducting research B) Identifying a clinical question C) Determining outcomes D) Collaborating with the patient
16. A group of students are reviewing information about mental health care after World War II. The students demonstrate understanding of this information when they identify which of the following as a result of the National Mental Health Act? A) Discovery of psychopharmacology B) Passage of the Hill-Burton Act C) Establishment of the National Institute of Mental Health D) Development of community mental health centers
17. When providing care to a patient, the psychiatricmental health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual? A) Hildegarde Peplau B) Florence Nightingale C) Dorothea Dix D) Sigmund Freud
18. After teaching a class to a group of nursing students about the historical perspectives of mental health care, the instructor determines that the group has understood the information when they identify which of the following as a common belief about mental illness during the medieval period? A) Mental illness in an individual was the result of being possessed by demons. B) A person was removed from a contaminated environment to protect him or her. C) Exorcisms were used as primary mode of treatment to cleanse the person of his or her sins. D) The focus was on moral treatment to promote the individual’s safety and comfort. Answer Key
19. C
20. B

11. B

12. A

13. B

14. C

15. B

16. C

17. A

18. B

Chapter 02: Mental Health and Mental Disorders

1. A nursing instructor is describing the DSM-IV-TR to a group of nursing students. Which of the following would the instructor include as the primary purpose of this classification? A) Provide a commonly understood diagnostic category for clinical practice. B) Describe treatment modalities for psychiatric disorders and mental illnesses. C) Identify various etiologies for mental disorders based on family histories. D) Provide optimal outcomes for treatment for individuals with mental illnesses.
2. A nurse is providing care to a patient with a mental disorder classified by the DSM-IV-TR. The nurse understands that although the first three axes appear to contain all the diagnostic information about a patient, a truly accurate picture of the client is incomplete without considering other factors such as an estimate of current functioning and: A) Life stressors B) Cultural background C) Marital status D) Genetic history
3. A patient’s global assessment functioning reveals that he has minimal symptoms with good functioning in all areas. Which score would the nurse correlate with these findings? A) 94 B) 82 C) 75 D) 63
4. A female patient was admitted to the hospital with pneumonia, and in the course of her treatment, it was determined that she was experiencing alcohol dependence because she began experiencing alcohol withdrawal while she was in the hospital. When the psychiatrist who was called in as a consultant documented the patient’s mental disorder, he identified her alcohol dependence on which axis? A) Axis I B) Axis II C) Axis III D) Axis IV
5. A 25-year-old woman who recently had abdominal surgery was admitted to the psychiatric unit, where it was determined that she had a borderline personality disorder. During the first week on the unit, it was determined that she also has diabetes. Her diabetes mellitus would be listed in which axis of her DSM-IV-TR diagnosis? A) Axis I B) Axis II C) Axis III D) Axis IV

disorder.

7. A nurse is working in a community mental health center that provides care to a large population of Asian descent. When developing programs for this community, which of the following would be most important for the nurse to address? A) Public stigma B) Self-stigma C) Label avoidance D) Negative life events
8. A group of students are reviewing the multiaxial diagnostic system of the DSM-IV-TR. The students demonstrate understanding of the axes when they identify that each axis represents which of the following? A) An evidence-based research finding B) An experimental design to guide care C) A domain of information D) A laboratory test finding
9. A nursing student is assigned to care for a patient diagnosed with schizophrenia. When talking about this patient in a clinical postconference, the student would use which terminology when referring to the patient? A) Committed patient B) Schizophrenic C) Schizophrenic patient D) Person with schizophrenia
10. Mrs. Green is a patient on a psychiatric unit. At the time of her admission, her dog was killed when a car accidentally ran over it; in addition to that, she just found out that her mother has been diagnosed with colon cancer. This information would be addressed in which DSM-IV axis? A) Axis I B) Axis II C) Axis III D) Axis IV
11. A nursing student is reviewing journal articles about major depression. One of the articles describes the number of persons newly diagnosed with the disorder during the past year. The student interprets this as which of the following? A) Rate B) Prevalence C) Point prevalence D) Incidence
12. While working in a community mental health treatment center, the nurse overhears one of the receptionists saying that one of the patients is really psycho. Later in the day, the nurse talks with the receptionist about the comment. This action by the nurse demonstrates an attempt to address which issue? A) Lack of knowledge B) Public stigma

C) Label avoidance D) Self-stigma

13. After teaching a group of students about mental health and mental illness, the instructor determines that the teaching was successful when the group identifies which of the following as reflecting mental disorders?

A) Cocaine dependence B) Bipolar I disorder C) Chronic obstructive pulmonary disorder D) Cellulitis E) Homelessness F) Arrest for cocaine possession with intent to sell

20. A college-aged student and his friend arrive at the student health center. The friend reports that the

patient has been having difficulties concentrating, remembering, and thinking. He’s had quite a few research papers due this past week. After ruling out other problems, the nurse determines that the patient is experiencing a culture-bound syndrome. Which of the following would the nurse most likely suspect? A) Ataque de nervios B) Brain fog C) Mal de ojo D) Shenjing shuairo Answer Key

1. A
2. A
3. B
4. A
5. C
6. A
7. C
8. C
9. D
10. D
11. D
12. B
13. C
14. C
15. B, C
16. B
17. C
18. D
19. C, D
20. B

6. A psychiatricmental health nurse is working with a patient who is being treated for depression. Which patient statement would indicate that her spirituality is intact? A) My church friends came to visit me this past Sunday afternoon. B) Nothing will ever be the same again; my life is not worth living. C) I know I am as well off as I can be under the circumstances. D) I know God must be punishing me for all my sins.

7. A patient is being treated for prostate cancer; his prognosis is very poor. The patient has a strong faith, and he has been active in his church for many years. He is concerned about his health and the challenges he faces as his cancer progresses. Which comment by the nurse reflects the most appropriate spiritual nursing intervention for the patient? A) I’ll take you to visit my church if you can get a pass. B) You have to belong to the same church I do if you’re going to go to heaven. C) Would you like me to bring you a guided imagery audiotape? D) We can pray together if you’d like.
8. A psychiatricmental health nurse is teaching a class about social factors associated with mental illness at a community health center. When describing the influence of poverty and effects of the downward economic spiral on mental health, which population would the nurse identify as being the most at risk? A) Older adults B) Individuals with physical disabilities C) Single-parent families D) Homeless individuals
9. During an assessment, the patient states, We rely on our large extensive family for moral support and help and we treat our elders with a great deal of respect. If someone gets sick, the family takes care of him. The nurse interprets this as indicating which of the following? A) Acculturation B) Cultural identity C) Cultural competence D) Linguistic competence
10. Within the context of the culture of poverty, which of the following most clearly describes why individuals who are part of this culture become trapped in a downward economic spiral? A) Unemployment causes poverty; a lack of willpower and motivation can, in turn, cause unemployment in people who do not have a strong work ethic. B) Individuals lack the finances to pay rent, so they eventually do not have an address to use in filling out job applications. C) Characteristics of poverty (joblessness and lack of financial independence) can, in turn, contribute to attributes (feelings of powerlessness and low self-esteem) that sustain poverty. D) Poverty is passed on from generation to generation; individuals learn at an early age that there is no way to escape living in poverty.
11. A group of nursing students are reviewing information about spirituality and religiousness. The group demonstrates understanding of these concepts when they identify religiousness as which of the following? A) Feeling of connectedness B) Way of interpreting life events C) Relationship with a unifying force D) Community participation in common worship

would be most appropriate for the nurse to do? A) Research information about the cultures of the population being served after assessing the patients. B) Recognize that one’s own culture is the predominant way of addressing a patient’s health care needs. C) Assume that any individual of a racial or ethnic group is the same as another individual in that group. D) Demonstrate an appreciation of and a genuine interest in the individual and his or her cultural beliefs.

14. During assessment, a patient tells the nurse that he follows Buddhist beliefs. The nurse would integrate understanding of which of the following when developing the patient’s plan of care? A) Desire is the cause of all human suffering and misery. B) Self-indulgence is necessary to reach nirvana. C) Present behavior is based on current unhappiness. D) Salvation is achieved through faith and humility.
15. After teaching a group of students about the beliefs associated with the major religions, the instructor determines that additional teaching is needed when the students identify which belief as associated with Confucianism? A) People are born good. B) People are assigned to castes. C) Authority figures are respected. D) Self-responsibility leads to improvement.
16. During an interview, a patient states, God does not exist for me. The nurse interprets this statement as reflecting which of the following? A) Animism B) Agnosticism C) Atheism D) Polytheism
17. After reviewing the major beliefs of Hinduism, a nursing student identifies the following castes. The student demonstrates understanding by identifying which of the following as the highest caste? A) Kshatriyas B) Vaisyas C) Brahmans D) Untouchables
18. The nurse is assessing an Asian American patient. During the interview, the nurse determines that the patient likely follows Taoism based on which statement? A) Purity and balance guide all of my actions. B) I strive to be in happy harmony with nature. C) Nature’s powers must be respected in life. D) God is worshipped out of love, not fear.

Answer Key

1. D
2. D
3. C
4. C
5. A
6. C