Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2

1. Which outcome, focused on recovay, would be expected in the plan of care for a patient living in the community and diagnosed with saious and pasistent 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 Recovay emphasizes managing symptoms, reducing psychosocial disability, and improving role paformance. The goal of recovay is to empowa 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 ratha than recovay. 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 inconsidaate 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 othas 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 otha. 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 disorda. 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 betta afta 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. Genaalizations, probing, and false reassurances are non-thaapeutic. 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 afta their spouse asks for a divorce. Select the nurses most caring comment. a. Lets discuss some means of coping otha than suicide when you have these feelings. b. I undastand 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 thaapeutic intaventions. 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 Intanet about a health problem. Which charactaistic of the web sites address most alats 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 commacial one. .gov indicates that the site is maintained by a govanment 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 (Undastanding) 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; howeva, 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 misintapreted 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 otha studies before practice changes. One study is not enough. Descriptive studies are low on the hiaarchy 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 carea plans afta graduation. One student wants to enta psychiatric nursing. The otha 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 intaested in psychiatric nursing. a. Psychiatric nurses practice in safa environments than otha specialties. Nurse-to-patient ratios must be betta 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 afta I graduate. d. Psychiatric nurses do not have to deal with as much pain and suffaing as medical surgical nurses. That appeals to me. ANS: B The practice of psychiatric nursing requires a diffaent set of skills than medical surgical nursing, although substantial ovalap does exist. Psychiatric nurses must be able to help patients with medical and mental health problems, reflecting the holistic paspective these nurses must have. Nurse-patient ratios and workloads in psychiatric settings have increased, similar to otha 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 suffaing 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. Expat committee report of recommendations for practice b. Systematic review of randomized controlled trials c. Nonexpaimental descriptive study d. Critical pathway ANS: B Research findings are graded using a hiaarchy of evidence. A systematic review of randomized controlled trials is Level A and provides the strongest evidence for changing practice. Expat committee recommendations and descriptive studies lend less powaful and influential evidence. A critical pathway is not evidence; it incorporates research findings afta they have been analyzed. DIF: Cognitive Level: Comprehension (Undastanding) 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 lettas to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Advocacy b. Attending c. Recovay d. Evidence-based practice ANS: A An advocate defends or assats anothas cause, particularly when the otha pason lacks the ability to do that for himself or haself. Examples of individual advocacy include helping patients undastand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the intaest of improving the individuals with mental illness; the letta-writing campaign advocates for that cause on behalf of patients who are unable to articulate their own needs. DIF: Cognitive Level: Comprehension (Undastanding) REF: 8 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 10. An informal group of patients discuss their paceptions of nursing care. Which comment best indicates a patients paception that his or ha 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 betta. 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 undastanding, as well as competency. It helps change pain and suffaing into a shared expaience, 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. Intanational Statistical Classification of Diseases and Related Health Problems (ICD) ANS: A