TEST BANK PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITIONTable of Contents
Chapter 01. The Concept of Stress Adaptation ........................................................................................................................................ 1 Chapter 02. Mental Healt...
1 | P a g e Table of Contents Chapter 01. The Concept of Stress Adaptation ................................ ................................ ................................ ................................ ........ 1 Chapter 02. Mental Health/Mental Illness: Historical and Theoretical Concepts ................................ ................................ .... 8 Chapter 03. Psychopharmacology ................................ ................................ ................................ ................................ .............................. 20 Chapter 04. Concepts of Psychobiology ................................ ................................ ................................ ................................ ................... 27 Chapter 05. Ethical and Legal Issues in Psychiatric/Mental Health Nursing ................................ ................................ .......... 36 Chapter 06. Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing ................................ ........ 46 Chapter 07. Relationship Development ................................ ................................ ................................ ................................ ................... 54 Chapter 08. Therapeutic Communication ................................ ................................ ................................ ................................ .............. 62 Chapter 09. The Nursing Process in Psychiatric/Mental Health Nursing ................................ ................................ ............... 74 Chapter 10. Therapeutic Groups ................................ ................................ ................................ ................................ ................................ . 86 Chapter 11. Intervention With Families ................................ ................................ ................................ ................................ .................. 94 Chapter 12. Milieu Therapy - The Therapeutic Community ................................ ................................ ................................ ....... 100 Chapter 13. Crisis Intervention ................................ ................................ ................................ ................................ ................................ 105 Chapter 14. Assertiveness Training ................................ ................................ ................................ ................................ ....................... 109 Chapter 15. Promoting Self-Esteem ................................ ................................ ................................ ................................ ....................... 117 Chapter 16. Anger/Aggression Management ................................ ................................ ................................ ................................ ..... 123 Chapter 17. The Suicidal Client ................................ ................................ ................................ ................................ ................................ . 130 Chapter 18. Behavior Therapy ................................ ................................ ................................ ................................ ................................ .. 139 Chapter 19. Cognitive Therapy ................................ ................................ ................................ ................................ ................................ . 146 Chapter 20. Electroconvulsive Therapy ................................ ................................ ................................ ................................ ............... 155 Chapter 21. The Recovery Model ................................ ................................ ................................ ................................ ............................. 163 Chapter 22. Neurocognitive Disorders ................................ ................................ ................................ ................................ ................. 169 Chapter 23. Substance -Related and Addictive Disorders ................................ ................................ ................................ ............ 175 Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders ................................ ................................ .................. 186 Chapter 25. Depressive Disorders ................................ ................................ ................................ ................................ ........................... 197 Chapter 26. Bipolar and Related Disorders ................................ ................................ ................................ ................................ ........ 208 Chapter 27. Anxiety, Obsessive -Compulsive, and Related Disorders ................................ ................................ ..................... 220 Chapter 28: Trauma and Stressor -Related Disorders ................................ ................................ ................................ ................... 231 Chapter 29. Somatic Symptom and Dissociative Disorders ................................ ................................ ................................ ........ 239 Chapter 30. Issues Related to Human Sexuality and Gender Dysphoria ................................ ................................ .............. 244 Chapter 31. Eating Disorders ................................ ................................ ................................ ................................ ................................ ..... 250 Chapter 32. Personality Disorders ................................ ................................ ................................ ................................ .......................... 257 Chapter 33. Children and Adolescents ................................ ................................ ................................ ................................ .................. 270 Chapter 34. The Aging Individual ................................ ................................ ................................ ................................ ............................ 281 Chapter 35. Survivors of Abuse or Neglect ................................ ................................ ................................ ................................ ......... 286 Chapter 36. Community Mental Health Nursing ................................ ................................ ................................ .............................. 292 Chapter 37. The Bereaved Individual ................................ ................................ ................................ ................................ .................... 299 Chapter 38. Military Families ................................ ................................ ................................ ................................ ................................ .... 304 Chapter 01. The Concept of Stress Adaptation Multiple Choice 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 2 | P a g e knowledge of coping resources and available supports. D. The client may view these losses as challenges and perceive them as opportunities. ANS: C The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe -Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year -score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social support can limit susceptibility to stress -related illnesses. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 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 ANS: D The client perceives the situation of job loss as a challenge and an opportunity for growth. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 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. ANS: A Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 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 3 | P a g e C. Stage of exhaustion D. Fight -or-flight stage ANS: C At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 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. ANS: D Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. KEY: Cognitive Level: Application | Integrated Processes : Nursing Process: Implementation | Client Need: Psychosocial Integrity 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 ANS: B The student must assess his or her situation and determine the best course of action. Problem -
solving training, by providing structure and objectivity, can assist in decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 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. 4 | P a g e 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. ANS: C During times of high anxiety and stress, clients will need more assistance in problem -solving and decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 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. ANS: B Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that other adolescents experience. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 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 ANS: A Meditation produces relaxation by creating a special state of consciousness through focused concentration. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 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?
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