Table of Contents
Chapter 01: Mental Health and Mental Illness ...............................................................................................................................2
Chapter 02: Theories and Therapies ............................................................................................................................................. 11
Chapter 03: Psychobiology and Psychopharmacology .............................................................................................................. 25
Chapter 04: Treatment Settings ..................................................................................................................................................... 38
Chapter 05: Cultural Implications ................................................................................................................................................. 53
Chapter 06: Legal and Ethical Considerations ............................................................................................................................ 65
Chapter 07: The Nursing Process and Standards of Care ......................................................................................................... 77
Chapter 08: Therapeutic Relationships......................................................................................................................................... 88
Chapter 09: Therapeutic Communication.................................................................................................................................... 99
Chapter 10: Stress Responses and Stress Management ............................................................................................................ 109
Chapter 11: Childhood and Neurodevelopmental Disorders ................................................................................................. 118
Chapter 12: Schizophrenia Spectrum Disorders ....................................................................................................................... 129
Chapter 13: Bipolar and Related Disorders ............................................................................................................................... 144
Chapter 14: Depressive Disorders .............................................................................................................................................. 158
Chapter 15: Anxiety and Obsessive-Compulsive Disorders ................................................................................................... 170
Chapter 16: Trauma, Stressor-Related, and Dissociative Disorders ....................................................................................... 183
Chapter 17: Somatic Symptom Disorders.................................................................................................................................. 194
Chapter 18: Eating and Feeding Disorders................................................................................................................................ 204
Chapter 19: Sleep–Wake Disorders............................................................................................................................................. 215
Chapter 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias................................................................................. 225
Chapter 21: Impulse Control Disorders ..................................................................................................................................... 235
Chapter 22: Substance-Related and Addictive Disorders ........................................................................................................ 243
Chapter 23: Neurocognitive Disorders ...................................................................................................................................... 255
Chapter 24: Personality Disorders .............................................................................................................................................. 267
Chapter 25: Suicide and Nonsuicidal Self-Injury ...................................................................................................................... 278
Chapter 26: Crisis and Disaster ................................................................................................................................................... 288
Chapter 27: Anger, Aggression, and Violence ........................................................................................................................... 298
Chapter 28: Child, Older Adult, and Intimate Partner Violence ............................................................................................ 308
Chapter 29: Sexual Assault ........................................................................................................................................................... 316
Chapter 30: Dying, Death, and Grieving ................................................................................................................................... 325
Chapter 31: Older Adults .............................................................................................................................................................. 333
Chapter 32: Serious Mental Illness .............................................................................................................................................. 345
Chapter 33: Forensic Nursing ...................................................................................................................................................... 358
Chapter 34: Therapeutic Groups ................................................................................................................................................. 367
Chapter 35: Family Interventions ................................................................................................................................................ 378
Chapter 36: Integrative Care ........................................................................................................................................................ 389
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, Chapter 01: Mental Health and Mental Illness
MULTIPLE CHOICE
1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advancedpractice
nurse to perform which additional intervention? a. Conduct mental health
assessments.
b. Prescribe psychotropic medication.
c. Establish therapeutic relationships.
d. Individualize nursing care plans.
ANS: B
In most states, prescriptive privileges are granted to master‘s-prepared nurse practitioners andclinical
nurse specialists who have taken special courses on prescribing medication. The nurseprepared at the
basic level is permitted to perform mental health assessments, establish relationships, and provide
individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-23 TOP:
Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. A nursing student expresses concerns that mental health nurses ―lose all their clinical nursingskills.‖ Select
the best response by the mental health nurse.
a. ―Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must
be better because of the nature of the patients‘ problems.‖
b. ―Psychiatric nurses use complex communication skills as well as critical thinking to solve
multidimensional problems. I am challenged by those situations.‖
c. ―That‘s a misconception. Psychiatric nurses frequently use high technology monitoring equipment
and manage complex intravenous therapies.‖
d. ―Psychiatric nurses do not have to deal with as much pain and suffering as medical– surgical
nurses do. That appeals to me.‖
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical–surgical nursing, though
there is substantial overlap. Psychiatric nurses must be able to help patientswith medical as well as
mental health problems, reflecting the holistic perspective these nurses must have. Nurse–patient ratios
and workloads in psychiatric settings have increased,just like other specialties. Psychiatric nursing
involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical
pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2, 21 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental
illness, a group of nurses write letters to their elected representatives in opposition to the legislation.
Which role have the nurses fulfilled?
a. Recovery
b. Attending
c. Advocacy
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, d. Evidence-based practice
ANS: C
An advocate defends or asserts another‘s cause, particularly when the other person lacks the ability to do
that for self. Examples of individual advocacy include helping patients understand their rights or make
decisions. On a community scale, advocacy includes politicalactivity, public speaking, and publication in
the interest of improving the human condition.
Since funding is necessary to deliver quality programming for persons with mental illness, theletter-writing
campaign advocates for that cause on behalf of patients who are unable to articulate their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-26 TOP:
Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
4. A family has a long history of conflicted relationships among the members. Which family
member‘s comment best reflects a mentally healthy perspective?
a. ―I‘ve made mistakes but everyone else in this family has also.‖
b. ―I remember joy and mutual respect from our early years together.‖
c. ―I will make some changes in my behavior for the good of the family.‖
d. ―It‘s best for me to move away from my family. Things will never change.‖
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the importance of
relationships. Mental health includes rational thinking, communication skills, learning, emotional growth,
resilience, and self-esteem. Recalling joy from earlier in life maybe healthy, but the correct response
shows a higher level of mental health. The other incorrectresponses show blaming and avoidance.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrity
5. Which assessment finding most clearly indicates that a patient may be experiencing a mentalillness? The
patient
a. reports occasional sleeplessness and anxiety.
b. reports a consistently sad, discouraged, and hopeless mood.
c. is able to describe the difference between ―as if‖ and ―for real.‖
d. perceives difficulty making a decision about whether to change jobs.
ANS: B
The correct response describes a mood alteration, which reflects mental illness. The distracters
describe behaviors that are mentally healthy or within the usual scope of humanexperience.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2 to 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior‖ was
achieved for an adult patient? The patient
a. sees self as capable of achieving ideals and meeting demands.
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, b. behaves without considering the consequences of personal actions.
c. aggressively meets own needs without considering the rights of others.
d. seeks help from others when assuming responsibility for major areas of own life.
ANS: A
The correct response describes an adaptive, healthy behavior. The distracters describe
maladaptive behaviors.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2 to 4 TOP: Nursing Process: Evaluation
MSC: Client Needs: Psychosocial Integrity
7. A nurse encounters an unfamiliar psychiatric disorder on a new patient‘s admission form. Which resource
should the nurse consult to determine criteria used to establish this diagnosis? a.
International Statistical Classification of Diseases and Related Health Problems(ICD-10)
b. The ANA‟s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual
ANS: C
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guidelinefor
diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric
illness.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-18, 19 TOP: Nursing Process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resourcewould have
the most complete information?
a. Nursing Outcomes Classification (NOC)
b. DSM-V
c. The ANA‟s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. ICD-10
ANS: B
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline for
diagnosing psychiatric disorders. The other references are good resources but donot define the diagnostic
criteria.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 1-18, 19 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
9. Which individual is demonstrating the highest level of resilience? One who
a. is able to repress stressors.
b. becomes depressed after the death of a spouse.
c. lives in a shelter for 2 years after the home is destroyed by fire.
d. takes a temporary job to maintain financial stability after loss of a permanent job.
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