TEST BANK PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITIONTable of Contents
Chapter 01. The Concept of Stress Adaptation ....................................................................................................................................... 1 Chapter 02. Mental Health...
Table of Contents
Chapter 01. The Concept of Stress Adaptation ....................................................................................................................................... 1
Chapter 02. Mental Health/Mental Illness: Historical and TheoreticalConcepts ............................................................................. 8
Chapter 03. Psychopharmacology ............................................................................................................................................................ 19
Chapter 04. Concepts of Psychobiology ................................................................................................................................................. 26
Chapter 05. Ethical and Legal Issues in Psychiatric/Mental HealthNursing ................................................................................... 34
Chapter 06. Cultural and Spiritual Concepts Relevant toPsychiatric/Mental Health Nursing...................................................... 44
Chapter 07. Relationship Development .................................................................................................................................................. 51
Chapter 08. Therapeutic Communication............................................................................................................................................... 58
Chapter 09. The Nursing Process in Psychiatric/Mental Health Nursing ...................................................................................... 70
Chapter 10. Therapeutic Groups .............................................................................................................................................................. 81
Chapter 11. Intervention With Families .................................................................................................................................................. 89
Chapter 12. Milieu Therapy - The Therapeutic Community .............................................................................................................. 95
Chapter 13. Crisis Intervention ................................................................................................................................................................. 99
Chapter 14. Assertiveness Training ........................................................................................................................................................ 103
Chapter 15. Promoting Self-Esteem ...................................................................................................................................................... 111
Chapter 16. Anger/Aggression Management....................................................................................................................................... 117
Chapter 17. The Suicidal Client ............................................................................................................................................................... 123
Chapter 18. Behavior Therapy................................................................................................................................................................. 132
Chapter 19. Cognitive Therapy ............................................................................................................................................................... 139
Chapter 20. Electroconvulsive Therapy ................................................................................................................................................ 147
Chapter 21. The Recovery Model ........................................................................................................................................................... 154
Chapter 22. Neurocognitive Disorders.................................................................................................................................................. 160
Chapter 23. Substance-Related and Addictive Disorders .................................................................................................................. 166
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders .......................................................................................... 176
Chapter 25. Depressive Disorders .......................................................................................................................................................... 187
Chapter 26. Bipolar and Related Disorders .......................................................................................................................................... 197
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders ............................................................................................ 208
Chapter 28: Trauma and Stressor-Related Disorders ......................................................................................................................... 218
Chapter 29. Somatic Symptom and Dissociative Disorders ............................................................................................................. 226
Chapter 30. Issues Related to Human Sexuality and Gender Dysphoria....................................................................................... 231
Chapter 31. Eating Disorders .................................................................................................................................................................. 236
Chapter 32. Personality Disorders .......................................................................................................................................................... 243
Chapter 33. Children and Adolescents .................................................................................................................................................. 255
Chapter 34. The Aging Individual .......................................................................................................................................................... 265
Chapter 35. Survivors of Abuse or Neglect.......................................................................................................................................... 270
Chapter 36. Community Mental Health Nursing ................................................................................................................................ 276
Chapter 37. The Bereaved Individual .................................................................................................................................................... 282
Chapter 38. Military Families ................................................................................................................................................................... 287
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 knowledge of
coping resources and available supports.
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, 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.
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.
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.
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
C. Stage of exhaustion
D. Fight-or-flight stage
ANS: C
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, 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.
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.
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.
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
inthe clinic nurse. Which is the most appropriate nursing intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
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
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, During times of high anxiety and stress, clients will need more assistance in problem-solving and decision
making.
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.
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?
A. Determine the risks and benefits for each alternative.
B. Formulate goals for resolution of the problem.
C. Evaluate the outcome of the implemented alternative.
D. Assess the facts of the situation.
ANS: D
Before any other steps can be taken, accurate information about the situation must be gathered and assessed.
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