Psychiatric Mental Health Nursing 7th Edition Test Bank
Chapter 1
1. The nurse is assessing the factors contributing to the well-being of a newly admitted client.
Which of the following would the nurse identify as having a positive impact on the
individual's mental health?
A) Not needing others for companionship
B) The ability to effectively manage stress
C) A family history of mental illness
D) Striving for total self-reliance
Ans: B
Feedback:
Individual factors influencing mental health include biologic makeup, autonomy, independence,
self-esteem, capacity for growth, vitality, ability to find meaning in life,emotional resilience or
hardiness, sense of belonging, reality orientation, and coping or stress management abilities.
Interpersonal factors such as intimacy and a balance of separateness and connectedness are both
needed for good mental health, and therefore ahealthy person would need others for
companionship. A family history of mental illness could relate to the biologic makeup of an
individual, which may have a negativeimpact on an individual's mental health, as well as a negative
impact on an individual's interpersonal and socialñcultural factors of health. Total self-reliance is
not possible, and a positive social/cultural factor is access to adequate resources.
2. Which of the following statements about mental illness are true? Select all that apply.
A) Mental illness can cause significant distress, impaired functioning, or both.
B) Mental illness is only due to social/cultural factors.
C) Social/cultural factors that relate to mental illness include excessive dependencyon or
withdrawal from relationships.
D) Individuals suffering from mental illness are usually able to cope effectively withdaily life.
E) Individuals suffering from mental illness may experience dissatisfaction with
relationships and self.
Ans: A, D, E
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental illness may be
related to individual, interpersonal, or social/cultural factors. Excessivedependency on or
withdrawal from relationships are interpersonal factors that relate tomental illness. Individuals
suffering from mental illness can feel overwhelmed with daily life. Individuals suffering from mental
illness may experience dissatisfaction withrelationships and self.
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, 3. Which of the following are true regarding mental health and mental illness?
A) Behavior that may be viewed as acceptable in one culture is always
unacceptable in other cultures.
B) It is easy to determine if a person is mentally healthy or mentally ill.
C) In most cases, mental health is a state of emotional, psychological, and socialwellness
evidenced by satisfying interpersonal relationships, effective behaviorand coping, positive
self-concept, and emotional stability.
D) Persons who engage in fantasies are mentallyill.
Ans: C
Feedback:
What one society may view as acceptable and appropriate behavior, another society maysee that as
maladaptive, and inappropriate. Mental health and mental illness are difficultto define precisely. In
most cases, mental health is a state of emotional, psychological, and social wellness evidenced by
satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and
emotional stability. Persons who engage in fantasies may be mentally healthy, but the inability to
distinguish reality from fantasyis an individual factor that may contribute to mental illness.
4. A client grieving the recent loss of her husband asks if she is becoming mentallyill because
she is so sad. The nurse's best response would be,
A) ìYou may have a temporary mental illness because you are experiencing so muchpain.î
B) ìYou are not mentally ill. This is an expected reaction to the loss you have
experienced.î
C) ìWere you generally dissatisfied with your relationship before your husband'sdeath?î
D) ìTry not to worry about that right now. You never know what the future brings.îAns: B
Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships, ineffective coping,
and lack of personal growth. Additionally the behavior must not be culturally expected. Acute grief
reactions are expected and therefore not considered mental illness. False reassurance or overanalysis
does not accurately address the client'sconcerns.
5. The nurse consults the DSM for which of the following purposes?
A) To devise a plan of care for a newly admitted client
B) To predict the client's prognosis of treatment outcomes
C) To document the appropriate diagnostic code in the client's medical record
D) To serve as a guide for client assessmentAns:
D
Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and identifies
underlying causes of mental disorders. It does not provide care plans or prognostic outcomes of
treatment. Diagnosis of mental illness is not within the generalist RN's scope of practice, so
documenting the code in the medical record wouldbe inappropriate.
6. Which would be a reason for a student nurse to use the DSM?
A) Identifying the medical diagnosis
B) Treat clients
C) Evaluate treatments
D) Understand the reason for the admission and the nature of psychiatric
illnesses. Ans: D
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, Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a helpful
resource to understand the reason for the admission and to begin building knowledge about the
nature of psychiatric illnesses. Identifying the medical diagnosis,treating, and evaluating treatments
are not a part of the nursing process.
7. The legislation enacted in 1963 was largely responsible for which of the followingshifts in
care for the mentally ill?
A) The widespread use of community-based services
B) The advancement in pharmacotherapies
C) Increased access to hospitalization
D) Improved rights for clients in long-term institutional careAns: A
Feedback:
The Community Mental Health Centers Construction Act of 1963 accomplished therelease of
individuals from long-term stays in state institutions, the decrease in admissions to hospitals, and
the development of community-based services as an alternative to hospital care.
8. Which one of the following is a result of federal legislation?
A) Making it easier to commit people for mental health treatment against their will.
B) Making it more difficult to commit people for mental health treatment againsttheir will.
C) State mental institutions being the primary source of care for mentally ill persons.
D) Improved care for mentally ill persons.Ans:
B
Feedback:
Commitment laws changed in the early 1970s, making it more difficult to commit people for
mental health treatment against their will. Deinstitutionalization accomplished the release of
individuals from long-term stays in state institutions. Deinstitutionalization also had negative effects
in that some mentally ill persons are subjected to the revolving door effect, which may limit care for
mentally ill persons.
9. The goal of the 1963 Community Mental Health Centers Act was to
A) ensure patients' rights for the mentally ill.
B) deinstitutionalize state hospitals.
C) provide funds to build hospitals with psychiatric units.
D) treat people with mental illness in a humane fashion.Ans: B
Feedback:
The 1963 Community Mental Health Centers Act intimated the movement toward treating those
with mental illness in a less restrictive environment. This legislation resulted in the shift of clients
with mental illness from large state institutions to carebased in the community. Answer choices A,
C, and D were not purposes of the 1963 Community Mental Health Centers Act.
10. The creation of asylums during the 1800s was meant to
A) improve treatment of mental disorders.
B) provide food and shelter for the mentally ill.
C) punish people with mental illness who were believed to be possessed.
D) remove dangerous people with mental illness from the community.Ans: B
Feedback:
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, The asylum was meant to be a safe haven with food, shelter, and humane treatment for the mentally
ill. Asylums were not used to improve treatment of mental disorders or topunish mentally ill people
who were believed to be possessed. The asylum was not created to remove the dangerously
mentally ill from the community.
11. The major problems with large state institutions are: Select all that apply.
A) attendants were accused of abusing the residents.
B) stigma associated with residence in an insane asylum.
C) clients were geographically isolated from family and community.
D) increasing financial costs to individual residents.Ans:
A, C
Feedback:
Clients were often far removed from the local community, family, and friends becausestate
institutions were usually in rural or remote settings. Choices B and D were notmajor problems
associated with large state instructions.
12. A significant change in the treatment of people with mental illness occurred in the1950s
when
A) community support services were established.
B) legislation dramatically changed civil commitment procedures.
C) the Patient's Bill of Rights was enacted.
D) psychotropic drugs became available for use.Ans:
D
Feedback:
The development of psychotropic drugs, or drugs used to treat mental illness, beganin the
1950s. Answer choices A, B, and C did not occur in the 1950s.
13. Before the period of the enlightenment, treatment of the mentally ill included
A) creating large institutions to provide custodial care.
B) focusing on religious education to improve their souls.
C) placing the mentally ill on display for the public's amusement.
D) providing a safe refuge or haven offering protection.Ans:
C
Feedback:
In 1775, visitors at St. Mary's of Bethlehem were charged a fee for viewing and ridiculing the
mentally ill, who were seen as animals, less than human. Custodial carewas not often provided as
persons who were considered harmless were allowed to wander in the countryside or live in rural
communities, and more dangerous lunatics were imprisoned, chained, and starved. In early
Christian times, primitive beliefs and superstitions were strong. The mentally ill were viewed as evil
or possessed. Priests performed exorcisms to rid evil spirits, and in the colonies, witch hunts were
conductedwith offenders burned at the stake. It was not until the period of enlightenment when
persons who were mentally ill were offered asylum as a safe refuge or haven offeringprotection at
institutions.
14. The first training of nurses to work with persons with mental illness was in 1882in which
state?
A) California
B) Illinois
C) Massachusetts
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