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Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 1
Table of Contents
Table of Contents 1
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing 2
Chapter 02: Mental Health and Mental Illness 7
Chapter 03: Theories and Therapies 12
Chapter 04: Biological Basis for Understanding Psychopharmacology 20
Chapter 05: Settings for Psychiatric Care 28
Chapter 06: Legal and Ethical Basis for Practice 35
Chapter 07: Nursing Process and QSEN: The Foundation for Safe and Effective Care 43
Chapter 08: Communication Skills: Medium for All Nursing Practice 51
Chapter 09: Therapeutic Relationships and the Clinical Interview 58
Chapter 10: Trauma and Stress-Related Disorders 67
Chapter 11: Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders 74
Chapter 12: Somatic System Disorders and Dissociative Disorders 85
Chapter 13: Personality Disorders 94
Chapter 14: Eating Disorders 103
Chapter 15: Mood Disorders: Depression 111
Chapter 16: Bipolar Spectrum Disorders 121
Chapter 17: Schizophrenia Spectrum Disorders and Other Psychotic Disorders 131
Chapter 18: Neurocognitive Disorders 142
Chapter 19: Substance-Related and Addictive Disorders 151
Chapter 20: Crisis and Mass Disaster 163
Chapter 21: Child, Partner, and Elder Violence 171
Chapter 22: Sexual Violence 179
Chapter 23: Suicidal Thoughts and Behavior 186
Chapter 24: Anger, Aggression, and Violence 195
Chapter 25: Care for the Dying and Those Who Grieve 204
Chapter 26: Children and Adolescents 213
Chapter 27: Adults 221
Chapter 28: Older Adults 230
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Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient living in the
community and diagnosed with serious and persistent 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
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving role performance.
The goal of recovery is to empower 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 rather than recovery.
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 inconsiderate 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 on-coming nurse needs to take action to ensure
that others 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 other.
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 disorder. 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 better after 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. Generalizations, probing, and
false reassurances are non-therapeutic.
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 after their spouse asks for a divorce. Select the
nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand 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?
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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 therapeutic
interventions.
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 Internet about a health problem. Which characteristic of the
web sites address most alerts 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 commercial one. .gov indicates that the site is maintained by a government 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 (Understanding) 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; however, 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 misinterpreted 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 other studies
before practice changes. One study is not enough. Descriptive studies are low on the hierarchy 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 career plans after graduation. One student wants to enter psychiatric nursing.
The other 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 interested in psychiatric nursing.
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be
better 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 after I graduate.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical nurses. That
appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical surgical nursing, although
substantial overlap does exist. Psychiatric nurses must be able to help patients with medical and mental health
problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in
psychiatric settings have increased, similar to other specialties. Psychiatric nursing involves clinical practice,
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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 suffering 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. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANS: B
Research findings are graded using a hierarchy of evidence. A systematic review of randomized controlled
trials is Level A and provides the strongest evidence for changing practice. Expert committee
recommendations and descriptive studies lend less powerful and influential evidence. A critical pathway is not
evidence; it incorporates research findings after they have been analyzed.
DIF: Cognitive Level: Comprehension (Understanding) 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 letters to their elected representatives in opposition to the legislation. Which role have
the nurses fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANS: A
An advocate defends or asserts anothers cause, particularly when the other person lacks the ability to do that
for himself or herself. Examples of individual advocacy include helping patients understand their rights or
make decisions. On a community scale, advocacy includes political activity, public speaking, and publication
in the interest of improving the individuals with mental illness; the letter-writing campaign advocates for that
cause on behalf of patients who are unable to articulate their own needs.
DIF: Cognitive Level: Comprehension (Understanding) REF: 8
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
10. An informal group of patients discuss their perceptions of nursing care. Which comment best indicates a
patients perception that his or her 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 better.
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 understanding, as well as competency. It helps change pain and suffering into a
shared experience, 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
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