TEST BANK
Davis Advantage for Townsend's Psychiatric Mental Health
Nursing
Karyn I. Morgan
11th Edition
,Table of Contents
Chapter 01 The Concept of Stress Adaptation 1
Chapter 02 Mental Health and Mental Illness: Historical and Theoretical Concepts 22
Chapter 03 Concepts of Psychobiology 51
Chapter 04 Psychopharmacology 78
Chapter 05 Ethical and Legal Issues 102
Chapter 06 Relationship Development 133
Chapter 07 Therapeutic Communication 159
Chapter 08 The Nursing Process in Psychiatric-Mental Health Nursing 196
Chapter 09 Therapeutic Groups 225
Chapter 10 Intervention With Families 245
Chapter 11 Psychosocial Interventions and Spiritual Care 261
Chapter 12 Crisis Intervention 283
Chapter 13 Assertiveness Training 295
Chapter 14 Promoting Self-Esteem 315
Chapter 15 Anger and Aggression Management 330
Chapter 16 Suicide Prevention 352
Chapter 17 Behavior Therapy 380
Chapter 18 Cognitive Behavior Therapy 398
Chapter 19 Electroconvulsive Therapy 419
Chapter 20 The Recovery Model 437
Chapter 21 Caring for Patients With Mental Illness and Substance Use Disorders in
General Practice Settings 452
Chapter 22 Neurocognitive Disorders 467
Chapter 23 Substance-Related and Addictive Disorders 492
Chapter 24 Schizophrenia Spectrum and Other Psychotic Disorders 524
Chapter 25 Depressive Disorders 556
Chapter 26 Bipolar and Related Disorders 586
Chapter 27 Anxiety, Obsessive-Compulsive, and Related Disorders 618
Chapter 28 Trauma- and Stressor-Related Disorders 652
Chapter 29 Somatic Symptom and Dissociative Disorders 679
Chapter 30 Eating Disorders 703
Chapter 31 Personality Disorders 725
Chapter 32 Children and Adolescents 769
Chapter 33 The Aging Individual 798
Chapter 34 Survivors of Abuse or Neglect 819
Chapter 35 Community Mental Health Nursing 844
Chapter 36 The Bereaved Individual 869
Chapter 37 Military Families 887
Chapter 38 Theoretical Models of Personality Development 899
Chapter 39 Cultural Concepts Relevant to Psychiatric-Mental Health Nursing 932
Chapter 40 Complementary Therapies and Integrative Health 947
,Chapter 41 Issues Related to Human Sexuality and Gender Dysphoria 962
Next Generation NCLEX Questions 980
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
Chapter 1. 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. The client’s 6-month score on the Recent Life Changes
Questionnaire is 110. The nurse:
1. Understands the client is at risk of significant stress-related illness.
2. Determines the client is not at risk of significant stress-related illness.
3. Needs further assessment of the client’s coping skills to determine susceptibility to
stress-related illness.
4. Recognizes the client may view the losses as challenges and perceive them as
opportunities.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 5
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse
should assess the client’s coping skills and available support before determining
susceptibility to stress-related physical and psychological illnesses. The Recent Life
Changes Questionnaire is an expanded version of 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 client’s life and susceptibility to stress-related
illness.
2. This is incorrect. Assessment is the first step in the nursing process. The nurse
should assess the client’s coping skills and available support before determining the
client’s perception of the current stresses. A 6-month score of 300 or more or a year
score total of 500 or more on the Recent Life Changes Questionnaire indicates high
stress in a client’s life and susceptibility to stress-related physical and psychological
illness.
3. This is correct. Assessment is the first step in the nursing process. The nurse should
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
assess the client’s coping skills and available support before determining
susceptibility to stress-related physical and psychological illness. A 6-month score of
300 or more or a year score of 500 or more indicates high stress in a client’s life and
risk of significant stress-related physical and psychological illness.
4. This is incorrect. Assessment is the first step in the nursing process. The nurse
should assess the client’s coping skills and available support before determining
susceptibility to stress-related illness. A 6-month score of 300 or more or a year
score total of 500 or more on the Recent Life Changes Questionnaire indicates high
stress in a client’s life and susceptibility to significant stress-related physical and
psychological illness.
CON: Stress and Coping
2. A physically and emotionally healthy client has just been fired. During a routine
office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll
consider pursuing an art degree.” The nurse determines the client perceives the stressor
of his job loss as:
1. Irrelevant
2. Harm or loss
3. Threatening
4. A challenge
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment >
Individual’s Perception of the Event > Primary Appraisal
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds no
significance for the individual.
2. This is incorrect. A harm or loss appraisal refers to damage or loss already
experienced by the individual.
3. This is incorrect. A threatening appraisal is perceived as anticipated harms or losses.
4. This is correct. The client’s statement indicates he perceives the loss of his job as a
challenge and an opportunity for growth, demonstrated by his statement to consider
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
an art degree.
CON: Stress and Coping
CON: Stress
3. Which of the following is a stage in the general adaptation syndrome?
1. Journaling thoughts and feelings
2. Adapting to and overcoming a stressor
3. Primary appraisal
4. Spending time with a pet
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 3
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Journaling thoughts and feelings is a positive adaptive coping
mechanism but is not a stage in the general adaptation syndrome.
2. This is correct. Adapting to and overcoming a stressor is the stage of resistance in
the general adaptation syndrome defined by Selye.
3. This is incorrect. Primary appraisal is a concept of stress defined by Lazarus and
Folkman in 1984.
4. This is incorrect. Spending time with a pet is a positive adaptive coping mechanism
but is not a stage in the general adaptation syndrome.
CON: Stress and Coping
4. A nursing student comes down with a sinus infection toward the end of every
semester. Which stage of stress is the student most likely experiencing when this occurs?
1. Alarm reaction
2. Resistance
3. Exhaustion
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
4. Fight or flight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 3
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. At the alarm reaction stage, physiological responses of the fight-or-
flight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individual uses the physiological
responses of the first stage as a defense in an attempt to adapt to the stressor.
Physiological symptoms may disappear.
3. This is correct. At the stage of exhaustion, the student’s exposure to stress has been
prolonged, and adaptive energy has been depleted. Diseases of adaptation occur
more frequently in this stage.
4. This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
CON: Stress and Coping
5. A school nurse is assessing a high school student who is overly concerned about her
appearance. The client’s parent states, “That’s not something to be stressed about!”
Which response by the nurse is best?
1. “Teenagers don’t truly understand stress.”
2. “Why are you so concerned about your appearance?”
3. “You surely know that isn’t something to be concerned with.”
4. “I understand you feel stressed about this; tell me more about your stress.”
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Describe the core concept of stress as an environmental event.
Page: 6-7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. This response is judgmental and nontherapeutic. This response
minimizes the student’s concerns.
2. This is incorrect. This response puts the student in a defensive position to justify her
feelings. It is nontherapeutic.
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s
feelings. This does not allow the student to verbalize her concerns.
4. This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation, which is an individual’s evaluation of the
personal significance of the event or occurrence. Stress can be physical or
psychological in nature. A perceived threat to self-esteem can be as stressful as a
physiological change. This response recognizes the situation and helps to explore the
situation.
CON: Stress and Coping
6. A student confides in the school nurse that he is feeling stress about deciding whether
to go to college or work to provide needed income for his family. Which is the best
approach by the nurse to assist the student?
1. Teach the student meditation techniques.
2. Assist the student with problem-solving strategies.
3. Suggest relaxation methods for the student.
4. Recommend getting a pet for the student.
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. This is not the best approach because it only addresses a means to
reduce stress-related symptoms and does not address the underlying concern for the
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
student.
2. This is correct. The student is facing a problem that needs to be viewed objectively,
and the nurse can assist the student, if needed, to apply problem-solving strategies.
3. This is incorrect. While relaxation may assist the student with coping with the
stressor, it does not address the student’s underlying concern.
4. This is incorrect. Getting a pet can assist with coping with life stressors; however,
the student has already expressed financial concerns, to which the pet will only add.
CON: Stress and Coping
7. An unemployed college graduate confides in the clinic nurse that she is experiencing
severe anxiety over not finding a teaching position and that she is having difficulty with
independent problem-solving. Which nursing intervention is best?
1. Encourage her to seek counseling from a therapist.
2. Instruct her to listen to her favorite music daily.
3. Assist her with the problem-solving process.
4. Encourage her to keep a daily journal of feelings.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 9
Heading: Stress Management > Adaptive Coping Strategies > Problem-Solving
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. Counseling is not likely needed in this case due to the situational
nature the student is describing.
2. This is incorrect. Listening to music may assist with the stress symptoms; however,
it does not address the underlying problem.
3. This is correct. Assist the client with problem-solving. During times of high anxiety
and stress, clients will need more assistance in problem-solving and decision-
making.
4. This is incorrect. A daily journal may assist her with managing her symptoms but
does not address the underlying concern the client is expressing.
CON: Stress and Coping
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Test Bank - Townsend's Psychiatric Mental Health Nursing, 11th Edition (Morgan, 2024)
Morgan
PMHN, 11e
Chapter 1 - ETB
8. The school nurse is assessing a high school student who is distraught because her
parents cannot afford horseback riding lessons. The nurse recognizes the student’s
perception is that the problem is:
1. Endangering her well-being
2. Personally relevant
3. Based on immaturity
4. Challenging to her
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the concept of stress as a transaction between the individual and the
environment.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. The student is not expressing that it endangers her well-being; the
distress is related to the fact that she sees it as personally significant.
2. This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation. An event becomes relevant to an individual
when the outcome holds personal significance.
3. This is incorrect. The distress the client is feeling is not related to immaturity; rather,
she sees it as having personal significance and therefore relevant.
4. This is incorrect. The emotions associated with challenging events tend to be
positive, such as eagerness and excitement, rather than being distraught.
CON: Stress and Coping
9. Meditation has been shown to be an effective stress management technique. Which
finding indicates meditation has been effective?
1. Achieving a state of relaxation
2. Attaining insight into one’s feelings
3. Demonstrating appropriate role behaviors
4. Enhanced problem-solving skills
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