Psychiatric Mental Health Nursing Concepts of Care
in Evidence-Based Practice 10th Edition 2024/2025
Updated Version Grade A+
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:
Recognizes the client may view the losses as challenges and perceive them as opportunities.
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:
A challenge
Which client statement alerts the nurse that the client may be maladaptively responding
to stress?
"Avoiding contact w others to help me cope."
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?
Exhaustion
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?
"I understand you feel stressed about this; tell me more about your stress."
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?
Assist the student with problem-solving strategies
,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?
Assist her with the problem-solving process
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:
Personally relevant
Meditation has been shown to be an effective stress management technique. Which
finding indicates meditation has been effective?
Achieving a state of relaxation
A first-time parent is crying and asks the nurse, "How can I go to work if I can't afford child
care?" Which is the appropriate initial response by the nurse to assist with problem-
solving?
Assess the facts of the situation
The client is hospitalized with coronary artery disease and demonstrates other conditions
often associated with diseases of adaptation, including headaches and depression.
Currently, the client is demonstrating anxiety and states he is "really worried" about his
spouse. Which is the most appropriate nursing response to the situation?
Encourage the client to talk through his concerns about his spouse.
When an individual's stress response is sustained over a long period, the nurse anticipates
which physiological effect?
Decreased resistance to disease
Which is a typical part of the fight-or-flight syndrome?
Decreased peristalsis
,A nurse is assessing a client who is experiencing occasional feelings of sadness because of
the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine
have not changed. The nurse determines the client's behaviors:
Show common symptoms of grief and do not indicate mental illness
Which indicates a client is likely demonstrating a mental disorder?
The client displays an inability to concentrate, including reduced job performance.
A mental health nurse is speaking with parents who are concerned about their teenage
children's responses to stress. One child becomes anxious and irritable and the other
withdraws and cries. Which is the nurse's best response?
"Individual responses to stress are affected by many factors and can vary."
The nurse is interviewing a client with a history of excessive drinking and multiple arrests
for impaired driving. The client states, "I work hard to provide for my family. I don't see
why I can't drink to relax." Which defense mechanism is the client demonstrating?
Rationalization
Which best describes the impact that the National Mental Health Act of 1946 had on care
for the mentally ill in the United States?
People were no longer perceived as demonized when displaying mental illness.
A new psychiatric-mental health nurse states, "This client's use of defense mechanisms
should be eliminated." Which is the correct evaluation of the nurse's statement?
Defense mechanisms are self-protective responses to stress and do not need to be
eliminated.
During an intake assessment, the nurse asks a client physiological and psychosocial
questions. The client angrily responds, "I'm here for my heart problems, not for my head."
Which is the nurse's best response?
"Psychological stress can affect medical conditions."
, Teaching regarding the concepts of mental health and mental illness is effective when the
student nurse states which of the following?
"The concepts are multidimensional and culturally defined."
The nurse recognizes that a client is mildly anxious when beginning a session that incudes
client teaching. Which is the most appropriate interpretation of the situation?
The nurse should wait until there is no anxiety to achieve the best learning.
A high school student is attracted to a female teacher. The student is uncomfortable with
his feelings and says to his friend, "I know she wants me." Which defense mechanism is
the student demonstrating?
Projection
A client diagnosed with major depressive disorder asks, "Which part of my brain controls
my emotions?" Which nursing response is best?
"The limbic system is largely responsible for one's emotional state."
Which part of the nervous system would the nurse identify as playing a major role during
stressful situations?
Sympathetic nervous system
Which client statement indicates the nurse's teaching about the effect of circadian
rhythms is effective?
"I'm a morning person, so I get my best work done in the a.m."
Six months after a client's spouse and children were killed in a car accident, the client is
diagnosed with ulcerative colitis. The nurse should recognize that this situation validates
which study perspective?
Psychoneuroimmunology
A client who is diagnosed with schizophrenia expresses little emotion and refuses to
attend group therapy is influenced by which component of the nervous system?
Neurotransmitters
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