Test Bank For Varcarolis' Essentials of Psychiatric
Mental Health Nursing, 5th Edition By Chyllia D Fosbre
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. - ANSWER Report a sense of well-being
2. A patient is hospitalized for depression and suicidal ideation after their spouse
asks for a divorce. Select the nurse's most caring comment.
a. "Let's discuss some means of coping other than suicide when you have these
feelings."
b. "I understand why you're 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?" - ANSWER
ANS: A
The nurse's 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.
3. 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. "Let's 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." - ANSWER 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.
4. 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 isn't 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. "I'd like to sit with you a while so you may feel more comfortable talking with me." -
ANSWER ANS: D
Attending is a technique that demonstrates the nurse's 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.
5. A patient shows the nurse an article from the Internet about a health problem.
Which characteristic of the web site's 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." - ANSWER 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.
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 nurse's 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. - ANSWER 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.
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. I'm 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." - ANSWER 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, not simply documentation. Psychosocial pain is real and
can cause as much suffering as physical pain.
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 - ANSWER 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.
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 - ANSWER ANS: A
An advocate defends or asserts another's 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.
10. An informal group of patients discuss their perceptions of nursing care. Which
comment best indicates a patient's 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 I'm not alone." - ANSWER 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.
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
d. International Statistical Classification of Diseases and Related Health Problems
(ICD) - ANSWER ANS: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment
approaches drawn from large databases of information. These guidelines help the
treatment team make decisions cognizant of an individual patient's needs, such as
ethnic origin, age, or gender. A clinical pathway is a map of interventions and
treatments related to a specific disorder. Clinical practice guidelines summarize best
practices about specific health problems. The ICD classifies diseases.
12. Which historical nursing leader helped focus practice to recognize the
importance of science in psychiatric nursing?
a. Abraham Maslow
b. Hildegard Peplau
c. Kris Martinsen
d. Harriet Bailey - ANSWER ANS: B
Although all these leaders included science as an important component of practice,
Hildegard Peplau most influenced its development in psychiatric nursing. Maslow
was not a nurse, but his theories influence how nurses prioritize problems and care.
Bailey wrote a textbook in the 1930s on psychiatric nursing interventions. Kris
Martinsen emphasized the importance of caring in nursing practice.
13. A nurse consistently strives to demonstrate caring behaviors during interactions
with patients. Which reaction by a patient indicates this nurse is effective? A patient
reports feeling:
a. distrustful of others.
b. connected with others.
c. uneasy about the future.
d. discouraged with efforts to improve. - ANSWER ANS: B
A patient is likely to respond to caring with a sense of connectedness with others.
The absence of caring can make patients feel distrustful, disconnected, uneasy, and
discouraged.
1. An experienced nurse says to a new graduate, "When you've practiced as long as
I have, you will instantly know how to take care of psychotic patients." What is the
new graduate's best analysis of this comment? Select all that apply.
a. The experienced nurse may have lost sight of patients' individuality, which may
compromise the integrity of practice.
b. New research findings must be continually integrated into a nurse's practice to
provide the most effective care.
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