TEST BANK
Varcarolis Essentials of Psychiatric Mental
Health Nursing 5th Edition by Fosbre,
All Chapters 1 – 28 Full Complete 2024
,TABLE OF CONTENTS
,Chapter 01: Practicing the Science and the Art of Psychiatric Nursing
MULTIPLECHOICE
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: 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.
ANSWER: 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 thepatient.
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 createconflict.
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.
ANSWER: 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?
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 3
ANSWER: 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 arenot
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.
ANSWER: B
Financial influences on a site are a clue that the information may be biased. .com at the endof
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 themin
practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
change.
ANSWER: 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 toa
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, soI
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: 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,
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th 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
ANSWER: 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 powerfuland
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
ANSWER: 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 makeit
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 Imnot
alone.
ANSWER: 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
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 5
d. International Statistical Classification of Diseases and Related Health Problems (ICD)
ANSWER: 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 makedecisions
cognizant of an individual patients 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. TheICD
classifies diseases.
,DIF: Cognitive Level: Application (Applying) REF: 5
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 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: 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 anurse, 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.DIF:
Cognitive Level: Knowledge (Remembering) REF: 4
TOP: Nursing Process: N/A MSC: NCLEX: Psychosocial Integrity 13. A nurse consistently
strives to demonstrate caring behaviors during interactions with patients. Which reactionby 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: 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.
DIF: Cognitive Level: Comprehension (Understanding) REF: 7
TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity MULTIPLE
RESPONSE
, 1. An experienced nurse says to a new graduate, When youve practiced as long as I have,
you will instantly know how to take care of psychotic patients. What is the new graduates
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 nurses practice to provide
the most effective care.
c. Experience provides mental health nurses with the tools and skills needed for effective
professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for psychotic patients
through trial and error.
e. Effective psychiatric nurses should be continually guided by an intuitive sense of patients
needs.
ANSWER: A, B
Evidence-based practice involves using research findings to provide the most effective
nursing care. Evidence is continually emerging; therefore, nurses cannot rely solely on
experience. The effective nurse also maintains
Test Bank: Essentials of Psychiatric Mental Health Nursing (5th Edition by Varcarolis) 6
respect for each patient as an individual. Overgeneralization compromises that perspective.
Intuition and trial and error are unsystematic approaches to care.
DIF: Cognitive Level: Application (Applying) REF: 2
TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 2. Which
patient statements identify qualities of nursing practice with high therapeutic value? (Select
all that apply.) My nurse:
a. talks in language I can understand.
b. helps me keep track of my medications.
c. is willing to go to social activities with me.
d. lets me do whatever I choose without interfering.
e. looks at me as a whole person with different needs.
ANSWER: A, B, E
