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Test Bank - Varcarolis Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019), Chapter 1-35 | All Chapters $16.49
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Test Bank - Varcarolis Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019), Chapter 1-35 | All Chapters

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Test Bank - Varcarolis Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019), Chapter 1-35 | All Chapters

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  • September 20, 2023
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TEST BANK
Varcarolis's Canadian Psychiatric Mental Health Nursing


Margaret Jordan Halter, Cheryl L. Pollard, and Sonya L. Jakubec

2nd Edition

,Table of Contents

Chapter 01 Mental Health and Mental Illness 1
Chapter 02 Historical Overview of Psychiatric Mental Health Nursing 11
Chapter 03 Overview of Psychiatric Mental Health Nursing Care Within Various Settings 15
Chapter 04 Relevant Theories and Therapies for Nursing Practice 28
Chapter 05 Understanding Responses to Stress 41
Chapter 06 The Nursing Process and Standards of Care for Psychiatric Mental Health
Nursing 51
Chapter 07 Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health
Nursing Practice 62
Chapter 08 Cultural Considerations for Psychiatric Mental Health Nursing 74
Chapter 09 Therapeutic Relationships 86
Chapter 10 Communication and the Clinical Interview 97
Chapter 11 Psychotropic Drugs 106
Chapter 12 Anxiety and Related Disorders 118
Chapter 13 Depressive Disorders 140
Chapter 14 Bipolar Disorders 152
Chapter 15 Schizophrenia Spectrum and Other Psychotic Disorders 165
Chapter 16 Eating and Feeding Disorders 179
Chapter 17 Neurocognitive Disorders 189
Chapter 18 Psychoactive Substance Use and Treatment 201
Chapter 19 Personality Disorders 213
Chapter 20 Sleep–Wake Disorders 224
Chapter 21 Crisis and Disaster 234
Chapter 22 Suicide and Nonsuicidal Self-Injury 244
Chapter 23 Anger, Aggression, and Violence 254
Chapter 24 Interpersonal Violence Child, Older Adult, and Intimate Partner Abuse 264
Chapter 25 Sexual Assault 273
Chapter 26 Sexuality and Gender 282
Chapter 27 Disorders of Children and Adolescents 292
Chapter 28 Psychosocial Needs of the Older Adult 302
Chapter 29 Living With Recurrent and Persistent Mental Illness 314
Chapter 30 Psychological Needs of Patients With Medical Conditions 327
Chapter 31 Care for the Dying and for Those Who Grieve 337
Chapter 32 Forensic Psychiatric Nursing 349
Chapter 33 Therapeutic Groups 359
Chapter 34 Family Interventions 370
Chapter 35 Integrative and Complimentary Therapies 381

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Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019)

Chapter 01: Mental Health and Mental Illness
Halter: Varcarolis’s Canadian Psychiatric Mental Health Nursing, 2nd Edition


MULTIPLE CHOICE

1. A staff nurse completes orientation to a psychiatric unit. Which of the following would the
nurse expect as an advanced practice intervention?
a. Conduct mental health assessments
b. Prescribe psychotropic medication
c. Establish therapeutic relationships
d. Individualize nursing care plans
ANS: B
Prescriptive privileges are granted to master’s-prepared nurse practitioners who have taken
special courses on prescribing medication; thus it is an advanced-practice intervention. The
nurse prepared at the basic level is permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe Effective Care Environment

2. When a nursing student expresses concerns about how mental health nurses “lose all their
nursing skills,” which of the following is the best response by the mental health nurse?
a. “Psychiatric nurses practise in safer environments than other specialties.
Nurse-to-patient ratios must be better because of the nature of the patients’
problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking
to solve multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequently use high-technology
monitoring equipment and manage complex intravenous therapies.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as
medical–surgical nurses do. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills from medical–surgical
nursing, though there is substantial overlap. Two domains relate specifically to psychiatric
nursing: behavioural, including communication, coping, and education; and safety, covering
crisis and risk management. Basic psychosocial nursing concepts are central to psychiatric
nursing practice and increase your competency as a practitioner in all clinical settings.
Whatever setting you choose to work in, you will have the opportunity to improve the lives of
people who are experiencing mental illness as an additional challenge to their health. Your
experience in the mental health nursing rotation can help you gain insight into yourself and
greatly increase your insight into the experiences of others. This part of nursing education can
provide guidelines for and the opportunity to learn new skills for dealing with a variety of
challenging behaviours. Psychosocial pain and suffering are as real as physical pain and
suffering.

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation




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Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019)

MSC: Client Needs: Safe Effective Care Environment

3. When a new bill introduced in Parliament reduces funding for care of people with mental
illness, a group of people with mild mental illness write letters to their elected representatives
in opposition to the legislation for all people with mental illness. Which role does this action
portray?
a. Recovery
b. Self-care
c. Advocacy
d. Social action
ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for himself or herself. On a community scale, advocacy includes political
activity, public speaking, and publication in the interest of improving the human condition.
Since funding is necessary to deliver quality programming for people with mental illness, the
letter-writing campaign advocates for the cause for all people with mental illness.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe Effective Care Environment

4. Which of the following has been identified as a significant trend that will affect the future of
psychiatric mental health nursing in Canada?
a. Decrease in the aging population
b. Increase in cultural diversity
c. Role of the advanced-practice nurse
d. Shortage of physicians in rural and urban areas
ANS: B
Four significant trends have been identified that will affect the future of psychiatric mental
health nursing in Canada; these include an aging population, an increase in cultural diversity,
expanding technology, and an increased awareness of the impact of the determinants of health
on mental illness.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe Effective Care Environment

5. Which assessment finding most clearly indicates that a patient may be experiencing a mental
illness?
a. The patient reports occasional sleeplessness and anxiety.
b. The patient reports a consistently sad, discouraged, and hopeless mood.
c. The patient is able to describe the difference between “as if” and “for real.”
d. The patient perceives difficulty making a decision about whether to change jobs.
ANS: B
The correct response describes a mood alteration, which reflects mental illness. Alterations in
cognition, mood, or behaviour that are coupled with significant distress and impaired
functioning characterize mental illness. The distracters describe behaviours that are mentally
healthy or within the usual scope of human experience.



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Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019)


DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

6. Which finding best indicates that the goal “Demonstrates mentally healthy behaviour” was
achieved?
a. A patient sees self as capable of achieving ideals and meeting demands.
b. A patient behaves without considering the consequences of personal actions.
c. A patient aggressively meets own needs without considering the rights of others.
d. A patient seeks help from others when assuming responsibility for major areas of
own life.
ANS: A
The correct response describes an adaptive, healthy behaviour. The WHO defines mental
health as “a state of well-being in which each individual is able to realize his or her own
potential, cope with the normal stresses of life, work productively and fruitfully, and make a
contribution to the community” (World Health Organization, 2010). The distracters describe
maladaptive behaviours.

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Evaluation
MSC: Client Needs: Psychosocial Integrity

7. A nurse encounters an unfamiliar psychiatric disorder on a new patient’s admission form.
Which resource should the nurse consult to determine criteria used to establish this diagnosis?
a. International Statistical Classification of Diseases and Related Health Problems
(ICD-10)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
c. A behavioural health reference manual
d. NurseOne online
ANS: B
The DSM-5 gives the criteria used to diagnose each mental disorder. The distracters may not
contain diagnostic criteria for a psychiatric illness.

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment
MSC: Client Needs: Safe Effective Care Environment

8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
would have the most complete information?
a. Nursing Outcomes Classification (NOC)
b. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
c. The ANA’s Psychiatric–Mental Health Nursing Scope and Standards of Practice
d. International Statistical Classification of Diseases and Related Health Problems
(ICD-10)
ANS: B
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions and is the official
guide for diagnosing psychiatric disorders. The other references are good resources but do not
define the diagnostic criteria.

DIF: Cognitive Level: Understand (Comprehension)



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3|Page

,______________________________________________________________________________________________
Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019)

TOP: Nursing Process: Implementation
MSC: Client Needs: Safe Effective Care Environment

9. Which individual is demonstrating the highest level of resilience?
a. One who is able to repress stressors.
b. One who becomes depressed after the death of a spouse.
c. One who lives in a shelter for 2 years after his or her home is destroyed by fire.
d. One who is able to connect with their support systems and secure the resources
they need to be well.
ANS: D
Resilience is closely associated with the process of adapting and helps people facing
tragedies, loss, trauma, and severe stress. It is a process and outcome of complex cultural
systems rather than simply an individual’s ability to overcome adversity. Repression and
depression are unhealthy. Living in a shelter for 2 years shows a failure to move forward after
a tragedy. See related audience response question.

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

10. Complete this analogy. NANDA: clinical judgement; NIC:____________
a. Patient outcomes
b. Nursing actions
c. Diagnoses
d. Symptoms
ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis
Association, identifies diagnostic statements regarding human responses to actual or potential
health problems. These statements represent clinical judgements. NIC (Nursing Interventions
Classification) identifies actions provided by nurses that enhance patient outcomes. Nursing
care activities may be direct or indirect.

DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe Effective Care Environment

11. A college student said, “Most of the time I’m happy and feel good about myself. I have
learned that what I get out of something is proportional to the effort I put into it.” According
to the Epp classification, which quadrant outcome should the nurse select?
a. Optimal mental health with mental illness
b. Poor mental health with mental illness
c. Optimal mental health without mental illness
d. Poor mental health without mental illness
ANS: C
The student is happy and has an adequate self-concept. The student is reality-oriented, works
effectively, and has control over his or her own behaviour. Mental health does not mean that a
person is always happy.

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity




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4|Page

,______________________________________________________________________________________________
Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019)


12. Which disorder is a culture-bound syndrome?
a. Epilepsy
b. Schizophrenia
c. Running amok
d. Major depression
ANS: C
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized
by people in those cultures. A syndrome recognized in parts of Southeast Asia is running
amok, in which a person (usually a male) runs around engaging in furious, almost
indiscriminate violent behaviour.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

13. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies which of the
following?
a. Deviant behaviours
b. Present disability or distress
c. People with mental disorders
d. Mental disorders people have
ANS: D
The DSM-5 classifies disorders people have rather than people themselves. The terminology
of the tool reflects this distinction by referring to individuals with a disorder rather than as a
“schizophrenic” or “alcoholic,” for example. Deviant behaviour is not generally considered a
mental disorder. Present disability or distress is only one aspect of the diagnosis.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe Effective Care Environment

14. A visitor at a community health fair asks the nurse, “What is the most prevalent mental
disorder in Canada?” Select the nurse’s best response.
a. Schizophrenia
b. Bipolar disorder
c. Generalized anxiety disorder
d. Major depression
ANS: D
The prevalence of major depressive disorder is 47%, and approximately 11.3% of adults will
experience major depression at some time in their lives. The prevalence of schizophrenia is
1.3% per year. The prevalence of bipolar disorder is 1.5%. The prevalence for generalized
anxiety disorder is about 2.6% annually.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance




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5|Page

, ______________________________________________________________________________________________
Test Bank - Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition (Halter, 2019)

15. Which of the following represents an outcome domain of the Nursing Outcomes
Classification (NOS)?
a. Mental health
b. Perceived health
c. Chronic illness
d. Mental illness
ANS: B
One of the seven outcome domains is perceived health; the other six are functional health,
physiologic health, psychosocial health, health knowledge, family health, and community
health.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

16. A patient’s relationships are intense and unstable. The patient initially idealizes the significant
other and then devalues him or her, resulting in frequent feelings of emptiness. This patient
will benefit from interventions to develop which aspect of mental health?
a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships
ANS: D
The information provided centres on relationships with others that are described as intense
and unstable. The relationships of mentally healthy individuals are stable, satisfying, and
socially integrated. They have rich social relationships. Data are not present to describe work
effectiveness, communication skills, or activities.

DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

17. Which belief will best support a nurse’s efforts to provide patient advocacy during a
multidisciplinary patient care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental disorders reflect a person’s cultural patterns.
ANS: D
A nurse who understands that a patient’s symptoms are influenced by culture will be able to
advocate for the patient to a greater degree than a nurse who believes that culture is of little
relevance. The distracters are untrue statements.

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity




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