TEST BANK VARCAROLIS ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 3RD EDITIONTable of Contents
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing .......................................................... 1 Chapter 02: Mental Health and Mental Illness ...........................
Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd
Edition by Varcarolis)
Table of Contents
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing ..........................................................1
Chapter 02: Mental Health and Mental Illness ..................................................................................................8
Chapter 03: Theories and Therapies ................................................................................................................ 15
Chapter 04: Biological Basis for Understanding Psychopharmacology ....................................................... 26
Chapter 05: Settings for Psychiatric Care ........................................................................................................ 38
Chapter 06: Legal and Ethical Basis for Practice ............................................................................................ 47
Chapter 07: Nursing Process and QSEN: The Foundation for Safe and Effective Care ........................ 57
Chapter 08: Communication Skills: Medium for All Nursing Practice ........................................................ 69
Chapter 09: Therapeutic Relationships and the Clinical Interview............................................................... 77
Chapter 10: Trauma and Stress-Related Disorders......................................................................................... 89
Chapter 11: Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders....................................... 98
Chapter 12: Somatic System Disorders and Dissociative Disorders .......................................................... 114
Chapter 13: Personality Disorders .................................................................................................................. 126
Chapter 14: Eating Disorders .......................................................................................................................... 138
Chapter 15: Mood Disorders: Depression .................................................................................................... 150
Chapter 16: Bipolar Spectrum Disorders....................................................................................................... 164
Chapter 17: Schizophrenia Spectrum Disorders and Other Psychotic Disorders .................................. 178
Chapter 18: Neurocognitive Disorders .......................................................................................................... 193
Chapter 19: Substance-Related and Addictive Disorders ............................................................................ 205
Chapter 20: Crisis and Mass Disaster ............................................................................................................. 223
Chapter 21: Child, Partner, and Elder Violence ............................................................................................ 234
Chapter 22: Sexual Violence ............................................................................................................................ 245
Chapter 23: Suicidal Thoughts and Behavior ................................................................................................ 255
Chapter 24: Anger, Aggression, and Violence............................................................................................... 267
Chapter 25: Care for the Dying and Those Who Grieve ............................................................................. 279
Chapter 26: Children and Adolescents........................................................................................................... 291
Chapter 27: Adults ............................................................................................................................................ 302
Chapter 28: Older Adults................................................................................................................................. 315
Chapter 01: Practicing the Science and the Art of Psychiatric Nursing
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,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 3months, 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.ANS:
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. Theincorrect options focus on the
classic medical model rather than recovery.
2. In the shift-change report, an off-going nurse criticizes a patient who wears heavymakeup. 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.ANS: D
Accepting patients needs for self-expression and seeking to teach skills that will contributeto 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.
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.
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,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.ANS: 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.
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. Selectthe 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?
3ANS: 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 prejudicedinformation?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net.
ANS: 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.
, 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 notwork. 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 nursespecialists.
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 notchange.
ANS: A
Descriptive research findings provide evidence for practice but must be viewed in relationto 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. Twonursing 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-patientratios must be
better because of the nature of patients problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solvemultidimensional
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 medicalsurgical nurses.
That appeals to me.
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 thesenurses must have. Nurse-patient ratios and workloads in
psychiatric settings have increased, similar to other specialties. Psychiatric nursing involves clinical practice,
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not simply documentation. Psychosocial pain is real and can cause as much suffering asphysical pain.
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