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,Table of Contents
UNIT I: Foundations in Theory
Chapter 1. Mental Health and Mental Illness
Chapter 2. Theories and Therapies
Chapter 3. Psychobiology and Psychopharmacology
UNIT II: Foundations for Practice
Chapter 4. Treatment Settings
Chapter 5. Cultural Implications
Chapter 6. Legal and Ethical Considerations
UNIT III: Psychosocial Nursing Tools
Chapter 7. The Nursing Process and Standards of Care
Chapter 8. Therapeutic Relationships
Chapter 9. Therapeutic Communication
Chapter 10. Stress Responses and Stress Management
UNIT IV: Psychobiological Disorders
Chapter 11. Childhood and Neurodevelopmental Disorders
Chapter 12. Schizophrenia Spectrum Disorders
Chapter 13. Bipolar and Related Disorders
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Chapter 14. Depressive Disorders
Chapter 15. Anxiety and Obsessive-Compulsive Disorders
Chapter 16. Trauma, Stressor-Related, and Dissociative Disorders
Chapter 17. Somatic Symptom Disorders
Chapter 18. Eating and Feeding Disorders
Chapter 19. Sleep-Wake Disorders
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Chapter 20. Sexual Dysfunction, Gender Dysphoria, and Paraphilic Disorders
Chapter 21. Impulse Control Disorders
Chapter 22. Substance-Related and Addictive Disorders
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Chapter 23. Neurocognitive Disorders
Chapter 24. Personality Disorders
UNIT V: Trauma Interventions
Chapter 25. Suicide and Non-suicidal Self-Injury
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Chapter 26. Crisis and Disaster
Chapter 27. Anger, Aggression, and Violence
Chapter 28. Child, Older Adult, and Intimate Partner Violence
Chapter 29. Sexual Assault
UNIT VI: Interventions for Special Populations
Chapter 30. Dying, Death, and Grieving
Chapter 31. Older Adults
Chapter 32. Serious Mental Illness
Chapter 33. Forensic Nursing
UNIT VII: Other Intervention Modalities
Chapter 34. Therapeutic Groups
Chapter 35. Family Interventions
Chapter 36. Integrative Care
,Chapter 01: Mental Health and Mental Illness
Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical
Approach, 9th Edition
MULTIPLE CHOICE
1. The scope of practiced for an advanced nurse practitioner would include which intervention?
a. Conducting a mental health assessment.
b. Prescribing psychotropic medication.
c. Establishing a therapeutic relationship.
d. Individualizing a nursing care plan.
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
prepared at the basic level is permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
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skills.” Select the best response by the mental health nurse.
a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-
client ratios must be better because of the nature of the clients’ problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking
to solve multidimensional problems. I am challenged by those situations.”
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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
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medical–surgical nurses do. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical–surgical
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nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients
with medical as well as mental health problems, reflecting the holistic perspective these nurses
must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like
other specialties. Psychiatric nursing involves clinical practice, not just documentation.
Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
mental illness, a group of nurses write letters to their elected representatives in opposition to
the legislation. Which role have the nurses fulfilled?
a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
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ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for self. Examples of individual advocacy include helping clients understand
their rights or make decisions. 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 persons with mental illness, the letter-
writing campaign advocates for that cause on behalf of clients who are unable to articulate
their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
4. A family has a long history of conflicted relationships among the members. Which family
member’s comment best reflects a mentally healthy perspective?
a.“I’ve made mistakes but everyone else in this family has also.”
b.“I remember joy and mutual respect from our early years together.”
c.“I will make some changes in my behavior for the good of the family.”
d.“It’s best for me to move away from my family. Things will never change.”
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the
importance of relationships. Mental health includes rational thinking, communication skills,
learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
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be healthy, but the correct response shows a higher level of mental health. The other incorrect
responses show blaming and avoidance.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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5. Which assessment finding most clearly indicates that a client may be experiencing a mental
illness?
a. reporting occasional sleeplessness and anxiety.
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b. reporting a consistently sad, discouraged, and hopeless mood.
c. being able to describe the difference between “as if” and “for real.”
d. experiencing difficulty making a decision about whether to change jobs.
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ANS: B
The correct response describes a mood alteration, which reflects mental illness. The distracters
describe behaviors that are mentally healthy or within the usual scope of human experience.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
achieved for an adult client?
a. being willing to work towards achieving ideals and meeting demands.
b. behaving without considering the consequences of personal actions.
c. aggressively meeting personal needs without considering the rights of others.
d. seeking help from others to avoid assuming responsibility for major areas of own
life.
, ANS: A
Mental health is a state of well-being in which individuals reach their own potential, cope
with the normal stresses of life, work productively, and contribute to the community. Mental
health provides people with the capacity for rational thinking, communication skills, learning,
emotional growth, resilience, and self-esteem. The correct response describes an adaptive,
healthy behavior. The distracters describe maladaptive behaviors.
PTS: 1 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 client’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. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual
ANS: C
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
psychiatric illness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
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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)
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b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. ICD-10
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ANS: B
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
guideline for diagnosing psychiatric disorders. The other references are good resources but do
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not define the diagnostic criteria.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
9. Which individual behavior demonstrates resilience?
a. Repress stressors associated with a divorce.
b. Continuing to grieve the death of a spouse for 5 years.
c. Continuing to live in a shelter for 2 years after the home is destroyed by fire.
d. Taking a temporary job to maintain financial stability after loss of a permanent
job.
ANS: D
, Resilience is closely associated with the process of adapting and helps people facing tragedies,
loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources
they need to support their well-being. Repression and protracted grief are unhealthy. Living in
a shelter for 2 years shows a failure to move forward after a tragedy. See related audience
response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
10. The relationship of the North American Nursing Diagnosis Association (NANDA) is to
clinical judgment as Nursing Interventions Classification (NIC) is to what?
a. client outcomes.
b. nursing actions.
c. diagnosis.
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 judgments. NIC (Nursing Interventions
Classification) identifies actions provided by nurses that enhance client outcomes. Nursing
care activities may be direct or indirect.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
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TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment
11. An adult says, “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.” Which number on this
mental health continuum should the nurse select?
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Mental Illness Mental Health
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a. 1
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b. 2
c. 3
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d. 4
e. 5
ANS: E
The adult is generally happy and has an adequate self-concept. The statement indicates the
adult is reality-oriented, works effectively, and has control over own behavior. Mental health
does not mean that a person is always happy.
PTS: 1 DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
12. Which disorder is an example of a culture-bound syndrome?
a. Epilepsy
b. Schizophrenia
c. Running amok
d. Major depressive disorder
