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Essentials of Psychiatric Mental Health Nursing - Concepts of Care in Evidence- Based Practice 8th Edition - Morgan Townsend Test Bank Essentials of Psychiatric Mental Health Nursing - Concepts of Care in Evidence- Based Practice 8th Edition - Morgan Townsend Test Bank Essentials of Psychiatric M...

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  • January 29, 2025
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  • 8th edition
  • 8th edition
  • essentials of psychiatric mental health nursing
  • psychiatric mental health nursing
  • concepts of care in evidence based practice 8th
  • concepts of care in evidence based practice

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2. When maladaptive responses to stress are coupled with interference in daily
Essentials of Psychiatric Mental Health Nursing functioning.
3. When a client communicates significant distress.
- 4. When a client uses defense mechanisms as ego protection.

Concepts of Care in Evidence- Based Practice ANS: 2
Rationale: The nurse should determine that the client is at risk for mental illness when

8th Edition - Morgan Townsend responses to stress are maladaptive and interfere with daily functioning. The DSM-5
indicates that in orderto be diagnosed with a mental illness, daily functioning must be

Test Bank significantly impaired. The clients ability to communicate distress would be considered
a positive attribute.

Cognitive Level: Application

Chapter 1. Mental Health and Mental Integrated Process:

IllnessMultiple Choice Assessment

1. A nurse is assessing a client who is experiencing occasional feelings of sadness 3. A nurse is assessing a set of 15-year-old identical twins who respond very differently

because of therecent death of a beloved pet. The clients appetite, sleep patterns, and to stress.One twin becomes anxious and irritable, and the other withdraws and cries.

daily routine have not changed. How should the nurse interpret the clients behaviors? How should the nurse explain these different stress responses to the parents?

1. The clients behaviors demonstrate mental illness in the form of depression. 1. Reactions to stress are relative rather than absolute; individual responses to stress

2. The clients behaviors are extensive, which indicates the presence of mental illness. vary.

3. The clients behaviors are not congruent with cultural norms. 2. It is abnormal for identical twins to react differently to similar stressors.

4. The clients behaviors demonstrate no functional impairment, indicating no mental 3. Identical twins should share the same temperament and respond similarly to stress.

illness. 4. Environmental influences to stress weigh more heavily than genetic influences.

ANS: 4
Rationale: The nurse should assess that the clients daily functioning is not impaired. The
client who experiences feelings of sadness after the loss of a pet is responding within
normal expectations. Without significant impairment, the clients distress does not
indicate a mental illness.

Cognitive Level: Analysis
Integrated Process:
Assessment

2. At what point should the nurse determine that a client is at risk for developing a
mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.

,ANS: 1 Rationale: The nurse should determine that defense mechanisms can be appropriate

Rationale: The nurse should explain to the parents that, although the twins have during timesof stress. The client with no defense mechanisms may have a lower

identical DNA,there are several other factors that affect reactions to stress. Mental tolerance for stress, thus leading to anxiety disorders. Defense mechanisms should be

health is a state of being thatis relative to the individual client. Environmental confronted when they impede the client from developing healthy coping skills.

influences and temperament can affect stress reactions. Cognitive Level:
Cognitive Level: Application Application Integrated
Integrated Process: Process: Evaluation
Implementation 6. During an intake assessment, a nurse asks both physiological and psychosocial

4. Which client should the nurse anticipate to be most receptive to psychiatric treatment? questions. Theclient angrily responds, Im here for my heart, not my head problems.

1. A Jewish, female social worker. Which is the nurses best response?

2. A Baptist, homeless male. 1. Its just a routine part of our assessment. All clients are asked these same questions.

3. A Catholic, black male. 2. Why are you concerned about these types of questions?

4. A Protestant, Swedish business executive. 3. Psychological factors, like excessive stress, have been found to affect medical
conditions.
ANS: 1
4. We can skip these questions, if you like. It isnt imperative that we complete this
Rationale: The nurse should anticipate that the client of Jewish culture would place a
section.
high importance on preventative health care and would consider mental health as
equally important asphysical health. Women are also more likely to seek treatment for
mental health problems than men.

Cognitive Level:
ApplicationIntegrated
Process: Planning

5. A psychiatric nurse intern states, This clients use of defense mechanisms should be
eliminated.Which is a correct evaluation of this nurses statement?
1. Defense mechanisms can be appropriate responses to stress and need not be
eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
and shouldalways be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged and not eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.

ANS: 1

,ANS: 3 making excuses to justify behavior.Projection refers to the attribution of unacceptable

Rationale: The nurse should attempt to educate the client on the negative effects of feelings or behaviors to another person.

excessivestress on medical conditions. It is not appropriate to skip physiological and Sublimation refers to channeling unacceptable drives or impulses into more

psychosocial questions, as this would lead to an inaccurate assessment. constructive,acceptable activities.

Cognitive Level: Application Cognitive Level: Application

Integrated Process: Integrated Process:

Implementation Assessment

7. An employee uses the defense mechanism of displacement when the boss openly 9. Which nursing statement about the concept of neurosis is most accurate?

disagrees with suggestions. What behavior would be expected from this employee? 1. An individual experiencing neurosis is unaware that he or she is experiencing distress.

1. The employee assertively confronts the boss. 2. An individual experiencing neurosis feels helpless to change his or her situation.

2. The employee leaves the staff meeting to work out in the gym. 3. An individual experiencing neurosis is aware of psychological causes of his or her

3. The employee criticizes a coworker. behavior.

4. The employee takes the boss out to lunch. 4. An individual experiencing neurosis has a loss of contact with reality.

ANS: 3 ANS: 2

Rationale: The nurse should expect that the client using the defense mechanism Rationale: The nurse should define the concept of neurosis with the following

displacement would criticize a coworker after being confronted by the boss. characteristics:

Displacement refers to transferring feelings from one target to a neutral or less-
threatening target.

Cognitive Level: Analysis
Integrated Process:
Assessment

8. A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior
should be identified by a nurse as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation

ANS: 3
Rationale: The nurse should identify that the boy is using reaction formation as a
defense mechanism. Reaction formation is the attempt to prevent undesirable thoughts
from being expressed by expressing opposite thoughts or behaviors. Displacement
refers to transferring feelings from one target to another. Rationalization refers to

, The client feels helpless to change his or her situation, the client is aware that he or she Cognitive Level: Application

is experiencing distress, the client is aware the behaviors are maladaptive, the client is Integrated Process:

unaware of the psychological causes of the distress, and the client experiences no loss of Assessment

contact with reality. 12. Devastated by a divorce from an abusive husband, a wife completes grief counseling.

Cognitive Level: Application Whichstatement by the wife should indicate to a nurse that the client is in the

Integrated Process: acceptance stage of grief?

Assessment 1. If only we could have tried again, things might have worked out.
2. I am so mad that the children and I had to put up with him as long as we did.
10. Which nursing statement regarding the concept of psychosis is most accurate?
3. Yes, it was a difficult relationship, but I think I have learned from the experience.
1. Individuals experiencing psychoses are aware that their behaviors are maladaptive.
4. I still dont have any appetite and continue to lose weight.
2. Individuals experiencing psychoses experience little distress.
3. Individuals experiencing psychoses are aware of experiencing psychological problems. ANS: 3
4. Individuals experiencing psychoses are based in reality. Rationale: The nurse should evaluate that the client is in the acceptance stage of grief
because during this stage of the grief process, the client would be able to focus on the
ANS: 2
reality of the lossand its meaning in relation to life.
Rationale: The nurse should understand that the client with psychosis experiences
little distress owing to his or her lack of awareness of reality. The client with psychosis
is unaware that his orher behavior is maladaptive or that he or she has a psychological
problem.

Cognitive Level: Application
Integrated Process:
Assessment

11. When under stress, a client routinely uses alcohol to excess. Finding her drunk, her
husband yells at the client about her chronic alcohol abuse. Which action alerts the
nurse to the clients useof the defense mechanism of denial?
1. The client hides liquor bottles in a closet.
2. The client yells at her son for slouching in his chair.
3. The client burns dinner on purpose.
4. The client says to the spouse, I dont drink too much!

ANS: 4
Rationale: The clients statement I dont drink too much! alerts the nurse to the use of
the defensemechanism of denial. The client is refusing to acknowledge the existence of
a real situation andthe feelings associated with it.

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