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NUR 350 Examination with Q&A University of Notre Dame 2024

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NUR 350 Examination with Q&A University of Notre Dame 2024 Chapter 2. Mental Health/Mental Illness: Historical and Theoretical Concepts  A mental health technician asks the nurse, How do psychiatrists determine which diagnosis to give a patient? Which of these responses by the nurse would b...

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Chapter 2. Mental Health/Mental Illness: Historical and
Theoretical Concepts

 A mental health technician asks the nurse, How do psychiatrists
determine which diagnosis to give a patient? Which of these
responses by the nurse would be most accurate?
A. Psychiatrists use pre-established criteria from the APAs
Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

B. Hospital policy dictates how psychiatrists diagnose mental disorders.

C. Psychiatrists assess the patient and identify diagnoses based on
the patients unhealthy responses and contributing factors.

D. The American Medical Association identifies 10 diagnostic
labels that psychiatrists can choose from.

ANS: A
The DSM-5 is an organized manual describing mental disorders and the
criteria that determine whether a given diagnosis is appropriate. It is
published by the American Psychiatric Association (APA). It intends to
facilitate accurate and reliable medical diagnosis and treatment. Item C
describes nursing rather than medical diagnosis.
KEY: Cognitive Level: Application | Integrated Processes: Nursing
Process: Assessment | Client Need: Psychosocial Integrity

 The nurse is preparing to provide medication instruction for a
patient. Which of the following understandings about anxiety will be
essential to effective instruction?

A. Learning is best when anxiety is moderate to severe.

B. Learning is enhanced when anxiety is mild.

C. Panic level anxiety helps the nurse teach better.

D. Severe anxiety is characterized by intense concentration and

,enhances the attention span.

ANS: B

Mild anxiety sharpens the senses, increases the perceptual field, and
results in heightened awareness of the environment. Learning is
enhanced. As anxiety increases, attention span decreases and learning
becomes more difficult.
KEY: Cognitive Level: Comprehension | Integrated Processes:
Nursing Process: Planning | Client Need: Health Promotion and
Maintenance
 Which of the following are identified as psychoneurotic responses
to severe anxiety as they appear in the DSM-5?

A. Somatic symptom disorders

B. Grief responses

C. Psychosis

D. Bipolar disorder

ANS: A

Somatic symptom disorder is characterized by preoccupation with
physical symptoms for which there is no demonstrable organic
pathology. One of the diagnostic criteria is a high level of anxiety about
health concerns or illness.

KEY: Cognitive Level: Comprehension | Integrated Processes:
Nursing Process: Assessment | Client Need: Psychosocial Integrity

 An employee uses the defense mechanism of displacement when
the boss openly disagrees with suggestions. What behavior would be
expected from this employee?

A. The employee assertively confronts the boss

B. The employee leaves the staff meeting to work out in the gym

C. The employee criticizes a coworker

D. The employee takes the boss out to lunch

,ANS: C

The client using the defense mechanism of displacement would criticize
a coworker after being confronted by the boss. Displacement refers to
transferring feelings from one target to a neutral or less-threatening
target.
KEY: Cognitive Level: Application | Integrated Processes: Nursing
Process: Assessment | Client Need: Psychosocial Integrity

 A teenage boy is attracted to a female teacher. Without objective
evidence, a school nurse overhears the boy state, I know she wants
me. This statement reflects which defense mechanism?

A. Displacement

B. Projection

C. Rationalization

D. Sublimation

ANS: B

The nurse should determine that the clients statement reflects the
defense mechanism of projection. Projection refers to the attribution of
ones unacceptable feelings or impulses to another person. When the
client passes the blame of the undesirable feelings, anxiety is reduced.
Displacement refers to transferring feelings from one target to another.
Rationalization refers to making excuses to justify behavior. Sublimation
refers to channeling unacceptable drives or impulses into more
constructive, acceptable activities.

KEY: Cognitive Level: Application | Integrated Processes: Nursing
Process: Assessment | Client Need: Psychosocial Integrity

 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?

A. Displacement

B. Projection

, C. Reaction formation

D. Sublimation

ANS: C
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 making excuses to justify behavior. Projection
refers to the attribution of unacceptable feelings or behaviors to another
person.
Sublimation refers to channeling unacceptable drives or impulses into more
constructive, acceptable activities.

KEY: Cognitive Level: Application | Integrated Processes: Nursing
Process: Assessment | Client Need: Psychosocial Integrity

 Which nursing statement about the concept of neuroses is most accurate?

A. An individual experiencing neurosis is unaware that he or she is
experiencing distress.

B. An individual experiencing neurosis feels helpless to change
his or her situation.

C. An individual experiencing neurosis is aware of psychological
causes of his or her behavior.

D. An individual experiencing neurosis has a loss of contact with reality.

ANS: B

The nurse should understand that the concept of neuroses includes the
following characteristics. The client feels helpless to change his or her
situation, the client is aware that he or she is experiencing distress, the
client is aware the behaviors are maladaptive, the client is unaware of
the psychological causes of the distress, and the client experiences no
loss of contact with reality.

KEY: Cognitive Level: Comprehension | Integrated Processes:

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