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Chapter 1. Examination and Diagnosis of the Psychiatric Patient
Multiple Choice
Identify the choice that best completes the statement or answers the question. 1. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client’s appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client’s behaviors?
1.The client’s behaviors demonstrate mental illness in the form of depression.
2.The client’s behaviors are extensive, which indicates the presence of mental illness.
3.The client’s behaviors are not congruent with cultural norms.
4.The client’s behaviors demonstrate no functional impairment, indicating no mental
illness. 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.
2.When maladaptive responses to stress are coupled with interference in daily
functioning.
3.When a client communicates significant distress.
4.When a client uses defense mechanisms as ego protection. 3. A nurse is assessing a set of 15-year-old identical twins who respond very differently to stress. One twin becomes anxious and irritable, and the other withdraws and cries. How should the nurse explain these different stress responses to the parents?
1.Reactions to stress are relative rather than absolute; individual responses to stress
vary.
2.It is abnormal for identical twins to react differently to similar stressors.
3.Identical twins should share the same temperament and respond similarly to stress.
4.Environmental influences to stress weigh more heavily than genetic influences. 1.Reactions to stress are relative rather than absolute; individual responses to stress
vary.
2.It is abnormal for identical twins to react differently to similar stressors.
3.Identical twins should share the same temperament and respond similarly to stress.
4.Environmental influences to stress weigh more heavily than genetic influences. 4. Which client should the nurse anticipate to be most receptive to psychiatric treatment?
1. A Jewish, female social worker.
2. A Baptist, homeless male.
3. A Catholic, black male.
4. A Protestant, Swedish business executive. 5. A psychiatric nurse intern states, “This client’s use of defense mechanisms should be eliminated.” Which is a correct evaluation of this nurse’s 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
should always 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. 6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best response?
1.“It is just a routine part of our assessment. All clients are asked these same
questions.”
2.“Why are you concerned about these types of questions?”
3.“Psychological factors, like excessive stress, have been found to affect medical
conditions.”
4.“We can skip these questions, if you like. It isn’t imperative that we complete this
section.” 1.“It is just a routine part of our assessment. All clients are asked these same
questions.”
2.“Why are you concerned about these types of questions?”
3.“Psychological factors, like excessive stress, have been found to affect medical
conditions.”
4.“We can skip these questions, if you like. It isn’t imperative that we complete this
section.” 7. An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?
1. The employee assertively confronts the boss.
2.The employee leaves the staff meeting to work out in the gym.
3. The employee criticizes a coworker.
4. The employee takes the boss out to lunch. 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 9. Which nursing statement about the concept of neurosis is most accurate?
1.An individual experiencing neurosis is unaware that he or she is experiencing
distress.
2.An individual experiencing neurosis feels helpless to change his or her situation.
3.An individual experiencing neurosis is aware of the psychological causes of his or
her behavior.
4.An individual experiencing neurosis has a loss of contact with reality. 10. Which nursing statement regarding the concept of psychosis is most accurate?
1.Individuals experiencing psychoses are aware that their behaviors are maladaptive.
2.Individuals experiencing psychoses experience little distress.
3.Individuals experiencing psychoses are aware of experiencing psychological
problems.
4.Individuals experiencing psychoses are based in reality.
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