TEST BANK
Psychiatric Nursing: Contemporary Practice
Mary Ann Boyd, and Rebecca Ann Luebbert
7th Edition Table of Contents
Chapter 01 Psychiatric–Mental Health Nursing and Evidence-Based Practice 1
Chapter 02 Mental Health and Mental Disorders: Fighting Stigma and Promoting Recovery 9
Chapter 03 Cultural and Spiritual Issues Related to Mental Health Care 17
Chapter 04 Patient Rights and Legal Issues 25
Chapter 05 Mental Health Care in the Community 37
Chapter 06 Ethics, Standards, and Nursing Frameworks 47
Chapter 07 Psychosocial Theoretic Basis of Psychiatric Nursing 55
Chapter 08 Biologic Foundations of Psychiatric Nursing 64
Chapter 09 Recovery Framework for Mental Health Nursing 73
Chapter 10 Communication and the Therapeutic Relationship 81
Chapter 11 The Psychiatric–Mental Health Nursing Process 89
Chapter 12 Psychopharmacology, Dietary Supplements, and Biologic Interventions 98
Chapter 13 Cognitive Interventions in Psychiatric Nursing 109
Chapter 14 Group Interventions 118
Chapter 15 Family Assessment and Interventions 128
Chapter 16 Mental Health Promotion for Children and Adolescents 137
Chapter 17 Mental Health Promotion for Young and Middle-Aged Adults 147
Chapter 18 Mental Health Promotion for Older Adults 155
Chapter 19 Stress and Mental Health 164
Chapter 20 Management of Anger, Aggression, and Violence 173
Chapter 21 Crisis, Loss, Grief, Bereavement, and Disaster Management 182
Chapter 22 Suicide Prevention-Screening, Assessment, and Intervention 191
Chapter 23 Mental Health Care for Survivors of Violence 200
Chapter 24 Schizophrenia and Related Disorders: Nursing Care of Persons with Thought Disorders 209
Chapter 25 Depression: Nursing Care of Persons with Depressive Moods and Suicidal Behavior 227
Chapter 26 Bipolar Disorders: Nursing Care of Person with Mood Lability 235
Chapter 27 Anxiety Disorders: Nursing Care of Patients with Anxiety, Phobia, and Panic 244
Chapter 28 Obsessive-Compulsive and Related Disorders: Nursing Care of Persons with Obsessions and Compulsions 253
Chapter 29 Trauma and Stressor-Related Disorders: Nursing Care of Persons with Posttraumatic Stress and Other Trauma-Related Disorders 263
Chapter 30 Personality and Impulse-Control Disorders: Nursing Care of Persons with Personality and Impulse-Control Disorders 272
Chapter 31 Addiction and Substance Use-Related Disorders: Nursing Care of Persons with Alcohol and Drug Use Disorders 285
Chapter 32 Eating Disorders: Nursing Care of Persons with Eating and Weight-Related Disorders 293
Chapter 33 Somatic Symptom and Dissociative Disorders: Nursing Care of Persons with Somatization 301 Chapter 34 Sleep–Wake Disorders: Nursing Care of Persons with Insomnia and Sleep Problems 310
Chapter 35 Sexual Disorders: Management of Persons with Sexual Dysfunctions and Paraphilias 319
Chapter 36 Mental Health Assessment of Children and Adolescents 328
Chapter 37 Mental Health Disorders of Childhood and Adolescence 337
Chapter 38 Mental Health Assessment of Older Adults 346
Chapter 39 Neurocognitive Disorders 355
Chapter 40 Care of Veterans with Mental Health Needs 364
Chapter 41 Caring for Persons Who Are Experiencing Homelessness and Mental Illness 374
Chapter 42 Caring for Persons with Co-occurring Mental Disorders 383
Chapter 43 Care of Persons Who Are Medically Compromised 393 WWW.TBSM.WSChapter 1, Psychiatric–Mental Health Nursing and Ev idence-Based Practice MULTIPLE CHOICE 1. A group of nurses are reviewing information abo ut the evolution of mental health care and are discussing the recommendations of the final rep ort of the Joint Commission on Mental Illness and Health. The nurses demonstrate an under standing of this information when they identify that the report recommended an increase in what? a. Number of mental health hospitals b. Institutionalization of clients with mental health problems c. Number of clinics supplemented by general hospital units d. Use of psychotherapy by psychiatrists ANS: C The final report of the Joint Commission on Mental Illness and Health, called Action for Mental Health, recommended increased numbers of com munity clinics supplemented by general hospital units for mental illness care. The ideas in the report shifted responsibility for mental health care to the federal, state, and l ocal governments. PTS: 1 REF: p. 9, A New National Objective: Communi ty Treatment OBJ: 5 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Remember NOT: Multiple Choice 2. A nurse is reviewing literature that sanctions the involvement of psychiatric– mental health nurses in the provision of holistic nursing care. I ntegrating knowledge of the various theories and views of mental health and illness, th e nurse identifies which as most strongly linked to this holistic approach? a. Sigmund Freud’s psychoanal ytic theory b. Florence Nightingale’s Notes on Nursing c. Lavinia Lloyd Dock’s Materia Medica for Nurses d. Clifford Beers’ A Mind That Found Itself ANS: B The American Nurses Association’s Statement on Psychiatric Nursing Practice (1967) officially sanctioned a holistic approach to nursin g care for the first time. The roots of this contemporary psychiatric–mental health nursing thou ght can be traced to Florence Nightingale’s Notes on Nursing , which presented a holistic view of the patient, w ith the view of the patient as living within a family and c ommunity. Freud’s psychoanalytic theory focused on personality development and unconscious motivations for drives. Beers’ autobiography described the inhumane treatments use d for mental illness, which led to the formation of a National Committee for Mental Hygien e. PTS: 1 REF: p. 2–3, Emergence of Modern Nursing Per spectives OBJ: 2 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Psychiatric Nursing: Contemporary Practice, 7th Edition (Ann Boyd, 2022)
1 | P a g e WWW.TBSM.WS 3. A psychiatric–mental health nurse is preparing a presentation about key events and people that influenced the development of contemporary men tal health and illness care. When describing the effects of World War II, which would the nurse most likely include? a. People began to view mental illness as more commonp lace and acceptable. b. The biologic understanding of mental illness was al most fully developed. c. Deinstitutionalization occurred in response to the community health movement. d. Mental illnesses became categorized as psychoses or neuroses. ANS: A During World War II, mental illness was beginning t o be seen as a problem that could happen to anyone. Many “normal” people who voluntee red for service were disqualified on the grounds that they were psychologically unfit to serve. Others who had already served a tour of duty developed psychiatric and emotional pr oblems related to their wartime experiences. The biologic understanding of mental i llness continues to evolve. Deinstitutionalization and the community mental hea lth movement occurred during the 1960s. In the early 20th century, Freud categorized mental illness as either a psychosis or neurosis. PTS: 1 REF: p. 8, National Action OBJ: 4 NAT: Client Needs: Health Promotion and Maintenance KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice 4. A nurse is presenting a discussion of the histo ry of psychiatric–mental health nursing and its place within nursing history. Which would be most a ppropriate to include? a. Certification for the psychiatric–mental health nursing specialty was first emphasized by Mary Adelaide Nutting. b. Psychiatric nurses played a part in seeing that all deinstitutionalized clients got treatment at community mental health centers. c. There is a historical link between the first nur sing program to admit male students and the first training school for psychiatric nursi ng. d. The first graduate program in psychiatric nursin g was established in response to the publication of psychiatric nursing specialty jo urnals. ANS: C In 1882, the first training school for psychiatric nursing was established at the McLean Asylum by E. Cowles; this was also the first nursin g program to admit men. Nutting emphasized psychiatric–mental health nursing role d evelopment. Unfortunately, deinstitutionalization failed. Hildegard E. Peplau was responsible for establishing the first graduate program in psychiatric–mental health nursi ng, in 1954. Publication of journals soon followed, beginning in the 1960s. PTS: 1 REF: p. 3, Box 1.2 History of Psychiatric–Me ntal Health Nursing OBJ: 2 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analysis NOT: Multiple Choice 5. When reviewing the evolution of mental health a nd illness care, which event is associated with mental disorders beginning to be viewed as ill nesses requiring treatment? a. Establishment of Pennsylvania H ospital in Philadelphia ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Psychiatric Nursing: Contemporary Practice, 7th Edition (Ann Boyd, 2022)
2 | P a g e WWW.TBSM.WSb. Quaker establishment of asylums c. Creation of the state hospital system d. Freud’s views on the causes of mental illnesses ANS: A Mental disorders began to be viewed as illnesses wi th the establishment of Pennsylvania Hospital, the first institution in the United State s to receive those with mental disorders for treatment and cure. The Quaker establishment of asy lums reflected the impetus toward moral treatment. Dorothea L. Dix advocated for the humane treatment of clients with mental illness with the creation of state hospitals. Freud believed that the primary causes of mental illnesses were psychological and a result of distur bed personality development and faulty parenting. PTS: 1 REF: p. 5, Table 1.1 Premoral Treatment Era OBJ: 2 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 6. A psychiatric–mental health nurse is working on a committee that is developing programs that integrate the objectives for mental health and mental disorders, as identified in Healthy People 2030. Which type of program would be least a ppropriate? a. Single substance abuse treatment programs b. Depression -screening programs for primary care providers c. Mental health programs for the homeless population d. Employment programs for those with serious mental i llness ANS: A The objectives of Healthy People 2030 identify the need to increase the proportion of persons with co-occurring substance abuse and menta l disorders receiving treatment for both disorders. Thus, single substance abuse treatm ent programs would be least beneficial. The objectives call for an increase in depression s creening by primary care providers, an increase in the proportion of homeless adults with mental health problems who receive mental health treatment, and an increase in the pro portion of persons with serious mental illness who are employed. PTS: 1 REF: p. 10, National Mental Health Objective s OBJ: 5 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analysis NOT: Multiple Choice 7. The following events are important in the devel opment of psychiatric–mental health nursing practice. Which event occurred first? a. Publication of Standards of Psychiatric -Mental Health Nursing by the ANA b. Publication of Standards of Child and Adolescent Psychiatric and M ental Health Nursing Practice c. Establishment of the first graduate program in p sychiatric nursing at Rutgers University d. Publication of the first psychiatric nursing tex t, Nursing Mental Disease , by Harriet Bailey ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Psychiatric Nursing: Contemporary Practice, 7th Edition (Ann Boyd, 2022)
3 | P a g e WWW.TBSM.WSANS: D In 1920, the first psychiatric nursing text was pub lished. In 1954, the first graduate program in psychiatric nursing was established. In 1967, th e ANA published the Standards of Psychiatric- Mental Health Nursing . In 1985, the Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice was published. PTS: 1 REF: p. 2, Early Founders OBJ: 2 NAT: Client Needs: Safe, Effective Care Environment : Management of Care KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Remember NOT: Multiple Choice 8. A nurse is preparing a presentation about the c urrent status of mental health services in the United States. Which statement would the nurse incl ude as the most reflective of this status? a. “Mental health care in the United States is equally accessible to individuals.” b. “Mental illness ranks second among conditions ca using responsible for chronic disability.” c. “Mental health care primarily focuses on the cure o f mental illness.” d. “Mental health care services are inadequate and fra gmented.” ANS: D Today, mental health services in the United States are inadequate and fragmented, with millions of adults and children being disabled by m ental illness every year. Mental illness ranks first in terms of causing disability in the U nited States compared with other illnesses. Recovery from mental illness, not cure, is the curr ent worldwide goal. PTS: 1 REF: p. 11, Box 1.6 Mental Health and Mental Disord ers Objectives for the Year 2030 OBJ: 5 NAT: Client Needs: Safe, Effective Care Environment : Management of Care KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analysis NOT: Multiple Choice 9. A group of nurses are reviewing the goals ident ified by the New Freedom Commission on Mental Health . The nurses demonstrate understanding of this repo rt when they identify what as a goal? a. Mental health is viewed as an isolated component of overall health. b. The consumer and family are the driving forces for mental health care. c. Screening is of greater importance than assessment and referral for services. d. Disparities in mental health services are maintaine d. ANS: B According to the New Freedom Commission on Mental H ealth, one goal is to ensure that mental health care is consumer and family driven. I n addition, the goals address the need to understand that mental health is essential to overa ll health, not just that it is one part of overall health. It also emphasizes that early menta l health screening, assessment, and referral to services are common practice. Thus, screening is as important as assessment and referral. Moreover, the goals address the need for disparitie s in mental health services to be eliminated, not just reduced. PTS: 1 REF: p. 9, Contemporary Mental Health Care ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Psychiatric Nursing: Contemporary Practice, 7th Edition (Ann Boyd, 2022)
4 | P a g e WWW.TBSM.WSOBJ: 5 NAT: Client Needs: Safe, Effective Care Environment : Management of Care KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice 10. As part of a career day presentation to a grou p of nursing students, a psychiatric– mental health nurse plans to describe how this specialty d eveloped. Which individual would the nurse describe as playing a major role in the devel opment of specialty training programs for psychiatric nurses? a. Mary Adelaide Nutting b. Hildegard E. Peplau c. Harriet Bailey d. Linda Richards ANS: B Hildegard E. Peplau developed the first graduate pr ogram in psychiatric nursing, identifying it as a specialty. Mary Adelaide Nutting emphasized nursing role development. Harriet Bailey wrote the first psychiatric nursing textbook . Linda Richards was the first trained nurse in the United States and opened the Boston Ci ty Hospital Training School for Nurses at McLean Hospital, a psychiatric facility. PTS: 1 REF: p. 2, Emergence of Modern Nursing Persp ectives OBJ: 2 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice 11. A group of students is reviewing information a bout mental health care after World War II. The students demonstrate an understanding of this i nformation when they identify which action that took place as a result of the National Mental Health Act? a. Discovery of psychopharmacology b. Passage of the Hill –Burton Act c. Establishment of the National Institute of Mental H ealth d. Development of community mental health centers ANS: C The National Mental Health Act created a six-member National Mental Health Advisory Council that established the National Institute of Mental Health, which was responsible for overseeing and coordinating research and training. Passage of this act did not lead to the discovery of psychopharmacology. The Hill–Burton Ac t, which followed the passage of the National Mental Health Act, provided federal suppor t for hospital construction. The development of community mental health centers was the result of the Action for Mental Health, which provided the basis for the Mental Ret ardation Facilities and Community Mental Health Centers Construction Act of 1963. PTS: 1 REF: p. 8, National Action OBJ: 2 NAT: Client Needs: Safe, Effective Care Environment : Management of Care KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice ______________________________________________________________________________________________
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5 | P a g e WWW.TBSM.WS 12. When providing care to a client, the psychiatr ic–mental health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual? a. Hildegard E. Peplau b. Florence Nightingale c. Dorothea L. Dix d. Sigmund Freud ANS: A Hildegard E. Peplau conceptualized nursing practice as independent of physicians and emphasized the use of self as a nursing tool. Flore nce Nightingale identified the need to view clients holistically, was sensitive to human e motions, and recommended interactions that today would be classified as therapeutic commu nication. Dorothea L. Dix crusaded for the humane treatment of clients with mental illness . Sigmund Freud developed a personal theory based on unconscious motivations for behavio r. PTS: 1 REF: p. 2–3, Emergence of Modern Nursing Per spectives OBJ: 1 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choi ce 13. After teaching a group of nurses about the his torical perspectives of mental health care, the presenter determines that the group has understood the information when they identify which as a common belief about mental illness durin g the later medieval period from 1000 to 1300? a. Mental illness in an individual was the result of b eing possessed by demons. b. A person was removed from a contaminated environmen t to protect him or her. c. Exorcisms were used as primary mode of treatment to cleanse the person of his or her sins. d. The focus was on moral treatment to promote the ind ividual’s safety and comfort. ANS: B During the medieval period, contaminated environmen ts were believed to cause mental illness. Consequently, individuals were removed fro m their sick environments and placed in protected asylums. During the early Christian perio d, sin or demonic possession was thought to cause mental disorders. Thus, exorcisms were com monly performed. Moral treatment was the focus of care primarily during the 19th century . PTS: 1 REF: p. 4, Evolution of Mental Health Recove ry OBJ: 2 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analysis NOT: Multiple Choice 14. A psychiatric–mental health nurse is implement ing evidence-based practice. The nurse understands that this approach is developed by doin g what first? a. Conducting research b. Identifying a clinical question c. Determining outcomes d. Collaborating with the client ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Psychiatric Nursing: Contemporary Practice, 7th Edition (Ann Boyd, 2022)
6 | P a g e WWW.TBSM.WSANS: B In an evidence-based approach, first clinical quest ions are defined. Then evidence is discovered and analyzed. Next, the research finding s are applied in a practical manner and in collaboration with the patient, and outcomes are evaluated. PTS: 1 REF: p. 3–4, Evidence-Based Practice and Current Ps ychiatric Nursing OBJ: 3 NAT: Client Needs: Safe, Effective Care Environment : Management of Care KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choi ce 15. A psychiatric–mental health nurse is describin g the various programs offered by the local community mental health center. When explaining how these programs work, the nurse would emphasize which concept? a. autocratic leadership b. paternalistic decision making c. complete autonomy d. collaboration ANS: D In today’s environment, the traditional medical mod el, which is viewed as autocratic and paternalistic, is being replaced by a collaborative model whereby mental health professionals work in partnership with consumers to help rebuild their lives. Consumer advocacy efforts have led to the implementation of recovery philosophy and practices. PTS: 1 REF: p. 10, Recovery and the Consumer Moveme nt OBJ: 5 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice 16. A psychiatric–mental health nurse wants to use an evidence-based approach to care. Which action would the nurse implement first? a. Analyze the evidence. b. Define the clinical question. c. Practically apply research findings. d. Evaluate outcomes. ANS: B When using an evidence-based approach, the nurse wo uld first define the clinical questions, then discover and analyze the evidence, apply the r esearch findings in a practical manner and in collaboration with the patient, and lastly e valuate the outcomes. PTS: 1 REF: p. 3–4, Evidence-Based Practice and Current Ps ychiatric Nursing OBJ: 3 NAT: Client Needs: Psychosocial Integrity KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Psychiatric Nursing: Contemporary Practice, 7th Edition (Ann Boyd, 2022)
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