Test Bank For Psychiatric Mental Health Nursing, 6th Edition
Test Bank For Psychiatric Mental Health Nursing, 6th Edition ensures you’re prepared with expertly crafted questions and solutions.
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Page 1
1. The nurse understands that crises are self-limiting. This implies that upon evaluation of
crisis intervention, the nurse should assess for which outcome?
A) The patient will identify possible causes for the crisis.
B) The patient will discover a new sense of self-sufficiency in coping.
C) The patient will resume the precrisis level of functioning.
D) The patient will express anger regarding the crisis event.
Ans: C
Feedback:
Crises usually exist for 4 to 6 weeks. At the end of that time, the crisis is resolved in one
of three ways. In the first two, the person either returns to his or her precrisis level of
functioning or begins to function at a higher level; both are positive outcomes for the
individual. The third resolution is that the person's functioning stabilizes at a level lower
than precrisis functioning, which is a negative outcome for the individual. Assisting the
person to use existing supports or helping the individual find new sources of support can
decrease the feelings of being alone or overwhelmed. The patient may develop guilt if
he or she examines possible causes for the crisis. Expression of anger at 4 to 6 weeks
indicates a less than favorable outcome of crisis intervention.
2. A patient who has been working on controlling impulsive behavior shows a
strengthening ego through which of the following behaviors?
A) Going to therapy only when there is nothing more desirable to do
B) Weighing the advantages and disadvantages before making a decision
C) Telling others in the group the right way to act
D) Reporting having fun at a recent social event
Ans: B
Feedback:
The id is the part of one's nature that reflects basic or innate desires such as pleasure-
seeking behavior, aggression, and sexual impulses. The id seeks instant gratification,
causes impulsive unthinking behavior, and has no regard for rules or social convention.
The superego is the part of a person's nature that reflects moral and ethical concepts,
values, and parental and social expectations; therefore, it is in direct opposition to the id.
The third component, the ego, is the balancing or mediating force between the id and the
superego. The ego represents mature and adaptive behavior that allows a person to
function successfully in the world.
1. The nurse understands that crises are self-limiting. This implies that upon evaluation of
crisis intervention, the nurse should assess for which outcome?
A) The patient will identify possible causes for the crisis.
B) The patient will discover a new sense of self-sufficiency in coping.
C) The patient will resume the precrisis level of functioning.
D) The patient will express anger regarding the crisis event.
Ans: C
Feedback:
Crises usually exist for 4 to 6 weeks. At the end of that time, the crisis is resolved in one
of three ways. In the first two, the person either returns to his or her precrisis level of
functioning or begins to function at a higher level; both are positive outcomes for the
individual. The third resolution is that the person's functioning stabilizes at a level lower
than precrisis functioning, which is a negative outcome for the individual. Assisting the
person to use existing supports or helping the individual find new sources of support can
decrease the feelings of being alone or overwhelmed. The patient may develop guilt if
he or she examines possible causes for the crisis. Expression of anger at 4 to 6 weeks
indicates a less than favorable outcome of crisis intervention.
2. A patient who has been working on controlling impulsive behavior shows a
strengthening ego through which of the following behaviors?
A) Going to therapy only when there is nothing more desirable to do
B) Weighing the advantages and disadvantages before making a decision
C) Telling others in the group the right way to act
D) Reporting having fun at a recent social event
Ans: B
Feedback:
The id is the part of one's nature that reflects basic or innate desires such as pleasure-
seeking behavior, aggression, and sexual impulses. The id seeks instant gratification,
causes impulsive unthinking behavior, and has no regard for rules or social convention.
The superego is the part of a person's nature that reflects moral and ethical concepts,
values, and parental and social expectations; therefore, it is in direct opposition to the id.
The third component, the ego, is the balancing or mediating force between the id and the
superego. The ego represents mature and adaptive behavior that allows a person to
function successfully in the world.
Page 1
1. The nurse understands that crises are self-limiting. This implies that upon evaluation of
crisis intervention, the nurse should assess for which outcome?
A) The patient will identify possible causes for the crisis.
B) The patient will discover a new sense of self-sufficiency in coping.
C) The patient will resume the precrisis level of functioning.
D) The patient will express anger regarding the crisis event.
Ans: C
Feedback:
Crises usually exist for 4 to 6 weeks. At the end of that time, the crisis is resolved in one
of three ways. In the first two, the person either returns to his or her precrisis level of
functioning or begins to function at a higher level; both are positive outcomes for the
individual. The third resolution is that the person's functioning stabilizes at a level lower
than precrisis functioning, which is a negative outcome for the individual. Assisting the
person to use existing supports or helping the individual find new sources of support can
decrease the feelings of being alone or overwhelmed. The patient may develop guilt if
he or she examines possible causes for the crisis. Expression of anger at 4 to 6 weeks
indicates a less than favorable outcome of crisis intervention.
2. A patient who has been working on controlling impulsive behavior shows a
strengthening ego through which of the following behaviors?
A) Going to therapy only when there is nothing more desirable to do
B) Weighing the advantages and disadvantages before making a decision
C) Telling others in the group the right way to act
D) Reporting having fun at a recent social event
Ans: B
Feedback:
The id is the part of one's nature that reflects basic or innate desires such as pleasure-
seeking behavior, aggression, and sexual impulses. The id seeks instant gratification,
causes impulsive unthinking behavior, and has no regard for rules or social convention.
The superego is the part of a person's nature that reflects moral and ethical concepts,
values, and parental and social expectations; therefore, it is in direct opposition to the id.
The third component, the ego, is the balancing or mediating force between the id and the
superego. The ego represents mature and adaptive behavior that allows a person to
function successfully in the world.
1. The nurse understands that crises are self-limiting. This implies that upon evaluation of
crisis intervention, the nurse should assess for which outcome?
A) The patient will identify possible causes for the crisis.
B) The patient will discover a new sense of self-sufficiency in coping.
C) The patient will resume the precrisis level of functioning.
D) The patient will express anger regarding the crisis event.
Ans: C
Feedback:
Crises usually exist for 4 to 6 weeks. At the end of that time, the crisis is resolved in one
of three ways. In the first two, the person either returns to his or her precrisis level of
functioning or begins to function at a higher level; both are positive outcomes for the
individual. The third resolution is that the person's functioning stabilizes at a level lower
than precrisis functioning, which is a negative outcome for the individual. Assisting the
person to use existing supports or helping the individual find new sources of support can
decrease the feelings of being alone or overwhelmed. The patient may develop guilt if
he or she examines possible causes for the crisis. Expression of anger at 4 to 6 weeks
indicates a less than favorable outcome of crisis intervention.
2. A patient who has been working on controlling impulsive behavior shows a
strengthening ego through which of the following behaviors?
A) Going to therapy only when there is nothing more desirable to do
B) Weighing the advantages and disadvantages before making a decision
C) Telling others in the group the right way to act
D) Reporting having fun at a recent social event
Ans: B
Feedback:
The id is the part of one's nature that reflects basic or innate desires such as pleasure-
seeking behavior, aggression, and sexual impulses. The id seeks instant gratification,
causes impulsive unthinking behavior, and has no regard for rules or social convention.
The superego is the part of a person's nature that reflects moral and ethical concepts,
values, and parental and social expectations; therefore, it is in direct opposition to the id.
The third component, the ego, is the balancing or mediating force between the id and the
superego. The ego represents mature and adaptive behavior that allows a person to
function successfully in the world.
Page 2
3. A patient has just been told she has cervical cancer. When asked about how this is
impacting her, she states, ìIt's just an infection; it will clear up.î The statement indicates
that this patient
A) needs education on cervical cancer.
B) is unable to express her true emotions.
C) should be immediately referred to a cancer support group.
D) is using denial to protect herself from an emotionally painful thought.
Ans: D
Feedback:
Ego defense mechanisms are methods of attempting to protect the self and cope with
basic drives or emotionally painful thoughts, feelings, or events. Most defense
mechanisms operate at the unconscious level of awareness, so people are not aware of
what they are doing and often need help to see the reality. Education and referrals are
premature at this point in the patient's ability to cope.
4. A teenage patient defies the nurse's repeated requests to turn off the video game and go
to sleep. The teen says angrily, ìYou sound just like my mother at home!î and continues
to play the video game. The nurse understands that this statement likely indicates
A) the need of stricter discipline at home.
B) early signs of oppositional defiant disorder.
C) viewing the nurse as her mother.
D) expression of developing autonomy.
Ans: C
Feedback:
Transference occurs when the client displaces onto the therapist attitudes and feelings
that the client originally experienced in other relationships. Transference patterns are
automatic and unconscious in the therapeutic relationship. The occurrence of
transference does not indicate ineffective parenting or disciplinary practices, nor is it
indicative of a disorder. Autonomy is developed much earlier in the toddler years.
5. A patient reports a pattern of being suspicious and mistrusting of others, causing
difficulty in sustaining lasting relationships. Which stage according to Erikson's
psychosocial development was not successfully completed?
A) Trust
B) Autonomy
C) Initiative
D) Industry
Ans: A
Feedback:
The formation of trust is essential: mistrust, the negative outcome of this stage, will
impair the person's development throughout his or her life.
3. A patient has just been told she has cervical cancer. When asked about how this is
impacting her, she states, ìIt's just an infection; it will clear up.î The statement indicates
that this patient
A) needs education on cervical cancer.
B) is unable to express her true emotions.
C) should be immediately referred to a cancer support group.
D) is using denial to protect herself from an emotionally painful thought.
Ans: D
Feedback:
Ego defense mechanisms are methods of attempting to protect the self and cope with
basic drives or emotionally painful thoughts, feelings, or events. Most defense
mechanisms operate at the unconscious level of awareness, so people are not aware of
what they are doing and often need help to see the reality. Education and referrals are
premature at this point in the patient's ability to cope.
4. A teenage patient defies the nurse's repeated requests to turn off the video game and go
to sleep. The teen says angrily, ìYou sound just like my mother at home!î and continues
to play the video game. The nurse understands that this statement likely indicates
A) the need of stricter discipline at home.
B) early signs of oppositional defiant disorder.
C) viewing the nurse as her mother.
D) expression of developing autonomy.
Ans: C
Feedback:
Transference occurs when the client displaces onto the therapist attitudes and feelings
that the client originally experienced in other relationships. Transference patterns are
automatic and unconscious in the therapeutic relationship. The occurrence of
transference does not indicate ineffective parenting or disciplinary practices, nor is it
indicative of a disorder. Autonomy is developed much earlier in the toddler years.
5. A patient reports a pattern of being suspicious and mistrusting of others, causing
difficulty in sustaining lasting relationships. Which stage according to Erikson's
psychosocial development was not successfully completed?
A) Trust
B) Autonomy
C) Initiative
D) Industry
Ans: A
Feedback:
The formation of trust is essential: mistrust, the negative outcome of this stage, will
impair the person's development throughout his or her life.
Page 3
6. The nurse has established a therapeutic relationship with a patient. The patient is
beginning to share feelings openly with the nurse. The relationship has entered which
phase according to Peplau's theory?
A) Orientation
B) Identification
C) Exploitation
D) Resolution
Ans: B
Feedback:
The orientation phase is directed by the nurse and involves engaging the client in
treatment, providing explanations and information, and answering questions. The
identification phase begins when the client works interdependently with the nurse,
expresses feelings, and begins to feel stronger. In the exploitation phase, the client
makes full use of the services offered. In the resolution phase, the client no longer needs
professional services and gives up dependent behavior and the relationship ends.
7. A nurse is meeting with a crisis support group. In efforts to help patients identify with
one another, the nurse explains which of the following about the crisis experience?
A) ìEven happy events can cause a crisis if the stress is overwhelming.î
B) ìOnly people who have unfortunate life events will experience a crisis.î
C) ìA person has no control over how a crisis will affect him or her.î
D) ìPeople can prevent all crises if they develop good coping skills early.î
Ans: A
Feedback:
Not all events that result in crisis are ìnegativeî in nature. Events like marriage,
retirement, and childbirth are often desirable for the individual but may still present
overwhelming challenges. All individuals can experience a crisis when they confront
some life circumstance or stressor that they cannot effectively manage through use of
their customary coping skills. A number of factors can influence how a person
experiences a crisis.
6. The nurse has established a therapeutic relationship with a patient. The patient is
beginning to share feelings openly with the nurse. The relationship has entered which
phase according to Peplau's theory?
A) Orientation
B) Identification
C) Exploitation
D) Resolution
Ans: B
Feedback:
The orientation phase is directed by the nurse and involves engaging the client in
treatment, providing explanations and information, and answering questions. The
identification phase begins when the client works interdependently with the nurse,
expresses feelings, and begins to feel stronger. In the exploitation phase, the client
makes full use of the services offered. In the resolution phase, the client no longer needs
professional services and gives up dependent behavior and the relationship ends.
7. A nurse is meeting with a crisis support group. In efforts to help patients identify with
one another, the nurse explains which of the following about the crisis experience?
A) ìEven happy events can cause a crisis if the stress is overwhelming.î
B) ìOnly people who have unfortunate life events will experience a crisis.î
C) ìA person has no control over how a crisis will affect him or her.î
D) ìPeople can prevent all crises if they develop good coping skills early.î
Ans: A
Feedback:
Not all events that result in crisis are ìnegativeî in nature. Events like marriage,
retirement, and childbirth are often desirable for the individual but may still present
overwhelming challenges. All individuals can experience a crisis when they confront
some life circumstance or stressor that they cannot effectively manage through use of
their customary coping skills. A number of factors can influence how a person
experiences a crisis.
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Page 4
8. Which of the following theories could be classified as humanistic theories? Select all
that apply.
A) Cognitive therapy
B) Maslow's hierarchy of needs
C) Gestalt therapy
D) Rogers' client-centered therapy
E) Rational emotive therapy
F) Piaget's cognitive stages of development
Ans: B, D
Feedback:
Humanism represents a significant shift away from the psychoanalytic view of the
individual as a neurotic, impulse-driven person with repressed psychic problems and
away from the focus on and examination of the client's past experiences. Humanistic
theories include Maslow's hierarchy of needs and Rogers' client-centered therapy.
Cognitive therapy is an existential therapy that focuses on immediate thought
processingóhow a person perceives or interprets his or her experience and determines
how he or she feels and behaves. Gestalt therapy is an existential therapy that
emphasizes the person's feelings and thoughts in the here and now. Rational emotive
therapy is an existential theory that looks at irrational beliefs and automatic thoughts
that make people unhappy. Piaget's cognitive stages of development is a developmental
theory.
9. Which of the following are examples of adventitious crises? Select all that apply.
A) Death of a loved one
B) Natural disasters
C) Violent crimes
D) War
E) Leaving home for the first time
Ans: B, C, D
Feedback:
Adventitious crises include natural disasters like floods, earthquakes, or hurricanes; war,
terrorist attacks; riots; and violent crimes such as rape or murder. Maturational or
developmental crises are predictable events in the normal course of life, such as leaving
home for the first time, getting married, having a baby, and beginning a career.
Situational crises are unanticipated or sudden events that threaten the individual's
integrity, such as the death of a loved one, loss of a job, and physical or emotional
illness in the individual or family member.
8. Which of the following theories could be classified as humanistic theories? Select all
that apply.
A) Cognitive therapy
B) Maslow's hierarchy of needs
C) Gestalt therapy
D) Rogers' client-centered therapy
E) Rational emotive therapy
F) Piaget's cognitive stages of development
Ans: B, D
Feedback:
Humanism represents a significant shift away from the psychoanalytic view of the
individual as a neurotic, impulse-driven person with repressed psychic problems and
away from the focus on and examination of the client's past experiences. Humanistic
theories include Maslow's hierarchy of needs and Rogers' client-centered therapy.
Cognitive therapy is an existential therapy that focuses on immediate thought
processingóhow a person perceives or interprets his or her experience and determines
how he or she feels and behaves. Gestalt therapy is an existential therapy that
emphasizes the person's feelings and thoughts in the here and now. Rational emotive
therapy is an existential theory that looks at irrational beliefs and automatic thoughts
that make people unhappy. Piaget's cognitive stages of development is a developmental
theory.
9. Which of the following are examples of adventitious crises? Select all that apply.
A) Death of a loved one
B) Natural disasters
C) Violent crimes
D) War
E) Leaving home for the first time
Ans: B, C, D
Feedback:
Adventitious crises include natural disasters like floods, earthquakes, or hurricanes; war,
terrorist attacks; riots; and violent crimes such as rape or murder. Maturational or
developmental crises are predictable events in the normal course of life, such as leaving
home for the first time, getting married, having a baby, and beginning a career.
Situational crises are unanticipated or sudden events that threaten the individual's
integrity, such as the death of a loved one, loss of a job, and physical or emotional
illness in the individual or family member.
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Page 5
10. A nursing supervisor reprimands an employee for being chronically late for work. If the
employee handles the reprimand using the defense mechanism of displacement, he
would most likely do which of the following?
A) Argue with the supervisor that he is usually on time
B) Make a special effort to be on time tomorrow
C) Tell fellow employees that the supervisor is picking on him
D) Tell the unit housekeeper that his work is sloppy
Ans: D
Feedback:
Displacement involves venting feelings toward another, less threatening person.
Arguing is denial. Making a special effort is compensation. Telling fellow employees
that the supervisor is picking on him is projection.
11. The nurse is assessing a client who is talking about her son's recent death but who
shows no emotion of any kind. The nurse recognizes this behavior as which of the
following defense mechanisms?
A) Dissociation
B) Displacement
C) Intellectualization
D) Suppression
Ans: C
Feedback:
The client is aware of the facts of the situation but does not show the emotions
associated with the situation. Dissociation involves dealing with emotional conflict by a
temporary alteration in consciousness or identity. Displacement is the ventilation of
intense feelings toward a person less threatening than the one who aroused those
feelings. Suppression is replacing the desired gratification with one that is more readily
available.
10. A nursing supervisor reprimands an employee for being chronically late for work. If the
employee handles the reprimand using the defense mechanism of displacement, he
would most likely do which of the following?
A) Argue with the supervisor that he is usually on time
B) Make a special effort to be on time tomorrow
C) Tell fellow employees that the supervisor is picking on him
D) Tell the unit housekeeper that his work is sloppy
Ans: D
Feedback:
Displacement involves venting feelings toward another, less threatening person.
Arguing is denial. Making a special effort is compensation. Telling fellow employees
that the supervisor is picking on him is projection.
11. The nurse is assessing a client who is talking about her son's recent death but who
shows no emotion of any kind. The nurse recognizes this behavior as which of the
following defense mechanisms?
A) Dissociation
B) Displacement
C) Intellectualization
D) Suppression
Ans: C
Feedback:
The client is aware of the facts of the situation but does not show the emotions
associated with the situation. Dissociation involves dealing with emotional conflict by a
temporary alteration in consciousness or identity. Displacement is the ventilation of
intense feelings toward a person less threatening than the one who aroused those
feelings. Suppression is replacing the desired gratification with one that is more readily
available.
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Page 6
12. A college student decides to go to a party the night before a major exam instead of
studying. After receiving a low score on the exam, the student tells a fellow student, ìI
have to work too much and don't have time to study. It wouldn't matter anyway because
the teacher is so unreasonable.î The defense mechanisms the student is using are
A) denial and displacement
B) rationalization and projection
C) reaction formation and resistance
D) regression and compensation
Ans: B
Feedback:
When stating that it wouldn't matter if the student studied, the student is using
rationalization, which is excusing own behavior to avoid guilt, responsibility, conflict,
anxiety, or loss of self-respect. When stating that the teacher is unreasonable, the student
is using projection or the unconscious blaming of unacceptable inclinations or thoughts
as an external object. Denial is the failure to acknowledge an unbearable condition.
Displacement is the ventilation of intense feelings toward persons less threatening than
the one who aroused those feelings. Reaction formation is acting the opposite of what
one thinks or feels. Resistance is overt or covert antagonism toward remembering or
processing anxiety-producing information. Regression is moving back to a previous
developmental stage to feel safe or have needs met. Compensation is overachievement
in one area to offset real or perceived deficiencies in another area.
13. A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks
for a bed bath, and makes many demands of the nurses. He also yells that they are lazy
and incompetent. The client's behavior is an example of which of the following defense
mechanisms?
A) Introjection
B) Projection
C) Rationalization
D) Reaction formation
Ans: B
Feedback:
Projection is blaming unacceptable thoughts on others; the client cannot accept the fact
that he may be lazy or incompetent to care for himself. Introjection is accepting another
person's attitudes, beliefs, and values as one's own. Rationalization is excusing one's
own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-concept.
Reaction formation is acting the opposite of what one thinks or feels.
12. A college student decides to go to a party the night before a major exam instead of
studying. After receiving a low score on the exam, the student tells a fellow student, ìI
have to work too much and don't have time to study. It wouldn't matter anyway because
the teacher is so unreasonable.î The defense mechanisms the student is using are
A) denial and displacement
B) rationalization and projection
C) reaction formation and resistance
D) regression and compensation
Ans: B
Feedback:
When stating that it wouldn't matter if the student studied, the student is using
rationalization, which is excusing own behavior to avoid guilt, responsibility, conflict,
anxiety, or loss of self-respect. When stating that the teacher is unreasonable, the student
is using projection or the unconscious blaming of unacceptable inclinations or thoughts
as an external object. Denial is the failure to acknowledge an unbearable condition.
Displacement is the ventilation of intense feelings toward persons less threatening than
the one who aroused those feelings. Reaction formation is acting the opposite of what
one thinks or feels. Resistance is overt or covert antagonism toward remembering or
processing anxiety-producing information. Regression is moving back to a previous
developmental stage to feel safe or have needs met. Compensation is overachievement
in one area to offset real or perceived deficiencies in another area.
13. A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks
for a bed bath, and makes many demands of the nurses. He also yells that they are lazy
and incompetent. The client's behavior is an example of which of the following defense
mechanisms?
A) Introjection
B) Projection
C) Rationalization
D) Reaction formation
Ans: B
Feedback:
Projection is blaming unacceptable thoughts on others; the client cannot accept the fact
that he may be lazy or incompetent to care for himself. Introjection is accepting another
person's attitudes, beliefs, and values as one's own. Rationalization is excusing one's
own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-concept.
Reaction formation is acting the opposite of what one thinks or feels.
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Page 7
14. A client begins to take stock of his life and look into the future. The nurse assesses that
this client is in which of Erikson's developmental stages?
A) Identity versus role confusion
B) Industry versus inferiority
C) Integrity versus despair
D) Generativity versus stagnation
Ans: C
Feedback:
Erikson's stage of integrity versus despair is when an adult begins to reflect on his or her
life. Identity versus role confusion occurs in adolescence when the person is forming a
sense of self and belonging. Integrity versus despair occurs in maturity; accepting
responsibility for oneself and life is the corresponding task. Generativity versus
stagnation occurs in middle adulthood, which includes the tasks of being creative and
productive and establishing the next generation.
15. A basic assumption of Freud's psychoanalytic theory is that
A) all human behavior can be caused and can be explained.
B) human behavior is entirely unconscious.
C) free association is the key to understanding.
D) sexuality does not relate to behavior.
Ans: A
Feedback:
Freud believed that everything we do has meaning, whether it is conscious or
unconscious. Freud believed that human behavior can be motivated by subconscious
thoughts and feelings but could also be in the preconscious or unconscious. Freud based
his theory of childhood development on the belief that sexual energy, termed libido, was
the driving force of human behavior.
16. Which of the following is a major developmental task of middle adulthood?
A) Developing intimacy
B) Learning to manage conflict
C) Reexamining life goals
D) Resolving the past
Ans: C
Feedback:
An important task for middle-aged adults is to examine life goals, ideally with some
satisfaction. Developing intimacy occurs in young adulthood. Learning to manage
conflict occurs in preschool. Resolving the past and accepting responsibility for oneself
and life occur in maturity.
14. A client begins to take stock of his life and look into the future. The nurse assesses that
this client is in which of Erikson's developmental stages?
A) Identity versus role confusion
B) Industry versus inferiority
C) Integrity versus despair
D) Generativity versus stagnation
Ans: C
Feedback:
Erikson's stage of integrity versus despair is when an adult begins to reflect on his or her
life. Identity versus role confusion occurs in adolescence when the person is forming a
sense of self and belonging. Integrity versus despair occurs in maturity; accepting
responsibility for oneself and life is the corresponding task. Generativity versus
stagnation occurs in middle adulthood, which includes the tasks of being creative and
productive and establishing the next generation.
15. A basic assumption of Freud's psychoanalytic theory is that
A) all human behavior can be caused and can be explained.
B) human behavior is entirely unconscious.
C) free association is the key to understanding.
D) sexuality does not relate to behavior.
Ans: A
Feedback:
Freud believed that everything we do has meaning, whether it is conscious or
unconscious. Freud believed that human behavior can be motivated by subconscious
thoughts and feelings but could also be in the preconscious or unconscious. Freud based
his theory of childhood development on the belief that sexual energy, termed libido, was
the driving force of human behavior.
16. Which of the following is a major developmental task of middle adulthood?
A) Developing intimacy
B) Learning to manage conflict
C) Reexamining life goals
D) Resolving the past
Ans: C
Feedback:
An important task for middle-aged adults is to examine life goals, ideally with some
satisfaction. Developing intimacy occurs in young adulthood. Learning to manage
conflict occurs in preschool. Resolving the past and accepting responsibility for oneself
and life occur in maturity.
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Page 8
17. Which cognitive mode, according to Harry Stack Sullivan, begins in early childhood as
the child begins to connect experiences in sequence?
A) Prototaxic mode
B) Parataxic mode
C) Bitaxic mode
D) Syntaxic mode
Ans: B
Feedback:
The parataxic mode begins in early childhood as the child begins to connect experiences
in sequence. The child may not make logical sense of the experiences, although he or
she may not understand what he or she is doing. The prototaxic mode involves brief,
unconnected experiences that have no relationship to one another. In the syntaxic mode,
the person begins to perceive himself or herself and the world within the context of the
environment and can analyze experiences in a variety of settings. There is not a bitaxic
mode.
18. Group members are actively discussing a common topic. Members are sharing that they
identify with what others are saying. The nurse leader recognizes that the group is in
which stage of group development?
A) Planning
B) Initial
C) Working
D) Termination
Ans: C
Feedback:
The working stage of group development begins as members begin to focus their
attention on the purpose or task the group is trying to accomplish. The beginning stage
of group development, or the initial stage, commences as soon as the group begins to
meet. Members introduce themselves, a leader can be selected, the group purpose is
discussed, and rules and expectations for group participation are reviewed. The final
stage, or termination, of the group occurs before the group disbands. The work of the
group is reviewed, with the focus on group accomplishments or growth of group
members.
17. Which cognitive mode, according to Harry Stack Sullivan, begins in early childhood as
the child begins to connect experiences in sequence?
A) Prototaxic mode
B) Parataxic mode
C) Bitaxic mode
D) Syntaxic mode
Ans: B
Feedback:
The parataxic mode begins in early childhood as the child begins to connect experiences
in sequence. The child may not make logical sense of the experiences, although he or
she may not understand what he or she is doing. The prototaxic mode involves brief,
unconnected experiences that have no relationship to one another. In the syntaxic mode,
the person begins to perceive himself or herself and the world within the context of the
environment and can analyze experiences in a variety of settings. There is not a bitaxic
mode.
18. Group members are actively discussing a common topic. Members are sharing that they
identify with what others are saying. The nurse leader recognizes that the group is in
which stage of group development?
A) Planning
B) Initial
C) Working
D) Termination
Ans: C
Feedback:
The working stage of group development begins as members begin to focus their
attention on the purpose or task the group is trying to accomplish. The beginning stage
of group development, or the initial stage, commences as soon as the group begins to
meet. Members introduce themselves, a leader can be selected, the group purpose is
discussed, and rules and expectations for group participation are reviewed. The final
stage, or termination, of the group occurs before the group disbands. The work of the
group is reviewed, with the focus on group accomplishments or growth of group
members.
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19. The family members of a patient with bipolar disorder express frustration with the
unpredictable behaviors of their loved one. Which group should the nurse suggest as
most helpful to this family?
A) Family therapy group
B) Family education group
C) Psychotherapy group
D) Self-help support group
Ans: B
Feedback:
Family education discusses the clinical treatment of mental illnesses and teaches the
knowledge and skills that family members need to cope more effectively. The goals of
family therapy groups include understanding how family dynamics contribute to the
client's psychopathology, mobilizing the family's inherent strengths and functional
resources, restructuring maladaptive family behavioral styles, and strengthening family
problem-solving behaviors. The goal of a psychotherapy group is for members to learn
about their behavior and to make positive changes in their behavior by interacting and
communicating with others. In a self-help group, members share a common experience,
but the group is not a formal or structured therapy group.
20. A student nurse attends a self-help group as part of a class assignment. While there the
student recognizes a family friend. Upon returning home, the student talks about the
experience with the family. The student's actions can be described as
A) appropriate; persons familiar with group members are allowed self-help group
membership.
B) appropriate; self-help groups are not professional and therefore are open to public
knowledge.
C) inappropriate; most self-help groups have a rule of confidentiality.
D) inappropriate; the student should not have been allowed to attend the group.
Ans: C
Feedback:
Most self-help groups have a rule of confidentiality: whoever is seen and whatever is
said at the meetings cannot be divulged to others or discussed outside the group. In
many 12-step programs, such as Alcoholics Anonymous and Gamblers Anonymous,
people use only their first names, so their identities are not divulged (although in some
settings, group members do know one another's names).
19. The family members of a patient with bipolar disorder express frustration with the
unpredictable behaviors of their loved one. Which group should the nurse suggest as
most helpful to this family?
A) Family therapy group
B) Family education group
C) Psychotherapy group
D) Self-help support group
Ans: B
Feedback:
Family education discusses the clinical treatment of mental illnesses and teaches the
knowledge and skills that family members need to cope more effectively. The goals of
family therapy groups include understanding how family dynamics contribute to the
client's psychopathology, mobilizing the family's inherent strengths and functional
resources, restructuring maladaptive family behavioral styles, and strengthening family
problem-solving behaviors. The goal of a psychotherapy group is for members to learn
about their behavior and to make positive changes in their behavior by interacting and
communicating with others. In a self-help group, members share a common experience,
but the group is not a formal or structured therapy group.
20. A student nurse attends a self-help group as part of a class assignment. While there the
student recognizes a family friend. Upon returning home, the student talks about the
experience with the family. The student's actions can be described as
A) appropriate; persons familiar with group members are allowed self-help group
membership.
B) appropriate; self-help groups are not professional and therefore are open to public
knowledge.
C) inappropriate; most self-help groups have a rule of confidentiality.
D) inappropriate; the student should not have been allowed to attend the group.
Ans: C
Feedback:
Most self-help groups have a rule of confidentiality: whoever is seen and whatever is
said at the meetings cannot be divulged to others or discussed outside the group. In
many 12-step programs, such as Alcoholics Anonymous and Gamblers Anonymous,
people use only their first names, so their identities are not divulged (although in some
settings, group members do know one another's names).
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21. The nurse would recommend individual therapy for the patient who expresses a desire
to
A) bring about personal changes.
B) gain a sense of belonging.
C) develop leadership skills.
D) learn more about treatment.
Ans: A
Feedback:
People generally seek individual psychotherapy based on their desire to understand
themselves and their behavior, to make personal changes, to improve interpersonal
relationships, or to get relief from emotional pain or unhappiness. Groups are
recommended for persons to accomplish tasks that require cooperation, collaboration, or
working together.
22. Which one of the following statements is most accurate regarding the cohesiveness of a
group in group therapy?
A) It is commonly present in the first meeting of the group.
B) It is necessary for the group to have maximum cohesiveness, the more the better.
C) Group cohesiveness is the degree to which members think alike and many things
are left unspoken.
D) Cohesiveness is a desirable group characteristic that is associated with positive
group outcomes.
Ans: D
Feedback:
Cohesiveness is a desirable group characteristic that is associated with positive group
outcomes. It is not common for the group to be cohesive during the first meeting of the
group. During the first meeting, or the initial stage, members introduce themselves and
the parameters of the group are established. Group members begin to ìcheck outî one
another and the leaders as they determine their levels of comfort in the group setting.
Cohesiveness is associated with the working stage of a group that may take two or three
sessions in a therapy group because members must develop some level of trust before
sharing personal feelings or difficult situations. If a group is ìoverly cohesive,î in that
uniformity and agreement become the group's implicit goals, there may be a negative
effect on the group outcome as members may not offer needed feedback and this may
thwart critical thinking and creative problem solving. Group cohesiveness is the degree
to which members work together cooperatively to accomplish the purpose.
21. The nurse would recommend individual therapy for the patient who expresses a desire
to
A) bring about personal changes.
B) gain a sense of belonging.
C) develop leadership skills.
D) learn more about treatment.
Ans: A
Feedback:
People generally seek individual psychotherapy based on their desire to understand
themselves and their behavior, to make personal changes, to improve interpersonal
relationships, or to get relief from emotional pain or unhappiness. Groups are
recommended for persons to accomplish tasks that require cooperation, collaboration, or
working together.
22. Which one of the following statements is most accurate regarding the cohesiveness of a
group in group therapy?
A) It is commonly present in the first meeting of the group.
B) It is necessary for the group to have maximum cohesiveness, the more the better.
C) Group cohesiveness is the degree to which members think alike and many things
are left unspoken.
D) Cohesiveness is a desirable group characteristic that is associated with positive
group outcomes.
Ans: D
Feedback:
Cohesiveness is a desirable group characteristic that is associated with positive group
outcomes. It is not common for the group to be cohesive during the first meeting of the
group. During the first meeting, or the initial stage, members introduce themselves and
the parameters of the group are established. Group members begin to ìcheck outî one
another and the leaders as they determine their levels of comfort in the group setting.
Cohesiveness is associated with the working stage of a group that may take two or three
sessions in a therapy group because members must develop some level of trust before
sharing personal feelings or difficult situations. If a group is ìoverly cohesive,î in that
uniformity and agreement become the group's implicit goals, there may be a negative
effect on the group outcome as members may not offer needed feedback and this may
thwart critical thinking and creative problem solving. Group cohesiveness is the degree
to which members work together cooperatively to accomplish the purpose.
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23. Which one of the following is an important characteristic of an effective therapistñclient
relationship in individual psychotherapy?
A) Homogeneity between the client and the therapist.
B) Mutual benefit for the client and the therapist.
C) The client must adapt to the therapist's style of therapy and theoretical beliefs.
D) Match between the theoretical beliefs and style of therapy and the client's needs
and expectations of therapy.
Ans: B
Feedback:
Compatibility between the therapist and the client is required for therapy to be effective.
The client must select a therapist whose theoretical beliefs and style of therapy are
congruent with the client's needs and expectations of therapy. It is not required that the
client and therapist be the same. The client's benefit is the most important consideration.
The client also may have to try different therapists to find a good match.
24. Which of the following is most essential when planning care for a client who is
experiencing a crisis?
A) Explore previous coping strategies
B) Explore underlying personality dynamics
C) Focus on emotional deficits
D) Offer a referral to a self-help group
Ans: A
Feedback:
Crisis intervention focuses on using the person's strengths, such as previous coping
skills, and providing support to deal with the current situation. Exploring underlying
personality dynamics and focusing on emotional deficits would not help the client in the
crisis situation. When the client is in a crisis situation, offering a self-help group would
not be appropriate.
25. During the initial interview with a client in crisis, the initial priority is to
A) assess the adequacy of the support system.
B) assess for substance use.
C) determine the precrisis level of functioning.
D) evaluate the potential for self-harm.
Ans: D
Feedback:
Safety is always the priority; clients in crisis may be suicidal. Assessing the adequacy of
the support system, assessing for substance use, and determining the precrisis level of
functioning would be important assessments but not as high priority as evaluating the
potential for self-harm.
23. Which one of the following is an important characteristic of an effective therapistñclient
relationship in individual psychotherapy?
A) Homogeneity between the client and the therapist.
B) Mutual benefit for the client and the therapist.
C) The client must adapt to the therapist's style of therapy and theoretical beliefs.
D) Match between the theoretical beliefs and style of therapy and the client's needs
and expectations of therapy.
Ans: B
Feedback:
Compatibility between the therapist and the client is required for therapy to be effective.
The client must select a therapist whose theoretical beliefs and style of therapy are
congruent with the client's needs and expectations of therapy. It is not required that the
client and therapist be the same. The client's benefit is the most important consideration.
The client also may have to try different therapists to find a good match.
24. Which of the following is most essential when planning care for a client who is
experiencing a crisis?
A) Explore previous coping strategies
B) Explore underlying personality dynamics
C) Focus on emotional deficits
D) Offer a referral to a self-help group
Ans: A
Feedback:
Crisis intervention focuses on using the person's strengths, such as previous coping
skills, and providing support to deal with the current situation. Exploring underlying
personality dynamics and focusing on emotional deficits would not help the client in the
crisis situation. When the client is in a crisis situation, offering a self-help group would
not be appropriate.
25. During the initial interview with a client in crisis, the initial priority is to
A) assess the adequacy of the support system.
B) assess for substance use.
C) determine the precrisis level of functioning.
D) evaluate the potential for self-harm.
Ans: D
Feedback:
Safety is always the priority; clients in crisis may be suicidal. Assessing the adequacy of
the support system, assessing for substance use, and determining the precrisis level of
functioning would be important assessments but not as high priority as evaluating the
potential for self-harm.
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26. Patients on an inpatient psychiatric unit can earn off-unit privileges for daily use of
socially appropriate behavior. This is an example of employing which concept of
behavior modification?
A) Systematic desensitization
B) Negative reinforcement
C) Classical conditioning
D) Operant conditioning
Ans: D
Feedback:
The theory of operant conditioning says people learn their behavior from their history or
past experiences, particularly those experiences that were repeatedly reinforced.
Behavior that is rewarded with reinforcers tends to recur. Positive reinforcers that
follow a behavior increase the likelihood that the behavior will recur. In classical
conditioning, behavior can be changed through conditioning with external or
environmental conditions or stimuli. Negative reinforcement involves removing a
stimulus immediately after a behavior occurs so that the behavior is more likely to occur
again. In systematic desensitization, the client learns and practices relaxation techniques
to decrease and manage anxiety. He or she is then exposed to the least anxiety
provoking situation and uses the relaxation techniques to manage the resulting anxiety.
27. A patient states, ìI hate spending time with my family. They're always on my back about
something! I won't do anything they ask me to do.î Which response by the nurse reflects
a behavioral perspective?
A) ìLet's play like I'm your parent, and we'll practice some better ways to
communicate that won't result in an argument.î
B) ìSome medicines really help with anger. Are you interested in talking to your
physician about starting you on something?î
C) ìThat's probably your way of getting back at them for being strict with you when
you were younger.î
D) ìIf you agree to start doing what your parents request, then they have agreed to
respect your privacy more.î
Ans: D
Feedback:
Behaviorism is a school of psychology that focuses on observable behaviors and what
one can do externally to bring about behavior changes. It does not attempt to explain
how the mind works. Behavior can be changed through a system of rewards and
punishments. Practicing communication is a psychotherapy technique to improve
interpersonal relationships. Use of medications is not grounded in behavioral
perspective. Analyzing the reasons for the behavior is not grounded in behavioral
perspective.
26. Patients on an inpatient psychiatric unit can earn off-unit privileges for daily use of
socially appropriate behavior. This is an example of employing which concept of
behavior modification?
A) Systematic desensitization
B) Negative reinforcement
C) Classical conditioning
D) Operant conditioning
Ans: D
Feedback:
The theory of operant conditioning says people learn their behavior from their history or
past experiences, particularly those experiences that were repeatedly reinforced.
Behavior that is rewarded with reinforcers tends to recur. Positive reinforcers that
follow a behavior increase the likelihood that the behavior will recur. In classical
conditioning, behavior can be changed through conditioning with external or
environmental conditions or stimuli. Negative reinforcement involves removing a
stimulus immediately after a behavior occurs so that the behavior is more likely to occur
again. In systematic desensitization, the client learns and practices relaxation techniques
to decrease and manage anxiety. He or she is then exposed to the least anxiety
provoking situation and uses the relaxation techniques to manage the resulting anxiety.
27. A patient states, ìI hate spending time with my family. They're always on my back about
something! I won't do anything they ask me to do.î Which response by the nurse reflects
a behavioral perspective?
A) ìLet's play like I'm your parent, and we'll practice some better ways to
communicate that won't result in an argument.î
B) ìSome medicines really help with anger. Are you interested in talking to your
physician about starting you on something?î
C) ìThat's probably your way of getting back at them for being strict with you when
you were younger.î
D) ìIf you agree to start doing what your parents request, then they have agreed to
respect your privacy more.î
Ans: D
Feedback:
Behaviorism is a school of psychology that focuses on observable behaviors and what
one can do externally to bring about behavior changes. It does not attempt to explain
how the mind works. Behavior can be changed through a system of rewards and
punishments. Practicing communication is a psychotherapy technique to improve
interpersonal relationships. Use of medications is not grounded in behavioral
perspective. Analyzing the reasons for the behavior is not grounded in behavioral
perspective.
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28. A nurse is working with a patient with an eating disorder who refuses to eat a muffin.
The nurse asks the patient ìIs there any way that you could see the muffin as just flour
and water, basic nutrients your body needs?î In this statement, the nurse is using which
type of therapy?
A) Rational emotive therapy
B) Cognitive therapy
C) Gestalt therapy
D) Reality therapy
Ans: B
Feedback:
Cognitive therapy focuses on immediate thought processing, or how a person perceives
or interprets his or her experience and determines how he or she behaves. Rational
emotive therapy considers not only thoughts but feelings associated with thoughts.
Gestalt therapy focuses on the person's thoughts and feelings in the here and now.
Reality therapy challenges people to examine how behavior interferes with life goals.
29. A patient is blaming his impending divorce on the fact that his wife goes out frequently
with her girlfriends. If using reality therapy, the nurse would help the patient with which
of the following responses?
A) ìIf you really love her, she should love you as well.î
B) ìWhat does being divorced mean for you?î
C) ìHow do you feel about your marriage ending?î
D) ìWhat role do you think you have played in the end of your marriage?î
Ans: D
Feedback:
Reality therapy challenges clients to examine the ways in which their own behavior
thwarts their attempts to achieve life goals. Others are often assigned the blame when
people hold onto irrational thinking. The search for meaning is associated with
logotherapy. Exploring feelings are associated with gestalt therapy.
28. A nurse is working with a patient with an eating disorder who refuses to eat a muffin.
The nurse asks the patient ìIs there any way that you could see the muffin as just flour
and water, basic nutrients your body needs?î In this statement, the nurse is using which
type of therapy?
A) Rational emotive therapy
B) Cognitive therapy
C) Gestalt therapy
D) Reality therapy
Ans: B
Feedback:
Cognitive therapy focuses on immediate thought processing, or how a person perceives
or interprets his or her experience and determines how he or she behaves. Rational
emotive therapy considers not only thoughts but feelings associated with thoughts.
Gestalt therapy focuses on the person's thoughts and feelings in the here and now.
Reality therapy challenges people to examine how behavior interferes with life goals.
29. A patient is blaming his impending divorce on the fact that his wife goes out frequently
with her girlfriends. If using reality therapy, the nurse would help the patient with which
of the following responses?
A) ìIf you really love her, she should love you as well.î
B) ìWhat does being divorced mean for you?î
C) ìHow do you feel about your marriage ending?î
D) ìWhat role do you think you have played in the end of your marriage?î
Ans: D
Feedback:
Reality therapy challenges clients to examine the ways in which their own behavior
thwarts their attempts to achieve life goals. Others are often assigned the blame when
people hold onto irrational thinking. The search for meaning is associated with
logotherapy. Exploring feelings are associated with gestalt therapy.
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30. A nurse is assisting a patient who is working on the technique of systematic
desensitization. When the patient feels anxious, the nurse can best use the principles of
this technique by stating,
A) ìUse the deep breathing techniques we practiced yesterday.î
B) ìWhat is the worst that will happen if you confront this fear?î
C) ìTell me how you are feeling right now.î
D) ìI can see you are anxious. Let's stop for a minute.î
Ans: A
Feedback:
Systematic desensitization can be used to help clients overcome irrational fears and
anxiety associated with phobias. The client learns and practices relaxation techniques to
decrease and manage anxiety. He or she is then exposed to the least anxiety provoking
situation and uses the relaxation techniques to manage the resulting anxiety.
Confronting irrational thoughts is part of rational emotive therapy. Encouraging
expression of feelings is associated with gestalt therapy.
31. The nurse is working with a client who has a history of inflicting spousal abuse.
Although the nurse does not condone domestic violence, the nurse treats the client with
unconditional positive regard through which of the following?
A) The nurse tries to understand the feelings that might have led to violent behavior.
B) The nurse uses honest emotional expression in relating to client.
C) The client is still viewed as someone worthy of respect and assistance.
D) The nurse relates to the client as if he were her own spouse.
Ans: C
Feedback:
Unconditional positive regard involves nonjudgmental caring for the client that is not
dependent on the client's behavior. Genuineness is a realness or congruence between
what the therapist feels and what he or she says to the client. Empathetic understanding
is when the therapist senses the feelings and personal meaning from the client and
communicates this understanding to the client.
30. A nurse is assisting a patient who is working on the technique of systematic
desensitization. When the patient feels anxious, the nurse can best use the principles of
this technique by stating,
A) ìUse the deep breathing techniques we practiced yesterday.î
B) ìWhat is the worst that will happen if you confront this fear?î
C) ìTell me how you are feeling right now.î
D) ìI can see you are anxious. Let's stop for a minute.î
Ans: A
Feedback:
Systematic desensitization can be used to help clients overcome irrational fears and
anxiety associated with phobias. The client learns and practices relaxation techniques to
decrease and manage anxiety. He or she is then exposed to the least anxiety provoking
situation and uses the relaxation techniques to manage the resulting anxiety.
Confronting irrational thoughts is part of rational emotive therapy. Encouraging
expression of feelings is associated with gestalt therapy.
31. The nurse is working with a client who has a history of inflicting spousal abuse.
Although the nurse does not condone domestic violence, the nurse treats the client with
unconditional positive regard through which of the following?
A) The nurse tries to understand the feelings that might have led to violent behavior.
B) The nurse uses honest emotional expression in relating to client.
C) The client is still viewed as someone worthy of respect and assistance.
D) The nurse relates to the client as if he were her own spouse.
Ans: C
Feedback:
Unconditional positive regard involves nonjudgmental caring for the client that is not
dependent on the client's behavior. Genuineness is a realness or congruence between
what the therapist feels and what he or she says to the client. Empathetic understanding
is when the therapist senses the feelings and personal meaning from the client and
communicates this understanding to the client.
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Page 15
32. A patient is being admitted to an inpatient unit for treatment of anorexia nervosa. Of the
following assessment data, which should the nurse place as highest priority in the plan
of care?
A) Weight 24% below normal for height
B) Distorted body image
C) Feelings of inadequacy
D) Frequent vomiting after meals
Ans: D
Feedback:
Maslow's hierarchy of needs hypothesizes that the basic needs at the bottom of the
pyramid dominate the person's behavior until those needs were met, at which time the
next level of needs would become dominant. Vomiting threatens fluid and electrolyte
balance and poses a more acute threat to survival than low weight. Once basic physical
needs are met, the higher level needs such as body image and self-esteem can be
addressed.
33. The primary purpose for generalist nurses to develop skills with psychosocial
interventions is
A) psychosocial interventions are included on the nursing licensure examinations.
B) psychosocial interventions are needed in all nursing practice settings.
C) nurses will be consulted to assist in the care of psychiatric patients in acute care
settings.
D) there are a growing number of nursing practice opportunities in mental health
settings.
Ans: B
Feedback:
Nurses often use psychosocial interventions to help meet clients' needs and achieve
outcomes in all practice settings, not just mental health. Psychosocial interventions are
included on the licensing exam, but that is not the primary reason for developing
proficiency. Any health-care personnel will care for psychiatric patients in acute care
settings. Current trends reflect a decline in mental health services and employment
opportunities.
32. A patient is being admitted to an inpatient unit for treatment of anorexia nervosa. Of the
following assessment data, which should the nurse place as highest priority in the plan
of care?
A) Weight 24% below normal for height
B) Distorted body image
C) Feelings of inadequacy
D) Frequent vomiting after meals
Ans: D
Feedback:
Maslow's hierarchy of needs hypothesizes that the basic needs at the bottom of the
pyramid dominate the person's behavior until those needs were met, at which time the
next level of needs would become dominant. Vomiting threatens fluid and electrolyte
balance and poses a more acute threat to survival than low weight. Once basic physical
needs are met, the higher level needs such as body image and self-esteem can be
addressed.
33. The primary purpose for generalist nurses to develop skills with psychosocial
interventions is
A) psychosocial interventions are included on the nursing licensure examinations.
B) psychosocial interventions are needed in all nursing practice settings.
C) nurses will be consulted to assist in the care of psychiatric patients in acute care
settings.
D) there are a growing number of nursing practice opportunities in mental health
settings.
Ans: B
Feedback:
Nurses often use psychosocial interventions to help meet clients' needs and achieve
outcomes in all practice settings, not just mental health. Psychosocial interventions are
included on the licensing exam, but that is not the primary reason for developing
proficiency. Any health-care personnel will care for psychiatric patients in acute care
settings. Current trends reflect a decline in mental health services and employment
opportunities.
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Page 16
34. Which of the following considerations should have the most influence in the nurse's
choice of the treatment for the client?
A) The client's feelings and perceptions about his or her situation
B) The nurse's beliefs about the theories of psychosocial development
C) The nurse's familiarity with the type of treatment
D) Any approach to treatment should work with any client.
Ans: A
Feedback:
The client's feelings and perceptions about his or her situation are the most influential
factors in determining his or her response to therapeutic interventions, rather than what
the nurse believes the client should do. The nurse must examine his or her beliefs about
the theories of psychosocial development and realize that many treatment approaches
are available. Different treatments may work for different clients: no one approach
works for everyone. Becoming familiar with the variety of psychosocial approaches for
working with clients will increase the nurse's effectiveness in promoting the client's
health and well-being.
35. Which approach to therapy is most effective when planning for a client with negative
thinking?
A) Behavior modification
B) Client-centered therapy
C) Cognitive therapy
D) Reality therapy
Ans: C
Feedback:
Cognitive therapy focuses on changing the client's thinking first, in the belief that then
feelings and behavior can change as well. Behavior modification is a method of
attempting to strengthen a desired behavior or response by reinforcement, either positive
or negative. Client-centered therapy focuses on the role of the client, rather than the
therapist, as the key to the healing process. Reality therapy focuses on the person's
behavior and how that behavior keeps him or her from achieving life goals.
34. Which of the following considerations should have the most influence in the nurse's
choice of the treatment for the client?
A) The client's feelings and perceptions about his or her situation
B) The nurse's beliefs about the theories of psychosocial development
C) The nurse's familiarity with the type of treatment
D) Any approach to treatment should work with any client.
Ans: A
Feedback:
The client's feelings and perceptions about his or her situation are the most influential
factors in determining his or her response to therapeutic interventions, rather than what
the nurse believes the client should do. The nurse must examine his or her beliefs about
the theories of psychosocial development and realize that many treatment approaches
are available. Different treatments may work for different clients: no one approach
works for everyone. Becoming familiar with the variety of psychosocial approaches for
working with clients will increase the nurse's effectiveness in promoting the client's
health and well-being.
35. Which approach to therapy is most effective when planning for a client with negative
thinking?
A) Behavior modification
B) Client-centered therapy
C) Cognitive therapy
D) Reality therapy
Ans: C
Feedback:
Cognitive therapy focuses on changing the client's thinking first, in the belief that then
feelings and behavior can change as well. Behavior modification is a method of
attempting to strengthen a desired behavior or response by reinforcement, either positive
or negative. Client-centered therapy focuses on the role of the client, rather than the
therapist, as the key to the healing process. Reality therapy focuses on the person's
behavior and how that behavior keeps him or her from achieving life goals.
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Page 1
1. Which of the following factors is primarily responsible for the changes in inpatient
hospital treatment between the 1980s and the present?
A) Progress in treatment options for mentally ill persons
B) The growth of managed care
C) Less stigma associated with mental illness
D) The current use of milieu therapy
Ans: B
Feedback:
Managed care exerts cost-control measures such as recertification of admissions,
utilization review, and case managementóall of which have altered inpatient treatment
significantly. There has been some progress in treatment options for mentally ill
persons, but that is not the primary factor that has changed mental health inpatient
hospital care. There is lesser stigma associated with mental illness, but that is not the
primary factor that has changed mental health inpatient hospital care. In the 1980s, a
typical psychiatric unit emphasized milieu therapy, which required long lengths of stay
because clients with more stable conditions helped to provide structure and support for
newly admitted clients with more acute conditions.
2. The factor having the most influence on the current trend in treatment settings is the fact
in recent years,
A) funding for community programs has been inadequate.
B) laws have enabled more people to be committed to treatment.
C) state hospitals have expanded to meet the demand.
D) community programs have been fully developed to meet treatment needs.
Ans: A
Feedback:
Adequate funding has not kept pace with the need for community programs and
treatment. Commitment laws have led to deinstitutionalization. Large state hospitals
emptied as a result. Treatment in the community was intended to replace much of state
hospital inpatient care, but funding has been inadequate.
1. Which of the following factors is primarily responsible for the changes in inpatient
hospital treatment between the 1980s and the present?
A) Progress in treatment options for mentally ill persons
B) The growth of managed care
C) Less stigma associated with mental illness
D) The current use of milieu therapy
Ans: B
Feedback:
Managed care exerts cost-control measures such as recertification of admissions,
utilization review, and case managementóall of which have altered inpatient treatment
significantly. There has been some progress in treatment options for mentally ill
persons, but that is not the primary factor that has changed mental health inpatient
hospital care. There is lesser stigma associated with mental illness, but that is not the
primary factor that has changed mental health inpatient hospital care. In the 1980s, a
typical psychiatric unit emphasized milieu therapy, which required long lengths of stay
because clients with more stable conditions helped to provide structure and support for
newly admitted clients with more acute conditions.
2. The factor having the most influence on the current trend in treatment settings is the fact
in recent years,
A) funding for community programs has been inadequate.
B) laws have enabled more people to be committed to treatment.
C) state hospitals have expanded to meet the demand.
D) community programs have been fully developed to meet treatment needs.
Ans: A
Feedback:
Adequate funding has not kept pace with the need for community programs and
treatment. Commitment laws have led to deinstitutionalization. Large state hospitals
emptied as a result. Treatment in the community was intended to replace much of state
hospital inpatient care, but funding has been inadequate.
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Page 2
3. A patient who has continuously experienced severe symptoms of schizoaffective
disorder for the past 17 years is experiencing an acute psychotic episode. Which level of
care is most appropriate for this patient at this time?
A) Partial hospitalization
B) Residential treatment
C) Inpatient hospital treatment
D) Clubhouse
Ans: C
Feedback:
Long-stay clients in an inpatient setting are people with severe and persistent mental
illness who continue to require acute care services despite the current emphasis on
decreased hospital stays. This population includes clients who were hospitalized before
deinstitutionalization and remain hospitalized despite efforts at community placement. It
also includes clients who have been hospitalized consistently for long periods despite
efforts to minimize their hospital stays. Partial hospitalization is designed for patients
transitioning to independent living. Residential treatment and clubhouse model provide
supervised independent living.
4. A patient with depression is admitted to an inpatient hospital unit for treatment. The
type of therapy most likely provided in this setting includes
A) leisure skills.
B) self-monitoring of treatment.
C) skills for daily living.
D) talk therapy.
Ans: D
Feedback:
A typical psychiatric unit emphasizes talk therapy, or one-on-one interactions between
residents and staff, and milieu therapy, meaning the total environment and its effect on
the client's treatment. Partial hospitalization programs teach skills for daily living.
Clubhouse models provide patients opportunities for leisure activities and self-
monitoring of treatment.
5. Which of the following is the highest priority for admission to inpatient care?
A) Confusion or disorientation
B) Need for medication changes
C) Safety of self or others
D) Withdrawal from alcohol or other drugs
Ans: C
Feedback:
Safety is a priority; the inpatient setting provides for the safety of the client and/or
others. Confusion or disorientation, need for medication changes, and withdrawal from
alcohol or other drugs may also require inpatient care but the priority is safety.
3. A patient who has continuously experienced severe symptoms of schizoaffective
disorder for the past 17 years is experiencing an acute psychotic episode. Which level of
care is most appropriate for this patient at this time?
A) Partial hospitalization
B) Residential treatment
C) Inpatient hospital treatment
D) Clubhouse
Ans: C
Feedback:
Long-stay clients in an inpatient setting are people with severe and persistent mental
illness who continue to require acute care services despite the current emphasis on
decreased hospital stays. This population includes clients who were hospitalized before
deinstitutionalization and remain hospitalized despite efforts at community placement. It
also includes clients who have been hospitalized consistently for long periods despite
efforts to minimize their hospital stays. Partial hospitalization is designed for patients
transitioning to independent living. Residential treatment and clubhouse model provide
supervised independent living.
4. A patient with depression is admitted to an inpatient hospital unit for treatment. The
type of therapy most likely provided in this setting includes
A) leisure skills.
B) self-monitoring of treatment.
C) skills for daily living.
D) talk therapy.
Ans: D
Feedback:
A typical psychiatric unit emphasizes talk therapy, or one-on-one interactions between
residents and staff, and milieu therapy, meaning the total environment and its effect on
the client's treatment. Partial hospitalization programs teach skills for daily living.
Clubhouse models provide patients opportunities for leisure activities and self-
monitoring of treatment.
5. Which of the following is the highest priority for admission to inpatient care?
A) Confusion or disorientation
B) Need for medication changes
C) Safety of self or others
D) Withdrawal from alcohol or other drugs
Ans: C
Feedback:
Safety is a priority; the inpatient setting provides for the safety of the client and/or
others. Confusion or disorientation, need for medication changes, and withdrawal from
alcohol or other drugs may also require inpatient care but the priority is safety.
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Page 3
6. The priority of inpatient care for people with severe mental illness is
A) family issues.
B) insight into illness.
C) social skills.
D) symptom management.
Ans: D
Feedback:
Rapid assessment, stabilization of symptoms, and discharge planning are the focus of
inpatient care today. Family issues, insight into illness, and social skills would not be
priorities of care for clients with severe mental illness.
7. Discharge planning from inpatient care for people with severe mental illness must
address which of the following to be effective? Select all that apply.
A) Finding housing for the client
B) Finding a job for the client
C) Finding transportation for the client
D) Improving family support
E) Identifying ideal recreational activities
Ans: A, C
Feedback:
Clinicians help clients recognize symptoms, identify coping skills, and choose discharge
supports in the inpatient setting. People are able to remain in the community for longer
periods of time when discharge planning addresses environmental supports, housing,
transportation, and access to community support services. Finding a job for the client
may be helpful if appropriate but may not be appropriate for the individual at the time of
discharge from inpatient care. Improving family support and identifying ideal
recreational activities are desirable but not essential for successful reintegration with the
community.
6. The priority of inpatient care for people with severe mental illness is
A) family issues.
B) insight into illness.
C) social skills.
D) symptom management.
Ans: D
Feedback:
Rapid assessment, stabilization of symptoms, and discharge planning are the focus of
inpatient care today. Family issues, insight into illness, and social skills would not be
priorities of care for clients with severe mental illness.
7. Discharge planning from inpatient care for people with severe mental illness must
address which of the following to be effective? Select all that apply.
A) Finding housing for the client
B) Finding a job for the client
C) Finding transportation for the client
D) Improving family support
E) Identifying ideal recreational activities
Ans: A, C
Feedback:
Clinicians help clients recognize symptoms, identify coping skills, and choose discharge
supports in the inpatient setting. People are able to remain in the community for longer
periods of time when discharge planning addresses environmental supports, housing,
transportation, and access to community support services. Finding a job for the client
may be helpful if appropriate but may not be appropriate for the individual at the time of
discharge from inpatient care. Improving family support and identifying ideal
recreational activities are desirable but not essential for successful reintegration with the
community.
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Page 4
8. Which type of community residential treatment setting is most likely to be permanent in
any state?
A) Halfway house
B) Respite housing
C) Independent living programs
D) Evolving consumer household
Ans: D
Feedback:
Because the evolving consumer household is a permanent living arrangement, it
eliminates the problem of relocation. Halfway houses usually serve as temporary
placements that provide support as the clients prepare for independence. Clients who are
served by respite housing are those who live in group homes or independently most of
the time but have a need for ìrespiteî from their usual residences when the client
experiences a crisis, feels overwhelmed, or cannot cope with problems or emotions.
Independent living programs are available in many states, but may vary a great deal in
regard to services provided with some agencies providing a broad range of services or
shelter but few services.
9. A patient is being transferred from a group home to an evolving consumer household.
The goal of this transition is for the patient to eventually
A) meet with a therapist on a weekly basis.
B) resolve crises within a shorter time period.
C) fulfill daily responsibilities without supervision.
D) use the increased emotional support of paid staff.
Ans: C
Feedback:
The evolving consumer household is a group-living situation in which the residents
make the transition from a traditional group home to a residence where they fulfill their
own responsibilities and function without onsite supervision from paid staff.
8. Which type of community residential treatment setting is most likely to be permanent in
any state?
A) Halfway house
B) Respite housing
C) Independent living programs
D) Evolving consumer household
Ans: D
Feedback:
Because the evolving consumer household is a permanent living arrangement, it
eliminates the problem of relocation. Halfway houses usually serve as temporary
placements that provide support as the clients prepare for independence. Clients who are
served by respite housing are those who live in group homes or independently most of
the time but have a need for ìrespiteî from their usual residences when the client
experiences a crisis, feels overwhelmed, or cannot cope with problems or emotions.
Independent living programs are available in many states, but may vary a great deal in
regard to services provided with some agencies providing a broad range of services or
shelter but few services.
9. A patient is being transferred from a group home to an evolving consumer household.
The goal of this transition is for the patient to eventually
A) meet with a therapist on a weekly basis.
B) resolve crises within a shorter time period.
C) fulfill daily responsibilities without supervision.
D) use the increased emotional support of paid staff.
Ans: C
Feedback:
The evolving consumer household is a group-living situation in which the residents
make the transition from a traditional group home to a residence where they fulfill their
own responsibilities and function without onsite supervision from paid staff.
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Page 5
10. What is an important role of the nurse with regard to residents opposing plans to
establish a group home or residential facility in their neighborhood?
A) To provide information to correct misinformation related to stereotypes of persons
with mental illnesses
B) To persuade neighborhood residents that mentally ill people need safe, affordable,
and desirable housing
C) To provide for the safety and security of the neighborhood
D) To ensure the security of persons in the group home
Ans: A
Feedback:
Frequently, residents oppose plans to establish a group home or residential facility in
their neighborhood. They argue that having a group home will decrease their property
values, and they may believe that people with mental illness are violent, will act
bizarrely in public, or will be a menace to their children. These people have strongly
ingrained stereotypes and a great deal of misinformation. Local residents must be given
the facts, and nurses are in a position to advocate for clients by educating members of
the community. The neighborhood residents who object to the establishment of a group
home or residential setting may not be motivated to understand the needs of mentally ill
people. It is not the responsibility for the nurse to provide for the safety and security of
the neighborhood or protect the safety and security of persons in the group home.
11. What are the two essential components of transitional care discharge model that is used
in Canada and Scotland?
A) Peer support and bridging staff
B) Collaboration and funding
C) Relapse and hospitalization
D) Poverty and entitlements
Ans: A
Feedback:
Two essential components of the transitional care discharge model are peer support and
bridging staff. Peer support is provided by a consumer now living successfully in the
community. Bridging staff refers to an overlap between hospital and community
careóhospital staff do not terminate their therapeutic relationship with the client until a
therapeutic relationship has been established with the community care provider. This
model requires collaboration, administrative support, and adequate funding to
effectively promote the patient's health and well-being and prevent relapse and
rehospitalization. Poverty among people with mental illness is a significant barrier to
maintaining housing. Mentally ill persons often rely on government entitlements for
their income which forces people to have to choose continuation of the entitlement and
dependence versus working inconsistently in unskilled, part-time, and low-paying jobs
with no health insurance.
10. What is an important role of the nurse with regard to residents opposing plans to
establish a group home or residential facility in their neighborhood?
A) To provide information to correct misinformation related to stereotypes of persons
with mental illnesses
B) To persuade neighborhood residents that mentally ill people need safe, affordable,
and desirable housing
C) To provide for the safety and security of the neighborhood
D) To ensure the security of persons in the group home
Ans: A
Feedback:
Frequently, residents oppose plans to establish a group home or residential facility in
their neighborhood. They argue that having a group home will decrease their property
values, and they may believe that people with mental illness are violent, will act
bizarrely in public, or will be a menace to their children. These people have strongly
ingrained stereotypes and a great deal of misinformation. Local residents must be given
the facts, and nurses are in a position to advocate for clients by educating members of
the community. The neighborhood residents who object to the establishment of a group
home or residential setting may not be motivated to understand the needs of mentally ill
people. It is not the responsibility for the nurse to provide for the safety and security of
the neighborhood or protect the safety and security of persons in the group home.
11. What are the two essential components of transitional care discharge model that is used
in Canada and Scotland?
A) Peer support and bridging staff
B) Collaboration and funding
C) Relapse and hospitalization
D) Poverty and entitlements
Ans: A
Feedback:
Two essential components of the transitional care discharge model are peer support and
bridging staff. Peer support is provided by a consumer now living successfully in the
community. Bridging staff refers to an overlap between hospital and community
careóhospital staff do not terminate their therapeutic relationship with the client until a
therapeutic relationship has been established with the community care provider. This
model requires collaboration, administrative support, and adequate funding to
effectively promote the patient's health and well-being and prevent relapse and
rehospitalization. Poverty among people with mental illness is a significant barrier to
maintaining housing. Mentally ill persons often rely on government entitlements for
their income which forces people to have to choose continuation of the entitlement and
dependence versus working inconsistently in unskilled, part-time, and low-paying jobs
with no health insurance.
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Page 6
12. Some residential treatment settings are transitional. This means that clients are
eventually expected to
A) become self-sufficient.
B) find employment.
C) no longer need medication.
D) relocate to another setting.
Ans: D
Feedback:
Transitional housing is temporary; clients are expected to move to another residential
setting. Clients using transitional treatment settings are not expected to become totally
self-sufficient, find employment, or not be in need of medication.
13. The primary advantage of an evolving consumer household is that clients
A) are provided with adequate income to combat poverty.
B) do not have to relocate as they become more independent.
C) have on-site staff supervision 24 hours a day.
D) receive on-site medical care.
Ans: B
Feedback:
An evolving consumer household is a permanent living situation, eliminating the need
to change residential settings as clients gain independence. Many clients in evolving
consumer households rely on Social Security Insurance or Social Security Disability
Insurance. Clients function without onsite supervision.
14. The primary goal of a psychiatric rehabilitation program is to promote
A) return to prior level of functioning.
B) medication compliance.
C) complete recovery from mental illness.
D) stabilization and management of symptoms.
Ans: C
Feedback:
Psychiatric rehabilitation goes beyond management of symptoms and medication
management to include personal growth, reintegration into the community,
empowerment, increased independence, and improved quality of life. It is not a goal of
psychiatric rehabilitation to return to the prior level of functioning that may have been
dysfunctional. It may not be realistic for the client to completely recover from mental
illness, but rehabilitation can improve the quality of life for the client.
12. Some residential treatment settings are transitional. This means that clients are
eventually expected to
A) become self-sufficient.
B) find employment.
C) no longer need medication.
D) relocate to another setting.
Ans: D
Feedback:
Transitional housing is temporary; clients are expected to move to another residential
setting. Clients using transitional treatment settings are not expected to become totally
self-sufficient, find employment, or not be in need of medication.
13. The primary advantage of an evolving consumer household is that clients
A) are provided with adequate income to combat poverty.
B) do not have to relocate as they become more independent.
C) have on-site staff supervision 24 hours a day.
D) receive on-site medical care.
Ans: B
Feedback:
An evolving consumer household is a permanent living situation, eliminating the need
to change residential settings as clients gain independence. Many clients in evolving
consumer households rely on Social Security Insurance or Social Security Disability
Insurance. Clients function without onsite supervision.
14. The primary goal of a psychiatric rehabilitation program is to promote
A) return to prior level of functioning.
B) medication compliance.
C) complete recovery from mental illness.
D) stabilization and management of symptoms.
Ans: C
Feedback:
Psychiatric rehabilitation goes beyond management of symptoms and medication
management to include personal growth, reintegration into the community,
empowerment, increased independence, and improved quality of life. It is not a goal of
psychiatric rehabilitation to return to the prior level of functioning that may have been
dysfunctional. It may not be realistic for the client to completely recover from mental
illness, but rehabilitation can improve the quality of life for the client.
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Page 7
15. What is required for a transitional care model to be most effective in promoting the
client's health and well-being and prevent relapse and rehospitalization? Select all that
apply.
A) Collaboration
B) Administrative support
C) Adequate funding
D) Family support
E) Completely different providers
F) Isolation from peers who successfully live in the community
Ans: A, B, C
Feedback:
Two essential components of transitional care model are peer support and bridging staff.
Peer support is provided by a consumer now living successfully in the community.
Bridging staff refers to an overlap between hospital and community careóhospital staff
do not terminate their therapeutic relationship with the client until a therapeutic
relationship has been established with the community care provider. This model requires
collaboration, administrative support, and adequate funding to effectively promote the
patient's health and well-being and prevent relapse and rehospitalization.
16. A patient has just begun daily participation in a community-based partial hospitalization
program. The patient can expect the staff to assist with which of the following treatment
goals? Select all that apply.
A) Stabilizing psychiatric symptoms
B) Finding a better job
C) Improving activities of daily living
D) Learning to structure time
E) Improved family support
F) Developing social skills
Ans: A, C, D, F
Feedback:
Partial hospitalization programs are designed to help clients make a gradual transition
from being inpatients to living independently and to prevent repeat admissions. In day
treatment programs, clients return to home at night; evening programs are just the
reverse. Partial hospitalization programs provide assistance with stabilizing psychiatric
symptoms, monitoring drug effectiveness, stabilizing living environment, improving
activities of daily living, learning to structure time, developing social skills, obtaining
meaningful work, paid employment, or a volunteer position, and providing follow-up of
any health concerns. Finding a better job and improving family support are not goals of
partial hospitalization programs.
15. What is required for a transitional care model to be most effective in promoting the
client's health and well-being and prevent relapse and rehospitalization? Select all that
apply.
A) Collaboration
B) Administrative support
C) Adequate funding
D) Family support
E) Completely different providers
F) Isolation from peers who successfully live in the community
Ans: A, B, C
Feedback:
Two essential components of transitional care model are peer support and bridging staff.
Peer support is provided by a consumer now living successfully in the community.
Bridging staff refers to an overlap between hospital and community careóhospital staff
do not terminate their therapeutic relationship with the client until a therapeutic
relationship has been established with the community care provider. This model requires
collaboration, administrative support, and adequate funding to effectively promote the
patient's health and well-being and prevent relapse and rehospitalization.
16. A patient has just begun daily participation in a community-based partial hospitalization
program. The patient can expect the staff to assist with which of the following treatment
goals? Select all that apply.
A) Stabilizing psychiatric symptoms
B) Finding a better job
C) Improving activities of daily living
D) Learning to structure time
E) Improved family support
F) Developing social skills
Ans: A, C, D, F
Feedback:
Partial hospitalization programs are designed to help clients make a gradual transition
from being inpatients to living independently and to prevent repeat admissions. In day
treatment programs, clients return to home at night; evening programs are just the
reverse. Partial hospitalization programs provide assistance with stabilizing psychiatric
symptoms, monitoring drug effectiveness, stabilizing living environment, improving
activities of daily living, learning to structure time, developing social skills, obtaining
meaningful work, paid employment, or a volunteer position, and providing follow-up of
any health concerns. Finding a better job and improving family support are not goals of
partial hospitalization programs.
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Page 8
17. A patient has just been referred to a psychosocial rehabilitation program. The nurse
explains that the benefits of being involved in such a program include: Select all that
apply.
A) continuous monitoring of symptoms.
B) increased independence.
C) increased involvement in treatment decisions.
D) recovery from mental illness.
E) increased community integration.
F) greater opportunities for personal growth.
Ans: B, D, E
Feedback:
Goals of psychosocial rehabilitation programs include recovery from mental illness,
personal growth, quality of life, community reintegration, empowerment, increased
independence, decreased hospital admissions, improved social functioning, improved
vocational functioning, continuous treatment, increased involvement in treatment
decisions, improved physical health, and a recovered sense of self. Monitoring of
symptoms and medication education are major foci of partial hospitalization programs
18. Which type of psychiatric rehabilitation relies on intentional communities and
rehabilitation alliances?
A) Clubhouse model
B) Assertive community treatment
C) Group homes
D) Respite housing
Ans: A
Feedback:
The clubhouse model of psychiatric rehabilitation relies on intentional communities and
rehabilitation alliances. Assertiveness community treatment (ACT) has a problem-
solving orientation, and staff members who are in the community attend to specific life
issues of the client. Group homes are a residential form of treatment for mental illness
but do not provide complete psychiatric rehabilitation. Respite housing is temporary
housing for mentally ill persons and does not provide complete psychiatric
rehabilitation.
17. A patient has just been referred to a psychosocial rehabilitation program. The nurse
explains that the benefits of being involved in such a program include: Select all that
apply.
A) continuous monitoring of symptoms.
B) increased independence.
C) increased involvement in treatment decisions.
D) recovery from mental illness.
E) increased community integration.
F) greater opportunities for personal growth.
Ans: B, D, E
Feedback:
Goals of psychosocial rehabilitation programs include recovery from mental illness,
personal growth, quality of life, community reintegration, empowerment, increased
independence, decreased hospital admissions, improved social functioning, improved
vocational functioning, continuous treatment, increased involvement in treatment
decisions, improved physical health, and a recovered sense of self. Monitoring of
symptoms and medication education are major foci of partial hospitalization programs
18. Which type of psychiatric rehabilitation relies on intentional communities and
rehabilitation alliances?
A) Clubhouse model
B) Assertive community treatment
C) Group homes
D) Respite housing
Ans: A
Feedback:
The clubhouse model of psychiatric rehabilitation relies on intentional communities and
rehabilitation alliances. Assertiveness community treatment (ACT) has a problem-
solving orientation, and staff members who are in the community attend to specific life
issues of the client. Group homes are a residential form of treatment for mental illness
but do not provide complete psychiatric rehabilitation. Respite housing is temporary
housing for mentally ill persons and does not provide complete psychiatric
rehabilitation.
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Page 9
19. Which is the orientation of assertive community treatment (ACT)?
A) Setting limits on mundane life issues
B) Making a wide range of referrals
C) Providing services in offices
D) Problem-solving orientation
Ans: D
Feedback:
An ACT program has a problem-solving orientation: Staff members attend to specific
life issues, no matter how mundane. ACT programs provide most services directly
rather than relying on referrals to other programs or agencies, and they implement the
services in the clients' homes or communities, not in offices.
20. Which of the following are advantages of a crisis resolution team or home treatment
team? Select all that apply.
A) It is a residential treatment setting.
B) It is more likely to help a client to perceive his or her situation more accurately.
C) It is designed to assist clients in dealing with mental health crises without
hospitalization.
D) The client may feel better about asking for help.
E) The client must meet multiple criteria to receive this type of care.
Ans: B, C, D
Feedback:
Crisis resolution or respite care is a type of care for clients who have a perception of
being in crisis and needing a more structured environment. A client having access to
respite services is more likely to perceive his or her situation more accurately, feel better
about asking for help, and avoid hospitalization.
21. A nurse is meeting with the city council to advocate for mentally ill persons and the
establishment of a group home in a neighborhood where the plans have been strongly
opposed by the neighbors. The nurse can effectively educate the public on the realities
of group home by citing research that indicates
A) property values quickly rebound in neighborhoods that have group homes.
B) police surveillance will be increased to avert any violence by residents.
C) most people with mental illness do not represent a significant danger to others.
D) neighborhoods that provide park areas provide children a centralized and safe
place to play.
Ans: C
Feedback:
Frequently, residents oppose plans to establish a group home in their neighborhood,
arguing that having a group home will decrease their property values, and they may
believe that people with mental illness are violent, will act bizarrely in public, or will be
a menace to their children. These people have strongly ingrained stereotypes and a great
deal of misinformation.
19. Which is the orientation of assertive community treatment (ACT)?
A) Setting limits on mundane life issues
B) Making a wide range of referrals
C) Providing services in offices
D) Problem-solving orientation
Ans: D
Feedback:
An ACT program has a problem-solving orientation: Staff members attend to specific
life issues, no matter how mundane. ACT programs provide most services directly
rather than relying on referrals to other programs or agencies, and they implement the
services in the clients' homes or communities, not in offices.
20. Which of the following are advantages of a crisis resolution team or home treatment
team? Select all that apply.
A) It is a residential treatment setting.
B) It is more likely to help a client to perceive his or her situation more accurately.
C) It is designed to assist clients in dealing with mental health crises without
hospitalization.
D) The client may feel better about asking for help.
E) The client must meet multiple criteria to receive this type of care.
Ans: B, C, D
Feedback:
Crisis resolution or respite care is a type of care for clients who have a perception of
being in crisis and needing a more structured environment. A client having access to
respite services is more likely to perceive his or her situation more accurately, feel better
about asking for help, and avoid hospitalization.
21. A nurse is meeting with the city council to advocate for mentally ill persons and the
establishment of a group home in a neighborhood where the plans have been strongly
opposed by the neighbors. The nurse can effectively educate the public on the realities
of group home by citing research that indicates
A) property values quickly rebound in neighborhoods that have group homes.
B) police surveillance will be increased to avert any violence by residents.
C) most people with mental illness do not represent a significant danger to others.
D) neighborhoods that provide park areas provide children a centralized and safe
place to play.
Ans: C
Feedback:
Frequently, residents oppose plans to establish a group home in their neighborhood,
arguing that having a group home will decrease their property values, and they may
believe that people with mental illness are violent, will act bizarrely in public, or will be
a menace to their children. These people have strongly ingrained stereotypes and a great
deal of misinformation.
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Page 10
22. A patient with bipolar disorder has a long history of both hospitalizations and
incarcerations. The patient has no permanent residence and has infrequent contact with
his family. Upon admission to the inpatient psychiatric unit for stabilization, the nurse
documents all of the following in the record. Which of the following data most suggests
a positive outcome for this patient?
A) Reporting meeting with the same case manager monthly for the last 3 years
B) History of residential stays at several local homeless shelters
C) Last contact with siblings 4 years ago
D) Income from day labor for 10 days last month
Ans: A
Feedback:
Results are positive when personal connections with case managers are established. The
most recent report from the ACCESS project found frequent shifts between the street,
programs, and institutions worsen the lives of the homeless. The degree of social
support and employment has direct influence on quality of life.
23. A nurse is orienting to a new position working the infirmary in the state penitentiary.
When working with prisoners who are also mentally ill, the nurse examines her own
attitudes. Which of the following beliefs should the nurse discuss with her supervisor
before caring for incarcerated patients?
A) People with mental illness are inherently violent.
B) The mentally ill can get better treatment in prison than in the community.
C) People with mental illness are more vulnerable to victimization when
incarcerated.
D) Many mentally ill would not be in prison if they were stabilized on medication.
Ans: A
Feedback:
Although it is true that people with major mental illnesses who do not take prescribed
medication are at increased risk for being violent, most people with mental illness do
not represent a significant danger to others. Criminalization of mental illness refers to
the practice of arresting and prosecuting mentally ill offenders, even for misdemeanors,
at a rate four times that of the general population in an effort to contain them in some
type of institution where they might receive needed treatment. People with a mental
illness are more likely to be the victims of violence, both in prisons and in the
community.
22. A patient with bipolar disorder has a long history of both hospitalizations and
incarcerations. The patient has no permanent residence and has infrequent contact with
his family. Upon admission to the inpatient psychiatric unit for stabilization, the nurse
documents all of the following in the record. Which of the following data most suggests
a positive outcome for this patient?
A) Reporting meeting with the same case manager monthly for the last 3 years
B) History of residential stays at several local homeless shelters
C) Last contact with siblings 4 years ago
D) Income from day labor for 10 days last month
Ans: A
Feedback:
Results are positive when personal connections with case managers are established. The
most recent report from the ACCESS project found frequent shifts between the street,
programs, and institutions worsen the lives of the homeless. The degree of social
support and employment has direct influence on quality of life.
23. A nurse is orienting to a new position working the infirmary in the state penitentiary.
When working with prisoners who are also mentally ill, the nurse examines her own
attitudes. Which of the following beliefs should the nurse discuss with her supervisor
before caring for incarcerated patients?
A) People with mental illness are inherently violent.
B) The mentally ill can get better treatment in prison than in the community.
C) People with mental illness are more vulnerable to victimization when
incarcerated.
D) Many mentally ill would not be in prison if they were stabilized on medication.
Ans: A
Feedback:
Although it is true that people with major mental illnesses who do not take prescribed
medication are at increased risk for being violent, most people with mental illness do
not represent a significant danger to others. Criminalization of mental illness refers to
the practice of arresting and prosecuting mentally ill offenders, even for misdemeanors,
at a rate four times that of the general population in an effort to contain them in some
type of institution where they might receive needed treatment. People with a mental
illness are more likely to be the victims of violence, both in prisons and in the
community.
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24. The nurse is part of a group setting up a mobile crisis service in conjunction with the
local police department. Community education on which of the following this team will
focus includes?
A) Teaching police officers counseling skills
B) Crisis counseling services to be provided in the prison system
C) Educating about the dangers of the mentally ill in the community
D) Assisting police officers to recognize mental illness
Ans: D
Feedback:
Mobile crisis services are linked to police departments. These professionals are called to
the scene when police officers believe mental health issues are involved. Frequently, the
mentally ill individual can be diverted to crisis counseling services or to the hospital, if
needed, instead of being arrested and going to jail. Often, these same professionals
provide education to police to help them recognize mental illness and perhaps change
their attitude about mentally ill offenders. They do not provide direct counseling
training to police officers.
25. Which of the following are core skill areas that are needed of any effective team
member of an interdisciplinary team? Select all that apply.
A) Interpersonal skills
B) Teamwork skills
C) Communication skills
D) The ability to work independently
E) Risk assessment and risk management skills
Ans: A, B, C, E
Feedback:
The core skill areas that are needed to function as an effective team member of an
interdisciplinary team include interpersonal skills, such as tolerance, patience, and
understanding; humanity, such as warmth, acceptance, empathy, genuineness, and
nonjudgmental attitude; knowledge base about mental disorders, symptoms, and
behavior; communication skills; personal qualities, such as consistency, assertiveness,
and problem-solving abilities; teamwork skills, such as collaborating, sharing, and
integrating; risk assessment and risk management skills. Members of an
interdisciplinary group must work interdependently, not independently.
24. The nurse is part of a group setting up a mobile crisis service in conjunction with the
local police department. Community education on which of the following this team will
focus includes?
A) Teaching police officers counseling skills
B) Crisis counseling services to be provided in the prison system
C) Educating about the dangers of the mentally ill in the community
D) Assisting police officers to recognize mental illness
Ans: D
Feedback:
Mobile crisis services are linked to police departments. These professionals are called to
the scene when police officers believe mental health issues are involved. Frequently, the
mentally ill individual can be diverted to crisis counseling services or to the hospital, if
needed, instead of being arrested and going to jail. Often, these same professionals
provide education to police to help them recognize mental illness and perhaps change
their attitude about mentally ill offenders. They do not provide direct counseling
training to police officers.
25. Which of the following are core skill areas that are needed of any effective team
member of an interdisciplinary team? Select all that apply.
A) Interpersonal skills
B) Teamwork skills
C) Communication skills
D) The ability to work independently
E) Risk assessment and risk management skills
Ans: A, B, C, E
Feedback:
The core skill areas that are needed to function as an effective team member of an
interdisciplinary team include interpersonal skills, such as tolerance, patience, and
understanding; humanity, such as warmth, acceptance, empathy, genuineness, and
nonjudgmental attitude; knowledge base about mental disorders, symptoms, and
behavior; communication skills; personal qualities, such as consistency, assertiveness,
and problem-solving abilities; teamwork skills, such as collaborating, sharing, and
integrating; risk assessment and risk management skills. Members of an
interdisciplinary group must work interdependently, not independently.
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Page 12
26. A patient has been started on antidepressants. The interdisciplinary team member most
responsible for monitoring effectiveness and side effects of this new medication is the
A) pharmacist.
B) psychiatrist.
C) psychiatric nurse.
D) psychologist.
Ans: C
Feedback:
The nurse is also an essential team member in evaluating the effectiveness of medical
treatment, particularly medications. The pharmacist has a working knowledge of
medications but has limited contact with the patient. The primary function of the
psychiatrist is diagnosis of mental disorders and prescription of medical treatments. The
clinical psychologist practices therapy.
27. A patient is encouraged to join in daily outdoor games with peers on the unit. The
interdisciplinary team member who will monitor the patient's involvement will be the
A) occupational therapist.
B) recreation therapist.
C) vocational rehabilitation therapist.
D) psychiatric nurse.
Ans: B
Feedback:
The recreation therapist helps the client to achieve a balance of work and play in his or
her life and provides activities that promote constructive use of leisure or unstructured
time. Occupational therapy focuses on the functional abilities of the client and ways to
improve client functioning. Vocational rehabilitation includes determining clients'
interests and abilities and matching them with vocational choices. The nurse has a solid
foundation in health promotion, illness prevention, and rehabilitation in all areas,
allowing him or her to view the client holistically. The nurse is also an essential team
member in evaluating the effectiveness of medical treatment, particularly medications.
26. A patient has been started on antidepressants. The interdisciplinary team member most
responsible for monitoring effectiveness and side effects of this new medication is the
A) pharmacist.
B) psychiatrist.
C) psychiatric nurse.
D) psychologist.
Ans: C
Feedback:
The nurse is also an essential team member in evaluating the effectiveness of medical
treatment, particularly medications. The pharmacist has a working knowledge of
medications but has limited contact with the patient. The primary function of the
psychiatrist is diagnosis of mental disorders and prescription of medical treatments. The
clinical psychologist practices therapy.
27. A patient is encouraged to join in daily outdoor games with peers on the unit. The
interdisciplinary team member who will monitor the patient's involvement will be the
A) occupational therapist.
B) recreation therapist.
C) vocational rehabilitation therapist.
D) psychiatric nurse.
Ans: B
Feedback:
The recreation therapist helps the client to achieve a balance of work and play in his or
her life and provides activities that promote constructive use of leisure or unstructured
time. Occupational therapy focuses on the functional abilities of the client and ways to
improve client functioning. Vocational rehabilitation includes determining clients'
interests and abilities and matching them with vocational choices. The nurse has a solid
foundation in health promotion, illness prevention, and rehabilitation in all areas,
allowing him or her to view the client holistically. The nurse is also an essential team
member in evaluating the effectiveness of medical treatment, particularly medications.
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Page 13
28. A patient with bipolar disorder taking lithium returns from a walk outside and reports
feeling shaky and dizzy. The nurse suspects the patient is experiencing a toxic reaction
to the lithium and immediately notifies the
A) psychiatrist.
B) psychologist.
C) nurse manager.
D) recreation therapist.
Ans: A
Feedback:
The primary function of the psychiatrist is diagnosis of mental disorders and
prescription of medical treatments. Psychologists participate in the design of therapy
programs for groups of individuals. The nurse is an essential team member in evaluating
the effectiveness of medical treatment particularly medications. The recreation therapist
helps the client to achieve a balance of work and play.
29. A nurse documents that a patient has successfully acquired a job performing janitorial
services at a local manufacturing company. The goal of which of the following levels of
prevention has been achieved?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Community prevention
Ans: C
Feedback:
Nurses work to provide mental health prevention services to reduce risks to the mental
health of persons, families, and communities. Examples include primary prevention,
such as stress management education; secondary prevention, such as early identification
of potential mental health problems; and tertiary prevention, such as monitoring and
coordinating rehabilitation services for the mentally ill.
28. A patient with bipolar disorder taking lithium returns from a walk outside and reports
feeling shaky and dizzy. The nurse suspects the patient is experiencing a toxic reaction
to the lithium and immediately notifies the
A) psychiatrist.
B) psychologist.
C) nurse manager.
D) recreation therapist.
Ans: A
Feedback:
The primary function of the psychiatrist is diagnosis of mental disorders and
prescription of medical treatments. Psychologists participate in the design of therapy
programs for groups of individuals. The nurse is an essential team member in evaluating
the effectiveness of medical treatment particularly medications. The recreation therapist
helps the client to achieve a balance of work and play.
29. A nurse documents that a patient has successfully acquired a job performing janitorial
services at a local manufacturing company. The goal of which of the following levels of
prevention has been achieved?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Community prevention
Ans: C
Feedback:
Nurses work to provide mental health prevention services to reduce risks to the mental
health of persons, families, and communities. Examples include primary prevention,
such as stress management education; secondary prevention, such as early identification
of potential mental health problems; and tertiary prevention, such as monitoring and
coordinating rehabilitation services for the mentally ill.
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30. A psychiatric nurse is planning an educational program addressing primary prevention
strategies in the community. The nurse explores current research regarding which
health-care need?
A) Influencing schizophrenic patients to adhere to medication regimens
B) Assisting high school students to effectively manage stress
C) Coaching patients with depression to obtain employment
D) Teaching parents the early signs of attention deficit disorder in children
Ans: B
Feedback:
Nurses work to provide mental health prevention services to reduce risks to the mental
health of persons, families, and communities. Examples include primary prevention,
such as stress management education; secondary prevention, such as early identification
of potential mental health problems; and tertiary prevention, such as monitoring and
coordinating rehabilitation services for the mentally ill.
31. A psychiatric nurse is planning activities aimed at secondary prevention of mental
illness. Which activity would be most appropriate to develop?
A) Self-esteem building with a local after-school program
B) Social skills training for chronic schizophrenics
C) Parenthood classes at a local community center
D) Depression screening in an assisted living facility
Ans: D
Feedback:
Nurses work to provide mental health prevention services to reduce risks to the mental
health of persons, families, and communities. Examples include primary prevention,
such as stress management education; secondary prevention, such as early identification
of potential mental health problems; and tertiary prevention, such as monitoring and
coordinating rehabilitation services for the mentally ill.
32. Which element would be present in an assertive community treatment (ACT) program?
A) 24-hour-a-day services
B) Infrequent contact with clients
C) Many clients to each staff member
D) Limited length of service
Ans: A
Feedback:
ACT includes a 24-hour-a-day service, many staff members for each client, in-home or
community services, intense and frequent contact, and unlimited length of service.
30. A psychiatric nurse is planning an educational program addressing primary prevention
strategies in the community. The nurse explores current research regarding which
health-care need?
A) Influencing schizophrenic patients to adhere to medication regimens
B) Assisting high school students to effectively manage stress
C) Coaching patients with depression to obtain employment
D) Teaching parents the early signs of attention deficit disorder in children
Ans: B
Feedback:
Nurses work to provide mental health prevention services to reduce risks to the mental
health of persons, families, and communities. Examples include primary prevention,
such as stress management education; secondary prevention, such as early identification
of potential mental health problems; and tertiary prevention, such as monitoring and
coordinating rehabilitation services for the mentally ill.
31. A psychiatric nurse is planning activities aimed at secondary prevention of mental
illness. Which activity would be most appropriate to develop?
A) Self-esteem building with a local after-school program
B) Social skills training for chronic schizophrenics
C) Parenthood classes at a local community center
D) Depression screening in an assisted living facility
Ans: D
Feedback:
Nurses work to provide mental health prevention services to reduce risks to the mental
health of persons, families, and communities. Examples include primary prevention,
such as stress management education; secondary prevention, such as early identification
of potential mental health problems; and tertiary prevention, such as monitoring and
coordinating rehabilitation services for the mentally ill.
32. Which element would be present in an assertive community treatment (ACT) program?
A) 24-hour-a-day services
B) Infrequent contact with clients
C) Many clients to each staff member
D) Limited length of service
Ans: A
Feedback:
ACT includes a 24-hour-a-day service, many staff members for each client, in-home or
community services, intense and frequent contact, and unlimited length of service.
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Subject
Nursing