Varcarolis' Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach 8th Edition Test Bank

Name: Varcarolis' Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach 8th Edition Test Bank
Brand: Academic Documents Platform
Price: 17 USD
Availability: InStock
Author: Claire Mitchell

Ensure success with Varcarolis' Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach 8th Edition Test Bank, an essential exam guide that helps you grasp concepts quickly and effectively.

Claire Mitchell

Contributor

4.1

28 days ago

Preview (16 of 414)

Chapter 01: Mental Health and Mental Illness
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical
Approach, 8th Edition
MULTIPLE CHOICE
1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced
practice nurse to perform which additional intervention?
a. Conduct mental health assessments.
b. Prescribe psychotropic medication.
c. Establish therapeutic relationships.
d. Individualize nursing care plans.
ANS: B
In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and
clinical nurse specialists who have taken special courses on prescribing medication. The nurse
prepared at the basic level is permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-23 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing
skills.” Select the best response by the mental health nurse.
a. “Psychiatric nurses practice in safer environments than other specialties.
Nurse-to-patient ratios must be better because of the nature of the patients’
problems.”
b. “Psychiatric nurses use complex communication skills as well as critical thinking
to solve multidimensional problems. I am challenged by those situations.”
c. “That’s a misconception. Psychiatric nurses frequently use high technology
monitoring equipment and manage complex intravenous therapies.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as
medical–surgical nurses do. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical–surgical
nursing, though there is substantial overlap. Psychiatric nurses must be able to help patients
with medical as well as mental health problems, reflecting the holistic perspective these
nurses must have. Nurse–patient ratios and workloads in psychiatric settings have increased,
just like other specialties. Psychiatric nursing involves clinical practice, not just
documentation. Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2, 21 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with
mental illness, a group of nurses write letters to their elected representatives in opposition to
the legislation. Which role have the nurses fulfilled?

a. Recovery
b. Attending
c. Advocacy
d. Evidence-based practice
ANS: C
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for self. Examples of individual advocacy include helping patients
understand their rights or make decisions. On a community scale, advocacy includes political
activity, public speaking, and publication in the interest of improving the human condition.
Since funding is necessary to deliver quality programming for persons with mental illness, the
letter-writing campaign advocates for that cause on behalf of patients who are unable to
articulate their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-26 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
4. A family has a long history of conflicted relationships among the members. Which family
member’s comment best reflects a mentally healthy perspective?
a. “I’ve made mistakes but everyone else in this family has also.”
b. “I remember joy and mutual respect from our early years together.”
c. “I will make some changes in my behavior for the good of the family.”
d. “It’s best for me to move away from my family. Things will never change.”
ANS: C
The correct response demonstrates the best evidence of a healthy recognition of the
importance of relationships. Mental health includes rational thinking, communication skills,
learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may
be healthy, but the correct response shows a higher level of mental health. The other incorrect
responses show blaming and avoidance.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
5. Which assessment finding most clearly indicates that a patient may be experiencing a mental
illness? The patient
a. reports occasional sleeplessness and anxiety.
b. reports a consistently sad, discouraged, and hopeless mood.
c. is able to describe the difference between “as if” and “for real.”
d. perceives difficulty making a decision about whether to change jobs.
ANS: B
The correct response describes a mood alteration, which reflects mental illness. The distracters
describe behaviors that are mentally healthy or within the usual scope of human experience.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2 to 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was
achieved for an adult patient? The patient
a. sees self as capable of achieving ideals and meeting demands.
b. behaves without considering the consequences of personal actions.
c. aggressively meets own needs without considering the rights of others.
d. seeks help from others when assuming responsibility for major areas of own life.
ANS: A
The correct response describes an adaptive, healthy behavior. The distracters describe
maladaptive behaviors.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2 to 4 TOP: Nursing Process: Evaluation
MSC: Client Needs: Psychosocial Integrity
7. A nurse encounters an unfamiliar psychiatric disorder on a new patient’s admission form.
Which resource should the nurse consult to determine criteria used to establish this diagnosis?
a. International Statistical Classification of Diseases and Related Health Problems
(ICD-10)
b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
d. A behavioral health reference manual
ANS: C
The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline
for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a
psychiatric illness.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-18, 19 TOP: Nursing Process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource
would have the most complete information?
a. Nursing Outcomes Classification (NOC)
b. DSM-V
c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice
d. ICD-10
ANS: B
The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official
guideline for diagnosing psychiatric disorders. The other references are good resources but do
not define the diagnostic criteria.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 1-18, 19 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
9. Which individual is demonstrating the highest level of resilience? One who
a. is able to repress stressors.
b. becomes depressed after the death of a spouse.
c. lives in a shelter for 2 years after the home is destroyed by fire.

d. takes a temporary job to maintain financial stability after loss of a permanent job.
ANS: D
Resilience is closely associated with the process of adapting and helps people facing
tragedies, loss, trauma, and severe stress. It is the ability and capacity for people to secure the
resources they need to support their well-being. Repression and depression are unhealthy.
Living in a shelter for 2 years shows a failure to move forward after a tragedy. See related
audience response question.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-5, 6 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
10. Complete this analogy. NANDA: clinical judgment: NIC: _________________
a. patient outcomes.
b. nursing actions.
c. diagnosis.
d. symptoms.
ANS: B
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis
Association, identifies diagnostic statements regarding human responses to actual or potential
health problems. These statements represent clinical judgments. NIC (Nursing Interventions
Classification) identifies actions provided by nurses that enhance patient outcomes. Nursing
care activities may be direct or indirect.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 1-21, 22 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
11. An adult says, “Most of the time I’m happy and feel good about myself. I have learned that
what I get out of something is proportional to the effort I put into it.” Which number on this
mental health continuum should the nurse select?
Mental Illness Mental Health
1 2 3 4 5
a. 1
b. 2
c. 3
d. 4
e. 5
ANS: E
The adult is generally happy and has an adequate self-concept. The statement indicates the
adult is reality-oriented, works effectively, and has control over own behavior. Mental health
does not mean that a person is always happy.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

12. Which disorder is an example of a culture-bound syndrome?
a. Epilepsy
b. Schizophrenia
c. Running amok
d. Major depressive disorder
ANS: C
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized
by people in those cultures. A syndrome recognized in parts of Southeast Asia is running
amok, in which a person (usually a male) runs around engaging in furious, almost
indiscriminate violent behavior.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-7 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
13. The DSM-V classifies:
a. deviant behaviors.
b. present disability or distress.
c. people with mental disorders.
d. mental disorders people have.
ANS: D
The DSM-V classifies disorders people have rather than people themselves. The terminology
of the tool reflects this distinction by referring to individuals with a disorder rather than as a
“schizophrenic” or “alcoholic,” for example. Deviant behavior is not generally considered a
mental disorder. Present disability or distress is only one aspect of the diagnosis.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 1-18, 19 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
14. A citizen at a community health fair asks the nurse, “What is the most prevalent mental
disorder in the United States?” Select the nurse’s correct response.
a. Schizophrenia
b. Bipolar disorder
c. Dissociative fugue
d. Alzheimer’s disease
ANS: D
The 12-month prevalence for Alzheimer’s disease is 10% for persons older than 65% and
50% for persons older than 85. The prevalence of schizophrenia is 1.1% per year. The
prevalence of bipolar disorder is 2.6%. Dissociative fugue is a rare disorder.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-33 (Table 1-1) TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
15. In the majority culture of the United States, which individual has the greatest risk to be
labeled mentally ill? One who
a. describes hearing God’s voice speaking.
b. is usually pessimistic but strives to meet personal goals.

Loading page 6...

c. is wealthy and gives away $20 bills to needy individuals.
d. always has an optimistic viewpoint about life and having own needs met.
ANS: A
The question asks about risk. Hearing voices is generally associated with mental illness, but in
charismatic religious groups, hearing the voice of God or a prophet is a desirable event.
Cultural norms vary, which makes it more difficult to make an accurate diagnosis. The
individuals described in the other options are less likely to be labeled mentally ill.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 1-3, 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
16. A patient’s relationships are intense and unstable. The patient initially idealizes the significant
other and then devalues him or her, resulting in frequent feelings of emptiness. This patient
will benefit from interventions to develop which aspect of mental health?
a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Fulfilling relationships
ANS: D
The information given centers on relationships with others that are described as intense and
unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially
integrated. Data are not present to describe work effectiveness, communication skills, or
activities.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-32 (Figure 1-1) TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
17. Which belief will best support a nurse’s efforts to provide patient advocacy during a
multidisciplinary patient care planning session?
a. All mental illnesses are culturally determined.
b. Schizophrenia and bipolar disorder are cross-cultural disorders.
c. Symptoms of mental disorders are unchanged from culture to culture.
d. Assessment findings in mental illness reflect a person’s cultural patterns.
ANS: D
Symptoms must be understood in terms of a person’s cultural background. A nurse who
understands that a patient’s symptoms are influenced by culture will be able to advocate for
the patient to a greater degree than a nurse who believes that culture is of little relevance. The
distracters are untrue statements.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-27 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
18. A nurse is part of a multidisciplinary team working with groups of depressed patients. One
group of patients receives supportive interventions and antidepressant medication. The other
group receives only medication. The team measures outcomes for each group. Which type of
study is evident?

Loading page 7...

a. Incidence
b. Prevalence
c. Comorbidity
d. Clinical epidemiology
ANS: D
Clinical epidemiology is a broad field that addresses studies of the natural history (or what
happens if there is no treatment and the problem is left to run its course) of an illness, studies
of diagnostic screening tests, and observational and experimental studies of interventions used
to treat people with the illness or symptoms. Prevalence refers to numbers of new cases.
Comorbidity refers to having more than one mental disorder at a time. Incidence refers to the
number of new cases of mental disorders in a healthy population within a given period. See
related audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-17 TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
19. The spouse of a patient diagnosed with schizophrenia says, “I don’t understand how events
from childhood have anything to do with this disabling illness.” Which response by the nurse
will best help the spouse understand the cause of this disorder?
a. “Psychological stress is the basis of most mental disorders.”
b. “This illness results from developmental factors rather than stress.”
c. “Research shows that this condition more likely has a biological basis.”
d. “It must be frustrating for you that your spouse is sick so much of the time.”
ANS: C
Many of the most prevalent and disabling mental disorders have strong biological influences.
Genetics are only one part of biological factors. Empathy does not address increasing the
spouse’s level of knowledge about the cause of the disorder. The other distracters are not
established facts.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-5, 6 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
20. A category 5 tornado occurred in a community of 400 people. Many homes and businesses
were destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with
posttraumatic stress disorder (PTSD). Which term best applies to these newly diagnosed
cases?
a. Prevalence
b. Comorbidity
c. Incidence
d. Parity
ANS: C

Loading page 8...

Incidence refers to the number of new cases of mental disorders in a healthy population within
a given period of time. Prevalence describes the total number of cases, new and existing, in a
given population during a specific period of time, regardless of when they became ill. Parity
refers to equivalence, and legislation required insurers that provide mental health coverage to
offer annual and lifetime benefits at the same level provided for medical–surgical coverage.
Comorbidity refers to having more than one mental disorder at a time.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-16 TOP: Nursing Process: Planning/Outcomes Identification
MSC: Client Needs: Safe, Effective Care Environment
21. Which component of treatment of mental illness is specifically recognized by Quality and
Safety Education for Nurses (QSEN)?
a. All genomes are unique.
b. Care is centered on the patient.
c. Healthy development is vital to mental health.
d. Recovery occurs on a continuum from illness to health.
ANS: B
The key areas of care promoted by QSEN are patient-centered care, teamwork and
collaboration, evidence-based practice, quality improvement, safety, and informatics.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 1-14 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
22. Select the best response for the nurse to a question from another health professional regarding
the difference between a diagnosis in DSM-V and a nursing diagnosis.
a. “There is no functional difference between the two. Both identify human
disorders.”
b. “The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes
culture into account.”
c. “The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis
does not explore etiology.”
d. “The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis
offers a framework for identifying interventions for issues a patient is
experiencing.”
ANS: D
The medical diagnosis is concerned with the patient’s disease state, causes, and cures,
whereas the nursing diagnosis focuses on the patient’s response to stress and possible caring
interventions. Both tools consider culture. The DSM-V is multiaxial. Nursing diagnoses also
consider potential problems.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 1-21 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
23. Which nursing intervention below is part of the scope of an advanced practice
psychiatric/mental health nurse rather than a basic level registered nurse?
a. Coordination of care

Loading page 9...

b. Health teaching
c. Milieu therapy
d. Psychotherapy
ANS: D
Psychotherapy is part of the scope of practice of an advanced practice nurse. The distracters
are within a basic level registered nurse’s scope of practice.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 1-23, 35 (Table 1-2) TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
MULTIPLE RESPONSE
1. An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you
automatically know how to take care of patients experiencing psychosis.” Which factors
should the new graduate consider when analyzing this comment? (Select all that apply.)
a. The experienced nurse may have lost sight of patients’ individuality, which may
compromise the integrity of practice.
b. New research findings should be integrated continuously into a nurse’s practice to
provide the most effective care.
c. Experience provides mental health nurses with the essential tools and skills needed
for effective professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for mentally ill
patients through trial and error.
e. An intuitive sense of patients’ needs guides effective psychiatric nurses.
ANS: A, B
Evidence-based practice involves using research findings and standards of care to provide the
most effective nursing care. Evidence is continuously emerging, so nurses cannot rely solely
on experience. The effective nurse also maintains respect for each patient as an individual.
Overgeneralization compromises that perspective. Intuition and trial and error are
unsystematic approaches to care.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 1-14 TOP: Nursing Process: Diagnosis/Analysis
MSC: Client Needs: Safe, Effective Care Environment
2. Which findings are signs of a person who is mentally healthy? (Select all that apply.)
a. Says, “I have some weaknesses, but I feel I’m important to my family and friends.”
b. Adheres strictly to religious beliefs of parents and family of origin.
c. Spends all holidays alone watching old movies on television.
d. Considers past experiences when deciding about the future.
e. Experiences feelings of conflict related to changing jobs.
ANS: A, D, E
Mental health is a state of well-being in which each individual is able to realize his or her own
potential, cope with the normal stresses of life, work productively, and make a contribution to
the community. Mental health provides people with the capacity for rational thinking,
communication skills, learning, emotional growth, resilience, and self-esteem.

Loading page 10...

PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. A patient in the emergency department says, “Voices say someone is stalking me. They want
to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a
threat.” Which aspects of the patient’s mental health have the greatest and most immediate
concern to the nurse? (Select all that apply.)
a. Happiness
b. Appraisal of reality
c. Control over behavior
d. Effectiveness in work
e. Healthy self-concept
ANS: B, C, E
The aspects of mental health of greatest concern are the patient’s appraisal of and control over
behavior. The appraisal of reality is inaccurate. There are auditory hallucinations, delusions of
persecution, and delusions of grandeur. In addition, the patient’s control over behavior is
tenuous, as evidenced by the plan to stab anyone who seems threatening. A healthy
self-concept is lacking, as evidenced by the delusion of grandeur. Data are not present to
suggest that the other aspects of mental health (happiness and effectiveness in work) are of
immediate concern.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 1-3, 4 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

Loading page 11...

Chapter 02: Theories and Therapies
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach,
8th Edition
MULTIPLE CHOICE
1. A parent says, “My 2-year-old child refuses toilet training and shouts ‘No!’ when given
directions. What do you think is wrong?” Select the nurse’s best reply.
a. “Your child needs firmer control. It is important to set limits now.”
b. “This is normal for your child’s age. The child is striving for independence.”
c. “There may be developmental problems. Most children are toilet trained by age 2.”
d. “Some undesirable attitudes are developing. A child psychologist can help you
develop a plan.”
ANS: B
This behavior is conventional of a child around the age of 2 years, whose developmental
task is to develop autonomy. The distracters indicate the child’s behavior is abnormal.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 2-52 (Table 2-6) TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
2. A nurse wants to find information on current evidence-based research, programs, and
practices regarding mental illness and addictions. Which resource should the nurse consult?
a. American Psychiatric Association
b. American Psychological Association (APA)
c. Clinician’s Quick Guide to Interpersonal Psychotherapy
d. Substance Abuse and Mental Health Services Administration (SAMHSA)
ANS: D
The SAMHSA maintains a National Registry of Evidence-based Practices and Programs.
New therapies are entered into the database on a regular basis. The incorrect responses are
resources but do not focus on evidence-based information.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 2-32 TOP: Nursing Process: Planning
MSC: Client Needs: Management of Care
3. A 26-month-old displays negative behavior, refuses toilet training, and often says, “No!”
Which psychosocial crisis is evident?
a. Trust versus mistrust
b. Initiative versus guilt
c. Industry versus inferiority
d. Autonomy versus shame and doubt
ANS: D

Loading page 12...

The crisis of autonomy versus shame and doubt relates to the developmental task of gaining
control of self and environment, as exemplified by toilet training. This psychosocial crisis
occurs during the period of early childhood. Trust versus mistrust is the crisis of the infant.
Initiative versus guilt is the crisis of the preschool and early-school-aged child. Industry
versus inferiority is the crisis of the 6- to 12-year-old child.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 2-52 (Table 2-6) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
4. A 4-year-old grabs toys from other children and says, “I want that now!” From a
psychoanalytic perspective, this behavior is a product of impulses originating in which
system of the personality?
a. Id
b. Ego
c. Superego
d. Preconscious
ANS: A
The id operates on the pleasure principle, seeking immediate gratification of impulses. The
ego acts as a mediator of behavior and weighs the consequences of the action, perhaps
determining that taking the toy is not worth the mother’s wrath. The superego would oppose
the impulsive behavior as “not nice.” The preconscious is a level of awareness rather than an
aspect of personality.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 2-4, 5 TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
5. The parent of a 4-year-old rewards and praises the child for helping a sibling, being polite,
and using good manners. These qualities are likely to be internalized and become part of
which system of the personality?
a. Id
b. Ego
c. Superego
d. Preconscious
ANS: C
The superego contains the “shoulds,” or moral standards internalized from interactions with
significant others. Praise fosters internalization of desirable behaviors. The id is the center
of basic instinctual drives, and the ego is the mediator. The ego is the problem-solving and
reality-testing portion of the personality that negotiates solutions with the outside world.
The preconscious is a level of awareness from which material can be retrieved easily with
conscious effort. This item relates to an audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 2-4, 5 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance

Loading page 13...

6. A nurse supports a parent for praising a child who behaves in helpful ways to others. When
this child behaves with politeness and helpfulness in adulthood, which feeling will most
likely result?
a. Guilt
b. Anxiety
c. Humility
d. Self-esteem
ANS: D
The individual will be living up to the ego ideal, which will result in positive feelings about
self. The other options are incorrect because each represents a negative feeling.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 2-4, 5 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
7. An adult says, “I never know the answers,” and “My opinion does not count.” Which
psychosocial crisis was unsuccessfully resolved for this adult?
a. Initiative versus guilt
b. Trust versus mistrust
c. Autonomy versus shame and doubt
d. Generativity versus self-absorption
ANS: C
These statements show severe self-doubt, indicating that the crisis of gaining control over
the environment was not met successfully. Unsuccessful resolution of the crisis of initiative
versus guilt results in feelings of guilt. Unsuccessful resolution of the crisis of trust versus
mistrust results in poor interpersonal relationships and suspicion of others. Unsuccessful
resolution of the crisis of generativity versus self-absorption results in self-absorption that
limits the ability to grow as a person.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 2-52 (Table 2-6) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
8. Which statement by a patient would lead the nurse to suspect unsuccessful completion of the
psychosocial developmental task of infancy?
a. “I know how to do things right, so I prefer jobs where I work alone rather than on a
team.”
b. “I do not allow other people to truly get to know me.”
c. “I depend on frequent praise from others to feel good about myself.”
d. “I usually need to do things several times before I get them right.”
ANS: B
According to Erikson, the developmental task of infancy is the development of trust. The
correct response is the only statement clearly showing lack of ability to trust others. An
inability to work with others, coupled with a sense of superiority, suggests unsuccessful
completion of the task of intimacy versus isolation. Relying on praise from others suggests
unsuccessful completion of the task of identity versus role confusion. Shame suggests
failure to resolve the crisis of initiative versus guilt.

Loading page 14...

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Pages 2-28, 29, 52 (Table 2-6) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
9. A patient is suspicious and frequently manipulates others. To which psychosexual stage do
these traits relate?
a. Oral
b. Anal
c. Phallic
d. Genital
ANS: A
The behaviors in the stem develop as the result of attitudes formed during the oral stage,
when an infant first learns to relate to the environment. Anal-stage traits include stinginess,
stubbornness, orderliness, or their opposites. Phallic-stage traits include flirtatiousness,
pride, vanity, difficulty with authority figures, and difficulties with sexual identity.
Genital-stage traits include the ability to form satisfying sexual and emotional relationships
with members of the opposite sex, emancipation from parents, a strong sense of personal
identity, or the opposites of these traits.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Pages 2-4, 5, 40 (Table 2-1) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
10. A patient expresses a desire to be cared for by others and often behaves in a helpless
fashion. Which stage of psychosexual development is most relevant to the patient’s needs?
a. Latency
b. Phallic
c. Anal
d. Oral
ANS: D
Fixation at the oral stage sometimes produces dependent infantile behaviors in adults.
Latency fixations often result in difficulty identifying with others and developing social
skills, resulting in a sense of inadequacy and inferiority. Phallic fixations result in having
difficulty with authority figures and poor sexual identity. Anal fixation sometimes results in
retentiveness, rigidity, messiness, destructiveness, and cruelty. This item relates to an
audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 2-40 (Table 2-1) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
11. A nurse listens to a group of recent retirees. One says, “I volunteer with Meals on Wheels,
coach teen sports, and do church visitation.” Another laughs and says, “I’m too busy taking
care of myself to volunteer to help others.” Which psychosocial developmental task do these
statements contrast?
a. Trust and mistrust
b. Intimacy and isolation

Loading page 15...

c. Industry and inferiority
d. Generativity and self-absorption
ANS: D
Both retirees are in middle adulthood, when the developmental crisis to be resolved is
generativity versus self-absorption. One exemplifies generativity; the other embodies
self-absorption. This developmental crisis would show a contrast between relating to others
in a trusting fashion and being suspicious and lacking trust. Failure to negotiate this
developmental crisis would result in a sense of inferiority or difficulty learning and working
as opposed to the ability to work competently. Behaviors that would be contrasted would be
emotional isolation and the ability to love and commit oneself.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 2-52 (Table 2-6) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
12. An adult dies in a tragic accident. Afterward, the siblings plan a funeral service. Which
statement by a sibling best indicates a sense of self-actualization?
a. “Of all of us, I am the most experienced with planning these types of events.”
b. “Funerals are supposed to be conducted quietly, respectfully, and according to a
social protocol.”
c. “This death was unfair but I hope we can plan a service that everyone feels is a
celebration of life.”
d. “This death was probably the consequence of years of selfish and inconsiderate
behavior by our sibling.”
ANS: C
The correct response shows an accurate perception of reality as well as a focus on solving
the problem in a way that involves others. These factors are characteristic of
self-actualization. The incorrect responses demonstrate self-centeredness, rigidity, and
blaming which are characteristic of a failure to achieve self-actualization.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 2-24, 62 (Box 2-1) TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
13. A student nurse says, “I don’t need to interact with my patients. I learn what I need to know
by observation.” An instructor can best interpret the nursing implications of Sullivan’s
theory to this student by responding:
a. “Interactions are required in order to help you develop therapeutic communication
skills.”
b. “Nurses cannot be isolated. We must interact to provide patients with opportunities
to practice interpersonal skills.”
c. “Observing patient interactions will help you formulate priority nursing diagnoses
and appropriate interventions.”
d. “It is important to pay attention to patients’ behavioral changes, because these
signify adjustments in personality.”
ANS: B

Loading page 16...

15 more pages available. Scroll down to load them.

Preview Mode

100%

Study Now!

XY-Copilot AI

Unlimited Access

Secure Payment

Instant Access

24/7 Support

Document Chat

Document Details

Subject

Nursing

Varcarolis' Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach 8th Edition Test Bank

Study Now!

Document Details

Related Documents

Varcarolis's Canadian Psychiatric Mental Health Nursing, Canadian Edition, 1st Edition Class Notes

Test Bank For Varcarolis' Foundations Of Psychiatric Mental Health Nursing: A Clinical Approach, 7th Edition

Test Bank for Varcarolis' Foundations of Psychiatric-Mental Health Nursing, 9th Edition (Chapters 1-36)

RN Nutrition Online Practice 2023 B Remediation

Nasm CPT Final Exam Study Guide

Understanding the Patient's Chart

The Evolution of Nursing Science: Key Theories and Their Impact on Patient Care

Pediatric Gastrointestinal Disorders: Pathophysiology, Clinical Manifestations, Treatments, and Nursing Management

NUR/443 Cost and Effects of Performance Feedback and Nurse Case Management

NRS-427V Week 2 Epidemiology Paper

Company

Explore

Study Tools