€ 10.99

Essentials_of_Psychiatric_Mental_Health_Nursing_4th_Edition_Varcarolis_Nursing_Test_Banks/LATEST UPDATE

WWW.THENURSINGMASTERY.COM
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient
living in the community and diagnosed with serious and persistent mental illness? Within 3
months, the patient will demonstrate what behavior?
a. Denying suicidal ideation
b. Reporting a sense of well-being
c. Taking medications as prescribed
d. Attending clinic appointments on time
ANS: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving
role performance. The goal of recovery is to empower the individual with mental illness to
achieve a sense of meaning and satisfaction in life and to function at the highest possible level
of wellness. The incorrect options focus on the classic medical model rather than recovery.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Outcomes Identification
MSC: NCLEX: Health Promotion and Maintenance
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a
divorce. Select the nurse’s most caring comment.
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
b. “I understand why you’re so depressed. When I got divorced, I was devastated
too.”
c. “You should forget about your marriage and move on with your life.”
d. “How did you get so depressed that hospitalization was necessary?”
ANS: A
The nurse’s communication should evidence caring and a commitment to work with the
patient. This commitment lets the patient know the nurse will help. Probing and advice are not
helpful for therapeutic interventions.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
3. In the shift-change report, an off-going nurse criticizes a patient who wears extremely heavy
makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
d. “Our patients need our help to learn behaviors that will help them get along in
society.”
ANS: D
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
Nursing
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
Approach to Evidence-Based Care, 4th Edition
WWW.THENURSINGMASTERY.COM
Accepting patients’ needs for self-expression and seeking to teach skills that will contribute to
their well-being demonstrate respect and are important parts of advocacy. The on-coming
nurse needs to take action to ensure that others are not prejudiced against the patient. Humor
can be appropriate within the privacy of a shift report but not at the expense of respect for
patients. Judging the off-going nurse in a critical way will create conflict. Nurses must show
compassion for each other.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which
statement is an example of “attending”?
a. “We all have stress in life. Being in a psychiatric hospital is not the end of the
world.”
b. “Tell me why you felt you had to be hospitalized to receive treatment for your
depression.”
c. “You will feel better after we get some antidepressant medication started for you.”
d. “I’d like to sit with you for a while, so you may feel more comfortable talking with
me.”
ANS: D
Attending is a technique that demonstrates the nurse’s commitment to the relationship and
reduces feelings of isolation. This technique shows respect for the patient and demonstrates
caring. Generalizations, probing, and false reassurances are nontherapeutic.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
5. A patient shows the nurse an article from the Internet about a health problem. Which
characteristic of the website’s address most alerts the nurse that the site may have biased and
prejudiced information?
a. Address ends in “.org.”
b. Address ends in “.com.”
c. Address ends in “.gov.”
d. Address ends in “.net.”
ANS: B
Financial influences on a site are a clue that the information may be biased. “.com” at the end
of the address indicates that the site is a commercial one. “.gov” indicates that the site is
maintained by a government entity. “.org” indicates that the site is nonproprietary; the site
may or may not have reliable information, but it does not profit from its activities. “.net” can
have multiple meanings.
DIF: Cognitive Level: Comprehension (Understanding) TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
6. A nurse says, “When I was in school, I learned to call upset patients by name to get their
attention; however, I read a descriptive research study that says that this approach does not
work. I plan to stop calling patients by name.” Which statement is the best appraisal of this
nurse’s comment?
a. One descriptive research study rarely provides enough evidence to change practice.
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
b. Staff nurses apply new research findings only with the help from clinical nurse
specialists.
c. New research findings should be incorporated into clinical algorithms before using
them in practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not
change.
ANS: A
Descriptive research findings provide evidence for practice but must be viewed in relation to
other studies before practice changes. One study is not enough. Descriptive studies are low on
the hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do not
specify one response to a clinical problem. Classic tenets of practice should change as
research findings provide evidence for change.
DIF: Cognitive Level: Analysis (Analyzing) TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
7. Two nursing students discuss career plans after graduation. One student wants to enter
psychiatric nursing. The other student asks, “Why would you want to be a psychiatric nurse?
All they do is talk. You will lose your skills.” Select the best response by the student
interested in psychiatric nursing.
a. “Psychiatric nurses’ practice in safer environments than other specialties and
nurse-to-patient ratios are better because of the nature of patients’ problems.”
b. “Psychiatric nurses use complex communication skills, as well as critical thinking,
to solve multidimensional problems. I’m challenged by those situations.”
c. “I think I will be good in the mental health field. I do not like clinical rotations in
school, so I do not want to continue them after I graduate.”
d. “Psychiatric nurses do not have to deal with as much pain and suffering as
medical-surgical nurses. That appeals to me.”
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical-surgical
nursing, although substantial overlap does exist. Psychiatric nurses must be able to help
patients with medical and mental health problems, reflecting the holistic perspective these
nurses must have. Nurse–patient ratios and workloads in psychiatric settings have increased,
similar to other specialties. Psychiatric nursing involves clinical practice, not simply
documentation. Psychosocial pain is real and can cause as much suffering as physical pain.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
8. Which research evidence would most influence a group of nurses to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway
ANS: B
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
Research findings are graded using a hierarchy of evidence. A systematic review of
randomized controlled trials is level A and provides the strongest evidence for changing
practice. Expert committee recommendations and descriptive studies lend less powerful and
influential evidence. A critical pathway is not evidence; it incorporates research findings after
they have been analyzed.
DIF: Cognitive Level: Comprehension (Understanding) TOP: Nursing Process: Planning
MSC: NCLEX: Safe, Effective Care Environment
9. A bill introduced in Congress would reduce funding for the care of people diagnosed with
mental illnesses. A group of nurses write letters to their elected representatives in opposition
to the legislation. Which role have the nurses fulfilled?
a. Advocacy
b. Attending
c. Recovery
d. Evidence-based practice
ANS: A
An advocate defends or asserts another’s cause, particularly when the other person lacks the
ability to do that for him or herself. 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 individuals with
mental illness; the letter-writing campaign advocates for that cause on behalf of patients who
are unable to articulate their own needs.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
10. An informal group of patients discuss their perceptions of nursing care. Which comment best
indicates a patient’s perception that his or her nurse is caring?
a. “My nurse always asks me which type of juice I want to help me swallow my
medication.”
b. “My nurse explained my treatment plan to me and asked for my ideas about how to
make it better.”
c. “My nurse told me that if I take all the medicines the doctor prescribes, I will get
discharged soon.”
d. “My nurse spends time listening to me talk about my problems. That helps me feel
like I’m not alone.”
ANS: D
Caring evidences empathic understanding as well as competency. It helps change pain and
suffering into a shared experience, creating a human connection that alleviates feelings of
isolation. The incorrect options give examples of statements that demonstrate advocacy or
giving advice.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Evaluation
MSC: NCLEX: Psychosocial Integrity
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
11. A patient who immigrated to the United States from Honduras was diagnosed with
schizophrenia. The patient took an antipsychotic medication for 3 weeks but showed no
improvement. Which resource should the treatment team consult for information on more
effective medications for this patient?
a. Clinical algorithm
b. Clinical pathway
c. Clinical practice guideline
d. International Statistical Classification of Diseases and Related Health Problems
(ICD)
ANS: A
A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches
drawn from large databases of information. These guidelines help the treatment team make
decisions cognizant of an individual patient’s needs, such as ethnic origin, age, or gender. A
clinical pathway is a map of interventions and treatments related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The ICD
classifies diseases.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Evaluation
MSC: NCLEX: Safe, Effective Care Environment
12. A team of nurses wants to integrate evidence-based practice into a facility’s clinical pathways.
Which step should the team implement first?
a. Acquire findings from published literature.
b. Apply the research findings to clinical practice.
c. Assess the outcomes of using new research findings.
d. Ask questions to identify clinical problems that should be changed.
ANS: D
Integrating evidence-based practice is a multistep process rather than a single change event.
The first step is to identify clinical problems that should be changed. Each step must proceed
in order when integrated into a clinical environment.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Planning
MSC: NCLEX: Safe, Effective Care Environment
13. A nurse consistently strives to demonstrate caring behaviors during interactions with patients.
Which reaction reported by a patient indicates this nurse is most effective?
a. Feeling less distrustful of others
b. Sensing a connection with others
c. Experiencing only minimal uneasiness about the future
d. Being somewhat encouraged with efforts to improve
ANS: B
A patient is likely to respond most to caring with a sense of connectedness with others. The
absence of caring can make patients feel some degree of distrustful, disconnection, unease,
and discouragement.
DIF: Cognitive Level: Comprehension (Understanding) TOP: Nursing Process: Evaluation
MSC: NCLEX: Psychosocial Integrity
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
MULTIPLE RESPONSE
1. An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you
will instantly know how to take care of psychotic patients.” What is the new graduate’s best
analysis of 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 must be continually integrated into a nurse’s practice to
provide the most effective care.
c. Experience provides mental health nurses with the tools and skills needed for
effective professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for psychotic
patients through trial and error.
e. Effective psychiatric nurses should be continually guided by an intuitive sense of
patients’ needs.
ANS: A, B
Evidence-based practice involves using research findings to provide the most effective
nursing care. Evidence is continually emerging; therefore, 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.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Evaluation
MSC: NCLEX: Safe, Effective Care Environment
2. Which patient statements identify qualities of nursing practice with high therapeutic value?
“My nurse: (Select all that apply.)
a. “The nurses talk in language I can understand.”
b. “The nursing staff helps me keep track of my medications.”
c. “My nurse is willing to go to social activities with me.”
d. “The staff lets me do whatever I choose without interfering.”
e. “My nurses look at me as a whole person with different needs.”
ANS: A, B, E
Each correct answer demonstrates caring is an example of appropriate nursing foci:
communicating at a level understandable to the patient, using holistic principles to guide care,
and providing medication supervision. The incorrect options suggest a laissez-faire attitude on
the part of the nurse when the nurse should instead provide thoughtful feedback and help
patients test alternative solutions or violate boundaries.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
Chapter 02: Mental Health and Mental Illness
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
Approach to Evidence-Based Care, 4th Edition
MULTIPLE CHOICE
1. An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which
statement made by this patient best demonstrates resilience?
a. “I knew this would happen eventually.”
b. “Attending my weekly water aerobics class is too risky.”
c. “I don’t need that silly walker to get around by myself.”
d. “Maybe some physical therapy will help me with my balance.”
ANS: D
Resiliency is the ability to recover from or adjust to misfortune and change. The correct
response indicates that the patient is hopeful and thinking positively about ways to adapt to
the vertigo. Saying “I knew this would happen eventually” and discontinuing healthy
activities suggest a hopeless perspective on the health change. Refusing to use a walker
indicates denial.
DIF: Cognitive Level: Analysis (Analyzing)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
2. Which basic intervention should a psychiatric mental health nurse plan to provide for a patient
diagnosed with a mood disorder?
a. Sharing clinical expertise to enhance patient treatment
b. Performing individual or group psychotherapy for the patient
c. Using appropriate diagnostic tests to monitor patient condition
d. Conducting stress reduction and health maintenance classes
ANS: D
Conducting stress reduction and health maintenance classes is the basic intervention that
should be performed by a psychiatric mental health nurse. These classes will provide
individualized guidance to patients to prevent or reduce mental illness and improve mental
health. Community screenings and stress management classes are examples of health
maintenance classes. Consulting nurses from other disciplines to share clinical expertise and
enhance patient treatment is an advanced practice psychiatric mental health nursing
intervention. Performing individual and group psychotherapy and performing diagnostic tests
like blood pressure, etc., are also advanced practice psychiatric mental health nursing
interventions.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
3. A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that
the patient has a mental illness? The patient:
a. describes coping and relaxation strategies used when feeling anxious.
b. describes mood as consistently sad, discouraged, and hopeless.
c. can perform tasks attempted within the limits of own abilities.
d. reports occasional problems with insomnia.
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
ANS: B
A patient who reports having a consistently negative mood is describing a mood alteration
that affects the ability to function optimistically. The incorrect options describe mentally
healthy behaviors and common problems that do not indicate mental illness.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
4. The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan
of care to be achieved within 3 days?
a. Patient describes feelings associated with loss and stress.
b. Patient meet own needs before considering the rights of others.
c. Patient will identify healthy coping behaviors in response to stressful events.
d. Patient will allow others to assume responsibility for major areas of own life.
ANS: C
The patient’s ability to identify healthy coping behaviors indicates adaptive, healthy behavior
and demonstrates an increased ability to recover from severe stress. Describing feelings
associated with loss and stress does not move the patient toward adaptation. The remaining
options are maladaptive behaviors.
DIF: Cognitive Level: Analysis (Analyzing)
TOP: Nursing Process: Outcomes Identification
MSC: NCLEX: Psychosocial Integrity
5. A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patient’s
insurance form. Which resource should the nurse consult to discern the criteria used to
establish this diagnosis?
a. A psychiatric nursing textbook
b. NANDA International (NANDA-I)
c. A behavioral health reference manual
d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
ANS: D
The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses on
nursing diagnoses. A psychiatric nursing textbook or behavioral health reference manual may
not contain diagnostic criteria.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Analysis | Nursing Process: Diagnosis
MSC: NCLEX: Safe, Effective Care Environment
6. A nurse must assess several new patients at a community mental health center. Conclusions
concerning current functioning should be made on the basis of what factor?
a. The degree of conformity of the individual to society’s norms.
b. The degree to which an individual appears logical and rational.
c. A continuum from mentally healthy to mentally unhealthy.
d. The rate of their intellectual and emotional growth.
ANS: C
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
Because mental health and mental illness are relative concepts, assessment of functioning is
made by using a continuum. Mental health is not based on conformity; some mentally healthy
individuals do not conform to society’s norms. Most individuals occasionally display illogical
or irrational thinking. The rate of intellectual and emotional growth is not the most useful
criterion to assess mental health or mental illness.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Diagnosis | Nursing Process: Analysis
MSC: NCLEX: Psychosocial Integrity
7. A 40-year-old adult living with parents’ states, “I’m happy but I don’t socialize much. My
work is routine. When new things come up, my boss explains them a few times to make sure I
understand. At home, my parents make decisions for me, and I go along with them.” A nurse
should identify interventions to improve which patient characteristic?
a. Self-concept
b. Overall happiness
c. Appraisal of reality
d. Control over behavior
ANS: A
The patient feels the need for multiple explanations of new tasks at work and, despite being 40
years of age, allows both parents to make all decisions. These behaviors indicate a poorly
developed self-concept. Although the patient reports being happy, the subsequent comments
refute that self-appraisal. The patient’s comments do not indicate that he/she is out of touch
with reality. The patient’s needs are broader than control over own behavior.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
8. A patient tells a nurse, “I have psychiatric problems and am in and out of hospitals all the
time. Not one of my friends or relatives has these problems.” What is the nurse’s best
response?
a. “Comparing yourself with others has no real advantages.”
b. “Why do you blame yourself for having a psychiatric illness?”
c. “Mental illness affects 50% of the adult population in any given year.”
d. “Are you are concerned that others don’t experience the same challenges as you.”
ANS: D
Mental illness affects many people at various times in their lives. No class, culture, or creed is
immune to the challenges of mental illness. The correct response also demonstrates the use of
reflection, a therapeutic communication technique. It is not true that mental illness affects
50% of the population in any given year. Asking patients if they blame themselves is an
example of probing.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
9. A critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and a nursing diagnosis.
What is the psychiatric nurse’s best response?
a. “No functional difference exists between the two diagnoses. Both serve to identify
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
a human deviance.”
b. “The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis includes
cultural variables.”
c. “The DSM-5 diagnosis profiles present distress or disability, whereas a nursing
diagnosis considers past and present responses to actual mental health problems.”
d. “The DSM-5 diagnosis influences the medical treatment; the nursing diagnosis
offers a framework to identify interventions for problems a patient has or may
experience.”
ANS: D
The medical diagnosis, defined according to the DSM-5, 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 the DSM-5 and a nursing diagnosis
consider culture. Nursing diagnoses also consider potential problems.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
10. The partner of a patient diagnosed with schizophrenia says, “I don’t understand why
childhood experiences have anything to do with this disabling illness.” Which nurse’s
response will best help the partner understand this condition?
a. “Psychological stress is actually at the root of most mental disorders.”
b. “We now know that all mental illnesses are the result of genetic factors.”
c. “It must be frustrating for you that your spouse is sick so much of the time.”
d. “Research has shown schizophrenia has a biological rather than psychological
origin.”
ANS: D
Many of the most prevalent and disabling mental disorders have been found to have strong
biological influences. Helping the partner understand the importance of his or her role as a
caregiver is also important. Empathy is important but does not increase the spouse’s level of
knowledge about the cause of the patient’s condition. Not all mental illnesses are the result of
genetic factors. Psychological stress is not at the root of most mental disorders.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
11. Which belief by a nurse supports the highest degree of 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 constant from culture to culture.
d. Some symptoms of mental disorders may reflect a person’s cultural patterns.
ANS: D
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. All mental illnesses are not culturally determined. Schizophrenia and bipolar
disorder are cross-cultural disorders, but this understanding has little relevance to patient
advocacy. Symptoms of mental disorders change from culture to culture.
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Planning
MSC: NCLEX: Safe, Effective Care Environment
12. A patient’s history shows intense and unstable relationships with others. The patient initially
idealizes an individual and then devalues the person when the patient’s needs are not met.
Which aspect of mental health is a problem for this patient?
a. Effectiveness in work
b. Communication skills
c. Productive activities
d. Maintaining relationships
ANS: D
The information provided centers on relationships with others, which 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.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
13. In the majority culture of the United States, which individual is at greatest risk to be
incorrectly labeled mentally ill?
a. Person who is usually pessimistic but strives to meet personal goals.
b. Wealthy person who gives $20 bills to needy individuals in the community.
c. Person with an optimistic viewpoint about getting his or her own needs met.
d. Person who expresses strong beliefs about the existence of alien abductions.
ANS: D
Possessing and expressing unpopular or unsubstantiated beliefs often suggests an individual is
mentally unstable. In this situation, cultural norms vary, making it more difficult to make an
accurate DSM-5 diagnosis. The individuals described in the other options are less likely to be
labeled as mentally ill.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
14. A participant at a community education conference asks, “What is the most prevalent type of
mental disorder in the United States?” What is the nurse’s best response?
a. “Why do you ask?”
b. “Schizophrenia”
c. “Affective disorders”
d. “Anxiety disorders”
ANS: D
The prevalence for schizophrenia is 1.1% per year. The prevalence of all affective disorders
(e.g., depression, dysthymic disorder, bipolar) is 9.5%. The prevalence of anxiety disorders is
18.1%.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
15. A nurse wants to find a description of diagnostic criteria for a person diagnosed with
schizophrenia. Which resource should the nurse consult?
a. U.S. Department of Health and Human Services
b. Journal of the American Psychiatric Association
c. North American Nursing Diagnosis Association International (NANDA-I)
d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
ANS: D
The DSM-5 identifies diagnostic criteria for psychiatric diagnoses. The other sources have
useful information but are not the best resources for finding a description of the diagnostic
criteria for a psychiatric disorder.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Analysis | Nursing Process: Diagnosis
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. A patient in the emergency department reports, “I hear voices saying someone is stalking me.
They want to kill me because I found the cure for cancer. I will stab anyone that threatens
me.” Which aspects of mental health have the greatest immediate concern to a 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 patient’s appraisal of reality is inaccurate, and auditory hallucinations are
evident, as well as delusions of persecution and 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. Data are not present to suggest that the other aspects of mental
health (happiness and effectiveness in work) are of immediate concern.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Safe, Effective Care Environment
2. Which statements most clearly reflect the stigma of mental illness? (Select all that apply.)
a. “Many mental illnesses are hereditary.”
b. “Mental illness can be evidence of a brain disorder.”
c. “People claim mental illness, so they can qualify for disability.”
d. “If people with mental illness went to church, they would be fine.”
e. “Mental illness is a result of the breakdown of the American family.”
ANS: C, D, E
Stigma is represented by judgmental remarks that discount the reality and validity of mental
illness. Many mental illnesses are genetically transmitted. Neuroimaging can show changes
associated with some mental illnesses.
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
DIF: Cognitive Level: Analysis (Analyzing)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
Chapter 03: Theories and Therapies
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication
Approach to Evidence-Based Care, 4th Edition
MULTIPLE CHOICE
1. A 26-month-old child displays negative behaviors. The parent says, “My child refuses toilet
training and shouts, ‘No!’ when given direction. What do you think is wrong?” Select the
nurse’s best reply.
a. “This is normal for your child’s age. The child is striving for independence.”
b. “The child needs firmer control. Punish the child for disobedience and say, ‘No.’”
c. “There may be developmental problems. Most children are toilet trained by age 2
years.”
d. “Some undesirable attitudes are developing. A child psychologist can help you
develop a remedial plan.”
ANS: A
These negative behaviors are typical of a child around the age of 2 years whose
developmental task is to develop autonomy. The incorrect options indicate the child’s
behavior is abnormal.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. A 26-month-old child displays negative behavior, refuses toilet training, and often shouts,
“No!” when given directions. Using Freud’s stages of psychosexual development, a nurse
would assess the child’s behavior is based on which stage?
a. Oral
b. Anal
c. Phallic
d. Genital
ANS: B
In Freud’s stages of psychosexual development, the anal stage occurs from age 1 to 3 years
and has, as its focus, toilet training and learning to delay immediate gratification. The oral
stage occurs between birth and 1 year, the phallic stage occurs between 3 and 5 years, and the
genital stage occurs between 13 and 20 years.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
3. A 26-month-old child displays negative behavior, refuses toilet training, and often shouts,
“No!” when given direction. The nurse’s counseling with the parent should be based on the
premise that the child is engaged in which of Erikson’s psychosocial crises?
a. Trust versus Mistrust
b. Initiative versus Guilt
c. Industry versus Inferiority
d. Autonomy versus Shame and Doubt
ANS: D
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
The crisis of Autonomy versus Shame and Doubt is related 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, and
Industry versus Inferiority is the crisis of the 6- to 12-year-old child.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
4. A 4-year-old child grabs toys from siblings, saying, “I want that toy now!” The siblings cry,
and the child’s parent becomes upset with the behavior. Using the Freudian theory, a nurse
can interpret the child’s behavior as a product of impulses originating in the:
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 parent’s wrath. The superego would oppose
the impulsive behavior as “not nice.” The preconscious is a level of awareness.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
5. The parent of a 4 year old rewards and praises the child for helping a younger sibling, being
polite, and using good manners. A nurse supports the use of praise because, according to the
Freudian theory, these qualities will likely be internalized and become what part of the child’s
personality?
a. Id
b. Ego
c. Superego
d. Preconscious
ANS: C
In the Freudian theory, the superego contains the “thou shalts” 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 easily
retrieved with conscious effort.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
6. A nurse supports parental praise of a child who is behaving in a helpful way. When the
individual behaves with politeness and helpfulness in adulthood, which ego ideal will most
likely result?
a. Curiosity
b. Awareness
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
c. Honesty
d. Self-esteem
ANS: D
The individual will be living up to the ego ideal, which will result in positive feelings about
self. None of the other characteristics are as closely associated with the ego.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
7. A patient comments, “I never know the right answer” and “My opinion is not important.”
Using Erikson’s theory, which psychosocial crisis did the patient have difficulty resolving?
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 is not being successfully met. 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.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
8. Which patient statement would lead a nurse to suspect that the developmental task of infancy
was not successfully completed?
a. “I have very warm and close friendships.”
b. “I’m afraid to let anyone really get to know me.”
c. “I am always right and confident about my decisions.”
d. “I’m ashamed that I didn’t do it correctly in the first place.”
ANS: B
According to Erikson, the developmental task of infancy is the development of trust. The
patient’s statement that he or she is afraid of becoming acquainted with others clearly shows a
lack of ability to trust other people. Having warm and close friendships suggests the
developmental task of infancy was successfully completed. Believing one is always right
suggests rigidity rather than mistrust. Feelings of shame suggest failure to resolve the crisis of
Initiative versus Guilt.
DIF: Cognitive Level: Analysis (Analyzing)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
9. A nurse assesses that a patient is suspicious and frequently manipulates others. Using the
Freudian theory, these traits are related to which psychosexual stage?
a. Oral
b. Anal
c. Phallic
d. Genital
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
ANS: A
According to Freud, each of the behaviors mentioned develops 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, and a strong sense
of personal identity.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
10. An adult expresses the wish to be taken care of and often behaves in a helpless fashion. This
adult has needs related to which of Freud’s stages of psychosexual development?
a. Latency
b. Phallic
c. Anal
d. Oral
ANS: D
According to Freud, fixation at the oral stage sometimes produces dependent infantile
behaviors in adults. Latency fixations often result in a 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.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: 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. I don’t have time to help others.” These comments contrast which
developmental tasks?
a. Trust versus Mistrust
b. Industry versus Inferiority
c. Intimacy versus Isolation
d. Generativity versus 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. The developmental crisis of Trust versus Mistrust would show a contrast
between relating to others in a trusting fashion and being suspicious and lacking trust. Failure
to negotiate the developmental crisis of Industry versus Inferiority 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 in the crisis of Intimacy versus Isolation would be
emotional isolation and the ability to love and commit to oneself.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
12. Cognitive behavioral therapy was provided for a patient who frequently said, “I’m stupid.”
Which statement by the patient indicates the therapy was effective?
a. “I’m disappointed in my lack of ability.”
b. “I always fail when I try new things.”
c. “Things always go wrong for me.”
d. “Sometimes I do stupid things.”
ANS: D
“I’m stupid” is a cognitive distortion or irrational thought. A more rational thought is,
“Sometimes I do stupid things.” The latter thinking promotes emotional self-control. The
incorrect options reflect irrational thinking.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Evaluation
MSC: NCLEX: Psychosocial Integrity
13. A student nurse tells the instructor, “I don’t need to interact with my patients. I learn what I
need to know by observation.” The instructor can best interpret the nursing implications of
Sullivan’s theory by providing what response?
a. “Nurses cannot be isolated. We must interact to provide patients with opportunities
to practice interpersonal skills.”
b. “Observing patient interactions can help you formulate priority nursing diagnoses
and appropriate interventions.”
c. “I wonder how accurate your assessment of the patient’s needs can be if you do not
interact with the patient.”
d. “Noting patient behavioral changes is important because these signify changes in
personality.”
ANS: A
Sullivan believed that the nurse’s role includes educating patients and assisting them in
developing effective interpersonal relationships. Mutuality, respect for the patient,
unconditional acceptance, and empathy are cornerstones of Sullivan’s theory. The nurse who
does not interact with the patient cannot demonstrate these cornerstones. Observations provide
only objective data. Priority nursing diagnoses usually cannot be accurately established
without subjective data from the patient. The third response pertains to Maslow’s theory. The
fourth response pertains to behavioral theory.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
14. A psychiatric technician says, “Little of what takes place on the behavioral health unit seems
to be theory based.” A nurse educates the technician by identifying which common use of
Sullivan’s theory?
a. Structure of the therapeutic milieu of most behavioral health units
b. Frequent use of restraint and seclusion for behavior modification
c. Assessment tools based on age-appropriate versus arrested behaviors
d. Use of the nursing process to determine the best sequence for nursing actions
ANS: A
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
The structure of the therapeutic environment has, as its foci, an accepting atmosphere and
provision of opportunities for practicing interpersonal skills. Both constructs are directly
attributable to Sullivan’s theory of interpersonal relationships. Sullivan’s interpersonal theory
did not specifically consider the use of restraint or seclusion. Assessment based on the
developmental level is associated with Erikson’s theories. The nursing process applies
concepts from multiple theories.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
15. A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem
will receive priority?
a. Refuses to eat or bathe.
b. Reports feelings of alienation from family.
c. Is reluctant to participate in unit social activities.
d. Needs to be taught about medication action and side effects.
ANS: A
The need for food and hygiene is physiological and therefore takes priority over psychological
or meta-needs in care planning.
DIF: Cognitive Level: Analysis (Analyzing) TOP: Nursing Process: Planning
MSC: NCLEX: Safe, Effective Care Environment
16. Operant conditioning will be used to encourage speech in a child who is nearly mute. Which
technique would a nurse include in the treatment plan?
a. Ignore the child for using silence.
b. Have the child observe others talking.
c. Give the child a small treat for speaking.
d. Teach the child relaxation techniques, then coax speech.
ANS: C
Operant conditioning involves giving positive reinforcement for a desired behavior. Treats are
rewards to reinforce speech. Ignoring the child will not change the behavior. Having the child
observe others describes modeling. Teaching relaxation techniques and then coaxing speech is
an example of systematic desensitization.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
17. The parent of a child diagnosed with schizophrenia tearfully asks a nurse, “What could I have
done differently to prevent this illness?” Select the nurse’s most caring response.
a. “Although schizophrenia is caused by impaired family relationships, try not to feel
guilty. No one can predict how a child will respond to parental guidance.”
b. “Most of the damage is done, but there is still hope. Changing your parenting style
can help your child learn to cope more effectively with the environment.”
c. “Schizophrenia is a biological illness with similarities to diabetes and heart
disease. You are not to blame for your child’s illness.”
d. “Most mental illnesses result from genetic inheritance. Your genes are more at
fault than your parenting.”
ANS: C
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
Patients and families need reassurance that the major mental disorders are biological in origin
and are not the “fault” of parents. Knowing the biological nature of the disorder relieves
feelings of guilt over being responsible for the illness. The incorrect responses are neither
wholly accurate nor reassuring; they fall short of being reassuring and place the burden of
having faulty genes on the shoulders of the parents.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
18. A nurse uses Peplau’s interpersonal therapy while working with an anxious, withdrawn
patient. What should the focus of the interventions be?
a. Changing the patient’s perceptions about self
b. Improving the patient’s interactional skills
c. Using medications to relieve anxiety
d. Reinforcing specific behaviors
ANS: B
The nurse–patient relationship is structured to provide a model for adaptive interpersonal
relationships that can be generalized to others. Changing the patient’s perceptions about hisor herself would be appropriate for cognitive therapy. Reinforcing specific behaviors would
be used in behavioral therapy. Using medications is the focus of biological therapy.
DIF: Cognitive Level: Application (Applying) TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
19. A patient underwent psychotherapy weekly for 3 years. The therapist used free association,
dream analysis, and facilitated transference to help the patient understand unconscious
processes and foster personality changes. Which type of therapy was used?
a. Short-term dynamic psychotherapy
b. Transactional analysis
c. Cognitive therapy
d. Psychoanalysis
ANS: D
The therapy described is traditional psychoanalysis. Short-term dynamic psychotherapy would
last less than 1 year. Neither transactional analysis nor cognitive therapy makes use of the
techniques described.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
20. An advanced practice nurse determines that a group of patients would benefit from
opportunities to practice appropriate social behaviors and learn about basic living skills. The
nurse would arrange for what form of therapy?
a. Milieu therapy
b. Cognitive therapy
c. Short-term dynamic therapy
d. Systematic desensitization
ANS: A
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
Milieu therapy provides an opportunity for all members of the environment to contribute to
the planning and functioning of the setting, practice social behaviors in a safe setting, and gain
knowledge in basic living skills. The other therapies are all individual therapies that do not fit
the description.
DIF: Cognitive Level: Comprehension (Understanding) TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
21. A nurse psychotherapist works with an anxious, dependent patient. What therapeutic strategy
is most consistent with the framework of psychoanalytic psychotherapy?
a. Emphasizing medication compliance
b. Identifying the patient’s strengths and assets
c. Offering psychoeducational materials and groups
d. Focusing on feelings developed by the patient toward the nurse
ANS: D
Positive or negative feelings of the patient toward the nurse or therapist represent transference.
Transference is a psychoanalytic concept that can be used to explore previously unresolved
conflicts. Emphasizing medication compliance is more related to biological therapy.
Identifying patient strengths and assets would be consistent with supportive psychotherapy.
The use of psychoeducational materials is a common “homework” assignment used in
cognitive therapy.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
22. A person tells a nurse, “I was the only survivor in a small plane crash, but three business
associates died. I got anxious and depressed and saw a counselor three times a week for a
month. We talked about my feelings related to being a survivor, and now I am at peace with
the situation.” Which type of therapy was used?
a. Milieu therapy
b. Psychoanalysis
c. Behavior modification
d. Interpersonal therapy
ANS: D
Interpersonal therapy returns the patient to the former level of functioning by helping the
patient come to terms with the loss of friends and guilt over being a survivor. Milieu therapy
refers to environmental therapy. Psychoanalysis calls for a long period of exploration of
unconscious material. Behavior modification focuses on changing a behavior rather than
helping the patient understand what is going on in his or her life.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
23. What cognitive strategy should a nurse use to assist a very dependent patient achieve
independence?
a. Reveal dream content.
b. Take prescribed medications.
c. Examine thoughts about being autonomous.
d. Role model ways to ask for help from others.
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
ANS: C
Cognitive theory suggests that one’s thought processes are the basis of emotions and behavior.
Changing faulty learning makes the development of new adaptive behaviors possible.
Revealing dream content would be used in psychoanalytical therapy. Taking prescribed
medications is an intervention associated with biological therapy. A dependent patient needs
to develop independence.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
24. A single parent is experiencing feelings of inadequacy related to work and family since one
teenaged child ran away several weeks ago. The parent seeks the help of a therapist
specializing in cognitive therapy. The psychotherapist who uses cognitive therapy will
introduce what intervention?
a. Discussing ego states
b. Focusing on unconscious mental processes
c. Negatively reinforcing an undesirable behavior
d. Helping the patient identify and change faulty thinking
ANS: D
Cognitive therapy emphasizes the importance of changing erroneous ways people think about
themselves. Once faulty thinking changes, the individual’s behavior changes. Focusing on
unconscious mental processes is a psychoanalytic approach. Negatively reinforcing
undesirable behaviors is behavior modification and discussing ego states relates to
transactional analysis.
DIF: Cognitive Level: Comprehension (Understanding)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
25. A person received an invitation to be in the wedding of a friend who lives across the country.
The individual is afraid of flying. What type of therapy should the nurse recommend?
a. Psychoanalysis
b. Milieu therapy
c. Systematic desensitization
d. Short-term dynamic therapy
ANS: C
Systematic desensitization is a type of therapy aimed at extinguishing a specific behavior,
such as the fear of flying. Psychoanalysis and short-term dynamic therapy are aimed at
uncovering conflicts. Milieu therapy involves environmental factors.
DIF: Cognitive Level: Analysis (Analyzing) TOP: Nursing Process: Planning
MSC: NCLEX: Psychosocial Integrity
MULTIPLE RESPONSE
1. A basic level registered nurse works with patients in a community setting. Which groups
should this nurse expect to lead? (Select all that apply.)
a. Symptom management
b. Medication education
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
abirb.com/test
WWW.NURSYLAB.COM
WWW.THENURSINGMASTERY.COM
c. Family therapy
d. Psychotherapy
e. Self-care
ANS: A, B, E
Symptom management, medication education, and self-care groups represent
psychoeducation, a service provided by the basic level registered nurse. Advanced practice
registered nurses provide family therapy and psychotherapy.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. A patient states, “I’m starting cognitive behavioral therapy. What can I expect from the
sessions?” Which responses by the nurse are appropriate? (Select all that apply.)
a. “The therapist will be active and questioning.”
b. “You may be given homework assignments.”
c. “The therapist will ask you to describe your dreams.”
d. “The therapist will help you look at ideas and beliefs you have about yourself.”
e. “The goal is to increase your subjectivity about thoughts that govern your
behavior.”
ANS: A, B, D
Cognitive therapists are active rather than passive during therapy sessions because they help
patients to reality test their thinking. Homework assignments are given and completed outside
the therapy sessions. Homework is usually discussed at the next therapy session. The goals of
cognitive therapy are to assist the patient to identify inaccurate cognitions, to reality test their
thinking, and to formulate new, accurate cognitions. Dream describing applies

Preview document (3 of 294 pages)

Unlock document

Download all 294 pages for € 10,99

Add document to cart
Report document Report document

€ 10,99

Add document to cart
  • check Money back guarantee
  • check Documents can be downloaded immediately
  • check € 0,50 discount when paying with balance

Specifications

Seller

TestMania℃

88 documents uploaded


QUALITY WORK OF ALL KIND OF QUIZ or EXAM WITH GUARANTEE OF AN A

Earn from your summaries?

icon 2

Do you make summaries or do you have any completed assignments? Upload your documents to Knoowy and earn money.

Upload document

Subjects of Healthcare - Open University

More Healthcare ›

applied pathophysiology a conceptual approach to the mechanisms of disease 3rd edition braun test bank burns pediatric primary care 7th edition all chapters complete test bank cherry & jacob contemporary nursing issues, trends, and management, 7th edition chapter 15-28 current medical diagnosis and treatment 2020 testbank -studyguide edelman health promotion throughout the life span, 8th edition chapter 1-25 essentials_of_psychiatric_mental_health_nursing_4th_edition_varcarolis_nursing_test_banks.pdf (1) examination questions and answers in basic anatomy and physiology martin caon focus on nursing pharmacology 8th edition karch test bank all chapters covered 2021 foundations of maternity, women’s health, and child health nursing test bank allcomplete chapters healthcare - nursing hesi rn exit hesi rn exit exam v4 hesi rn exit v3 hesi rn fundamentals exam hesi- fundamentals of nursing (basics of nursing practice) +400 questions & answers everything you need to pass the exams and earn your highest score. human body in health and illness 6th edition herlihy test bank (latest edition 2021) international financial management test bank introductory maternity and pediatric nursing 4th edition hatfield test bank journey across the life span 6th edition polan test bank lilley pharmacology and the nursing process 7th edition marieb-essentials-of-human-anatomy-physiology-10th-test-bank/ latest update medical imaging physics pharmacology nextgen exam psychology test bank for nursing research in canada: methods, critical appraisal, and utilization, 4th edition lobiondo-wood isbn: 9781771720984 More Healthcare ›

Log in via e-mail
New password
Subscribe via e-mail
Sign up via Facebook
Shopping cart

Deal: get 10% off when you purchase 3 or more items!

Deal: get 10% off when you purchase 3 or more items!

[Inviter] gives you € 2.50 to purchase summaries

At Knoowy you buy and sell the best studies documents directly from students.
Upload at least one item, please help other students and get € 2.50 credit.

Register now and claim your credit