Chapter 12: Prevention and Mental Health Promotion My Nursing Test Banks

Chapter 12: Prevention and Mental Health Promotion

Test Bank

MULTIPLE CHOICE

1. The nurse explains that the main goal of primary prevention is the reduction of the _____ of mental disorders.

a.

severity

b.

duration

c.

incidence

d.

prevalence

ANS: C

Primary prevention is lowering the incidence of a mental disorder or reducing the rate at which new cases of the disorder develop. Secondary prevention reduces the prevalence of a mental disorder. Tertiary prevention reduces the severity of a mental disorder and its associated disability.

DIF: Cognitive Level: Comprehension REF: Text Page: 169

TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

2. A psychiatric nurse is assessing the need for mental health services at the clinic. When estimating the number of patients with bipolar disorder in the community, the nurse places highest priority on which data-gathering technique?

a.

Community forums that solicit data shared by patients and families

b.

Epidemiological studies that indicate incidence and prevalence of disease

c.

Use of key informants, such as local social service personnel, nurses, and physicians

d.

Statistics from local public reports about race, marital status, population density, and substance abuse

ANS: B

Epidemiological studies examine the incidence (number of new cases) and prevalence (number of current existing cases) of a disease or disorder in a defined population over a specified period. The nurse who is trying to plan for services would find these data very helpful. The remaining options refer to other methods of assessing community needs, but they are not as well suited to gathering the data identified by this question.

DIF: Cognitive Level: Application REF: Text Page: 169

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

3. What is the essential difference between the nursing prevention model and the medical prevention model?

a.

The medical model targets universal populations; the nursing model targets a selective population.

b.

The medical model assumes that all people are at equal risk; the nursing model attempts to identify those who are more vulnerable.

c.

The medical model attempts to identify the most likely cause of the disease; the nursing model stresses that mental disorders are multicausal.

d.

The medical model offers a continuum of nonspecific preventive measures; the nursing model offers one specific, tested, preventive measure.

ANS: C

The primary difference is the medical models attempt to identify a single cause of a disease; the nursing model assumes that mental disorders result from the interplay of several risk and protective factors.

DIF: Cognitive Level: Comprehension REF: Text Pages: 169-170

TOP: Nursing Process: N/A MSC: NCLEX: Psychosocial Integrity

4. A psychiatric nurse is responsible for providing patient-focused health education. In order to promote primary prevention of mental health problems, the nurse stresses:

a.

trust.

b.

resilience.

c.

networking.

d.

motivation.

ANS: B

The health education strategy of primary prevention in mental health involves the strengthening of individuals and groups through building of competence or resilience. The other answers do not address this particular trait.

DIF: Cognitive Level: Application REF: Text Page: 171

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

5. A nurse whose primary focus is tertiary prevention of mental disorders would focus on:

a.

providing prompt treatment of an individuals mental disorder.

b.

identifying social supports to prevent the need for hospitalization.

c.

funding rehabilitative activities to reduce the disability associated with mental disorders.

d.

forming a preretirement counseling program staffed by professional mental health nurses.

ANS: C

The nurses work in tertiary prevention involves rehabilitative efforts.

DIF: Cognitive Level: Application REF: Text Page: 169

TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity

6. A nurse who works in community mental health identifies a minority neighborhood group as having low self-efficacy and being particularly susceptible to a number of stressors. In which phase of the nursing process did this activity take place?

a.

Assessment

b.

Analysis

c.

Planning

d.

Implementation

e.

Evaluation

ANS: C

The analysis/nursing diagnosis phase of the nursing process is in use when the nurse identifies problem areas. Assessment identifies symptoms while planning and implementation involves putting solutions into the therapy plan. Evaluation reviews the outcomes of the therapy plan.

DIF: Cognitive Level: Application REF: Text Page: 170

TOP: Nursing Process: Analysis MSC: NCLEX: Psychosocial Integrity

7. People with low self-efficacy:

a.

are often found to engage in antisocial and/or criminal behavior.

b.

usually require an inordinately large percentage of the available community health resources.

c.

are usually well motivated and handle stress well and typically have low vulnerability to depression.

d.

give up in the face of difficulty, recover slowly from setbacks, and easily fall victim to depression.

ANS: D

Low self-efficacy negatively affects an individuals thoughts, motivation, mood, and health. A person with low self-efficacy dwells on obstacles and personal deficiencies, and such a person is depression prone. Successful interventions for groups with low self-efficacy can be planned and implemented.

DIF: Cognitive Level: Comprehension REF: Text Page: 171

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

8. When a community mental health nurse focuses on intervention strategies designed to increase self-efficacy among members of a minority neighborhood group, a realistic primary prevention goal would be:

a.

elimination of mental illness in the community.

b.

resolving social problems within the community.

c.

reducing both stressors and suffering in the group.

d.

reducing the incidence of depression in the group.

ANS: D

Primary prevention is aimed at reducing the incidence of mental illness. Depression is a frequent outcome of low self-efficacy. Therefore a goal of intervention to raise self-efficacy is to reduce the incidence of depression in the group.

DIF: Cognitive Level: Analysis REF: Text Page: 171

TOP: Nursing Process: Outcome Identification

MSC: NCLEX: Psychosocial Integrity

9. The identification of intervention strategies designed to increase self-efficacy among members of a minority neighborhood group would occur in which phase of the nursing process?

a.

Assessment

b.

Analysis

c.

Planning

d.

Implementation

e.

Evaluation

ANS: C

Planning is the elaboration of strategies designed to achieve a specific goal.

DIF: Cognitive Level: Application REF: Text Page: 170

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

10. A nurse assessing a person who is deemed to be at high risk for mental disorders will find that, as suggested by the nursing primary prevention model, the person has:

a.

fewer stressors.

b.

more protective factors.

c.

unusual developmental tasks.

d.

inadequate coping mechanisms.

ANS: D

Factors that place a person at high risk include the presence of many stressors, fewer protective factors, and inadequate coping mechanisms. (Developmental tasks are considered universal.)

DIF: Cognitive Level: Comprehension REF: Text Page: 171

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

11. In the event that a vaccine is developed to prevent schizophrenia, which population group would be selected to receive it first?

a.

The universal population

b.

The indicated population

c.

The developmental population

d.

The epidemiological population

ANS: B

An indicated population is one made up of high-risk individuals identified as having biological markers that indicate a predisposition for the disorder.

DIF: Cognitive Level: Application REF: Text Page: 170

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

12. Which person is most vulnerable to the development of psychiatric illness based on sociocultural factors?

a.

A 16-year-old who has a parent with bipolar disorder

b.

A 55-year-old who has retired with full pay from a job as a high school teacher

c.

A 24-year-old who was raised by a grandparent after both parents died in a plane crash

d.

A 67-year-old from a minority group who is poor and has no social support system

ANS: D

Being a minority, living in poverty, being elderly, and having no social support are sociocultural risk factors.

DIF: Cognitive Level: Analysis REF: Text Page: 176

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

13. To effectively use the nursing primary prevention model, it is most important for a nurse to have knowledge of:

a.

personality types.

b.

psychiatric medications.

c.

normal growth and development.

d.

the DSM-IV-TR diagnostic categories.

ANS: C

Knowledge of normal growth and development is necessary for assessing a persons functioning and for choosing appropriate preventive nursing interventions.

DIF: Cognitive Level: Application REF: Text Page: 170

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

14. A nurse working in a community health agency wishes to implement a primary preventive program in mental health for the elderly. Which action should occur first?

a.

Elaboration of specific preventive strategies

b.

Identification of stressors that precipitate maladaptive responses

c.

Application of selected nursing interventions to enhance adaptation

d.

Determination of the effectiveness of the existing nursing activities

ANS: B

Assessment is the first phase of the nursing process.

DIF: Cognitive Level: Application REF: Text Page: 170

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

15. A psychiatric nurse is working with patients in a health education group on strategies to improve anger management. The nurse would best evaluate the effectiveness of this intervention by determining changes in a patients:

a.

routinely used coping skills.

b.

opinion about own self-worth.

c.

knowledge of people and events that trigger anger.

d.

underlying mental health disorder, exhibited by the symptom of anger.

ANS: A

Health education for patients with mental health disorders can include interventions to increase the coping skills of the individual or group, such as problem solving, communication skills, tolerance of stress and frustration, motivation, hope, anger management, and self-esteem. The remaining options do not relate to an increase in coping skills related to anger management.

DIF: Cognitive Level: Application REF: Text Page: 172

TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity

16. A nurse working with adolescents recognizes which factor as being of greatest importance to this age group?

a.

Normal growth and development

b.

Peer relationships

c.

Career selection

d.

Child rearing

ANS: B

Topics that tend to be important to adolescents include those that discuss peer relationships, sexuality, or potential problems, such as drug abuse or promiscuity. Groups devoted to normal growth and development and child rearing are groups of most importance to parents. Career selection does not relate directly to health education, but it may indirectly affect the stressors in ones life.

DIF: Cognitive Level: Comprehension REF: Text Page: 173

TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

17. A nurse focuses on increasing gang members problem-solving and coping skills. This is an example of:

a.

crime reduction.

b.

community service.

c.

competency building.

d.

environmental manipulation.

ANS: C

Competency is improved when an individual is capable of critical thinking and possesses effective coping skills.

DIF: Cognitive Level: Comprehension REF: Text Page: 171

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

18. An individual considering a self-help group says to a nurse, I might go to the bereavement group meeting, but what if Im required to make changes I dont like? The nurses most therapeutic response would be:

a.

Perhaps youre not quite ready to join a group. Give yourself a few more weeks.

b.

These are natural concerns. Trying something new activates all our insecurities.

c.

Most group members will feel just like you do. They will help you hold your own against aggressive group members.

d.

Self-help groups are designed so that each member has sole responsibility for making changes in his or her own life.

ANS: D

This option acknowledges and provides an explanation for the patients expressed concern.

DIF: Cognitive Level: Application REF: Text Page: 174

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

19. A nurse working with mentally ill patients recognizes which factor as having the greatest impact on a patients tendency to seek treatment?

a.

Social stigma

b.

Financial burden

c.

Lack of support services

d.

Ineffective family support

ANS: A

The impact of stigma is enormous, with nearly two thirds of the population with diagnosable mental disorders failing to seek treatment as a result of real or imagined effects of stigma.

DIF: Cognitive Level: Application REF: Text Page: 175

TOP: Nursing Process: N/A MSC: NCLEX: Psychosocial Integrity

MULTIPLE RESPONSE

1. Primary prevention in mental health is based on the assumption that many maladaptive responses result from: (Select all that apply.)

a.

a lack of ability to manage ones own life.

b.

ineffective coping strategies.

c.

ineffective health education.

d.

environmental change.

e.

poor self-esteem.

ANS: A, B, C, E

An individual is more likely to experience mental health problems if he or she lacks good self-esteem and is incapable of controlling his or her life especially because of poor coping skills. Poor or ineffective health education adds to the problem. Environment is not a primary factor in primary prevention.

DIF: Cognitive Level: Comprehension REF: Text Page: 171

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

2. Which interventions would be helpful in achieving the goal of improving the social support system of an individual at risk for developing maladaptive coping responses? (Select all that apply.)

a.

Hospitalization in a mental health facility

b.

Encouraging participation in a self-help group

c.

Explaining to concerned others how they can help

d.

Providing services in a caring and supportive manner

e.

Identifying consequences for ineffective coping strategies

ANS: B, C, D

Hospitalization is more directed toward stabilizing a patient while identifying consequences and has little impact on improving social support. Providing social support includes cushioning the effects of potential stressors. Improving links between the individual and the community, strengthening natural caregiving networks, using informal support groups, and providing nursing support all are ways to increase social support for an individual.

DIF: Cognitive Level: Application REF: Text Page: 172

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

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