Chapter 33: Concepts of Mental Health My Nursing Test Banks

Chapter 33: Concepts of Mental Health

Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition

MULTIPLE CHOICE

1.What is the mental health nurse referring to when using the term behavior?

a. An isolated incident
b. The manner in which a person performs
c. A product of a coping strategy
d. Failure to adapt

ANS: B

Behavior may be defined as the manner in which a person performs any or all of the activities of daily living.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1110

OBJ:1TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

2.What definition should the nurse use to clarify the concept of mental health?

a. A wellness of attitude
b. A persons response to disease and dysfunction
c. The ability to cope and adjust to everyday stresses
d. How the person performs activities of daily living

ANS: C

Mental health can be defined as a persons ability to cope and adjust to everyday stresses.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1110

OBJ:1TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

3.How should the nurse document the behavior of a patient with mental illness?

a. Very disruptive to a person in society
b. Differing from socially acceptable behavior
c. Causing the person to be involved in problems
d. Resulting from an inability to exercise control

ANS: B

Mental illness can cause behavior that deviates from socially and culturally acceptable behavior.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1111

OBJ:2TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

4.How many people in the United States will develop a mental disorder during their lifetime?

a. One in two
b. One in five
c. One in eight
d. One in ten

ANS: A

It is estimated that 50% of people in the United States will develop a mental disorder during their lifetime.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1111

OBJ:2TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

5.During the 17th and 18th centuries, care of patients with mental illness often was cruel. What type of care was used by Dr. Philippe Pinel to bring about change?

a. Personal care
b. Individual care
c. Behavior care
d. Humane care

ANS: D

Dr. Philippe Pinel advocated humane care.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1112

OBJ: 1 TOP: Mental health KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

6.When was psychiatric training for nurses initially offered?

a. 1852
b. 1882
c. 1902
d. 1922

ANS: B

In 1882, McLean Hospital in Waverly, Massachusetts, provided the first psychiatric training school for nurses.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1112

OBJ: 1 TOP: Mental health KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

7.Using the mental health continuum as a guide, the nurse observes behavior that usually places an individual on the illness end of the continuum. What is true of this behavior?

a. It causes extreme concern about health.
b. It results in inability to function in society.
c. It demonstrates that the person is out of touch with reality.
d. It results in inability to interact with people.

ANS: C

On the illness end of the mental health continuum, the person is rarely in touch with reality.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1113

OBJ:1TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

8.The majority of people function in a relatively healthy manner. What can diminish their functional capacity?

a. Lack of a support system
b. Periods of crisis
c. Nutritional deficits
d. A physical disease process

ANS: B

Periods of crisis can decrease functional capacity, moving a person toward the illness end of the continuum.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1113

OBJ: 1 TOP: Mental health KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

9.What is the basis for classifying a person as having a mental illness?

a. Behavior exhibited and the context
b. Response of society to the behavior
c. Ability of the patient to conform
d. Patients history and previous behavior

ANS: A

A person is deemed to be mentally ill by the behavior exhibited and the context in which that behavior occurs.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1114

OBJ: 2 TOP: Mental health KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

10.Using Freuds personality theory, what action by a patient identifies the influence of the superego?

a. Eating an entire chocolate pie
b. Becoming anxious about having no visitors
c. Monopolizing the attention of the physician
d. Returning a $5 bill that another patient left on the table

ANS: D

The superego is the mediator between right and wrong (the conscience).

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1114, Box 33-2

OBJ:3TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

11.Using Freuds personality theory, what action by a patient indicates a strong ego?

a. Laughs at himself for being foolish
b. Continually boasts of his accomplishments
c. Apologizes continually
d. Insists that the TV channel stay tuned to CNN

ANS: A

Ego is the reality tester. Laughing at oneself shows that the patient can compare his own foolish behavior to the norm.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1114, Box 33-2

OBJ:3TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

12.Which theorist believed that personality development was based on task mastery?

a. Sigmund Freud
b. Erik Erikson
c. Jean Piaget
d. Friedrich Nietzsche

ANS: B

Erik Erikson provided a framework for understanding personality development in terms of task mastery. Sigmund Freud described personality development as having three parts: id, ego, and superego. Jean Piaget theorized that development was based on how humans acquire and utilize knowledge.  Friedrich Nietzsches theories had more to do with morality than personality development.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1114

OBJ: 2 TOP: Mental health KEY: Nursing Process Step: N/A

MSC: NCLEX: Psychosocial Integrity

13.Which role is an example of an ascribed role?

a. Sex
b. Occupation
c. Manner of dealing with stress
d. Attitude toward homosexuality

ANS: A

Ascribed roles are those that a person takes on, but had no personal choice in the matter. Ethnicity, sex, and nationality are examples of ascribed roles.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1115

OBJ:3TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

14.The nurse is assessing a young woman who is a teacher, happily married, raising two children, taking care of her disabled mother, and going to school to get a masters degree. How should the behavior of the young woman be classified?

a. Ego-centered
b. Role integrated
c. High-level wellness
d. Unbounded energy

ANS: B

Role integration is performing several ascribed roles at the same time.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1115

OBJ:3TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

15.What action consistently done by a patient should indicate to a nurse that the patient has a poor self-concept?

a. Wears bright-colored clothing
b. Demands the attention of staff
c. Apologizes to others repeatedly
d. Becomes angry when frustrated

ANS: C

Apologizing repeatedly is indicative of self-effacement. Anger, demanding attention, and wearing attention-getting clothing are not characteristics of a poor self-concept.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1115

OBJ:2TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

16.What does any event that requires change stimulate?

a. Anger
b. Depression
c. Stress
d. Anxiety

ANS: C

Any event that requires change leads to stress, which is the nonspecific response of the body to any demand.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1115

OBJ:7TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

17.A nurse tearfully confides to the head nurse that being assigned to care for eight patients is stressful and overwhelming. What demonstrates the use of a healthy coping mechanism?

a. Writing down long lists of needed interventions before starting the days work
b. Delegating appropriate care assignments to nursing assistants
c. Asking a co-worker to take one of her patients
d. Asking for the day off

ANS: B

The use of delegation is an effective coping mechanism. The other options are not healthy as they either delay or avoid dealing with the stress.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1116

OBJ:2TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

18.A perceived threat to self causes what emotion?

a. Fear
b. Anger
c. Depression
d. Anxiety

ANS: D

Anxiety can be defined as a vague feeling of apprehension resulting from a perceived threat to self.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1115

OBJ:7TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

19.What action by a student before taking a test should indicate to a nursing instructor that the student is demonstrating signs of moderate anxiety?

a. Studies for 6 hours
b. Sleeps 6 hours because of fatigue
c. Vomits
d. Argues about the scheduling of the test

ANS: C

Symptoms of anxiety include the following: vocal changes, rapid speech, increased pulse, respirations, and blood pressure, tremors, restlessness, increased perspiration, nausea, decreased appetite, diarrhea, frequent urination, and vomiting.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1115

OBJ:7TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

20.What coping mechanism demonstrated by a patient should indicate to the nurse that the patient is seeking ways to deal with and resolve stress?

a. Projection
b. Adaptation
c. Reaction formation
d. Compensation

ANS: B

An individual who develops ways to deal with stress and resolve it has adapted.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1116

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

21.A 40-year-old patient cries and has a tantrum when the physician refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism?

a. Compensation
b. Denial
c. Regression
d. Repression

ANS: C

Regression is a behavior that reflects the return to an earlier form of coping.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1117, Table 33-1

OBJ:6TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

22.When the patient who overeats insists that weight gain is related to retained fluids, the nurse recognizes the patient is using which defense mechanism?

a. Compensation
b. Rationalization
c. Sublimation
d. Regression

ANS: B

Defense mechanisms are unconscious reactions that offer protection to the self from stressful situations. Rationalization offers a reasonable explanation for an event rather than facing reality.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1117, Table 33-1

OBJ:6TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

23.After finding the patient with diabetes eating candy, the nurse reminds the patient that the candy will elevate blood sugar levels. The patients response is: Its only a little bit, and it wont do anything. Which defense mechanism is the patient using?

a. Conversion
b. Denial
c. Repression
d. Regression

ANS: B

The patient is using denial as a defense mechanism. Reality is denied.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1117, Table 33-1

OBJ:6TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

24.The patient complains to the nurse that the physician does not like him and wants him to fail at following the diet prescribed. The nurse recognizes that the patient is using which defense mechanism?

a. Conversion
b. Projection
c. Introjection
d. Repression

ANS: B

Projection is attributing to others characteristics that the person does not want to acknowledge.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1117, Table 33-1

OBJ:6TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

25.The nurse is sensitive to the fact that patients lose control over their lives when admitted to the hospital. In what does this loss of control frequently result?

a. Anger
b. Depression
c. Fear
d. Anxiety

ANS: D

Loss of control may result in feelings of apprehension and uncertainty.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1118

OBJ:5TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

26.The patient admitted to the hospital may adjust to illness by assuming a role in which everyday responsibilities are avoided. What is this role called?

a. Patient role
b. Illness role
c. Sick role
d. Dependent role

ANS: C

The sick role allows the patient to be excused from everyday responsibilities.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1118

OBJ:8TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

27.Why is it important for the nurse to be observant of patient behavior?

a. Behavior is preformed
b. Behavior is important
c. Behavior is learned
d. Behavior is repeated

ANS: C

Behavior is learned and has meaning.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1119

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

28.What is a nursing intervention that helps to build trust, encourages the patient to have faith in the care being received, and meets psychosocial needs?

a. Developing a care plan
b. Implementing nurse orders
c. Patient education
d. Meeting patient goals

ANS: C

One of the steps to meet the psychosocial needs of the patient is patient education.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1118

OBJ:10TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

29.A family is informed that the brain damage to their daughter is irreversible. The father is later overheard making vacation plans and discussing what the family will do when his daughter leaves the hospital. The nurse recognizes the father is in which crisis stage?

a. High anxiety
b. Denial
c. Reconciliation
d. Adaptation

ANS: B

The father is exhibiting signs of denial. Once the reality of the situation becomes evident, anger and confusion follow.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1119

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

30.When developing a care plan for a mentally ill patient, what should the nurse assess first?

a. Coping strategies
b. Emotional status
c. Medications taken
d. Nutritional status

ANS: B

The nurses first priority would be to assess the emotional status of the mentally ill patient.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1120

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

31.When the patient is told that his insurance will no longer pay for his physical therapy, the nurse is aware that this obstruction to his goal may result in which concept?

a. Conflict
b. Adaptation
c. Frustration
d. Anxiety

ANS: C

Frustration refers to anything that interferes with goal-directed activity.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1116

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

32.What is the most likely result when an attempt at adaptation fails?

a. Depression
b. Anger
c. Frustration
d. Anxiety

ANS: D

When adaptive behavior fails, anxiety increases.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1115

OBJ:5TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

33.The nurse is assessing a nervous 18-year-old patient who has vital signs of P 120, R 30, and BP 160/90. The patient states that he feels something bad is about to happen. Based on this data alone, how should the nurse identify the patients level of anxiety?

a. Mild
b. Moderate
c. Severe
d. Panic

ANS: C

Severe anxiety may be manifested by elevated blood pressure, pulse, and respiratory rate, a feeling of impending danger, and feelings of fatigue.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1116, Box 33-3

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

34.When assisting the older adult who is despondent about the need to leave his home, what technique should the nurse use?

a. Ask him if he has a drinking problem
b. Explore the option of his moving in with someone
c. Reminisce with the patient and review his life
d. Assess for hopelessness and helplessness

ANS: C

Reminiscence and life review are effective techniques to help older adults deal with changing life circumstances.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1118

OBJ:10TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

35.A patient admitted to the hospital after a motorcycle crash that has left him paralyzed from the waist down tells the nurse he has feelings of helplessness and hopelessness. What other feelings may the patient have that should be recognized?

a. Isolation
b. Suicidal ideation
c. Fear
d. Anger

ANS: B

Hopelessness and helplessness can lead to possible thoughts of suicide.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1118

OBJ:9TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

MULTIPLE RESPONSE

36.The nurse uses a diagram to show how the four parts of self fit together. What are the four parts? (Select all that apply.)

a. Body image
b. Ego
c. Self-esteem
d. Role
e. Identity

ANS: A, C, D, E

The four parts of the self are body image, self-esteem, role, and identity.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1114

OBJ:3TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

37.A variety of factors influence the level of anxiety experienced by the patient faced by a stressful situation. Which would the nurse outline? (Select all that apply.)

a. How others perceive the event
b. The number of stressors present at one time
c. Degree of change the stressors require
d. Present role assumption
e. Previous experience with a similar situation

ANS: B, C, D, E

The number of stressors present at one time, the degree of change the stressors require, present role assumption, and previous experience with a similar situation are all factors that can influence the level of anxiety experienced when faced with a stressful situation. The level of anxiety experienced is also influenced by how the event is perceived by the individual, not how the event is perceived by others.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1115

OBJ:7TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

COMPLETION

38.The situation in which a parent must choose between attending a daughters ballet recital or a sons baseball game is an example of a __________.

ANS:

conflict

Conflict occurs when there is a presence of simultaneous goals, only one of which can be met.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1116

OBJ:7TOP:Mental health

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

39.In the movie Gone with the Wind, Scarlett OHara says, Ill think about that tomorrow. Tomorrow is another day. The nurse recognizes the defense mechanism of __________.

ANS:

repression

Repression is an unconscious barring of anxiety-producing thoughts.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1117, Table 33-1

OBJ:6TOP:Mental health

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

OTHER

40.Place the events in the mental health care movement in chronologic order. Put a comma and space between each answer choice (A, B, C, D, etc.).

a. Establishment of Pennsylvania Hospital

b. Deinstitutionalization movement

c. Formation of Committee for Mental Health

d. Passage of Omnibus Budget Reconciliation Act (OBRA)

e. Dorothea Dix awakens public awareness of plight of mentally ill

ANS:

A, E, C, B, D

Pennsylvania Hospital1731, Dorothea Dix1882, Committee for Mental Health1909, deinstitutionalization movement1960, OBRA1981.

PTS: 1 DIF: Cognitive Level: Application REF: Pages 1111-1112

OBJ: 1 TOP: Mental health KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

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