Chapter 5 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 5

Question 1

Type: MCSA

Which statement indicates the psychiatricmental health nurse understands the basic principles of symbolic interactionism in working with clients?

1. Clients with mental disorders are unlikely to understand the personal meaning of their experiences.

2. I try to avoid interventions that ignore the personal meaning of experiences to my clients.

3. Clients with altered brain chemistry need frequent reassurance that they should not worry about their condition.

4. After my first year of working in mental health, I was able to develop standardized interventions for clients with the same diagnoses.

Correct Answer: 2

Rationale 1: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.

Rationale 2: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.

Rationale 3: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.

Rationale 4: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the major ideas of interactionism.

Question 2

Type: MCSA

Concepts of interactionism are evidenced in which of the following statements the nurse makes to the parent of an adolescent hospitalized for an overdose of cocaine and Valium?

1. Peer pressure is usually responsible for these accidental overdoses.

2. All behavior has meaning, so we will focus on trying to understand the meaning of the drug use as well as the occurrence of overdose.

3. Use of Valium probably means your child accidentally overdosed by trying to treat the effects of cocaine.

4. Adolescence is such a painful time. Rehabilitation programs give kids a chance to get away from their everyday pressures.

Correct Answer: 2

Rationale 1: To understand clients actions, the psychiatricmental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatricmental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurses personal point of view.

Rationale 2: To understand clients actions, the psychiatricmental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatricmental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurses personal point of view.

Rationale 3: To understand clients actions, the psychiatricmental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatricmental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurses personal point of view.

Rationale 4: To understand clients actions, the psychiatricmental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatricmental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurses personal point of view.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Discuss the major ideas of interactionism.

Question 3

Type: MCSA

A grieving widow tells a psychiatricmental health nurse, I feel so tired and alone. The nurse who incorporates an understanding of symbolic interactionism in practice would not suggest which of the following to the client?

1. You had a terrible loss. Feeling tired and alone must be very difficult for you.

2. I would like to hear more about how you are feeling now.

3. Try to get plenty of rest. Most people who suffer losses like yours need more sleep than usual to cope effectively.

4. You seem sad. Can I sit with you for a while?

Correct Answer: 3

Rationale 1: Giving advice and suggesting that the meaning of the widows loss is typical invalidates the persons unique experience, a basic premise of symbolic interactionismthat people interpret the world in their own way. Other responses indicate an understanding that a clients actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.

Rationale 2: Giving advice and suggesting that the meaning of the widows loss is typical invalidates the persons unique experience, a basic premise of symbolic interactionismthat people interpret the world in their own way. Other responses indicate an understanding that a clients actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.

Rationale 3: Giving advice and suggesting that the meaning of the widows loss is typical invalidates the persons unique experience, a basic premise of symbolic interactionismthat people interpret the world in their own way. Other responses indicate an understanding that a clients actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.

Rationale 4: Giving advice and suggesting that the meaning of the widows loss is typical invalidates the persons unique experience, a basic premise of symbolic interactionismthat people interpret the world in their own way. Other responses indicate an understanding that a clients actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Discuss the major ideas of interactionism.

Question 4

Type: MCSA

The nurse received the change-of-shift report on a 74-year-old woman admitted for depression. She has aphasia from a recent stroke and communicates minimally by using pencil and paper. Her college-age grandson moved in with her to help with meals and household chores and a home health aide provides daily assistance with ADLs and medications. For the past week, she has refused to bathe, eats poorly, and has stopped writing. Which of the following statements best demonstrates that the nurse has the ability to plan holistic care for this client?

1. The clients psychobiologic health, rehabilitation, self-care potential, and discharge arrangements are interrelated.

2. Reliance on the grandson and home health aide have decreased her feelings of self-worth and caused this episode of depression.

3. The clients quality of life and prognosis are primarily related to her aphasia and inability to communicate.

4. Sudden life changes, such as a stroke, usually lead to depression in older clients.

Correct Answer: 1

Rationale 1: A holistic assessment of a client accounts for the interrelated effects of the clients social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the clients quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.

Rationale 2: A holistic assessment of a client accounts for the interrelated effects of the clients social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the clients quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.

Rationale 3: A holistic assessment of a client accounts for the interrelated effects of the clients social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the clients quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.

Rationale 4: A holistic assessment of a client accounts for the interrelated effects of the clients social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the clients quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Discuss the major ideas of interactionism.

Question 5

Type: MCSA

Which statement best describes a holistic-interactional approach to nursing care for clients with mental disorders?

1. Clients with psychotic symptoms rarely indicate an interest in creative activities.

2. Medication is the only treatment required to manage affective symptoms for clients with mood disorders.

3. Developing comfortable relationships with clinicians is the major factor in maintaining mental health.

4. I always try to understand the complex relationship between a clients psychobiologic health and expressions of self-esteem.

Correct Answer: 4

Rationale 1: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.

Rationale 2: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.

Rationale 3: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.

Rationale 4: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the major ideas of interactionism.

Question 6

Type: MCSA

When planning care for clients on the mental health unit, the nurse using principles of humanism would consider which of the following?

1. Clinical interventions are most effective when they focus on the current actions, feelings, and concerns of clients.

2. Clients rely on providers to develop solutions for their problems.

3. Emotional stress has a relationship to physical symptoms.

4. The mindbody relationship focuses on biological explanations of illness.

Correct Answer: 3

Rationale 1: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.

Rationale 2: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.

Rationale 3: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.

Rationale 4: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Discuss the major principles of humanism.

Question 7

Type: MCSA

The psychiatricmental health nurse understands that the philosophy underlying humanistic practice means which of the following?

1. Nurses must develop interests related to human beings, wherever they live and whatever their status or culture, in order to work for change within social and political systems.

2. The nurse must be cautious about empowering clients as they may make poor choices that impede their progress.

3. The model for intervention and change requires that the nurse feel comfortable confronting clients when they resist treatment goals.

4. Client and family education about the mental disorder and its treatment must be provided only when clients are stable enough to accept their illness.

Correct Answer: 1

Rationale 1: The humanistic perspective on mental disorders implies an expanded role for psychiatricmental health nurses who understand diversity and are prepared to work for change within social and political systems. The model for intervention and change is one of negotiation and advocacy, not directive interventions. Empowerment is a basic concept as the responsibility for change rests with the client who is viewed as accountable for his or her own behavior. Humanism contends that people have the potential to solve their own problems, thus, clients and families must be involved in treatment from the beginning. This requires the nurse to provide timely and complete psychoeducational information.

Rationale 2: The humanistic perspective on mental disorders implies an expanded role for psychiatricmental health nurses who understand diversity and are prepared to work for change within social and political systems. The model for intervention and change is one of negotiation and advocacy, not directive interventions. Empowerment is a basic concept as the responsibility for change rests with the client who is viewed as accountable for his or her own behavior. Humanism contends that people have the potential to solve their own problems, thus, clients and families must be involved in treatment from the beginning. This requires the nurse to provide timely and complete psychoeducational information.

Rationale 3: The humanistic perspective on mental disorders implies an expanded role for psychiatricmental health nurses who understand diversity and are prepared to work for change within social and political systems. The model for intervention and change is one of negotiation and advocacy, not directive interventions. Empowerment is a basic concept as the responsibility for change rests with the client who is viewed as accountable for his or her own behavior. Humanism contends that people have the potential to solve their own problems, thus, clients and families must be involved in treatment from the beginning. This requires the nurse to provide timely and complete psychoeducational information.

Rationale 4: The humanistic perspective on mental disorders implies an expanded role for psychiatricmental health nurses who understand diversity and are prepared to work for change within social and political systems. The model for intervention and change is one of negotiation and advocacy, not directive interventions. Empowerment is a basic concept as the responsibility for change rests with the client who is viewed as accountable for his or her own behavior. Humanism contends that people have the potential to solve their own problems, thus, clients and families must be involved in treatment from the beginning. This requires the nurse to provide timely and complete psychoeducational information.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Discuss the major principles of humanism.

Question 8

Type: MCSA

A nurse educator is teaching a group of students about humanism. The educator knows that humanism is a philosophy of service to benefit humanity through applying which of the following concepts?

1. Science is the core consideration of humanistic philosophy.

2. Caring practices and compassion must be approached holistically.

3. Limitations of life in todays world have little effect on planning effective interventions.

4. Mental health clients must rely on clinicians for difficult decision-making and care.

Correct Answer: 2

Rationale 1: In humanistic philosophy, healing and caring are approached holistically. The philosophy accounts for well-being within the limitations of life in todays world. Humanism purports that service to benefit humanity is accomplished through reason, science, and democracy. Clients are not passive recipients of care but rather have the potential to solve their own problems. They need to be supported and empowered to develop new perspectives and make self-directed choices.

Rationale 2: In humanistic philosophy, healing and caring are approached holistically. The philosophy accounts for well-being within the limitations of life in todays world. Humanism purports that service to benefit humanity is accomplished through reason, science, and democracy. Clients are not passive recipients of care but rather have the potential to solve their own problems. They need to be supported and empowered to develop new perspectives and make self-directed choices.

Rationale 3: In humanistic philosophy, healing and caring are approached holistically. The philosophy accounts for well-being within the limitations of life in todays world. Humanism purports that service to benefit humanity is accomplished through reason, science, and democracy. Clients are not passive recipients of care but rather have the potential to solve their own problems. They need to be supported and empowered to develop new perspectives and make self-directed choices.

Rationale 4: In humanistic philosophy, healing and caring are approached holistically. The philosophy accounts for well-being within the limitations of life in todays world. Humanism purports that service to benefit humanity is accomplished through reason, science, and democracy. Clients are not passive recipients of care but rather have the potential to solve their own problems. They need to be supported and empowered to develop new perspectives and make self-directed choices.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the major principles of humanism.

Question 9

Type: MCSA

Which statement made by a nurse indicates an understanding of the basic premises of psychobiology?

1. All mental disorders can now be fully classified and cured with biological interventions.

2. By focusing on the biologic sciences, we will diminish the art of psychiatricmental health nursing.

3. Because of the advances in psychobiology, the role of psychiatricmental health nurses focuses primarily on medication monitoring.

4. Genetics, immunology, biorhythms, brain structure, and brain biochemistry all influence mental disorders.

Correct Answer: 4

Rationale 1: Psychobiologic theory is growing rapidly and encompasses fields such as genetics, immunology, and brain chemistry and structure. Nurses do not give up humanistic, psychosocial, and interactional premises simply because of the breakthroughs being made in psychobiology. The psychobiologic model uses classification but also includes notions that the disease follows a predictable course, not necessarily cure. To bring a contemporary holistic perspective to care, nurses must integrate knowledge of psychobiology with social and humanistic knowledge.

Rationale 2: Psychobiologic theory is growing rapidly and encompasses fields such as genetics, immunology, and brain chemistry and structure. Nurses do not give up humanistic, psychosocial, and interactional premises simply because of the breakthroughs being made in psychobiology. The psychobiologic model uses classification but also includes notions that the disease follows a predictable course, not necessarily cure. To bring a contemporary holistic perspective to care, nurses must integrate knowledge of psychobiology with social and humanistic knowledge.

Rationale 3: Psychobiologic theory is growing rapidly and encompasses fields such as genetics, immunology, and brain chemistry and structure. Nurses do not give up humanistic, psychosocial, and interactional premises simply because of the breakthroughs being made in psychobiology. The psychobiologic model uses classification but also includes notions that the disease follows a predictable course, not necessarily cure. To bring a contemporary holistic perspective to care, nurses must integrate knowledge of psychobiology with social and humanistic knowledge.

Rationale 4: Psychobiologic theory is growing rapidly and encompasses fields such as genetics, immunology, and brain chemistry and structure. Nurses do not give up humanistic, psychosocial, and interactional premises simply because of the breakthroughs being made in psychobiology. The psychobiologic model uses classification but also includes notions that the disease follows a predictable course, not necessarily cure. To bring a contemporary holistic perspective to care, nurses must integrate knowledge of psychobiology with social and humanistic knowledge.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe the influence of the knowledge explosion in psychobiology.

Question 10

Type: MCSA

A nurse on a medical unit overhears a discussion about the failure of psychobiologic interventions for clients with mental disorders. Which statement could be made to counteract that supposition?

1. There is a current moratorium on development of new drugs to correct biochemical imbalances in the brain.

2. Contemporary research findings indicate that the field of psychobiology and effective interventions is growing rapidly.

3. There are subjective reports that exposure to bright light and white noise provides effective treatment for mental disorders.

4. Restriction of nutrients and non-nutrients is no longer believed to affect behavior.

Correct Answer: 2

Rationale 1: There are major breakthroughs in psychobiologic knowledge of the brain, the mind, the spirit, and behavior. Research has generated new understanding of how genetics, immunology, biorhythms, brain structure, and brain biochemistry influence mental disorders. New drugs are being tested and prescribed and psychobiologic interventions such as exposure to bright light and white noise have been shown to affect behavior. Psychobiologic interventions have become commonplace.

Rationale 2: There are major breakthroughs in psychobiologic knowledge of the brain, the mind, the spirit, and behavior. Research has generated new understanding of how genetics, immunology, biorhythms, brain structure, and brain biochemistry influence mental disorders. New drugs are being tested and prescribed and psychobiologic interventions such as exposure to bright light and white noise have been shown to affect behavior. Psychobiologic interventions have become commonplace.

Rationale 3: There are major breakthroughs in psychobiologic knowledge of the brain, the mind, the spirit, and behavior. Research has generated new understanding of how genetics, immunology, biorhythms, brain structure, and brain biochemistry influence mental disorders. New drugs are being tested and prescribed and psychobiologic interventions such as exposure to bright light and white noise have been shown to affect behavior. Psychobiologic interventions have become commonplace.

Rationale 4: There are major breakthroughs in psychobiologic knowledge of the brain, the mind, the spirit, and behavior. Research has generated new understanding of how genetics, immunology, biorhythms, brain structure, and brain biochemistry influence mental disorders. New drugs are being tested and prescribed and psychobiologic interventions such as exposure to bright light and white noise have been shown to affect behavior. Psychobiologic interventions have become commonplace.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Describe the influence of the knowledge explosion in psychobiology.

Question 11

Type: MCSA

Which of the following statements best reflects the nurses comprehensive understanding of medicalpsychobiologic theories?

1. Psychobiologic explanations of mental disorders do little to decrease the stigma associated with mental illness.

2. Individuals suffering from emotional disturbances have complex personalities that require changes in their motivation and willingness to comply with treatment.

3. Mental disorders rarely respond to physical or somatic treatments.

4. Mental disorders have characteristic structural, biochemical, and mental symptoms that can be diagnosed, run a characteristic course, and have a particular prognosis for recovery.

Correct Answer: 4

Rationale 1: Psychobiologic theory views mental illnesses as having characteristic structural, biochemical, and mental symptoms that can be diagnosed, classified and labeled, running a characteristic course, and having a particular prognosis for recovery. They respond to physical or somatic treatments, including drugs, chemicals, hormones, diet, or surgery. Psychobiologic explanations are beginning to offset the myths that mental disorders result from a lack of willpower or from flawed moral character and have reduced the stigma associated with them.

Rationale 2: Psychobiologic theory views mental illnesses as having characteristic structural, biochemical, and mental symptoms that can be diagnosed, classified and labeled, running a characteristic course, and having a particular prognosis for recovery. They respond to physical or somatic treatments, including drugs, chemicals, hormones, diet, or surgery. Psychobiologic explanations are beginning to offset the myths that mental disorders result from a lack of willpower or from flawed moral character and have reduced the stigma associated with them.

Rationale 3: Psychobiologic theory views mental illnesses as having characteristic structural, biochemical, and mental symptoms that can be diagnosed, classified, and labeled, running a characteristic course, and having a particular prognosis for recovery. They respond to physical or somatic treatments, including drugs, chemicals, hormones, diet, or surgery. Psychobiologic explanations are beginning to offset the myths that mental disorders result from a lack of willpower or from flawed moral character and have reduced the stigma associated with them.

Rationale 4: Psychobiologic theory views mental illnesses as having characteristic structural, biochemical, and mental symptoms that can be diagnosed, classified and labeled, running a characteristic course, and having a particular prognosis for recovery. They respond to physical or somatic treatments, including drugs, chemicals, hormones, diet, or surgery. Psychobiologic explanations are beginning to offset the myths that mental disorders result from a lack of willpower or from flawed moral character and have reduced the stigma associated with them.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe the influence of the knowledge explosion in psychobiology.

Question 12

Type: MCSA

Which of the following statements made by the nursing student best summarizes the medicalpsychobiologic position on mental disorders?

1. Factors related to mental disorders can include excesses or deficiencies of brain neurotransmitters as well as alterations in biologic rhythms, including the sleepwake cycle and genetic predispositions.

2. Mental illnesses with an organic cause have an unpredictable course and poor prognosis.

3. Mental disorders rarely respond to physical or somatic treatments without careful monitoring of progress by clinicians in medical settings.

4. Biological interventions such as hormones, diet, and medications must be changed frequently as they are only effective for short periods of time.

Correct Answer: 1

Rationale 1: Psychobiologic theories view the cause of mental illness as organic and as a deficit in central nervous system functioning. Reimbursement for treatment is the primary reason hospital care is utilized. Mental disorders respond to physical or somatic treatments unlinked to treatment settings. Intervention efficacy is based on diagnosis and course of a disease process, not on a time-limited prediction. Mental disorders follow a predictable course and are responsive to treatment when based on accurate diagnosis.

Rationale 2: Psychobiologic theories view the cause of mental illness as organic and as a deficit in central nervous system functioning. Reimbursement for treatment is the primary reason hospital care is utilized. Mental disorders respond to physical or somatic treatments unlinked to treatment settings. Intervention efficacy is based on diagnosis and course of a disease process, not on a time-limited prediction. Mental disorders follow a predictable course and are responsive to treatment when based on accurate diagnosis.

Rationale 3: Psychobiologic theories view the cause of mental illness as organic and as a deficit in central nervous system functioning. Reimbursement for treatment is the primary reason hospital care is utilized. Mental disorders respond to physical or somatic treatments unlinked to treatment settings. Intervention efficacy is based on diagnosis and course of a disease process, not on a time-limited prediction. Mental disorders follow a predictable course and are responsive to treatment when based on accurate diagnosis.

Rationale 4: Psychobiologic theories view the cause of mental illness as organic and as a deficit in central nervous system functioning. Reimbursement for treatment is the primary reason hospital care is utilized. Mental disorders respond to physical or somatic treatments unlinked to treatment settings. Intervention efficacy is based on diagnosis and course of a disease process, not on a time-limited prediction. Mental disorders follow a predictable course and are responsive to treatment when based on accurate diagnosis.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe the influence of the knowledge explosion in psychobiology.

Question 13

Type: MCSA

When meeting with a client for the first time, the psychiatricmental health nurse applying psychobiological principles is most likely to make which of the following statements?

1. Your abnormal behavior is directly related to living in an unsupportive environment.

2. You have a brain lesion and can expect to be hospitalized many times over the course of your life.

3. We are thoroughly assessing your symptoms because an accurate diagnosis is the basis of your treatment.

4. It is fairly certain that your children will feel stigmatized by their peers.

Correct Answer: 3

Rationale 1: Individuals with mental disorders have an illness characterized by structural, biochemical, and mental symptoms that can be diagnosed, classified, and labeled. Accurate assessment and diagnosis are required for treatment. The nurse who links environmental cause to symptoms in an initial meeting is not demonstrating knowledge of psychobiologic principles. The course and prognosis of a mental illness must be determined after an accurate diagnosis is made. Psychobiologic explanations of mental disorders often decrease the stigma associated with them.

Rationale 2: Individuals with mental disorders have an illness characterized by structural, biochemical, and mental symptoms that can be diagnosed, classified, and labeled. Accurate assessment and diagnosis are required for treatment. The nurse who links environmental cause to symptoms in an initial meeting is not demonstrating knowledge of psychobiologic principles. The course and prognosis of a mental illness must be determined after an accurate diagnosis is made. Psychobiologic explanations of mental disorders often decrease the stigma associated with them.

Rationale 3: Individuals with mental disorders have an illness characterized by structural, biochemical, and mental symptoms that can be diagnosed, classified, and labeled. Accurate assessment and diagnosis are required for treatment. The nurse who links environmental cause to symptoms in an initial meeting is not demonstrating knowledge of psychobiologic principles. The course and prognosis of a mental illness must be determined after an accurate diagnosis is made. Psychobiologic explanations of mental disorders often decrease the stigma associated with them.

Rationale 4: Individuals with mental disorders have an illness characterized by structural, biochemical, and mental symptoms that can be diagnosed, classified, and labeled. Accurate assessment and diagnosis are required for treatment. The nurse who links environmental cause to symptoms in an initial meeting is not demonstrating knowledge of psychobiologic principles. The course and prognosis of a mental illness must be determined after an accurate diagnosis is made. Psychobiologic explanations of mental disorders often decrease the stigma associated with them.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe the influence of the knowledge explosion in psychobiology.

Question 14

Type: MCSA

In comparing the major features of psychiatric theories, the nurse correctly concludes that:

1. Medicalpsychobiologic and psychoanalytic theories focus on the individual client.

2. Socialinterpersonal and medicalpsychobiologic theories seek to change behavior through pharmacology.

3. Socialinterpersonal and medicalpsychobiologic theories are in direct opposition to the other.

4. Cognitive behavioral and psychoanalytic theories share the premise that behavior stems from the unconscious and requires the client to develop insight.

Correct Answer: 1

Rationale 1: Medicalpsychobiologic theory focuses on the individuals genetics, immunology, biorhythms, brain structure, and brain biochemistry and psychoanalytic theory focuses on individual insight. Cognitive behavioral theory focuses on conscious feelings, thoughts, and meanings to develop interventions while psychoanalytic theory focuses on the role of the unconscious in developing insight. Socialinterpersonal theory focuses on self and social systems while psychobiologic theories focus on psychopharmacology and other biologic therapies. Socialinterpersonal and medicalpsychobiologic theories can be used holistically to understand the full range of a persons health and response to illness.

Rationale 2: Medicalpsychobiologic theory focuses on the individuals genetics, immunology, biorhythms, brain structure, and brain biochemistry and psychoanalytic theory focuses on individual insight. Cognitive behavioral theory focuses on conscious feelings, thoughts, and meanings to develop interventions while psychoanalytic theory focuses on the role of the unconscious in developing insight. Socialinterpersonal theory focuses on self and social systems while psychobiologic theories focus on psychopharmacology and other biologic therapies. Socialinterpersonal and medicalpsychobiologic theories can be used holistically to understand the full range of a persons health and response to illness.

Rationale 3: Medicalpsychobiologic theory focuses on the individuals genetics, immunology, biorhythms, brain structure, and brain biochemistry and psychoanalytic theory focuses on individual insight. Cognitive behavioral theory focuses on conscious feelings, thoughts, and meanings to develop interventions while psychoanalytic theory focuses on the role of the unconscious in developing insight. Socialinterpersonal theory focuses on self and social systems while psychobiologic theories focus on psychopharmacology and other biologic therapies. Socialinterpersonal and medicalpsychobiologic theories can be used holistically to understand the full range of a persons health and response to illness.

Rationale 4: Medicalpsychobiologic theory focuses on the individuals genetics, immunology, biorhythms, brain structure, and brain biochemistry and psychoanalytic theory focuses on individual insight. Cognitive behavioral theory focuses on conscious feelings, thoughts, and meanings to develop interventions while psychoanalytic theory focuses on the role of the unconscious in developing insight. Socialinterpersonal theory focuses on self and social systems while psychobiologic theories focus on psychopharmacology and other biologic therapies. Socialinterpersonal and medicalpsychobiologic theories can be used holistically to understand the full range of a persons health and response to illness.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how the premises of human interactionism and psychobiology relate to psychiatricmental health nursing.

Question 15

Type: MCSA

Sullivans interpersonal theory focusing on the clients relationships with others and modes of interacting with others is most similar to the theory developed by:

1. Emil Kraepelin.

2. Karl Menninger.

3. B. F. Skinner.

4. Sigmund Freud.

Correct Answer: 2

Rationale 1: Menninger viewed normal personality functioning and psychopathology in terms of general systems theory, a school of interpersonal theory. Skinners work is associated with cognitive behaviorist treatment not interpersonal approaches. Kraepelins descriptive diagnostic classification system was the first comprehensive medical model and the basis of psychobiological theories. Sigmund Freuds emphasis was on intrapsychic rather than interpersonal processes.

Rationale 2: Menninger viewed normal personality functioning and psychopathology in terms of general systems theory, a school of interpersonal theory. Skinners work is associated with cognitive behaviorist treatment not interpersonal approaches. Kraepelins descriptive diagnostic classification system was the first comprehensive medical model and the basis of psychobiological theories. Sigmund Freuds emphasis was on intrapsychic rather than interpersonal processes.

Rationale 3: Menninger viewed normal personality functioning and psychopathology in terms of general systems theory, a school of interpersonal theory. Skinners work is associated with cognitive behaviorist treatment not interpersonal approaches. Kraepelins descriptive diagnostic classification system was the first comprehensive medical model and the basis of psychobiological theories. Sigmund Freuds emphasis was on intrapsychic rather than interpersonal processes.

Rationale 4: Menninger viewed normal personality functioning and psychopathology in terms of general systems theory, a school of interpersonal theory. Skinners work is associated with cognitive behaviorist treatment not interpersonal approaches. Kraepelins descriptive diagnostic classification system was the first comprehensive medical model and the basis of psychobiological theories. Sigmund Freuds emphasis was on intrapsychic rather than interpersonal processes.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how the premises of human interactionism and psychobiology relate to psychiatricmental health nursing.

Question 16

Type: MCSA

The nurse who applies a conceptual framework that integrates the biologic and social sciences with the physical sciences in assessing clients is using:

1. Ericksons eight stages of development.

2. The medical model.

3. Social interactionism.

4. General systems theory.

Correct Answer: 4

Rationale 1: General systems theory, when applied to people, provides a conceptual framework for integrating the biologic and social sciences with the physical sciences. The medical model of care focuses on diagnostic categorization and medical treatments. Social interactionism stresses the general climate in the clients environment and attempts to understand the social and cultural conditions influencing behavior. Eriksons developmental theory of personality highlights tasks that individuals must accomplish in order to advance developmentally.

Rationale 2: General systems theory, when applied to people, provides a conceptual framework for integrating the biologic and social sciences with the physical sciences. The medical model of care focuses on diagnostic categorization and medical treatments. Social interactionism stresses the general climate in the clients environment and attempts to understand the social and cultural conditions influencing behavior. Eriksons developmental theory of personality highlights tasks that individuals must accomplish in order to advance developmentally.

Rationale 3: General systems theory, when applied to people, provides a conceptual framework for integrating the biologic and social sciences with the physical sciences. The medical model of care focuses on diagnostic categorization and medical treatments. Social interactionism stresses the general climate in the clients environment and attempts to understand the social and cultural conditions influencing behavior. Eriksons developmental theory of personality highlights tasks that individuals must accomplish in order to advance developmentally.

Rationale 4: General systems theory, when applied to people, provides a conceptual framework for integrating the biologic and social sciences with the physical sciences. The medical model of care focuses on diagnostic categorization and medical treatments. Social interactionism stresses the general climate in the clients environment and attempts to understand the social and cultural conditions influencing behavior. Eriksons developmental theory of personality highlights tasks that individuals must accomplish in order to advance developmentally.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how the premises of human interactionism and psychobiology relate to psychiatricmental health nursing.

Question 17

Type: MCSA

When providing orientation to a group of students, the psychiatricmental health nurse describes use of an eclectic clinical approach with newly admitted clients with a diagnosis of schizophrenia. Which of the following statements most accurately reflects the therapeutic value of an eclectic approach?

1. There is limited scientific evidence about treatment for schizophrenia, so a variety of medications and interventions must be tried over time.

2. Nurses do not need a philosophy of care to direct their practice.

3. It is difficult to determine a final plan of care for new clients with psychotic disorders.

4. Strategies from one or a combination of psychiatric theories are used to determine interventions and evaluation criteria for working with each client.

Correct Answer: 4

Rationale 1: Eclectic approaches use one psychiatric theory or a combination of psychiatric theories to determine what assessment information, interventions, approaches, and evaluation criteria are needed for any given client. An eclectic approach does not indicate indecision or use of interventions that are unsupported by evidence. An eclectic approach does not indicate a nurse is aphilosophical, but rather demonstrates that a range of theories are used to understand the best way to approach assessing and planning care for different clients.

Rationale 2: Eclectic approaches use one psychiatric theory or a combination of psychiatric theories to determine what assessment information, interventions, approaches, and evaluation criteria are needed for any given client. An eclectic approach does not indicate indecision or use of interventions that are unsupported by evidence. An eclectic approach does not indicate a nurse is aphilosophical, but rather demonstrates that a range of theories are used to understand the best way to approach assessing and planning care for different clients.

Rationale 3: Eclectic approaches use one psychiatric theory or a combination of psychiatric theories to determine what assessment information, interventions, approaches, and evaluation criteria are needed for any given client. An eclectic approach does not indicate indecision or use of interventions that are unsupported by evidence. An eclectic approach does not indicate a nurse is aphilosophical, but rather demonstrates that a range of theories are used to understand the best way to approach assessing and planning care for different clients.

Rationale 4: Eclectic approaches use one psychiatric theory or a combination of psychiatric theories to determine what assessment information, interventions, approaches, and evaluation criteria are needed for any given client. An eclectic approach does not indicate indecision or use of interventions that are unsupported by evidence. An eclectic approach does not indicate a nurse is aphilosophical, but rather demonstrates that a range of theories are used to understand the best way to approach assessing and planning care for different clients.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how the premises of human interactionism and psychobiology relate to psychiatricmental health nursing.

Question 18

Type: MCSA

A holistic view of the mindbody relationship is best demonstrated by which of the nurses comments to a student nurse?

1. My view is that clients have physical problems that have emotional consequences and psychological issues that cause physical problems.

2. Psychiatric clients often blame their problems on the side effects of the medications.

3. Clients come and go so quickly, we cant always complete a thorough physical exam.

4. We might as well be working on a medical unit. We focus mostly on medication management now.

Correct Answer: 1

Rationale 1: The humanisticinteractional view is that physical and mental factors are interrelated and that a change in one may result in a change in another. Healing and caring must be approached in a holistic manner. The nurse must help clients deal with the biologic aspects of their illness as well as emotional patterns and aspects of biologic experiences. Nurses must incorporate humanistic and interactional approaches and not simply rely only on psychopharmacology. Our practice and research must integrate high tech and high touch, nature and nurture, the biologic sciences, and the behavioral sciences.

Rationale 2: The humanisticinteractional view is that physical and mental factors are interrelated and that a change in one may result in a change in another. Healing and caring must be approached in a holistic manner. The nurse must help clients deal with the biologic aspects of their illness as well as emotional patterns and aspects of biologic experiences. Nurses must incorporate humanistic and interactional approaches and not simply rely only on psychopharmacology. Our practice and research must integrate high tech and high touch, nature and nurture, the biologic sciences, and the behavioral sciences.

Rationale 3: The humanisticinteractional view is that physical and mental factors are interrelated and that a change in one may result in a change in another. Healing and caring must be approached in a holistic manner. The nurse must help clients deal with the biologic aspects of their illness as well as emotional patterns and aspects of biologic experiences. Nurses must incorporate humanistic and interactional approaches and not simply rely only on psychopharmacology. Our practice and research must integrate high tech and high touch, nature and nurture, the biologic sciences, and the behavioral sciences.

Rationale 4: The humanisticinteractional view is that physical and mental factors are interrelated and that a change in one may result in a change in another. Healing and caring must be approached in a holistic manner. The nurse must help clients deal with the biologic aspects of their illness as well as emotional patterns and aspects of biologic experiences. Nurses must incorporate humanistic and interactional approaches and not simply rely only on psychopharmacology. Our practice and research must integrate high tech and high touch, nature and nurture, the biologic sciences, and the behavioral sciences.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain how the premises of human interactionism and psychobiology relate to psychiatricmental health nursing.

Question 19

Type: MCSA

The nursing student is studying the psychoanalytic theory. The student knows that which one of the following statements is not consistent with the psychoanalytic theory?

1. The structural model of the mind contends that the id, ego, and superego have specific interrelated functions.

2. Psychic determinism means that no behavior is accidental.

3. Psychoanalysis deals with the conscious mind.

4. Psychoanalytic therapy focuses on a dynamic view of mental phenomena rather than on the classification of illness.

Correct Answer: 3

Rationale 1: Psychoanalysis is a powerful method for studying the unconscious. Freud introduced the structural model of the mind which includes the id, ego, and superego which allies [interrelates] with the ego to control impulses of the id. Freuds work shifted the focus of psychiatry from classification to a dynamic view of mental phenomena. Psychic determinism states that no human behavior is accidental.

Rationale 2: Psychoanalysis is a powerful method for studying the unconscious. Freud introduced the structural model of the mind which includes the id, ego, and superego which allies [interrelates] with the ego to control impulses of the id. Freuds work shifted the focus of psychiatry from classification to a dynamic view of mental phenomena. Psychic determinism states that no human behavior is accidental.

Rationale 3: Psychoanalysis is a powerful method for studying the unconscious. Freud introduced the structural model of the mind which includes the id, ego, and superego which allies [interrelates] with the ego to control impulses of the id. Freuds work shifted the focus of psychiatry from classification to a dynamic view of mental phenomena. Psychic determinism states that no human behavior is accidental.

Rationale 4: Psychoanalysis is a powerful method for studying the unconscious. Freud introduced the structural model of the mind which includes the id, ego, and superego which allies [interrelates] with the ego to control impulses of the id. Freuds work shifted the focus of psychiatry from classification to a dynamic view of mental phenomena. Psychic determinism states that no human behavior is accidental.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic, psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.

Question 20

Type: MCSA

The nurse educator knows the approach that helps a client develop insight is aligned with which of the following theories?

1. Cognitive behavioral theory

2. Psychoanalytic theory

3. Socialinterpersonal theories

4. Medicalpsychobiologic theory

Correct Answer: 2

Rationale 1: Psychoanalysis is a method for studying the unconscious through clarifying the meaning of events, feelings, and behavior and thereby gaining insight about them. Medicalpsychobiological theory views the cause of mental illness as organic, located in the central nervous system, following a predictable course, and treated based on accurate diagnosis. Cognitive behavioral theory focuses on the present rather than the past. Socialinterpersonal theories focus on crucial social processes and cultural variation involving the development, identification, and resolution of disturbed human responses.

Rationale 2: Psychoanalysis is a method for studying the unconscious through clarifying the meaning of events, feelings, and behavior and thereby gaining insight about them. Medicalpsychobiological theory views the cause of mental illness as organic, located in the central nervous system, following a predictable course, and treated based on accurate diagnosis. Cognitive behavioral theory focuses on the present rather than the past. Socialinterpersonal theories focus on crucial social processes and cultural variation involving the development, identification, and resolution of disturbed human responses.

Rationale 3: Psychoanalysis is a method for studying the unconscious through clarifying the meaning of events, feelings, and behavior and thereby gaining insight about them. Medicalpsychobiological theory views the cause of mental illness as organic, located in the central nervous system, following a predictable course, and treated based on accurate diagnosis. Cognitive behavioral theory focuses on the present rather than the past. Socialinterpersonal theories focus on crucial social processes and cultural variation involving the development, identification, and resolution of disturbed human responses.

Rationale 4: Psychoanalysis is a method for studying the unconscious through clarifying the meaning of events, feelings, and behavior and thereby gaining insight about them. Medicalpsychobiological theory views the cause of mental illness as organic, located in the central nervous system, following a predictable course, and treated based on accurate diagnosis. Cognitive behavioral theory focuses on the present rather than the past. Socialinterpersonal theories focus on crucial social processes and cultural variation involving the development, identification, and resolution of disturbed human responses.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic, psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.

Question 21

Type: MCSA

Which statement indicates that the nurse understands the developmentalinterpersonal perspective of the self-system?

1. A persons sense of security is primarily derived from doing well in school.

2. Security is only achieved when a child discovers his or her autonomy.

3. Feelings of self-worth are established during infancy.

4. Childhood experiences influence the way people view and understand themselves.

Correct Answer: 4

Rationale 1: The self is a construct built from the childs experiences. To feel secure, the self requires feelings of approval and prestige as protection against anxiety across all developmental stages.

Rationale 2: The self is a construct built from the childs experiences. To feel secure, the self requires feelings of approval and prestige as protection against anxiety across all developmental stages.

Rationale 3: The self is a construct built from the childs experiences. To feel secure, the self requires feelings of approval and prestige as protection against anxiety across all developmental stages.

Rationale 4: The self is a construct built from the childs experiences. To feel secure, the self requires feelings of approval and prestige as protection against anxiety across all developmental stages.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic, psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.

Question 22

Type: MCSA

In explaining cognitive behavioral theory to a student, the nurse would not describe the concept of:

1. Reinforcement.

2. Psychic determinism.

3. Conditioned response.

4. Shaping.

Correct Answer: 2

Rationale 1: Psychic determinism is associated with psychoanalytic theory. Shaping, reinforcement, and conditioned responses are concepts linked to cognitive behavioral theory.

Rationale 2: Psychic determinism is associated with psychoanalytic theory. Shaping, reinforcement, and conditioned responses are concepts linked to cognitive behavioral theory.

Rationale 3: Psychic determinism is associated with psychoanalytic theory. Shaping, reinforcement, and conditioned responses are concepts linked to cognitive behavioral theory.

Rationale 4: Psychic determinism is associated with psychoanalytic theory. Shaping, reinforcement, and conditioned responses are concepts linked to cognitive behavioral theory.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic, psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.

Question 23

Type: MCSA

A nursing student is preparing a presentation on Eriksons developmental theory. The student wants to include in the presentation that Eriksons eight developmental stages are most closely aligned with:

1. Cognitive behaviorist concepts.

2. Maslows theory of self-actualization and hierarchy of needs.

3. Freuds psychosexual stages.

4. Sullivans stages of interpersonal development.

Correct Answer: 4

Rationale 1: Like Eriksons developmental theory, Sullivan believed that learning and development occur across the lifespan and that people can relearn tasks previously unaccomplished at earlier stages of life. Freud believed all developmental tasks were accomplished by a certain age, and unaccomplished tasks left individuals fixated at a particular stage causing lifelong psychiatric problems. Cognitive behaviorist concepts do not account for developmental tasks. Maslow proposed an order of basic human needs that were not linked to developmental stages or tasks. According to Maslow, physiologic needs must be met before higher-level needs such as self-esteem and self-actualization.

Rationale 2: Like Eriksons developmental theory, Sullivan believed that learning and development occur across the lifespan and that people can relearn tasks previously unaccomplished at earlier stages of life. Freud believed all developmental tasks were accomplished by a certain age, and unaccomplished tasks left individuals fixated at a particular stage causing lifelong psychiatric problems. Cognitive behaviorist concepts do not account for developmental tasks. Maslow proposed an order of basic human needs that were not linked to developmental stages or tasks. According to Maslow, physiologic needs must be met before higher-level needs such as self-esteem and self-actualization.

Rationale 3: Like Eriksons developmental theory, Sullivan believed that learning and development occur across the lifespan and that people can relearn tasks previously unaccomplished at earlier stages of life. Freud believed all developmental tasks were accomplished by a certain age, and unaccomplished tasks left individuals fixated at a particular stage causing lifelong psychiatric problems. Cognitive behaviorist concepts do not account for developmental tasks. Maslow proposed an order of basic human needs that were not linked to developmental stages or tasks. According to Maslow, physiologic needs must be met before higher-level needs such as self-esteem and self-actualization.

Rationale 4: Like Eriksons developmental theory, Sullivan believed that learning and development occur across the lifespan and that people can relearn tasks previously unaccomplished at earlier stages of life. Freud believed all developmental tasks were accomplished by a certain age, and unaccomplished tasks left individuals fixated at a particular stage causing lifelong psychiatric problems. Cognitive behaviorist concepts do not account for developmental tasks. Maslow proposed an order of basic human needs that were not linked to developmental stages or tasks. According to Maslow, physiologic needs must be met before higher-level needs such as self-esteem and self-actualization.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic, psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.

Question 24

Type: MCSA

Nursing roles associated with shifts in the delivery of psychiatric services to social and community settings would not include:

1. Leading community support groups for couples receiving genetic counseling.

2. Providing case management as part of an interdisciplinary team.

3. Participating as a member of a community board for social planning activities.

4. Providing individual therapy in a private practice setting.

Correct Answer: 4

Rationale 1: Traditional private practice is not associated with population or community-based levels of service, particularly groups previously neglected, or suffering from the effects of long-term institutionalization. Case management, participation in social planning, and providing supportive interventions and community support to various populations are all part of the shift of services from private to community settings.

Rationale 2: Traditional private practice is not associated with population or community-based levels of service, particularly groups previously neglected, or suffering from the effects of long-term institutionalization. Case management, participation in social planning, and providing supportive interventions and community support to various populations are all part of the shift of services from private to community settings.

Rationale 3: Traditional private practice is not associated with population or community-based levels of service, particularly groups previously neglected, or suffering from the effects of long-term institutionalization. Case management, participation in social planning, and providing supportive interventions and community support to various populations are all part of the shift of services from private to community settings.

Rationale 4: Traditional private practice is not associated with population or community-based levels of service, particularly groups previously neglected, or suffering from the effects of long-term institutionalization. Case management, participation in social planning, and providing supportive interventions and community support to various populations are all part of the shift of services from private to community settings.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic, psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.

Question 25

Type: MCSA

The humanistic perspective on mental disorders implies that psychiatricmental health nurses function in expanded roles. Which statement does not reflect this perspective?

1. Psychiatricmental health nurses are prepared to work for change within social and political systems.

2. Psychiatricmental health nursing focuses on the client and does not deal with social or political consequences.

3. Psychiatricmental health nurses develop philosophic and ethical frameworks to guide and evaluate the political outcomes of therapeutic intervention.

4. Psychiatricmental health nursing is involved in social goals that advance health holistically.

Correct Answer: 2

Rationale 1: Psychiatricmental health nursing includes client-oriented activities as well as involvement in social goals that advance health holistically. Because psychiatricmental health nursing has political consequences, nurses must be prepared to influence social and political systems, and contribute to development and evaluation of ethical frameworks to evaluate outcomes of therapeutic intervention at individual and system levels.

Rationale 2: Psychiatricmental health nursing includes client-oriented activities as well as involvement in social goals that advance health holistically. Because psychiatricmental health nursing has political consequences, nurses must be prepared to influence social and political systems, and contribute to development and evaluation of ethical frameworks to evaluate outcomes of therapeutic intervention at individual and system levels.

Rationale 3: Psychiatricmental health nursing includes client-oriented activities as well as involvement in social goals that advance health holistically. Because psychiatricmental health nursing has political consequences, nurses must be prepared to influence social and political systems, and contribute to development and evaluation of ethical frameworks to evaluate outcomes of therapeutic intervention at individual and system levels.

Rationale 4: Psychiatricmental health nursing includes client-oriented activities as well as involvement in social goals that advance health holistically. Because psychiatricmental health nursing has political consequences, nurses must be prepared to influence social and political systems, and contribute to development and evaluation of ethical frameworks to evaluate outcomes of therapeutic intervention at individual and system levels.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health nursing.

Question 26

Type: MCSA

The heart of the psychiatricmental health nurses therapeutic and caring role is characterized by:

1. Bringing unconscious childhood traumas into awareness.

2. Focusing on basic life issues of eating, sleeping, grooming, and hygiene as they relate to mental functioning.

3. Using the nurseclient relationship to support the client in exploring new definitions and actions for life situations.

4. Providing educational information about the clients mental illness.

Correct Answer: 3

Rationale 1: The humanistic use of self includes helping clients redefine their experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhancing the quality of their lives and social worlds. Focusing on physical functioning is part of, but not the essence of, the therapeutic relationship. Unless educated in psychoanalysis, nurses do not focus on uncovering unconscious experiences. Psychoeducation is part of the nursing role, but not the main focus of the nurseclient therapeutic relationship.

Rationale 2: The humanistic use of self includes helping clients redefine their experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhancing the quality of their lives and social worlds. Focusing on physical functioning is part of, but not the essence of, the therapeutic relationship. Unless educated in psychoanalysis, nurses do not focus on uncovering unconscious experiences. Psychoeducation is part of the nursing role, but not the main focus of the nurseclient therapeutic relationship.

Rationale 3: The humanistic use of self includes helping clients redefine their experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhancing the quality of their lives and social worlds. Focusing on physical functioning is part of, but not the essence of, the therapeutic relationship. Unless educated in psychoanalysis, nurses do not focus on uncovering unconscious experiences. Psychoeducation is part of the nursing role, but not the main focus of the nurseclient therapeutic relationship.

Rationale 4: The humanistic use of self includes helping clients redefine their experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhancing the quality of their lives and social worlds. Focusing on physical functioning is part of, but not the essence of, the therapeutic relationship. Unless educated in psychoanalysis, nurses do not focus on uncovering unconscious experiences. Psychoeducation is part of the nursing role, but not the main focus of the nurseclient therapeutic relationship.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health nursing.

Question 27

Type: MCSA

The psychiatricmental health nurses scope of practice includes:

1. Developing a comfortable relationship with the client.

2. Establishing a routine for clients to manage basic life issues of eating, sleeping, grooming, and hygiene.

3. Identifying client reasons for failure to comply with recommended treatments.

4. Exploring the meaning of life experiences such as birth and death, losses, life course changes, and human rights.

Correct Answer: 4

Rationale 1: The nurses key role is to help clients examine a full range of life experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhance the quality of their lives and social worlds. Focusing on failure of compliance undervalues concepts of human choice and empowerment within the nurseclient relationship. The goal of the nurseclient relationship is to create a therapeutic rather than a comfortable relationship. The scope of the nurses role includes understanding and facilitating exploration of client issues related to basic functions rather than assuming that issues need to be managed and understood separate from the holistic view of the person.

Rationale 2: The nurses key role is to help clients examine a full range of life experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhance the quality of their lives and social worlds. Focusing on failure of compliance undervalues concepts of human choice and empowerment within the nurseclient relationship. The goal of the nurseclient relationship is to create a therapeutic rather than a comfortable relationship. The scope of the nurses role includes understanding and facilitating exploration of client issues related to basic functions rather than assuming that issues need to be managed and understood separate from the holistic view of the person.

Rationale 3: The nurses key role is to help clients examine a full range of life experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhance the quality of their lives and social worlds. Focusing on failure of compliance undervalues concepts of human choice and empowerment within the nurseclient relationship. The goal of the nurseclient relationship is to create a therapeutic rather than a comfortable relationship. The scope of the nurses role includes understanding and facilitating exploration of client issues related to basic functions rather than assuming that issues need to be managed and understood separate from the holistic view of the person.

Rationale 4: The nurses key role is to help clients examine a full range of life experiences in more satisfying ways, learn new patterns of coping with stress, and generally enhance the quality of their lives and social worlds. Focusing on failure of compliance undervalues concepts of human choice and empowerment within the nurseclient relationship. The goal of the nurseclient relationship is to create a therapeutic rather than a comfortable relationship. The scope of the nurses role includes understanding and facilitating exploration of client issues related to basic functions rather than assuming that issues need to be managed and understood separate from the holistic view of the person.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health nursing.

Question 28

Type: MCSA

A middle-aged parent goes to the emergency room for symptoms of dizziness, headache, and suicidal ideation. The nurse assesses the patient for substance use, employment, child-rearing stressors, relationships with coworkers, recurring physical symptoms, and marital problems. The nurse is:

1. Failing to focus on the seriousness of the primary presenting problem.

2. Establishing rapport that will decrease the likelihood of suicide.

3. Doing more than the nurses share of the interdisciplinary assessment.

4. Formulating a holisticinteractional assessment needed to interpret clinical data.

Correct Answer: 4

Rationale 1: The nurse must conduct a holistic assessment and synthesize factors from many aspects of an individuals life to determine an effective plan of care. The nurse functions as an autonomous member of the mental health team and assumes a broad range of responsibilities within the RN scope of practice. Belief that developing rapport will decrease suicidal ideation indicates a knowledge deficit regarding the phenomenon of depression/suicidal ideation, and an unrealistic perspective on the role of the nurse. Predetermining what the presenting problem is before making a thorough holistic assessment indicates that the nurse does not understand the complexity of the human condition.

Rationale 2: The nurse must conduct a holistic assessment and synthesize factors from many aspects of an individuals life to determine an effective plan of care. The nurse functions as an autonomous member of the mental health team and assumes a broad range of responsibilities within the RN scope of practice. Belief that developing rapport will decrease suicidal ideation indicates a knowledge deficit regarding the phenomenon of depression/suicidal ideation, and an unrealistic perspective on the role of the nurse. Predetermining what the presenting problem is before making a thorough holistic assessment indicates that the nurse does not understand the complexity of the human condition.

Rationale 3: The nurse must conduct a holistic assessment and synthesize factors from many aspects of an individuals life to determine an effective plan of care. The nurse functions as an autonomous member of the mental health team and assumes a broad range of responsibilities within the RN scope of practice. Belief that developing rapport will decrease suicidal ideation indicates a knowledge deficit regarding the phenomenon of depression/suicidal ideation, and an unrealistic perspective on the role of the nurse. Predetermining what the presenting problem is before making a thorough holistic assessment indicates that the nurse does not understand the complexity of the human condition.

Rationale 4: The nurse must conduct a holistic assessment and synthesize factors from many aspects of an individuals life to determine an effective plan of care. The nurse functions as an autonomous member of the mental health team and assumes a broad range of responsibilities within the RN scope of practice. Belief that developing rapport will decrease suicidal ideation indicates a knowledge deficit regarding the phenomenon of depression/suicidal ideation, and an unrealistic perspective on the role of the nurse. Predetermining what the presenting problem is before making a thorough holistic assessment indicates that the nurse does not understand the complexity of the human condition.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health nursing.

Question 29

Type: MCSA

The psychiatricmental health nurse is asked to prepare an educational conference for unlicensed staff working in a day treatment program for hyperactive children with borderline intelligence. Using fundamental concepts of cognitive behaviorist theory, which of the following conference exercises would the nurse include?

1. Have a contest to choose the best staff-designed time-out room where children can comfortably spend significant periods alone.

2. Include sessions for staff to practice talking with parents about the benefits of having their child transferred to an institutional setting where he or she would have access to highly trained experts.

3. Ask staff to work in teams to develop a token economy program that uses a prescribed daily routine and reinforcers for the children.

4. Show a brief movie that demonstrates the simplicity of using behavior modification.

Correct Answer: 3

Rationale 1: In token economies, clients follow prescribed schedules for daily living in which they are rewarded for desired behavior by token reinforcers, such as food, candy, and verbal approval. Time-outs are only used for short periods of isolation to decease undesired behavior. Children with hyperactivity or borderline intelligence can be treated in the home when parents are taught how to use effective approaches. Treatment no longer requires the presence of highly trained experts. Behavior modification is complex, and nonprofessional staff must be taught the effective use of behaviorist principles to eliminate chronic, maladaptive behavior.

Rationale 2: In token economies, clients follow prescribed schedules for daily living in which they are rewarded for desired behavior by token reinforcers, such as food, candy, and verbal approval. Time-outs are only used for short periods of isolation to decease undesired behavior. Children with hyperactivity or borderline intelligence can be treated in the home when parents are taught how to use effective approaches. Treatment no longer requires the presence of highly trained experts. Behavior modification is complex, and nonprofessional staff must be taught the effective use of behaviorist principles to eliminate chronic, maladaptive behavior.

Rationale 3: In token economies, clients follow prescribed schedules for daily living in which they are rewarded for desired behavior by token reinforcers, such as food, candy, and verbal approval. Time-outs are only used for short periods of isolation to decease undesired behavior. Children with hyperactivity or borderline intelligence can be treated in the home when parents are taught how to use effective approaches. Treatment no longer requires the presence of highly trained experts. Behavior modification is complex, and nonprofessional staff must be taught the effective use of behaviorist principles to eliminate chronic, maladaptive behavior.

Rationale 4: In token economies, clients follow prescribed schedules for daily living in which they are rewarded for desired behavior by token reinforcers, such as food, candy, and verbal approval. Time-outs are only used for short periods of isolation to decease undesired behavior. Children with hyperactivity or borderline intelligence can be treated in the home when parents are taught how to use effective approaches. Treatment no longer requires the presence of highly trained experts. Behavior modification is complex, and nonprofessional staff must be taught the effective use of behaviorist principles to eliminate chronic, maladaptive behavior.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health nursing.

Question 30

Type: MCSA

The psychiatricmental health nurse is asked to consult with an emergency room nurse about a client who has been refusing to cooperate with lab work for over four hours. The client appears frightened, answers questions reluctantly, and has no family present. Which response of the psychiatricmental health nurse demonstrates a humanisticinteractional approach to the situation?

1. Have you asked if the client wants to have a friend or family member to be here?

2. Have you offered medication for anxiety?

3. Give the client some time alone to decide whether or not to accept treatment.

4. I would ask for a full psychiatric evaluation before discharge.

Correct Answer: 1

Rationale 1: Since all behavior has meaning, appearance and non-verbal cues suggest the client is fearful and potentially alienated. The offer to include someone from the clients larger support system recognizes the need for safety, security, and feeling connected with others. Suggesting medication for anxiety is premature without further assessment and underscores that the client is not in control of his or her emotions. The statement that a full psychiatric evaluation is needed suggests that the client has a larger problem which has not been unsubstantiated by a holistic assessment, further stigmatizing the client. Allowing the client to remain isolated overlooks the opportunity to develop a relationship where shared understanding can develop.

Rationale 2: Since all behavior has meaning, appearance and non-verbal cues suggest the client is fearful and potentially alienated. The offer to include someone from the clients larger support system recognizes the need for safety, security, and feeling connected with others. Suggesting medication for anxiety is premature without further assessment and underscores that the client is not in control of his or her emotions. The statement that a full psychiatric evaluation is needed suggests that the client has a larger problem which has not been unsubstantiated by a holistic assessment, further stigmatizing the client. Allowing the client to remain isolated overlooks the opportunity to develop a relationship where shared understanding can develop.

Rationale 3: Since all behavior has meaning, appearance and non-verbal cues suggest the client is fearful and potentially alienated. The offer to include someone from the clients larger support system recognizes the need for safety, security, and feeling connected with others. Suggesting medication for anxiety is premature without further assessment and underscores that the client is not in control of his or her emotions. The statement that a full psychiatric evaluation is needed suggests that the client has a larger problem which has not been unsubstantiated by a holistic assessment, further stigmatizing the client. Allowing the client to remain isolated overlooks the opportunity to develop a relationship where shared understanding can develop.

Rationale 4: Since all behavior has meaning, appearance and non-verbal cues suggest the client is fearful and potentially alienated. The offer to include someone from the clients larger support system recognizes the need for safety, security, and feeling connected with others. Suggesting medication for anxiety is premature without further assessment and underscores that the client is not in control of his or her emotions. The statement that a full psychiatric evaluation is needed suggests that the client has a larger problem which has not been unsubstantiated by a holistic assessment, further stigmatizing the client. Allowing the client to remain isolated overlooks the opportunity to develop a relationship where shared understanding can develop.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health nursing.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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