1. A staff nurse completes orientation to a psychiatric unit. This
nurse may expect an advanced practice nurse to perform which
additional intervention?
a
.
Conduct mental
health assessments.
c
.
Establish thera
...
1. A staff nurse completes orientation to a psychiatric unit. This
nurse may expect an advanced practice nurse to perform which
additional intervention?
a
.
Conduct mental
health assessments.
c
.
Establish therapeutic
relationships.
b
.
Prescribe psychotropic
medication.
d
.
Individualize nursing
care plans.
ANS: B
In most states, prescriptive privileges are granted to mastersprepared nurse practitioners who have taken special courses on
prescribing medication. The nurse prepared at the basic level is
permitted to perform mental health assessments, establish
relationships, and provide individualized care planning.
2. When a nursing student expresses concerns about how mental
health nurses lose all their nursing skills, the best response by the
mental health nurse is:
a
.
Psychiatric nurses practice in safer environments
than other specialties. Nurse-to-patient ratios
must be better because of the nature of the
patients problems.
b
.
Psychiatric nurses use complex communication
skills as well as critical thinking to solve
multidimensional problems. I am challenged by
those situations.
c
.
That’s a misconception. Psychiatric nurses
frequently use high technology monitoring
equipment and manage complex intravenous
therapies.
d
.
Psychiatric nurses do not have to deal with as
much pain and suffering as medical-surgical
nurses do. That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills
than medical-surgical nursing, though there is substantial overlap.
Psychiatric nurses must be able to help patients with medical as well
as mental health problems, reflecting the holistic perspective these
nurses must have. Nurse-patient ratios and workloads in psychiatric
settings have increased, just like other specialties. Psychiatric
nursing involves clinical practice, not just documentation.
Psychosocial pain and suffering are as real as physical pain and
suffering.
3. When a new bill introduced in Congress reduces funding for care
of persons with mental illness, a group of nurses writes letters to
their elected representatives in opposition to the legislation. Which
role have the nurses fulfilled?
a
. Recovery
c
. Advocacy
b
. Attending
d
.
Evidence-based
practice
ANS: C
An advocate defends or asserts another’s cause, particularly when
the other person lacks the ability to do that for self. Examples of
individual advocacy include helping patients understand their rights
or make decisions. On a community scale, advocacy includes
political activity, public speaking, and publication in the interest of
improving the human condition. Since funding is necessary to
deliver quality programming for persons with mental illness, the
letter- writing campaign advocates for that cause on behalf of
patients who are unable to articulate their own needs.
4. Which comment best indicates that a patient perceived the nurse
was caring? My nurse:
a
.
always asks me which type of juice I want to help
me swallow my medication.
b
.
explained my treatment plan to me and asked
for my ideas about how to make it better.
c
.
spends time listening to me talk about my
problems. That helps me feel like I am not alone.
d
.
told me that if I take all the medicines the doctor
prescribes, then I will get discharged sooner.
ANS: C
Caring evidences empathetic understanding as well as competency.
It helps change pain and suffering into a shared experience, creating
a human connection that alleviates feelings of isolation. The
distracters give examples of statements that demonstrate advocacy
or giving advice.
5. Which assessment finding most clearly indicates that a patient
may be experiencing a mental illness? The patient:
a
. reports occasional sleeplessness and anxiety.
b
.
reports a consistently sad, discouraged, and
hopeless mood.
c
.
is able to describe the difference between as if
and for real.
d
.
perceives difficulty making a decision about
whether to change jobs.
ANS: B
The correct response describes a mood alteration, which reflects
mental illness. The distracters describe behaviors that are mentally
healthy or within the usual scope of human experience.
6. Which finding best indicates that the goal Demonstrate mentally
healthy behavior was achieved? A patient:
a
.
sees self as capable of achieving ideals and
meeting demands.
b
.
behaves without considering the consequences
of personal actions.
c
.
aggressively meets own needs without
considering the rights of others.
d
.
seeks help from others when assuming
responsibility for major areas of own life.
ANS: A
The correct response describes an adaptive, healthy behavior. The
distracters describe maladaptive behaviors.
7. A nurse encounters an unfamiliar psychiatric disorder on a new
patients admission form. Which resource should the nurse consult to
determine criteria used to establish this diagnosis?
a
.
International Statistical Classification of Diseases
and Related Health Problems (ICD-10)
b
.
Diagnostic and Statistical Manual of Mental
Disorders (DSM-5)
c
. A behavioral health reference manual
d
. Wikipedia
ANS: B
The DSM-5 gives the criteria used to diagnose each mental disorder.
The distracters may not contain diagnostic criteria for a psychiatric
illness.
8. A nurse wants to find a description of diagnostic criteria for
anxiety disorders. Which resource would have the most complete
information?
a
. Nursing Outcomes Classification (NOC)
b Diagnostic and Statistical Manual of Mental
. Disorders (DSM-5)
c
.
The ANAs Psychiatric-Mental Health Nursing
Scope and Standards of Practice
d
.
International Statistical Classification of Diseases
and Related Health Problems (ICD-10)
ANS: B
The DSM-5 details the diagnostic criteria for psychiatric clinical
conditions. The other references are good resources but do not
define the diagnostic criteria.
9. Which individual is demonstrating the highest level of resilience?
One who:
a
. is able to repress stressors.
b
. becomes depressed after the death of a spouse.
c
.
lives in a shelter for two years after the home is
destroyed by fire.
d
.
takes a temporary job to maintain financial
stability after loss of a permanent job.
ANS: D
Resilience is closely associated with the process of adapting and
helps people facing tragedies, loss, trauma, and severe stress. It is
the ability and capacity for people to secure the resources they need
to support their well-being. Repression and depression are
unhealthy. Living in a shelter for two years shows a failure to move
forward after a tragedy. See related audience response question.
10. Complete this analogy. NANDA: clinical judgment: NIC:
_________________
a
. patient outcomes
c
. diagnosis
b
. nursing actions
d
. symptoms
ANS: B
Analogies show parallel relationships. NANDA, the North American
Nursing Diagnosis Association, identifies diagnostic statements
regarding human responses to actual or potential health problems.
These statements represent clinical judgments. NIC (Nursing
Interventions Classification) identifies actions provided by nurses
that enhance patient outcomes. Nursing care activities may be
direct or indirect.
11. A college student said, Most of the time Im happy and feel good
about myself. I have learned that what I get out of something is
proportional to the effort I put into it. Which number on this mental
health continuum should the nurse select?
Mental Illness
Mental
Health
1 2 3 4 5
a
. 1
b
. 2
c
. 3
d
. 4
e
. 5
ANS: E
The student is happy and has an adequate self-concept. The student
is reality-oriented, works effectively, and has control over own
behavior. Mental health does not mean that a person is always
happy
[Show More]
