Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2/GUIDE TO SCORE A

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Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 2 Chapter 01: Practicing the Science and the Art of Psychiatric Nursing MULTIPLE CHOICE 1. Which outcome, focus... ed on recovery, would be expected in the plan of care for a patient living in the community and diagnosed with serious and persistent mental illness? Within 3 months, the patient will: a. deny suicidal ideation. 2. In the shift-change report, an off-going nurse criticizes a patient who wears heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy? TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 3. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which statement is an example of attending? TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 4. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurses most caring comment. TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 5. A patient shows the nurse an article from the Internet about a health problem. Which characteristic of the web sites address most alerts the nurse that the site may have biased and prejudiced information? TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance 6. A nurse says, When I was in school, I learned to call upset patients by name to get their attention; however, I read a descriptive research study that says that this approach does not work. I plan to stop calling patients by name. Which statement is the best appraisal of this nurses comment? Descriptive research findings provide evidence for practice but must be viewed in relation to other studies before practice changes. One study is not enough. Descriptive studies are low on the hierarchy of evidence. Clinical algorithms use flow charts to manage problems and do not specify one response to a clinical problem. Classic tenets of practice should change as research findings provide evidence for change. DIF: Cognitive Level: Analysis (Analyzing) REF: 3 TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance 7. Two nursing students discuss career plans after graduation. One student wants to enter psychiatric nursing. The other student asks, Why would you want to be a psychiatric nurse? All they do is talk. You will lose your skills. Select the best response by the student interested in psychiatric nursing. a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be better because of the nature of patients problems. b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve multidimensional problems. Im challenged by those situations. c. I think I will be good in the mental health field. I do not like clinical rotations in school, so I do not want to continue them after I graduate. d. Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical nurses. That appeals to me. ANS: B The practice of psychiatric nursing requires a different set of skills than medical surgical nursing, although substantial overlap does exist. Psychiatric nurses must be able to help patients with medical and mental health problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in psychiatric settings have increased, similar to other specialties. Psychiatric nursing involves clinical practice, Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 4 not simply documentation. Psychosocial pain is real and can cause as much suffering as physical pain. DIF: Cognitive Level: Application (Applying) REF: 3 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 8. Which research evidence would most influence a group of nurses to change their practice? a. Expert committee report of recommendations for practice b. Systematic review of randomized controlled trials c. Nonexperimental descriptive study d. Critical pathway ANS: B Research findings are graded using a hierarchy of evidence. A systematic review of randomized controlled trials is Level A and provides the strongest evidence for changing practice. Expert committee recommendations and descriptive studies lend less powerful and influential evidence. A critical pathway is not evidence; it incorporates research findings after they have been analyzed. DIF: Cognitive Level: Comprehension (Understanding) REF: 3 TOP: Nursing Process: Planning MSC: NCLEX: Safe, Effective Care Environment 9. A bill introduced in Congress would reduce funding for the care of people diagnosed with mental illnesses. A group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Advocacy b. Attending c. Recovery d. Evidence-based practice ANS: A An advocate defends or asserts anothers cause, particularly when the other person lacks the ability to do that for himself or herself. Examples of individual advocacy include helping patients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the individuals with mental illness; the letter-writing campaign advocates for that cause on behalf of patients who are unable to articulate their own needs. DIF: Cognitive Level: Comprehension (Understanding) REF: 8 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 10. An informal group of patients discuss their perceptions of nursing care. Which comment best indicates a patients perception that his or her nurse is caring? a. My nurse always asks me which type of juice I want to help me swallow my medication. b. My nurse explained my treatment plan to me and asked for my ideas about how to make it better. c. My nurse told me that if I take all the medicines the doctor prescribes I will get discharged soon. d. My nurse spends time listening to me talk about my problems. That helps me feel like Im not alone. ANS: D Caring evidences empathic understanding, as well as competency. It helps change pain and suffering into a shared experience, creating a human connection that alleviates feelings of isolation. The incorrect options give examples of statements that demonstrate advocacy or giving advice. DIF: Cognitive Level: Application (Applying) REF: 3 TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity 11. A patient who immigrated to the United States from Honduras was diagnosed with schizophrenia. The patient took an antipsychotic medication for 3 weeks but showed no improvement. Which resource should the treatment team consult for information on more effective medications for this patient? a. Clinical algorithm b. Clinical pathway c. Clinical practice guideline Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 5 d. International Statistical Classification of Diseases and Related Health Problems (ICD) ANS: A A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches drawn from large databases of information. These guidelines help the treatment team make decisions cognizant of an individual patients needs, such as ethnic origin, age, or gender. A clinical pathway is a map of interventions and treatments related to a specific disorder. Clinical practice guidelines summarize best practices about specific health problems. The ICD classifies diseases. DIF: Cognitive Level: Application (Applying) REF: 5 TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 12. Which historical nursing leader helped focus practice to recognize the importance of science in psychiatric nursing? a. Abraham Maslow b. Hildegard Peplau c. Kris Martinsen d. Harriet Bailey ANS: B Although all these leaders included science as an important component of practice, Hildegard Peplau most influenced its development in psychiatric nursing. Maslow was not a nurse, but his theories influence how nurses prioritize problems and care. Bailey wrote a textbook in the 1930s on psychiatric nursing interventions. Kris Martinsen emphasized the importance of caring in nursing practice. DIF: Cognitive Level: Knowledge (Remembering) REF: 4 TOP: Nursing Process: N/A MSC: NCLEX: Psychosocial Integrity 13. A nurse consistently strives to demonstrate caring behaviors during interactions with patients. Which reaction by a patient indicates this nurse is effective? A patient reports feeling: a. distrustful of others. b. connected with others. c. uneasy about the future. d. discouraged with efforts to improve. ANS: B A patient is likely to respond to caring with a sense of connectedness with others. The absence of caring can make patients feel distrustful, disconnected, uneasy, and discouraged. DIF: Cognitive Level: Comprehension (Understanding) REF: 7 TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity MULTIPLE RESPONSE 1. An experienced nurse says to a new graduate, When youve practiced as long as I have, you will instantly know how to take care of psychotic patients. What is the new graduates best analysis of this comment? Select all that apply. a. The experienced nurse may have lost sight of patients individuality, which may compromise the integrity of practice. b. New research findings must be continually integrated into a nurses practice to provide the most effective care. c. Experience provides mental health nurses with the tools and skills needed for effective professional practice. d. Experienced psychiatric nurses have learned the best ways to care for psychotic patients through trial and error. e. Effective psychiatric nurses should be continually guided by an intuitive sense of patients needs. ANS: A, B Evidence-based practice involves using research findings to provide the most effective nursing care. Evidence is continually emerging; therefore, nurses cannot rely solely on experience. The effective nurse also maintains Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 6 respect for each patient as an individual. Overgeneralization compromises that perspective. Intuition and trial and error are unsystematic approaches to care. DIF: Cognitive Level: Application (Applying) REF: 2 TOP: Nursing Process: Evaluation MSC: NCLEX: Safe, Effective Care Environment 2. Which patient statements identify qualities of nursing practice with high therapeutic value? (Select all that apply.) My nurse: a. talks in language I can understand. b. helps me keep track of my medications. c. is willing to go to social activities with me. d. lets me do whatever I choose without interfering. e. looks at me as a whole person with different needs. ANS: A, B, E Each correct answer demonstrates caring is an example of appropriate nursing foci: communicating at a level understandable to the patient, using holistic principles to guide care, and providing medication supervision. The incorrect options suggest a laissez-faire attitude on the part of the nurse, when the nurse should instead provide thoughtful feedback and help patients test alternative solutions or violate boundaries. DIF: Cognitive Level: Application (Applying) REF: 6 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 7 Chapter 02: Mental Health and Mental Illness MULTIPLE CHOICE 1. An 86-year-old, previously healthy and independent, falls after an episode of vertigo. Which behavior by this patient best demonstrates resilience? The patient: a. says, I knew this would happen eventually. b. stops attending her weekly water aerobics class. c. refuses to use a walker and says, I dont need that silly thing. d. says, Maybe some physical therapy will help me with my balance. ANS: D Resiliency is the ability to recover from or adjust to misfortune and change. The correct response indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. Saying I knew this would happen eventually and discontinuing healthy activities suggest a hopeless perspective on the health change. Refusing to use a walker indicates denial. DIF: Cognitive Level: Comprehension (Understanding) REF: 14 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 2. A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that the patient has a mental illness? The patient: a. describes coping and relaxation strategies used when feeling anxious. b. describes mood as consistently sad, discouraged, and hopeless. c. can perform tasks attempted within the limits of own abilities. d. reports occasional problems with insomnia. ANS: B A patient who reports having a consistently negative mood is describing a mood alteration. The incorrect options describe mentally healthy behaviors and common problems that do not indicate mental illness. DIF: Cognitive Level: Application (Applying) REF: 11 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 3. The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the patient will: a. describe feelings associated with loss and stress. b. meet own needs without considering the rights of others. c. identify healthy coping behaviors in response to stressful events. d. allow others to assume responsibility for major areas of own life. ANS: C The patients ability to identify healthy coping behaviors indicates adaptive, healthy behavior and demonstrates an increased ability to recover from severe stress. Describing feelings associated with loss and stress does not move the patient toward adaptation. The remaining options are maladaptive behaviors. [Show More]

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