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Test Bank For Psychiatric Mental Health Nursing, 5th Edition By Fortinash
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Test Bank For Psychiatric Mental Health Nursing, 5th Edition By Fortinash
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Psychiatric Mental Health Nursing, 5th Edition, Katherine M. Fortinash, Patricia A. Holoday Worret Test Bank
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Test Bank for Davis Advantage for Psychiatric Mental Health Nursing 10th Edition by Karyn I. Morgan and Mary C. Townsend
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FORTINASH PSYCHIATRIC MENTAL HEALTH NURSING 5TH EDITIONFortinash: Psychiatric Mental Health Nursing, 5th Edition
Chapter 01: Psychiatric Nursing: Theory, Principles, and Trends
1. Which understanding is the basis for the nursing actions focused on minimizing
mental health promotion of families with chronically mentally ill members?
a. Family members are at an increased risk for mental illness.
b. The mental health care system is not prepared to deal with family crises.
c. Family members are seldom prepared to cope with a chronically ill individual.
d. The chronically mentally ill receive care best when delivered in a formal setting.
ANS: A
When families live with a dominant member who has a persistent and severe mental
disorder the outcomes are often expressed as family members who are at increased risk
for physical and mental illnesses. The remaining options are not necessarily true.
DIF: Cognitive Level: Application REF: Page 3
2. Which nursing activity shows the nurse actively engaged in the primary prevention of
mental disorders?
a. Providing a patient, whose depression is well managed, with medication on time
b. Making regular follow-up visits to a new mother at risk for post-partum
depression
c. Providing the family of a patient, diagnosed with depression, information on
suicide prevention
d. Assisting a patient who has obsessive compulsive tendencies prepare and
practice for a job interview
ANS: B
Primary prevention helps to reduce the occurrence of mental disorders by staying
involved with a patient. Providing medication and information on existing illnesses are
examples of secondary prevention which helps to reduce the prevalence of mental
disorders. Assisting a mentally ill patient with preparation for a job interview is tertiary
prevention since it involves rehabilitation.
DIF: Cognitive Level: Application REF: Page 4
3. Which intervention reflects attention being focused on the patient’s intentions
regarding his diagnosis of severe depression?
a. Being placed on suicide precautions
b. Encouraging visits by his family members
c. Receiving a combination of medications to address his emotional needs
d. Being asked to decide where he will attend his prescribed therapy sessions
ANS: D
A primary factor in patient treatment includes consideration of the patient’s intentions
regarding his or her own care. Patients are central to the process that determines their
care as their abilities allow. Under the guidance of PMH nurses and other mental health
personnel, patients are encouraged to make decisions and to actively engage in their
own treatment plans to meet their needs. The remaining options are focused on specifics
of the determined plan of care.
DIF: Cognitive Level: Application REF: Page 5
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,4. When a patient’s family asks why their chronically mentally ill adult child is being
discharged to a community-based living facility, the nurse responds:
a. “It is a way to meet the need for social support.”
b. “It is too expensive to keep stabilized patients in acute care settings.”
c. “This type of facility will provide the specialized care that is needed.”
d. “Being out in the community will help provide hope and purpose for living.”
ANS: D
Hospitalization may be necessary for acute care, but, when patients are stabilized, they
move into community-based, patient-centered settings or are discharged home with
continued outpatient treatment in the community. Concentrated efforts are made to
reduce the patient’s sick role by providing opportunities for the development of a
purposeful life and instilling hope for each patient’s future. Although social support is
important, such a living arrangement is not the only way to achieve it. Although acute
care is expensive, it is not the major concern when determining long-term care options.
Community-based facilities are not the only option for specialized care.
DIF: Cognitive Level: Application REF: Page 5
5. What is the best explanation to offer when the mother of a chronically ill teenage
patient asks, “Under what circumstances would he be considered incompetent?”
a. “When you can provide the court with enough evidence to show that he is not
able to care for himself safely.”
b. “It is not likely that someone his age would be determined to be incompetent
regardless of his mental condition.”
c. “He would have to engage in behavior that would result in harm to himself or to
someone else; like you or his siblings.”
d. “If the illness becomes so severe that his judgment is impaired to the point where
the decisions he makes are harmful to himself or to others.”
ANS: D
When a person is unable to cognitively process information or to make decisions about
his or her own welfare, the person may be determined to be mentally incompetent.
Providing self-care is not the only criteria considered. Age is not a factor considered. The
decision is often based on the potential for such behavior.
DIF: Cognitive Level: Application REF: Page 6
6. Which psychiatric nursing intervention shows an understanding of integrated care?
a. A chronically abused woman is assessed for anxiety.
b. A manic patient is taken to the gym to use the exercise equipment.
c. The older adult diagnosed with depression is monitored for suicidal ideations.
d. A teenager who refuses to obey the unit’s rules is not allow to play video games.
ANS: A
The majority of health disciplines now recognize that mental disorders and physical
illnesses are closely linked. The presence of a mental disorder increases the risk for the
development of physical illnesses and vice versa. Assessing a chronically abused
individual for anxiety call should attention to the psychiatric disorder that could develop
from the abuse. The remaining options show interventions that are appropriate for the
mental disorder.
DIF: Cognitive Level: Application REF: Page 6
7. What reason does the nurse give the patient for the emphasis and attention being
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, paid to the recovery phase of their treatment plan?
a. Recovery care, even when intensive, is less expensive than acute psychiatric
care.
b. Effective recovery care is likely to result in fewer relapses and subsequent
hospitalizations.
c. Planning for recovery care is time consuming and involves dealing with many
complicated details.
d. Recovery care is usually done on an outpatient basis and so is generally better
accepted by patients.
ANS: B
Much attention is paid to recovery care since effective recovery care helps improve
patient outcomes and thus minimize subsequent hospitalizations. Recovery care is not
necessarily less expensive than acute care. Although effective recovery care planning
may be time consuming and detail oriented, that is not the reason for implementing it.
Recovery care is not necessarily well accepted by patients.
DIF: Cognitive Level: Application REF: Page 7
8. The nurse is attending a neighborhood meeting where a half-way house is being
proposed for the neighborhood when a member of the community states, “We don’t
want the facility; we especially don’t want violent people living near us.” The
response by the nurse that best addresses the public’s concern is:
a. “In truth, most individuals with psychiatric disorder are passive and withdrawn
and pose little threat to those around them.”
b. “The mentally ill seldom behave in the manner they are portrayed by movies;
they are people just like the rest of us.”
c. “Patients with psychiatric disorder are so well medicated that they do not display
violent behaviors.”
d. “The mentally ill deserve a safe, comfortable place to live among people who
truly care for them.”
ANS: A
A major reason for the existence of the stigma placed on persons with mental illness is
lack of knowledge. The main fear is of violence, although only a small percentage of
patients with mental illness display this behavior. Providing the public with accurate
information can help reduce stigma. The remaining options do not directly address the
concerns stated.
DIF: Cognitive Level: Application REF: Pages 13-14
9. Which activity shows that a therapeutic alliance has been established between the
nurse and patient?
a. The nurse respects the patient’s right to privacy when visitors are spending time
with the patient.
b. The patient is eagerly attending all group sessions and working independently on
identifying their personal stressors.
c. The patient is freely describing their feelings related to the physical and
emotional trauma they experienced as a child with the nurse.
d. The nurse dutifully administers the patient’s medications on time and with
appropriate knowledge of the potential side effects.
ANS: C
A primary aspect of working with patients in any setting and particularly in the
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, psychiatric setting is the development of a therapeutic alliance with the patient. Such an
alliance is established on trust. It is a professional bond between the nurse and the
patient that serves as a vehicle for patients to freely discuss their needs and problems in
the absence of the nurse’s criticism or judgment. Any nurse has an obligation to respect
the patient’s rights and administer care effectively. The patient’s willingness to
participate in the plan of care reflects self motivation.
DIF: Cognitive Level: Application REF: Page 9
10. Mental health care reform has called for parity between psychiatric and medical
diagnoses. Which is an example of such parity?
a. Depression treatment is not paid for as readily as is treatment for asthma.
b. The mentally ill patient will be protected by law against social stigma.
c. Medical practitioners are trained to be proficient at treating mental disorders.
d. Psychiatric service reimbursement will be equivalent to that of medical services.
ANS: D
The term parity as used here refers to payments for mental health services that equal
payment schedules for medical or surgical conditions. The remaining options(B and C) do
not relate to financial reimbursement or funds allocated for mental health care being
equal to those of medical diagnoses.
DIF: Cognitive Level: Application REF: Page 15
1. Which assessment findings suggest to the nurse that this patient has characteristics
seen in an individual who has reached self-actualization? Select all that apply.
a. Reports to have, “found peace and security in my religious faith”
b. Effectively “changed occupations” when a chronic vision problem worsened
c. Has consistently earned a six-figure salary as an architect for the last 10 years
d. Has been in a supportive, loving relationship with the same individual for 15
years
e. Provides free literacy tutoring help at the local homeless shelter 3 evenings a
week
ANS: A, B, D, E
Characteristics of self actualization would include: spiritual well-being, open and flexible,
relationally fulfilled, and generosity toward others. Salary doesn’t necessarily reflect self-
actualization.
DIF: Cognitive Level: Application REF: Page 4
2. Which nursing activities represent the tertiary level of mental health care? Select all
that apply.
a. Providing a depression screening at a local college
b. Helping a mental-challenged patient learn to make correct change
c. Reporting an incidence of possible elder abuse to the appropriate legal agency
d. Regularly assessing a patient’s understanding of their prescribed antidepressants
e. Providing a 6-week parenting class to teenage parents through a local high school
ANS: B, D
Tertiary prevention reduces the residual effects of the disorder such as depression and
mental retardation. There is no quaternary level of prevention. Primary prevention
reduces occurrences of mental disorders such as screenings and parenting classes, and
secondary prevention reduces the prevalence of disorders as evidenced by assessing
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