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,Sheila L. Videbeck: Psychiatric-Mental Health Nursing 7th Edition
Chapter 1
1. The nurse is assessing the factors contributing to the well-being of a newly admitted
client. Which of the following would the nurse identify as having a positive impact
on the individual's mental health?
A) Not needingothers for companionship
B) The ability to effectivelymanage stress
C) Afamily history of mental illness
D) Striving fortotal self-reliance
Ans: B
Feedback:
Individual factors influencing mental health include biologic makeup, autonomy,
independence, self-esteem, capacity for growth, vitality, ability to find meaning in life,
emotionalresilienceor hardiness, sense of belonging, reality orientation, and coping or
stress management abilities. Interpersonal factors such as intimacy and a balance of
separateness and connectedness are bothneeded forgoodmental health, and therefore a
healthy person would need others for companionship. A family history of mental
illness couldrelate to the biologic makeup of anindividual, whichmay have a negative
impacton an individual's mentalhealth, as well as a negative impact on an individual's
interpersonal and socialñcultural factors of health. Total self-reliance is not possible,
and a positive social/cultural factor is access to adequate resources.
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2. Whichof the following statementsaboutmentalillness are true? Select all that apply.
A) Mentalillness cancausesignificantdistress, impaired functioning, or both.
B) Mentalillness is only due to social/cultural factors.
C) Social/culturalfactors that relate to mental illness include excessive dependency
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on or withdrawal from relationships.
D) Individualssufferingfrommental illness are usually able to cope effectively with
daily life.
E) Individualssuffering frommentalillness may experiencedissatisfaction with
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relationships and self.
Ans: A, D, E
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Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental
illness may be related to individual, interpersonal, or social/cultural factors. Excessive
dependency on or withdrawal from relationships are interpersonal factors that relate to
mental illness. Individuals suffering from mental illness can feel overwhelmed with
daily life. Individuals suffering frommental illness may experience dissatisfaction with
relationships and self.
,3. Aclient grieving the recent loss of her husband asks if she is becoming mentally
ill because she is so sad. The nurse's best response would be,
A) ìYou may have a temporary mental illness because you are experiencing so much
pain.î
B) ìYouare not mentally ill. This is an expected reaction to the loss you have
experienced.î
C) ìWere you generally dissatisfied with your relationship before your husband's
death?î
D) ìTrynot to worry about that right now. You never knowwhat the future brings.î
Ans: B
Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships,
ineffective coping, and lack of personal growth. Additionally the behavior must not be
culturally expected. Acute grief reactions are expected and therefore not considered
mentalillness. False reassuranceor overanalysis does not accurately address the client's
concerns.
4. Which of the following are true regarding mentalhealth andmental illness?
A) Behavior that may be viewed as acceptable in one culture is always
unacceptable in other cultures.
B) It is easy to determine if a person is mentally healthy or mentally ill.
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C) In most cases, mental health is a state of emotional, psychological, and social
wellness evidenced by satisfying interpersonal relationships, effective behavior
and coping, positive self-concept, and emotional stability.
D) Personswho engagein fantasies are mentally
ill. Ans: C
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Feedback:
What one society may view as acceptableand appropriate behavior, another society may
see that as maladaptive, and inappropriate. Mental health and mental illness are difficult
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to define precisely. In most cases, mental health is a state of emotional, psychological,
and social wellness evidenced by satisfying interpersonal relationships, effective
behavior and coping, positive self-concept, and emotional stability. Persons who engage
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in fantasiesmay be mentally healthy, butthe inability to distinguishreality from fantasyis
an individual factor that may contribute to mental illness.
5. The nurseconsults the DSM forwhich of the following purposes?
A) Todevise a plan of care for a newly admitted client
B) Topredict the client's prognosis of treatment outcomes
C) Todocument the appropriate diagnostic code in the client's medical record
D) To serve as a guide for client assessment
Ans: D
Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and
identifies underlying causes of mental disorders. It does not provide care plans or
prognostic outcomes of treatment. Diagnosis of mental illness is not within the
generalist RN's scope of practice, so documenting the code in the medical record wouldbe
inappropriate.
,6. Which would be a reason for a student nurse to use the DSM?
A) Identifying the medical diagnosis
B) Treatclients
C) Evaluatetreatments
D) Understand the reasonfor the admissionand the nature of psychiatric
illnesses. Ans: D
Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a
helpful resource to understand the reason for the admission and to begin building
knowledgeabout the natureof psychiatric illnesses. Identifying the medicaldiagnosis,
treating, and evaluating treatments are not a part of the nursing process.
7. The legislation enacted in 1963 waslargely responsibleforwhich of the following
shifts in care for the mentally ill?
A) Thewidespreaduseof community-based services
B) The advancement in pharmacotherapies
C) Increasedaccess to hospitalization
D) Improvedrightsforclients in long-terminstitutional care
Ans: A
Feedback:
The Community MentalHealth Centers Construction Actof 1963 accomplished the
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release of individuals from long-term stays in state institutions, the decrease in
admissions to hospitals, and the development of community-based services as an
alternative to hospital care.
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, 8. Whichone of the following is a result of federal legislation?
A) Making it easier to commitpeople formentalhealthtreatmentagainst their will.
B) Making it more difficult to commitpeople formental health treatment against
their will.
C) State mental institutions being the primary source of care formentally ill persons.
D) Improvedcare formentally ill persons.
Ans: B
Feedback:
Commitment laws changed in the early 1970s, making it more difficult to commit
people for mental health treatment against their will. Deinstitutionalization
accomplished the release of individuals from long-term stays in state institutions.
Deinstitutionalizationalso hadnegative effects in that some mentally ill persons are
subjected to the revolving door effect, which may limit careformentally ill persons.
9. The goal of the 1963 Community Mental Health Centers Act was to
A) ensurepatients' rights for the mentally ill.
B) deinstitutionalizestate hospitals.
C) provide funds to build hospitals with psychiatric units.
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D) treat peoplewithmentalillness in a humane fashion.
Ans: B
Feedback:
The 1963 Community Mental Health Centers Act intimated the movement toward
treating those with mental illness in a less restrictive environment. This legislation
resulted in the shift of clients with mentalillness from large state institutions to carebased
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in the community. Answer choices A, C, and D were not purposes of the 1963
Community Mental Health CentersAct.
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10. The creation of asylumsduring the 1800swasmeant to
A) improvetreatmentof mental disorders.
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B) providefood and shelter for the mentally ill.
C) punishpeoplewithmentalillness who were believed to be possessed.
D) remove dangerouspeople with mentalillness from the community.
Ans: B
Feedback:
The asylum was meant to be a safehaven with food, shelter, and humane treatment for the
mentally ill. Asylums were not used to improve treatment of mental disorders or topunish
mentally ill people who were believed to be possessed. The asylum was not created to
remove the dangerously mentally ill from the community.
, 11. The majorproblemswith large state institutions are: Select all that apply.
A) attendantswere accused ofabusing the residents.
B) stigmaassociated with residencein an insane asylum.
C) clientsweregeographicallyisolated from family and community.
D) increasingfinancialcosts to individualresidents.
Ans: A, C
Feedback:
Clients were often far removed from the local community, family, and friends because
state institutions were usually in rural or remote settings. Choices B and D were not
major problems associated with large state instructions.
12. Asignificant change in the treatment of peoplewith mental illness occurred in the
1950s when
A) communitysupportservices were established.
B) legislationdramaticallychanged civil commitment procedures.
C) the Patient's Bill of Rights was enacted.
D) psychotropic drugs became availablefor use.
Ans: D
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Feedback:
The development of psychotropic drugs, or drugs used to treat mental illness, beganIin
the 1950s. Answer choices A, B, and C did not occur in the 1950s.
13. Beforethe period of the enlightenment, treatmentof the mentally ill included
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A) creatinglarge institutions to provide custodial care.
B) focusing on religious education to improve their souls.
C) placing the mentally ill ondisplay for the public's amusement.
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D) providinga safe refuge or haven offering protection.
Ans: C
Feedback:
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In 1775, visitors at St. Mary's of Bethlehem were charged a fee for viewing and
ridiculing the mentally ill, who were seen as animals, less than human. Custodial care
was not often provided as persons who were considered harmless were allowed to
wander in the countryside or live in rural communities, and more dangerous lunatics
were imprisoned, chained, and starved. In early Christian times, primitive beliefs and
superstitions were strong. The mentally ill were viewed as evil or possessed. Priests
performedexorcisms to rid evil spirits, and in the colonies, witch hunts were conducted
with offenders burned at the stake. It was not until the period of enlightenment when
persons who were mentally ill were offered asylum as a safe refuge or haven offering
protection at institutions.
