Foundations of Mental Health Care 4e by Morrison-Valfre-Test Bank

$30.00

Category:

Description

INSTANT DOWNLOAD WITH ANSWERS
Foundations of Mental Health Care 4e by Morrison-Valfre-Test Bank

Morrison-Valfre: Foundations of Mental Health Care, 4th Edition

 

Test Bank

 

Chapter 2: Current Mental Health Care Systems

 

MULTIPLE CHOICE

 

  1. Because mental health care is not covered in Australia under the basic health plan, which citizens are more likely to receive mental health care?
a. Wealthy
b. Homeless
c. Disabled
d. Low-income

 

 

ANS:  A

Wealthy citizens, as well as those with private insurance, are more likely to receive mental health care in Australia because they are better able to afford the care than are homeless, disabled, or low-income citizens.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 10          OBJ:   1

TOP:   Mental Health Care in Australia      KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. What percentage of U.S. citizens have no health insurance?
a. 5%
b. 15%
c. 25%
d. 35%

 

 

ANS:  B

Approximately 15% of the U.S. population does not have health insurance, which amounts to almost 50 million people. The United States is the only wealthy, industrialized nation that does not have a universal health care system.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 10          OBJ:   1

TOP:   Mental Health Care in the United States

KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. Mental health care is available under the universal health care system in Britain, which is funded primarily by:
a. Employers
b. Private donations
c. Small businesses
d. Tax revenues

 

 

ANS:  D

Tax revenues are the primary funding source for Britain’s universal health care system. All aspects of health care, except for eye care and limited dental care, are covered under the standard benefit package for citizens of Britain.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 10          OBJ:   1

TOP:   Mental Health Care in Britain         KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. A client is seen in a mental health clinic in the United States. The client is covered by an insurance plan that consists of a network of providers who accept discounted payments from the insurance company. The client is able to see specialists without a referral from the primary provider. Which type of plan does the client most likely have?
a. Point-of-service plan
b. Preferred provider organization (PPO)
c. Health maintenance organization (HMO)
d. Fee-for-service plan

 

 

ANS:  B

A PPO consists of a network of physicians, hospitals, and clinics that provide care for different organizations at a discount. With a PPO, the client is not required to have a referral to see a specialist. A point-of-service plan is similar to a PPO, with the main difference being that referrals are required for the client to see a specialist. An HMO has some similarities to a PPO; but the plan requires referrals for specialists, members have set fees for services, and mental health care is limited with some HMOs. A fee-for-service plan allows selection of any provider.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 10          OBJ:   1

TOP:   Mental Health Care in the United States

KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. Because many individuals in the United States do not seek health care for mental illness until late into the illness, many end up being seen in:
a. Hospitals and nursing homes
b. Outpatient and community services
c. Emergency rooms and jails
d. Physicians’ offices

 

 

ANS:  C

Because many individuals do not seek treatment in time, symptoms escalate to the point that emergency room visits are required, and it is estimated that up to 1 million county jail admissions across the country are due to mental illness.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 11          OBJ:   2

TOP:   Care Settings                                   KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. The concept of recidivism is prevalent among individuals with chronic psychiatric problems. Which is the most accurate description of this concept?
a. Relapse of symptoms of a client’s mental health disease, resulting in frequent readmission to facilities
b. Coordination and cooperation between community mental health agencies and hospitals, resulting in continuity of care
c. Providing mental health care services to a client who lives on his own in his own home
d. Limited supervision in a community setting with emphasis on individual responsibility for care

 

 

ANS:  A

Recidivism occurs frequently as a result of fragmented care. Coordination and cooperation between mental health facilities and the hospital lead to lowering of recidivism rates. Outpatient mental health service consists of providing service to a client who lives on his own in his own home, and community-based mental health care involves limited supervision in a community setting with an emphasis on individual responsibility.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 11          OBJ:   2

TOP:   Outpatient Care                              KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. The __________ model views clients holistically with the goal of creating a support system designed to encourage independence in the client with a mental health disorder.
a. Community support systems
b. Case management
c. Multidisciplinary health care team
d. Client population

 

 

ANS:  A

The community support systems (CSS) model works by coordinating social, medical, and psychiatric services. Case management refers to individual management of clients and takes into consideration psychosocial rehabilitation, consults, referrals, therapy, and crisis intervention. A multidisciplinary health care team is made up of all of the professionals who work within a mental health care system, and client population simply refers to individuals who may potentially seek mental health care.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 11          OBJ:   3

TOP:   Outpatient Care                              KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Which type of community setting involves care for individuals with mental health issues in a protected and supervised environment within the community?
a. Psychiatric home care
b. Community mental health centers
c. Residential programs
d. Partial hospitalization

 

 

ANS:  C

A residential program involves care for individuals with mental health issues provided in a protected and supervised environment within the community. Psychiatric home care delivers mental health care to individuals within the home. Community mental health centers consist of programs such as crisis intervention centers, family counseling, and vocational and skills training. Partial hospitalization refers to day treatment centers.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 13          OBJ:   4

TOP:   Delivery of Community Mental Health Services

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. The brother of a male mental health client is concerned because he works during the day and has no one to care for his brother, who requires almost constant supervision. He wants to keep his brother at home but is unsure of what resources are available in the community. What is the nurse’s best response?
a. “Have you considered a residential group home?”
b. “Let me give you some information on a community day treatment center.”
c. “Psychiatric home care might be an option.”
d. “A community mental health center would be good for your brother.”

 

 

ANS:  B

The needs expressed by the client’s brother are best responded to by providing information on a community day treatment center. The other options do not address the need for constant supervision during the day, other than the possibility of a residential group home, and a residential group home does not meet the client’s need to keep his brother home.

 

DIF:    Cognitive Level: Application          REF:   Page 13          OBJ:   4

TOP:   Delivery of Community Mental Health Services

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. The home mental health nurse visits a female client to assess her ability to care for herself at home after discharge from an inpatient setting. Which component of the case management system does this demonstrate?
a. Consultation
b. Crisis intervention
c. Resource linkage
d. Psychosocial rehabilitation

 

 

ANS:  D

Psychosocial rehabilitation assists clients in gaining independence in activities of daily living to the best of their individual capabilities. Consultation refers to assistance obtained from specialists, such as a psychiatrist; crisis intervention refers to care provided during a crisis event; and resource linkage indicates referral to community resources.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 13          OBJ:   5

TOP:   Case Management Systems             KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. A client with a severe, treatment-resistant mental illness has been assigned to an assertive community treatment (ACT) team. An ACT treatment strategy that helps to prevent recurrent hospitalizations for mental health reasons is to meet with the client in the community setting:
a. Once per week
b. Two to four times per week
c. Five to six times per week
d. Seven to eight times per week

 

 

ANS:  B

The continuous care team that meets with a client two to four times per week has been found to be effective in directing the client’s treatment on a more continuous basis, resulting in greater stability for the client who is living in the community with the help of appropriate systems.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 14 | Page 15

OBJ:   5                    TOP:   Case Management Systems

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. Which member of the multidisciplinary mental health care team is primarily responsible for evaluating the family of the client, as well as the environmental and social surroundings of the client, and plays a major role in the admission of new clients?
a. Psychiatric nurse
b. Clinical psychologist
c. Psychiatrist
d. Psychiatric social worker

 

 

ANS:  D

These are the primary responsibilities of the psychiatric social worker. The psychiatric nurse’s primary responsibilities include assisting with the client’s activities of daily living and managing individual, family, and group psychotherapy. The clinical psychologist is involved in the planning of treatment and diagnostic processes, and the psychiatrist is the leader of the team.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 16          OBJ:   6

TOP:   Multidisciplinary Mental Health Care Team

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. It is estimated that approximately __________ of adults experience some form of mental or emotional disorder.
a. 11%
b. 19%
c. 27%
d. 35%

 

 

ANS:  B

It is difficult to obtain exact statistics on mental health disorders because many conditions remain undiagnosed and many affected individuals may become homeless or incarcerated.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 16          OBJ:   7

TOP:   Impact of Mental Illness                 KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. A male client with a diagnosis of bipolar disorder is admitted to an inpatient unit during a severe manic episode. As a result of guidelines implemented by the Health Care Financing Administration in 1983, the client’s Medicare will pay for his stay in this unit for:
a. The length of time necessary for his condition to be stabilized
b. Up to 6 months with appropriate documentation
c. A pre-determined length of time based on the diagnosis
d. 2 to 4 weeks

 

 

ANS:  C

Medicare payment guidelines are based on the diagnosis, which is classified under a diagnosis-related group (DRG), and specify a pre-determined payment for a particular diagnosis. This cost containment strategy has also been adopted by some private insurance companies. After the pre-determined time, the facility is responsible for additional costs incurred by the client’s stay.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 17          OBJ:   1

TOP:   Economic Issues of Mental Illness KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. A female client was given the diagnosis of schizophrenia and recently has lost her job. She tells the nurse that she has enough money for only two more house payments, and if she does not find a job, she fears she will become homeless. The nurse knows that this client falls in the group of nearly __________ of U.S. citizens who live below poverty level.
a. 1%
b. 6%
c. 12%
d. 25%

 

 

ANS:  C

Approximately 12% of Americans (or 33 million people) live below poverty level. Living in poverty often precipitates mental disorders, or mental disorders may occur while an individual is living in poverty. Both scenarios can cause an unbearable amount of stress.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 17          OBJ:   7

TOP:   Social Issues of Mental Illness        KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Addiction to recreational drugs, such as crack, cocaine, and heroin, combined with use of psychotherapeutic drugs is associated with:
a. Permanent psychotic states
b. Bipolar disorder
c. Generalized anxiety disorder
d. Obsessive-compulsive disorder

 

 

ANS:  A

Permanent psychotic states are occurring in mental health clients who combine their psychotherapeutic medications with the abuse of recreational drugs. As a result, the question of how to care for this population is a matter of growing concern. The combination of these two types of drugs is not commonly associated with bipolar disorder, generalized anxiety disorder, or obsessive-compulsive disorder.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 17          OBJ:   7

TOP:   Social Issues of Mental Illness        KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. A female client who is undergoing therapy for depression is divorced and has two children, ages 2 and 4. She has just enrolled in a local community college and is worried about providing food and clothes for her family while holding down a minimum wage job and devoting the time needed to be successful in school. The nurse determines that the best community resource for assisting this client to meet these needs is:
a. A shelter for victims of domestic violence
b. Women, Infants, and Children (WIC)
c. Family-planning agency
d. Family recreation center

 

 

ANS:  B

WIC gives assistance to low-income women and children up to the age of 5 who are at nutritional risk by providing foods to supplement the diet and information on healthy eating habits. This will lessen some of her financial burden while she is attending school. The other options do not address her situation because she has not voiced needs related to domestic violence or family planning, and a family recreation center will not meet her financial needs.

 

DIF:    Cognitive Level: Application          REF:   Page 12          OBJ:   4

TOP:   Delivery of Community Mental Health Services

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. The home care nurse is providing care to an older adult client with a diagnosis of depression who is caring for his wife with Alzheimer’s disease. He states that he hardly has enough energy to cook and clean the house. The couple has no children, and no relatives live within a close distance. Which community agency would be of greatest benefit to this client?
a. A recreational club
b. An adult education program
c. A day care center for elderly
d. Meals on Wheels

 

 

ANS:  D

Caring for a loved one with Alzheimer’s is very demanding, as is dealing with the client’s own depression. By providing food, Meals on Wheels would remove one responsibility for this client. A recreational club or an adult education program may be of assistance, but the priority need for this couple is food. A day care center for the elderly may be necessary in the future, but it is not a priority at this time.

 

DIF:    Cognitive Level: Application          REF:   Page 12          OBJ:   4

TOP:   Delivery of Community Mental Health Services

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. A 9-year-old girl is given the diagnosis of depression. She has low self-esteem, does not enjoy group therapy, and does not show her emotions. The nurse has had difficulty establishing rapport with this client and decides to ask for assistance from another treatment team member. Which team member would best assist in this situation?
a. Psychiatric assistant
b. Dietitian
c. Occupational therapist
d. Expressive therapist

 

 

ANS:  D

Expressive therapists work well with children who have difficulty expressing their thoughts and feelings. Expressive therapists use creative methods that appeal to children. The dietitian would not be the best team member to meet the needs of the client at this time. The psychiatric assistant, or technician, assists the nurse with daily activities and in monitoring clients during leisure activities. The occupational therapist works primarily with rehabilitational therapy, such as socialization and vocational retraining.

 

DIF:    Cognitive Level: Application          REF:   Page 16          OBJ:   6

TOP:   Multidisciplinary Mental Health Care Team

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. Nearly __________ of all countries in the world have no clear governmental policy that addresses mental health issues.
a. 7%
b. 26%
c. 50%
d. 75%

 

 

ANS:  C

In addition to nearly half of the countries in the world that have no policy on mental health issues, approximately one third have no program for coping with the increasing numbers of mental health disabilities.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 9            OBJ:   1

TOP:   Current Mental Health Care Systems

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

MULTIPLE RESPONSE

 

  1. Which principles characterize mental health care in Canada? Select all that apply.
a. Portability
b. Universality
c. Accessibility
d. Comprehensiveness
e. Private insurance models
f. Public administration

 

 

ANS:  A, B, C, D, F

Portability refers to retaining services in the event of moving; universality means that everyone in the nation of Canada is covered; accessibility indicates that everyone has access to health care; comprehensiveness means that all necessary treatment is covered; and public administration reveals that the health care system is publicly run and accountable. Private insurance models are the type of insurance provided in the United States.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 9            OBJ:   1

TOP:   Mental Health Care in Canada        KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Psychosocial Integrity

 

  1. In the United States, which factors determine whether a client requires inpatient rather than outpatient care? Select all that apply.
a. Severity of the illness
b. Level of dysfunction
c. Suitability of the setting for treating the problem
d. Anticipated diagnosis
e. Level of client cooperation
f. Ability to pay

 

 

ANS:  A, B, C, E, F

These options are the determining factors for inpatient mental health care. If a client meets the criteria, the diagnosis does not matter in the determination of whether the client requires inpatient or outpatient care.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 11          OBJ:   2

TOP:   Care Settings                                   KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. Which client populations are at greater risk for the development of mental health disorders? Select all that apply.
a. Homeless
b. Clients infected with HIV or AIDS
c. Those in crisis
d. Nurses
e. Clients living in rural areas
f. Older adults
g. Psychiatrists
h. Children

 

 

ANS:  A, B, C, E, F, H

These individuals are considered to be at high risk for various reasons. Nurses and psychiatrists are not considered at high risk for developing mental health disorders.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 15 | Page 16

OBJ:   7                    TOP:   Client Populations

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

COMPLETION

 

  1. A __________ is a form of health insurance that delivers health care to clients enrolled in its plan. Clients pay a fixed price for care, as long as they receive services from a provider within the company’s system.

 

ANS:

Health maintenance organization

Clients in a health maintenance organization (HMO) may or may not have a list of health care providers from which to choose (depending on their HMO company), and all require referrals for specialists.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 10          OBJ:   1

TOP:   Health Insurance                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Safe and Effective Care Environment

 

  1. The __________ therapist of the mental health team uses methods such as pet therapy and music therapy when working with clients and is responsible for providing leisure-time activities and for teaching inpatient clients useful ways to pass time.

 

ANS:

Recreational

These are the primary responsibilities of the recreational therapist, who has an advanced degree and specialized training in recreational therapy.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 16          OBJ:   6

TOP:   Multidisciplinary Mental Health Care Team

KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Safe and Effective Care Environment

Morrison-Valfre: Foundations of Mental Health Care, 4th Edition

 

Test Bank

 

Chapter 10: Therapeutic Communication

 

MULTIPLE CHOICE

 

  1. A male client with a diagnosis of schizophrenia begins to have hallucinations during a conversation with the nurse; this prevents him from receiving the message that the nurse is trying to communicate to him. According to Ruesch’s theory of communication, this unsuccessful interaction is called:
a. Disturbed communication
b. Nontherapeutic communication
c. Blocked communication
d. Therapeutic communication

 

 

ANS:  A

Ruesch called this type of interrupted communication disturbed communication. In addition to interference with receiving a message, as in the case of this client, the term applies to interference with the sending of messages, problems in language between people, insufficient information, and lack of the opportunity for feedback. Ruesch’s theory did not coin the term nontherapeutic or blocked communication, and this interaction would not be considered therapeutic.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 97          OBJ:   1

TOP:   Ruesch’s Theory                            KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Psychosocial Integrity

 

  1. The theorist Eric Berne theorized that an individual’s three ego states of parent, child, and adult make up one’s:
a. Conscience
b. Personality
c. Thought processes
d. Ability to communicate

 

 

ANS:  B

The three ego states, according to Berne, make up an individual’s personality. The parent ego focuses on rules and values, the child ego focuses on emotions and desires, and the focal point of the adult ego is previous observations. He did not address any of the other three options.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 97          OBJ:   1

TOP:   Transactional Analysis                   KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The nursing student is assigned a client to interview and is asked to practice the therapeutic communication technique of sharing perceptions. Which statement made by the student nurse best describes this technique?
a. “I noticed that you pace the halls, and you have a tense look on your face. I sense that you are anxious about something.”
b. “Can you tell me more about how you feel when you are arguing with your daughter?”
c. “I would like to talk with you about your plan of care.”
d. “Tell me if I understand you correctly.”

 

 

ANS:  A

Sharing perceptions lets the client know that you are listening and ensures that you understand what he or she is communicating. Asking the client to describe how he or she feels when arguing with his or her daughter describes focusing. Speaking to the client about the plan of care describes informing, and the nursing student is using clarification when asking whether he or she understands the client correctly.

 

DIF:    Cognitive Level: Application          REF:   Page 104        OBJ:   7

TOP:   Interacting Skills                             KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. The nurse is talking with a male client regarding his recent relapse of alcohol addiction. The client alludes to the fact that he started to drink again after a fight with his wife. The nurse uses clarification to ensure an accurate understanding of the client. Which statement is the best example of clarification?
a. “You said that the fight you had with your wife caused you to start drinking again?”
b. “Let’s discuss what made you feel the need to drink.”
c. “Could you tell me again when and what happened that you feel caused you to start drinking again?”
d. “Tell me what your childhood was like.”

 

 

ANS:  C

Clarification helps to confirm feelings, ideas, and perceptions. The other options are examples of restating, focusing, and changing the topic.

 

DIF:    Cognitive Level: Application          REF:   Page 104        OBJ:   7

TOP:   Interacting Skills                             KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A female client discusses her feelings of jealousy regarding the relationship between her mother and her daughter. The nurse responds in a nontherapeutic way by making a statement that is defensive and challenging. Which statement is the best example of a defensive and challenging nontherapeutic response?
a. “Tell me more about the feelings you have regarding their relationship.”
b. “I think that you should tell them how you feel.”
c. “That seems like a childish feeling to have about their relationship.”
d. “Don’t you think that you should be thankful that your daughter has a good relationship with her grandmother?”

 

 

ANS:  D

Defensive, challenging statements such as this one will block communication with the client because she will feel that she needs to respond defensively and answer to the nurse for her feelings. The therapeutic communication response that includes a broad opening statement is used when the nurse asks the client to tell more about her feelings. When the nurse tells the client that she should tell the mother and daughter how she feels, it describes giving advice. The nurse uses the nontherapeutic technique of belittling the client when the nurse states that the client’s feelings are childish.

 

DIF:    Cognitive Level: Application          REF:   Page 105        OBJ:   7

TOP:   Nontherapeutic Messages               KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A female client has been attending group therapy for support regarding an abusive relationship with her husband. The client voices concern about her 10-year-old daughter growing up in this environment but states that she just can’t find the strength to leave her husband. The nurse responds by using the nontherapeutic technique of reassuring. Which statement is the best example of this nontherapeutic technique?
a. “I can’t believe that you would want your daughter to grow up in this environment.”
b. “I understand your concern. Let me give you some information on our local council for domestic abuse.”
c. “I’m sure it won’t be that bad to be out on your own. I know you can do it.”
d. “I think you should not think about leaving and should just do it.”

 

 

ANS:  C

This is an example of the nontherapeutic technique of falsely reassuring the client. It dismisses the client’s concerns and does not support her. The nurse is showing disapproval in stating that she “can’t believe” that the client would want her daughter to grow up in such an environment. The nurse gives an appropriate therapeutic statement when she acknowledges the client’s concern and then provides the client with helpful information. The nurse is giving advice in offering her thoughts that the client should just leave.

 

DIF:    Cognitive Level: Application          REF:   Page 105        OBJ:   7

TOP:   Nontherapeutic Messages               KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. The nurse observes a male client who is sitting in a chair, staring out the window for a long time. The nurse asks the client whether he is okay. The client says that he is trying to talk himself into telling his wife about his gambling addiction and the money he has lost. He says that he is playing the scenario in his head and is thinking about how he wants to present the news to her and how she will respond. The client’s behavior is an example of:
a. Hallucinations
b. Intrapersonal communication
c. Delusions
d. Interpersonal communication

 

 

ANS:  B

Intrapersonal communication is described as self-talk or self-dialogue, and it can serve as a very helpful mechanism of coping, as in this situation. Hallucinations would be occurring if the client in this situation were hearing voices. Delusions would be occurring if he had irrational thoughts that could not be reasoned with. Interpersonal communication describes the communication that will occur between the client and his wife.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 98          OBJ:   2

TOP:   Types of Communication               KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. A female client with severe depression is about to be discharged from an inpatient mental health unit. The client’s highest level of education is 7th grade, and she reads at a 5th grade level. The nurse is giving her discharge instructions. Which instruction is most appropriate for this client?
a. “Your MAOI should be taken once a day at the same time each day.”
b. “This is the medicine for your depression, and you will take it every morning after you get up.”
c. “Your MAOI should be taken q.d.”
d. “Your antidepressant should be taken in the morning or in the evening at the same time each day.”

 

 

ANS:  B

Communicating with persons from different social classes must be considered in this situation. It is important not to talk down to clients with different educational backgrounds. The correct answer is stated clearly and can be followed easily as written instructions. Medical abbreviations, such as MAOI and qd, should not be used in this situation, and the term antidepressant also may be unclear to the client.

 

DIF:    Cognitive Level: Application          REF:   Page 99          OBJ:   8

TOP:   Factors that Influence Communication

KEY:  Nursing Process Step: Intervention MSC:  Client Needs: Psychosocial Integrity

 

  1. Therapeutic communication techniques support effective communication between the client and the nurse. Which group of therapeutic techniques is most likely to be effective when one is conversing with a client?
a. Broad openings, restating, and advising
b. Clarification, focusing, and confrontation
c. Listening, silence, and reflection
d. Humor, informing, and reassuring

 

 

ANS:  C

The techniques of listening, silence, and reflection are all therapeutic. Advising, confronting, and reassuring are all examples of nontherapeutic techniques.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 104        OBJ:   7

TOP:   Interacting Skills                             KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. A client tells the nurse that he feels his depression is improving. The client has a flat affect and a monotone voice, has not combed his hair or shaved in a week, and has not participated in his group therapy sessions for 2 weeks. What is the nurse’s most accurate interpretation of this situation?
a. The client’s true feelings of improvement in his depression were shared in his verbal communication
b. The client’s nonverbal communication indicates that there is no improvement in his depression
c. The client’s verbal communication and nonverbal communication convey the same message
d. Verbal communication is always the best indicator of how a person feels

 

 

ANS:  B

The client’s nonverbal communication is conveying more than his verbal communication is conveying. Nonverbal communication often is more accurate than verbal communication because it is more difficult to control. Verbal communication can be controlled for the purpose of saying what the other person wants to hear, as is apparent in this situation. The client’s verbal and nonverbal messages do not convey the same meaning in this situation, and verbal communication is not always the best indicator of a person’s feelings.

 

DIF:    Cognitive Level: Application          REF:   Page 100        OBJ:   4

TOP:   Nonverbal Communication            KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Psychosocial Integrity

 

  1. While the nurse is talking with a female client, the client becomes silent for several seconds. Which is the nurse’s best response?
a. To interpret this action as an indication that the client is finished with the conversation
b. To ask the client a question so the interaction can continue
c. To remain silent and be attentive to the client’s nonverbal communication
d. To tell the client that help can be more effective if she shares her feelings

 

 

ANS:  C

This is an example of the therapeutic communication technique of silence. It allows the client time to collect her thoughts. Although most people want to talk away the silence, it is important for the caregiver to become comfortable with the effective technique of silence. The three incorrect options prevent silence from occurring.

 

DIF:    Cognitive Level: Application          REF:   Page 104        OBJ:   7

TOP:   Interacting Skills                             KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A client who usually is very active in her therapy group tells the nurse that she really does “not feel well today” and would “rather not attend the group therapy session.”  Which is the nurse’s most appropriate response?
a. “You don’t feel like attending the group therapy today?”
b. “I will just stay with you for a while.”
c. “It’s okay to skip a session every once in a while.”
d. “Why don’t you want to attend group therapy?”

 

 

ANS:  A

The nurse is restating what the client said, which verifies what the client communicated and lets the client know that the nurse listened and understood her. The client did not ask the nurse to sit with her, so this action is inappropriate. Telling the client that it is okay to skip a session is giving advice and is not conveying an understanding of what the client really said. Asking the client why she doesn’t want to attend group therapy clearly conveys that the nurse did not listen to what the client communicated.

 

DIF:    Cognitive Level: Application          REF:   Page 104        OBJ:   7

TOP:   Interacting Skills                             KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A female client tells the nurse that she feels very depressed about her recent divorce. Which is the nurse’s best response?
a. “I know exactly how you feel.”
b. “Most people experience depressed feelings after a divorce.”
c. “I know this must be difficult for you.”
d. “Look on the bright side. You will be glad you divorced him in a couple of years.”

 

 

ANS:  C

This is an empathetic response that lets the client know that the nurse understood her and expresses compassion. The other options are nontherapeutic. Because no one can know exactly how someone feels, the nurse’s statement that she knows exactly how the client feels is belittling the client. The nurse’s statement that most people experience depression after divorce is generalizing the client’s feelings. Telling the client that she will be glad of the divorce in the future dismisses the client’s feelings as not important.

 

DIF:    Cognitive Level: Application          REF:   Page 104        OBJ:   7

TOP:   Interacting Skills                             KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. The nurse is talking with a male client with a diagnosis of schizophrenia who often experiences auditory hallucinations. For this communication to be most effective, the nurse should:
a. Sit with the client and encourage him to not verbalize
b. Do most of the talking
c. Discuss several different topics to keep the client’s attention
d. Use simple, concrete language

 

 

ANS:  D

Because this client has been given the diagnosis of schizophrenia and frequently has auditory hallucinations, his perception of the communication must be considered. Use of simple, concrete language will assist the client in following the conversation without having to interpret what the nurse means during the interaction. Encouraging the client not to verbalize and doing most of the talking do not allow the client to express himself, and discussing several different topics will be confusing and may cause the client undue stress during the interaction.

 

DIF:    Cognitive Level: Application          REF:   Page 99 | Page 100

OBJ:   8                    TOP:   Verbal Communication

KEY:  Nursing Process Step: Intervention MSC:  Client Needs: Psychosocial Integrity

 

  1. When documenting in a client’s mental health record, the nurse would be most accurate by:
a. Documenting exact words and phrases spoken by the client when appropriate
b. Using mental health terminology when documenting conversations
c. Waiting until the end of the shift to document activity for the day
d. Interpreting the client’s feelings for documentation purposes

 

 

ANS:  A

Documenting exact words and phrases will more effectively communicate an accurate picture of the client to other mental health team members. Mental health terminology will not be used in the same context as the communication that occurred, which may lead to lack of true meaning, and some team members may not be familiar with the terms used. Waiting until the end of the shift to document will lead to forgetting pertinent information, and interpreting the client’s feelings reveals the nurse’s own opinion.

 

DIF:    Cognitive Level: Application          REF:   Page 100        OBJ:   4

TOP:   Verbal Communication                  KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. The nurse’s ability to interpret communication effectively in the mental health setting depends mostly on:
a. How well the client communicates
b. The nurse’s relationship with the client
c. The nurse’s understanding of mental health disorders
d. The nurse’s ability to listen to and observe the client’s verbal and nonverbal messages

 

 

ANS:  D

Accurate interpretation of the client’s communication cannot occur if the nurse does not listen to and observe the client. It is not dependent on how well the client communicates because the nurse has no control over the client. The nurse’s relationship with the client and understanding of mental health disorders are important but will not supersede good observation and listening.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 101        OBJ:   6

TOP:   Therapeutic Communication Skills KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. Which nurse response is the best example of the therapeutic principle of respect?
a. “I’m interested in what you have to say.”
b. “Describe how you are feeling for me.”
c. “I hear how worried you are about your future and can imagine how you feel.”
d. “You signed a contract stating that you would let me know when you have those thoughts.”

 

 

ANS:  C

Although all of these responses are examples of therapeutic principles, this option best describes respect because it shows consideration and acceptance. The other options convey interest, the principle of concreteness, and honesty.

 

DIF:    Cognitive Level: Application          REF:   Page 102        OBJ:   6

TOP:   Therapeutic Communication Skills KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A female client is being discharged from an inpatient mental health unit after receiving treatment for bipolar disorder. She has responded well to treatment but voices concern about going home and maintaining balance in her life. The client would benefit most by a response from the nurse that conveyed the therapeutic communication principle of:
a. Permission
b. Respect
c. Interest
d. Protection

 

 

ANS:  D

A protective response such as, “Let’s look together again at what we have planned for you when you go home,” will help the client feel more confident in her ability to do well once she is discharged. The other options are examples of therapeutic principles but do not address the needs of this client at this time.

 

DIF:    Cognitive Level: Application          REF:   Page 102        OBJ:   6

TOP:   Therapeutic Communication Skills KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A nurse has just graduated from nursing school and has been hired on a mental health unit. The nurse wants to practice good communication skills with clients but knows that a mistake made by many new nurses in trying to communicate effectively involves:
a. Focusing
b. Parroting
c. Restating
d. Clarifying

 

 

ANS:  B

Parroting is the extreme form of the therapeutic communication skill of restating. It becomes very annoying to clients when the nurse continually repeats the client’s statements in an attempt to show understanding of the client’s message. The other options are therapeutic communication skills.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 105        OBJ:   7

TOP:   Nontherapeutic Messages               KEY:  Nursing Process Step: Planning

MSC:  Client Needs: Psychosocial Integrity

 

  1. A client has difficulty in communicating as a result of his illness. He displays a rapid, confusing delivery of speech patterns. Which term best describes this difficulty in communicating?
a. Aphasia
b. Dyslexia
c. Speech cluttering
d. Incongruent communications

 

 

ANS:  C

Rapid, confusing delivery of speech patterns is called speech cluttering and can result in the client’s inability to focus on verbal communication as the main form of interaction. Aphasia refers to the inability to speak, dyslexia refers to mixing of letters when reading that sometimes results in mixing of syllables when speaking, and incongruent communications occur when verbal messages do not match nonverbal messages.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 106        OBJ:   8

TOP:   Problems with Communication       KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

MULTIPLE RESPONSE

 

  1. Which elements must be present for communication to occur? Select all that apply.
a. Feedback
b. Transmission
c. Sender
d. Clarification
e. Receiver
f. Focusing
g. Context

 

 

ANS:  A, B, C, E, G

Feedback, transmission, sender, receiver, and context are the five elements that must be in place for communication to occur. The sender transmits the message to the receiver, resulting in feedback between them. The context, or setting, is where the communication takes place. Clarification and focusing are types of therapeutic communication.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 98          OBJ:   3

TOP:   Process of Communication             KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Psychosocial Integrity

 

  1. Which interventions assist the nurse to effectively communicate with clients from other cultures? Select all that apply.
a. The nurse adapts his or her behavior to accommodate the difference in communication styles.
b. The nurse identifies and clarifies confusion during the interaction.
c. The nurse recognizes the difference between communication styles and assists the client to change to the nurse’s communication style.
d. The nurse uses a limited number of slang terms when communicating with the client.

 

 

ANS:  A, B

Adaptation of behavior to accommodate differences in communication is effective because it is less difficult for the nurse to adapt to differences in communication, as with the use of an interpreter. Identifying and clarifying confusion prevents misinterpretation during the interaction. Recognizing differences in communication style is correct, but assisting the client to change to the communication style of the nurse is incorrect. Using a limited number of slang words indicates that some slang terms are acceptable; however, no slang terms should be used because these may block communication.

 

DIF:    Cognitive Level: Application          REF:   Page 101        OBJ:   5

TOP:   Intercultural Difference                  KEY:  Nursing Process Step: Planning

MSC:  Client Needs: Psychosocial Integrity

 

  1. Which nurse responses could block effective communication with a client? Select all that apply.
a. “This is what I think you should say…”
b. “Don’t stress over it. Everything will turn out fine.”
c. “Why did you do that?”
d. “Most people in your circumstance…”

 

 

ANS:  A, B, C, D

All of these options are nontherapeutic and should be avoided. When the nurse offers what she thinks the client should say, she is giving the client advice. Telling the client not to stress is giving the client false reassurance. Asking the question “Why did you do that?” will make the client defensive. When the nurse says “Most people in your circumstance…,” she is generalizing.

 

DIF:    Cognitive Level: Application          REF:   Page 105        OBJ:   7

TOP:   Nontherapeutic Messages               KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Psychosocial Integrity

 

COMPLETION

 

  1. __________ is the transferring between people of information, including ideas, beliefs, feelings and attitudes.

 

ANS:

Communication

For communication to be effective, information must be understood by all parties. Therapeutic communication is necessary if the interaction between the nurse and the client is to achieve successful outcomes.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 96          OBJ:   1

TOP:   Therapeutic Communication          KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

OTHER

 

  1. During the process of communication, a chain of events occurs as soon as the message is sent. Steps in this chain include transmission, perception, and evaluation. Place these steps in proper order.
  2. Transmission
  3. Perception
  4. Evaluation

 

ANS:

B, C, A

Perception of the message happens first because it is the step when recognition of a message occurs. Vision, hearing, and touch are used to perceive the message. Evaluation occurs next and is the internal assessment of the message. The last step, transmission, consists of conscious and unconscious responses to the message.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 98          OBJ:   3

TOP:   Process of Communication             KEY:  Nursing Process Step: Evaluation

MSC:  Client Needs: Psychosocial Integrity

Morrison-Valfre: Foundations of Mental Health Care, 4th Edition

 

Test Bank

 

Chapter 20: Loss and Grief

 

MULTIPLE CHOICE

 

  1. The clients have just survived a flood in which they lost their home, car, and all personal belongings. They are experiencing a(n):
a. Grief reaction
b. External loss
c. Internal loss
d. Permanent loss

 

 

ANS:  B

External losses include those losses outside the individual. A grief reaction refers to how the client reacts to a loss; internal loss refers to losses that include a part of oneself; and permanent loss is irreversible.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 213        OBJ:   1

TOP:   The Nature of Loss                         KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client is 21 years old and has just been given the diagnosis of terminal cancer. She is coping with a(n) ____ loss.
a. Expected
b. Imagined
c. Internal
d. Temporary

 

 

ANS:  C

Internal losses are personal and include losses that involve the self. Expected loss occurs gradually; imagined loss is perceived; and temporary loss is reversible.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 214        OBJ:   1

TOP:   Characteristics of Loss                   KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. School-age children have some idea about causes and events, but they still associate loss with:
a. Concern for themselves
b. Bad thoughts or misdeeds of their own
c. A sequence of natural events
d. Adult thinking and childlike reactions

 

 

ANS:  B

The child often feels responsible for the loss. Concern for themselves refers to toddlers’ reactions to loss. Viewing causes and events as a sequence of natural events is associated with adult thinking, and adult thinking and childlike reactions refer to the response of adolescents.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 214        OBJ:   2

TOP:   Behaviors Associated with Loss     KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The group best able to accept their losses and grow from their experiences is:
a. Adults
b. Toddlers
c. Adolescents
d. School-age children

 

 

ANS:  A

Adults who have experienced loss learn to accept their losses and learn from their experiences.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 214        OBJ:   2

TOP:   Behaviors Associated with Loss     KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The set of emotional reactions that accompany a loss is called:
a. Grief
b. Anxiety
c. Mourning
d. Bereavement

 

 

ANS:  A

Grief is the set of emotional reactions that accompany a loss. Anxiety is a vague, uneasy feeling that is not specifically related to a loss. Mourning refers to the process of resolving a loss, and bereavement refers to the thoughts, feelings and activities following a loss.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 215        OBJ:   3

TOP:   The Nature of Grief and Mourning KEY:  Nursing Process Step: N/A

MSC:  Client Needs: Psychosocial Integrity

 

  1. The behavioral state of thoughts, feelings, and activities that follow a loss is called:
a. Grief
b. Anxiety
c. Mourning
d. Bereavement

 

 

ANS:  D

This state is different with every person. Grief is the set of emotional reactions that accompany a loss. Anxiety is a vague, uneasy feeling that is not specifically related to a loss. Mourning is the process of working through or resolving one’s grief.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 215        OBJ:   3

TOP:   The Nature of Grief and Mourning KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Persons may refuse to acknowledge that a loss has occurred during the first stage of:
a. Crisis
b. The grieving process
c. The rage reaction
d. The denial process

 

 

ANS:  B

The first step in the grieving process is denial.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 215        OBJ:   3

TOP:   Stages of the Grieving Process        KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client lost her husband of 50 years 10 months ago. She now sees every day as a gray fog with no light. She has begun to experience changes in eating, sleeping, and activity levels; angry, hostile moods; and an inability to concentrate or complete work tasks. What is the client experiencing?
a. Complicated grief
b. A normal grief reaction
c. Complicated depression
d. Bereavement-related depression

 

 

ANS:  D

With bereavement-related depression, the griever feels the loss so intensely that despair and worthlessness overwhelm everything. This is not considered a normal grief reaction. Complicated grief refers to a constant yearning for the deceased without symptoms of depression. Complicated depression is not a grief reaction.

 

DIF:    Cognitive Level: Application          REF:   Page 216        OBJ:   4

TOP:   Unresolved Grief                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The last stage of growth and development is called:
a. Dying
b. Old age
c. Wisdom
d. Maturity

 

 

ANS:  A

Dying is the last stage of growth and development.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 217        OBJ:   7

TOP:   The Dying Process                          KEY:  Nursing Process Step: N/A

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Many funeral, burial, and mourning practices, such as the length of time for mourning and public displays of grief, are determined by a person’s:
a. Culture
b. Perceptions
c. Values and beliefs
d. Social interactions

 

 

ANS:  A

Cultural practices regarding dying, grief, and mourning have a strong influence on behaviors.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 219        OBJ:   6

TOP:   Cultural Factors, Dying, and Mourning

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

  1. The concerns of children in whom terminal conditions have been diagnosed focus on how the illness affects the child’s:
a. Loss of a future
b. Family and friends
c. Social activities
d. Activities of daily living

 

 

ANS:  D

Immediate concerns focus on how the illness affects the activities of daily living and limits their abilities. As individuals mature, concerns turn to the remaining three options.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 217 | Page 218

OBJ:   5                    TOP:   Age Differences and Dying

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

  1. To make the remainder of a terminally ill person’s life as meaningful and comfortable as possible is the goal of:
a. Hospice care
b. The stages of dying
c. The grieving process
d. Institutional care

 

 

ANS:  A

The goal of hospice care is to make the remainder of a terminally ill person’s life as meaningful and comfortable as is humanly possible. Hospice focuses not only on care of the client but on the family as well.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 220        OBJ:   9

TOP:   Hospice Care                                  KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. When care is provided for a dying client in pain, addiction to analgesics is:
a. Not an issue
b. To be evaluated daily
c. To be carefully avoided
d. To be prevented with pain management techniques

 

 

ANS:  A

Addiction is not an issue when care is provided for the terminally ill; the goal is to make the client comfortable and pain free.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 220        OBJ:   9

TOP:   Meeting the Needs of Dying Clients

KEY:  Nursing Process Step: Intervention MSC:  Client Needs: Physiological Integrity

 

  1. Decisions about a terminally ill client’s remaining time belong to the:
a. Person
b. Family members
c. Medical care team
d. Spiritual advisor

 

 

ANS:  A

In a “good death,” a person controls his or her own destiny.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 219        OBJ:   8

TOP:   Therapeutic Interventions               KEY:  Nursing Process Step: Planning

MSC:  Client Needs: Psychosocial Integrity

 

  1. To assist them with their grief experiences, many health care facilities offer caregivers who work with dying clients:
a. Extra income
b. Support groups            .
c. Time off from work
d. Peer evaluation groups

 

 

ANS:  B

Many health care facilities offer support groups for caregivers who work with dying clients to help them work through their own grief experiences.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 217        OBJ:   4

TOP:   Caregivers’ Grief                            KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. The wife of a recently deceased client states that she is going to return to work and rejoin her exercise class. She is displaying behavior that occurs at which stage of grieving?
a. Denial
b. Depression and identification
c. Acceptance and recovery
d. Yearning

 

 

ANS:  C

This is the phase of the grieving process during which individuals begin to focus their energies toward the living and their lives begin to stabilize. Denial is the first stage of grieving, when the person is in shock and rejects the loss of another. Depression and identification is the third stage of grieving, characterized by depressed feelings followed by a period of sharing memories and seeking support from others. Yearning is the second stage of grieving, in which the person longs for the deceased and feels overwhelmed by the loss.

 

DIF:    Cognitive Level: Application          REF:   Page 216        OBJ:   3

TOP:   Stages of the Grieving Process        KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The father of three young children dies. The wife expresses how worried she is about how to raise the children on her own without the support of her husband. She finds herself crying and living through each day without accomplishing anything. In which grieving stage is this behavior typically experienced?
a. Denial
b. Depression and identification
c. Acceptance and recovery
d. Yearning

 

 

ANS:  D

This is the second stage of grieving, in which the person longs for the deceased and feels overwhelmed by the loss. Denial is the first stage of grieving, when the person is in shock and rejects the loss of another; depression and identification is the third stage of grieving, characterized by depressed feelings followed by a period of sharing memories and seeking support from others; and acceptance and recovery is the phase of the grieving process during which individuals begin to focus their energies toward the living and their lives begin to stabilize.

 

DIF:    Cognitive Level: Application          REF:   Page 215        OBJ:   3

TOP:   The Grieving Process                                KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Three years after the loss of her husband of 35 years, the wife has a full-time job but finds that she cannot sleep well at night, has frequent mood changes, and attends the couple’s night out with friends that she and her husband attended. Upon seeking counseling, she discovers that she is exhibiting symptoms of:
a. Bereavement-related depression
b. Complicated grief
c. Anticipatory grief
d. Caregiver grief

 

 

ANS:  B

These are characteristic symptoms of complicated grief in which an individual experiences persistent yearning for the deceased person without signs of depression. Bereavement-related depression refers to depression following a loss that consumes every aspect of a person’s life; anticipatory grief refers to grief felt in anticipation of a loss; and caregiver grief refers to grief felt by health care providers.

 

DIF:    Cognitive Level: Application          REF:   Page 216        OBJ:   4

TOP:   Unresolved Grief                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The 39-year-old daughter of a client with a terminal illness tells the nurse that she thinks something is wrong with her because she frequently cries, is often sad, and can’t imagine losing her mother. The nurse assures the daughter that these are normal feelings associated with:
a. Bereavement-related depression
b. Complicated grief
c. Anticipatory grief
d. Caregiver grief

 

 

ANS:  C

These symptoms are typically experienced with grief that is felt in anticipation of a loss. Bereavement-related depression refers to depression following a loss that consumes every aspect of a person’s life; complicated grief is displayed as persistent yearning for the deceased person without signs of depression; and caregiver grief refers to grief experienced by health care providers.

 

DIF:    Cognitive Level: Application          REF:   Page 216        OBJ:   4

TOP:   Stages of the Grieving Process        KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The dying client is overheard by her family talking to her dead husband. The family is concerned that the client is confused. What is the nurse’s best response?
a. “Try to reorient her anytime you hear her talking to her deceased husband.”
b. “Engage in the conversation with her the next time she talks with the deceased.”
c. “Let me know when you hear this again and I will reorient her.”
d. “This is a normal symptom of approaching death.”

 

 

ANS:  D

This symptom is a way for the dying client to prepare for the transition period of death. It is not necessary to reorient the dying client or to participate in the conversation.

 

DIF:    Cognitive Level: Application          REF:   Page 221        OBJ:   9

TOP:   Meeting the Needs of Dying Clients

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

MULTIPLE RESPONSE

 

  1. Which of the following are therapeutic interventions for unresolved grief? Select all that apply.
a. Listening
b. Providing emotional support
c. Keeping the griever medicated
d. Referring to appropriate resources
e. Forcing the client to eat properly
f. Telling the client that he or she must learn to cope
g. Encouraging return to work as soon as possible

 

 

ANS:  A, B, D

Listening, providing emotional support, and referring to appropriate resources are interventions for unresolved grief.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 217        OBJ:   4

TOP:   Unresolved Grief                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Loss of which of the following can result in the individual’s experiencing external losses? Select all that apply.
a. Spouse
b. Possession
c. Career
d. Limb
e. Favorite piece of jewelry
f. Friendship

 

 

ANS:  A, B, E, F

External losses are considered losses that occur outside of the individual and include objects, possessions, the environment, loved ones, and support. Loss of career or limb is an internal loss that is more personal and involves some part of oneself.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 213        OBJ:   1

TOP:   The Nature of Loss                         KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

OTHER

 

  1. Place the steps of grieving in proper order.
  2. Acceptance and recovery
  3. Depression and identification
  4. Denial
  5. Yearning

 

ANS:

C, D, B, A

Not all individuals move through this process step-by-step. They may skip a step or may move back and forth between steps. If grieving is dysfunctional, an individual may skip a step completely.

 

DIF:    Cognitive Level: Application          REF:   Page 215 | Page 216

OBJ:   3                    TOP:   Stages of the Grieving Process

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

COMPLETION

 

  1. __________ occurs when an individual who has experienced a loss is working through or resolving his or her grief.

 

ANS:

Mourning

This period can be intense and painful, and its duration varies among individuals.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 215        OBJ:   2

TOP:   The Nature of Grief and Mourning KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Following the funeral of her husband, the wife is seen crying and holding his picture. She is demonstrating __________.

 

ANS:

Bereavement

Bereavement is the behavioral state of the thoughts, feelings, and activities following a loss.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 215        OBJ:   2

TOP:   The Nature of Grief and Mourning KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

Morrison-Valfre: Foundations of Mental Health Care, 4th Edition

 

Test Bank

 

Chapter 30: Personality Disorders

 

MULTIPLE CHOICE

 

  1. The unique pattern of thoughts, attitudes, values, and behaviors that each person develops when adapting to a particular environment and its standards is called the:
a. Ego
b. Person
c. Personality
d. Continuum of social responses

 

 

ANS:  C

This is the definition of personality.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 332        OBJ:   1

TOP:   Continuum of Social Responses     KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Infants who experience nurturing environments develop the ability to:
a. Test others
b. Trust others
c. Manipulate others
d. Model others’ behaviors

 

 

ANS:  B

When the infant’s needs are consistently met, a sense of trust and self-worth develops.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 333        OBJ:   2

TOP:   Personality in Childhood                KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Health Promotion and Maintenance

 

  1. Behavioral theorists see personality disorders as the result of:
a. Social stressors
b. Conditioned responses
c. Neurophysical problems
d. An imbalance among the three forces of the personality

 

 

ANS:  B

Behavioralists see personality disorders as the result of conditioned responses caused by previous events. Social stressors refer to sociocultural theories; neurophysical refers to biological theories; and imbalance among the three forces of the personality describes psychoanalytical theories.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 335        OBJ:   3

TOP:   Behavioral Theories                       KEY:  Nursing Process Step: N/A

MSC:  Client Needs: Psychosocial Integrity

 

  1. Paranoid personality disorders are diagnosed more often in:
a. Men
b. Women
c. Children
d. Adolescents

 

 

ANS:  A

Paranoid personality disorders are diagnosed in up to 2.5% of the population, more often in men than in women.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 336        OBJ:   5

TOP:   Eccentric Cluster                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The staff notices that the 80-year-old client’s behavior is changing. Although he once was outgoing and talkative, he now sits sullenly in his chair. Investigation of the client’s personality change is based on the premise that:
a. Personality patterns remain intact until death
b. Apathy in older people often goes unexpressed
c. A change in personality is a normal sign of aging
d. A change in personality indicates that death is near

 

 

ANS:  A

A sudden change in personality is not a normal sign of aging. By older adulthood, the personality is deeply entrenched. Patterns of thinking and behaving remain intact until death.

 

DIF:    Cognitive Level: Application          REF:   Page 334        OBJ:   2

TOP:   Personality in Older Adulthood      KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Studies of families, twins, and relatives with personality disorders have demonstrated that the developing personality is influenced by:
a. Genetics
b. Order of birth
c. Financial factors
d. Number of siblings

 

 

ANS:  A

Studies of families, twins, and relatives of individuals with personality disorders have demonstrated that behavior and personality have a strong genetic influence.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 334        OBJ:   3

TOP:   Biological Theories                         KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The group of personality disorders characterized by odd or strange behaviors is known as the ____ cluster.
a. Erratic
b. Fearful
c. Eccentric
d. Obsessive-compulsive

 

 

ANS:  C

The eccentric cluster is characterized by odd or strange behaviors. Individuals in this cluster find it difficult to be comfortable in social settings and do not relate well to others.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 336        OBJ:   5

TOP:   Eccentric Cluster                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client automatically assumes that everyone is out to harm, deceive, or exploit her. She often feels deeply injured by others, even when no evidence exists. Her behavior is described as:
a. Paranoid
b. Pleasant
c. Schizoid
d. Narcissistic

 

 

ANS:  A

Individuals with a paranoid personality disorder have a pattern of behaviors marked by suspicion and mistrust. They automatically assume that everyone is out to harm, deceive, or exploit them. Schizoid personality is characterized by an inability to develop and maintain relationships with other people; and narcissistic personality refers to an individual who has a grandiose sense of self-importance.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 336        OBJ:   5

TOP:   Eccentric Cluster                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The central feature of one of our most pressing mental health problems today is a pervasive pattern of disregard for, and violation of, the rights of others. This personality disorder is called:
a. Avoidant
b. Paranoid
c. Dependent
d. Antisocial

 

 

ANS:  D

One of our most pressing mental health problems today is antisocial personality disorder, manifested as a pervasive pattern of disregard for and violation of the rights of others. Avoidant personality disorder refers to individuals who avoid situations for fear of rejection and humiliation; paranoid personality refers to individuals who assume that everyone is out to harm, deceive, or exploit them; and dependent personality refers to individuals who express the need to be cared for so they can avoid turning people away.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 337        OBJ:   4

TOP:   Erratic Cluster                                           KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client relies on deceit and manipulation to get his own way. He seems to have a complete lack of conscience. His goal is always self-gratification at the other person’s expense. He is referred to as:
a. A nerd
b. A psychotic
c. A psychopath
d. Narcissistic

 

 

ANS:  C

The hallmark of psychopaths (sociopaths) is a lack of conscience. Psychopaths use charm, manipulation, intimidation, and violence to control others and satisfy their own selfish needs.

 

DIF:    Cognitive Level: Application          REF:   Page 337        OBJ:   5

TOP:   Erratic Cluster                                           KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The childhood trait that increases the risk for developing an antisocial personality disorder is:
a. Poor impulse control
b. Frequent reading in solitude
c. Poor preschool learning practices
d. Difficulty controlling others in the environment

 

 

ANS:  A

Some children have trouble controlling their impulses, so they become disruptive and develop antisocial ways of coping.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 335        OBJ:   2 | 5

TOP:   Erratic Cluster                                           KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client is a 38-year-old woman with a diagnosis of narcissistic personality disorder. Behaviors associated with this diagnosis are:
a. Avoidant
b. Odd or eccentric
c. Attention seeking
d. Reflective of lack of trust in others

 

 

ANS:  C

A narcissistic personality disorder is characterized by grandiosity and the need to be admired.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 336        OBJ:   5

TOP:   Erratic Cluster                                           KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client is a heavy drinker. He is frequently in bar fights because every time he visits a tavern, someone is “always picking a fight with me.” He has been given the diagnosis of paranoid personality disorder. He is also categorized as having a:
a. Dual diagnosis
b. Schizoid personality
c. Problem with fighting
d. Histrionic personality

 

 

ANS:  A

Individuals with personality disorders who also are suffering from substance abuse or other mental health problems are categorized as having a dual diagnosis.

 

DIF:    Cognitive Level: Application          REF:   Page 339        OBJ:   6

TOP:   Dual Diagnosis                               KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The client is unable to make a decision by herself. She clings to her husband and quickly moves to fill his requests. Although she sometimes appears angry, her emotions are not expressed. The client’s diagnosis is:
a. Neuroticism
b. Paranoid personality disorder
c. Dependent personality disorder
d. Narcissistic personality disorder

 

 

ANS:  C

The anxiety of dependent personality disorder is associated with separation and abandonment. Neuroticism refers to an individual who experiences a mental imbalance that causes distress and anxiety without affecting rational thought; paranoid personality disorder is displayed by assumptions that everyone is out to harm, deceive, or exploit; and narcissistic personality disorder is grandiose feelings of self-importance.

 

DIF:    Cognitive Level: Application          REF:   Page 339        OBJ:   5

TOP:   Fearful Cluster                                KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. The nurse is planning goals for a male client with the diagnosis of personality disorder. What is the main goal of the client’s therapy?
a. To adjust to his medications
b. To learn to get along with others
c. To learn to control his environment
d. To become aware of how his behavior affects his life

 

 

ANS:  D

Although all are goals of care for clients with personality disorder, the most important goal is to help clients identify and then become responsible for their own behavior. This is necessary for all other treatment to be effective.

 

DIF:    Cognitive Level: Application          REF:   Page 339        OBJ:   7

TOP:   Nursing (Therapeutic) Process        KEY:  Nursing Process Step: Planning

MSC:  Client Needs: Psychosocial Integrity

 

  1. Compliance with prescribed medications must be monitored frequently and safeguards must be put in place to prevent or reduce the risk for:
a. Deceit
b. Suicide
c. Homicide
d. Manipulation

 

 

ANS:  B

Clients may hoard their medications until they have enough to make up a lethal dose.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 340        OBJ:   8

TOP:   Treatments and Therapies

KEY:  Nursing Process Step: Assessment | Nursing Process Step: Intervention

MSC:  Client Needs: Physiological Integrity

 

  1. Care providers must keep in mind their own therapeutic boundaries and must communicate with each other frequently to prevent the client from:
a. Splitting the care team
b. Manipulating the care team
c. Having delusions of grandeur
d. Manipulating the environment

 

 

ANS:  A

Splitting is emotionally dividing the staff by complimenting one group and degrading another.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 340        OBJ:   9

TOP:   Nursing Process                              KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

  1. A male client has a schizotypal personality disorder. A female client compliments him on his style of dressing, and he interprets this as her caring deeply for him and desiring to date him. What is the client experiencing?
a. Paranoia
b. Ideas of reference
c. Inappropriate affect
d. Delusions of grandeur

 

 

ANS:  B

Ideas of reference are incorrect perceptions of casual events as having great or significant meaning and are commonly seen in clients with schizotypal personality disorder. Paranoia refers to individuals who assume that everyone is out to harm, deceive, or exploit them; inappropriate affect refers to inappropriate emotional expressions; and delusions of grandeur are irrational grandiose thoughts, but they differ from ideas of reference in that an interaction is not necessary to cause the delusions of grandeur.

 

DIF:    Cognitive Level: Application          REF:   Page 336        OBJ:   6

TOP:   Eccentric Cluster                            KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. A wife is discussing her co-worker with her husband. The wife states, “I am so tired of her. She is always dressing in flamboyant clothing and pretends to have an accent. She doesn’t relate well to any of our co-workers because she is so superficial.” Which personality disorder is being described?
a. Paranoid
b. Impulsive
c. Histrionic
d. Narcissistic

 

 

ANS:  C

An individual with this type of personality disorder displays a pattern of excessive emotional expression and attention-seeking behaviors. Paranoid personality refers to individuals who assume that everyone is out to harm, deceive, or exploit them; impulsive personality refers to disorders that include behaviors such as gambling, use of drugs, and spending money irresponsibly; and narcissistic personality refers to grandiose feelings of self-importance.

 

DIF:    Cognitive Level: Application          REF:   Page 336        OBJ:   6

TOP:   Erratic Cluster Personality Disorders

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

  1. Medications are used with extreme caution in clients with personality disorders because of their questionable effectiveness. If a client is receiving an antipsychotic medication, it is especially important for the nurse to monitor the client for side effects of:
a. Increased thirst and urination, nausea, and anorexia
b. Dry mouth, altered taste, sexual dysfunction, and dizziness
c. Bone marrow depression, gastrointestinal symptoms, and confusion
d. Extrapyramidal movements, dry mouth, blurred vision, and photophobia

 

 

ANS:  D

These side effects are characteristic of antipsychotic medications and should be assessed because they sometimes become irreversible. Increased thirst, urination, nausea, and anorexia are side effects most commonly seen with lithium; dry mouth, altered taste, sexual dysfunction, and dizziness are commonly seen with antidepressants; and bone marrow depression, gastrointestinal symptoms, and confusion are seen most frequently with anticonvulsants.

 

DIF:    Cognitive Level: Application          REF:   Page 340        OBJ:   8

TOP:   Treatments and Therapies               KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Physiological Integrity

 

MULTIPLE RESPONSE

 

  1. Which are characteristics of a personality disorder? Select all that apply.
a. Delusions
b. Depression
c. Social sensitivity
d. Out-of-control sexual behavior
e. Inflexible and maladaptive behaviors
f. Difficulties with interpersonal relations
g. Behaviors that cause significant functional impairment

 

 

ANS:  E, F, G

These are characteristics of personality disorders. The other options refer to other types of mental health disorders.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 335        OBJ:   4

TOP:   Personality Disorders                                KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

  1. Personality disorders that are considered to be in the erratic cluster include

(select all that apply):

a. Antisocial
b. Borderline
c. Paranoid
d. Histrionic
e. Avoidant
f. Obsessive-compulsive
g. Narcissistic

 

 

ANS:  A, B, D, G

The main characteristic of the erratic cluster of personality disorders is dramatic behavior.  Paranoid personality disorder belongs to the eccentric cluster of personality disorders; and avoidant personality disorder and obsessive-compulsive personality disorder belong to the fearful cluster.

 

DIF:    Cognitive Level: Knowledge          REF:   Page 337        OBJ:   4

TOP:   Personality Disorders                                KEY:              Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

COMPLETION

 

  1. A characteristic trait of an individual with __________ disorder is that his or her anxiety is focused on uncertainty of future events.

 

ANS:

Obsessive-compulsive personality

Persons with obsessive-compulsive personality disorder focus their anxiety on uncertainty of future events. They are extremely orderly and so precoccupied with details that they accomplish very little.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 339        OBJ:   4

TOP:   Fearful Cluster Personality Disorders

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

 

  1. An individual with an __________ personality disorder relies on deceit and manipulation to get his or her way.

 

ANS:

Antisocial

An individual with an antisocial personality disorder has a disregard for and repeatedly violates the rights of others through manipulation and deceit.

 

DIF:    Cognitive Level: Comprehension   REF:   Page 337        OBJ:   4

TOP:   Erratic Cluster Personality Disorders

KEY:  Nursing Process Step: Assessment  MSC:  Client Needs: Psychosocial Integrity

Reviews

There are no reviews yet.

Be the first to review “Foundations of Mental Health Care 4e by Morrison-Valfre-Test Bank”

Your email address will not be published. Required fields are marked *