| Content |
Table of Contents
Unit I: Essential Theoretical Concepts for Practice
1. Practicing the Science and the Art of Psychiatric Nursing
2. Mental Health and Mental Illness
3. Theories and Therapies
4. Biological Basis for Understanding Psychopharmacology
5. Settings for Psychiatric Care
6. Legal and Ethical Basis for Practice
Unit II: Tools for Practice of the Art
7. Nursing Process and QSEN: The Foundation for Safe and Effective Care
8. Skills: Medium for All Nursing Practice
9. Therapeutic Relationships and the Clinical Interview
Unit III: Caring for Patients with Psychobiological Disorders
10. Stress and Stress-Related Disorders
11. Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders
12. Somatic Symptom Disorders and Related Disorders
13. Personality Disorders
14. Eating Disorders
15. Mood Disorders: Depression
16. Bipolar Spectrum Disorders
17. Schizophrenia Spectrum Disorders and Other Psychotic Disorders
18. Neurocognitive Disorders
19. Substance-Related and Addictive Disorders
Unit IV: Caring for Patients Experiencing Psychiatric Emergencies
20. Crisis and Mass Disaster
21. Child, Partner, and Elder Violence
22. Sexual Violence
23. Suicidal Thoughts and Behaviors
24. Anger, Aggression, and Violence
25. Care for the Dying and Those Who Grieve
Unit V: Age-Related Mental Health Disorders
26. Children and Adolescents
27. Adults
28. Older Adults
| Chapter 01: Foundations of Maternity, Women’s Health, and Child Health Nursing
MULTIPLE CHOICE
- Which factor significantly contributed to the shift from home births to hospital births in the early 20th century?
| a. |
Puerperal sepsis was identified as a risk factor in labor and delivery. |
| b. |
Forceps were developed to facilitate difficult births. |
| c. |
The importance of early parental-infant contact was identified. |
| d. |
Technologic developments became available to physicians. |
ANS: D
Technologic developments were available to physicians, not lay midwives. So in-hospital births increased in order to take advantage of these advancements. Puerperal sepsis has been a known problem for generations. In the late 19th century, Semmelweis discovered how it could be prevented with improved hygienic practices. The development of forceps is an example of a technology advance made in the early 20th century but is not the only reason birthplaces moved. Unlike home births, early hospital births hindered bonding between parents and their infants.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Safe and Effective Care Environment
- Family-centered maternity care developed in response to
| a. |
demands by physicians for family involvement in childbirth. |
| b. |
the Sheppard-Towner Act of 1921. |
| c. |
parental requests that infants be allowed to remain with them rather than in a nursery. |
| d. |
changes in pharmacologic management of labor. |
ANS: C
As research began to identify the benefits of early extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of rooming-in and finally to family-centered maternity care. Family-centered care was a request by parents, not physicians. The Sheppard-Towner Act of 1921 provided funds for state-managed programs for mothers and children. The changes in pharmacologic management of labor were not a factor in family-centered maternity care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 2 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Psychosocial Integrity
- Which setting for childbirth allows the least amount of parent-infant contact?
| a. |
Labor/delivery/recovery/postpartum room |
| b. |
Birth center |
| c. |
Traditional hospital birth |
| d. |
Home birth |
ANS: C
In the traditional hospital setting, the mother may see the infant for only short feeding periods, and the infant is cared for in a separate nursery. The labor/delivery/recovery/postpartum room setting allows increased parent-infant contact. Birth centers are set up to allow an increase in parent-infant contact. Home births allow an increase in parent-infant contact.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 2 OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
- As a result of changes in health care delivery and funding, a current trend seen in the pediatric setting is
| a. |
increased hospitalization of children. |
| b. |
decreased number of children living in poverty. |
| c. |
an increase in ambulatory care. |
| d. |
decreased use of managed care. |
ANS: C
One effect of managed care has been that pediatric health care delivery has shifted dramatically from the acute care setting to the ambulatory setting in order to provide more cost-efficient care. The number of hospital beds being used has decreased as more care is given in outpatient settings and in the home. The number of children living in poverty has increased over the past decade. One of the biggest changes in health care has been the growth of managed care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 5 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
- The Women, Infants, and Children (WIC) program provides
| a. |
well-child examinations for infants and children living at the poverty level. |
| b. |
immunizations for high-risk infants and children. |
| c. |
screening for infants with developmental disorders. |
| d. |
supplemental food supplies to low-income pregnant or breastfeeding women. |
ANS: D
WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breastfeeding and to their children until age 5 years. Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment Program provides for well-child examinations and for treatment of any medical problems diagnosed during such checkups. Children in the WIC program are often referred for immunizations, but that is not the primary focus of the program. Public Law 99-457 is part of the Individuals with Disabilities Education Act that provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 8
OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance
- In most states, adolescents who are not emancipated minors must have the permission of their parents before
| a. |
treatment for drug abuse. |
| b. |
treatment for sexually transmitted diseases (STDs). |
| c. |
accessing birth control. |
| d. |
surgery. |
ANS: D
Minors are not considered capable of giving informed consent, so a surgical procedure would require consent of the parent or guardian. Exceptions exist for obtaining treatment for drug abuse or STDs or for getting birth control in most states.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 17 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
- The maternity nurse should have a clear understanding of the correct use of a clinical pathway. One characteristic of clinical pathways is that they
| a. |
are developed and implemented by nurses. |
| b. |
are used primarily in the pediatric setting. |
| c. |
set specific time lines for sequencing interventions. |
| d. |
are part of the nursing process. |
ANS: C
Clinical pathways are standardized, interdisciplinary plans of care devised for patients with a particular health problem. They are used to identify patient outcomes, specify time lines to achieve those outcomes, direct appropriate interventions and sequencing of interventions, include interventions from a variety of disciplines, promote collaboration, and involve a comprehensive approach to care. They are developed by multiple health care professionals and reflect interdisciplinary care. They can be used in multiple settings and for patients throughout the life span. They are not part of the nursing process but can be used in conjunction with the nursing process to provide care to patients.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 7 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
- The fastest growing group of homeless people is
| a. |
men and women preparing for retirement. |
| b. |
migrant workers. |
| c. |
single women and their children. |
| d. |
intravenous (IV) substance abusers. |
ANS: C
Pregnancy and birth, especially for a teenager, are important contributing factors for becoming homeless. People preparing for retirement, migrant workers, and IV substance abusers are not among the fastest growing groups of homeless people.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 14 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity
- A nurse wishes to work to reduce infant mortality in the United States. Which activity would this nurse most likely participate in?
| a. |
Creating pamphlets in several different languages using an interpreter. |
| b. |
Assisting women to enroll in Medicaid by their third trimester. |
| c. |
Volunteering to provide prenatal care at community centers. |
| d. |
Working as an intake counselor at a women’s shelter. |
ANS: C
Prenatal care is vital to reducing infant mortality and medical costs. This nurse would most likely participate in community service providing prenatal care outreach activities in community centers, particularly in low-income areas. Pamphlets in other languages, enrolling in Medicaid, and working at a women’s shelter all might impact infant mortality, but the greatest effect would be from assisting women to get consistent prenatal care.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 14 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
- The intrapartum woman sees no need for a routine admission fetal monitoring strip. If she continues to refuse, what is the first action the nurse should take?
| a. |
Consult the family of the woman. |
| b. |
Notify the provider of the situation. |
| c. |
Document the woman’s refusal in the nurse’s notes. |
| d. |
Make a referral to the hospital ethics committee. |
ANS: B
Patients must be allowed to make choices voluntarily without undue influence or coercion from others. The physician, especially if unaware of the patient’s decision, should be notified immediately. Both professionals can work to ensure the mother understands the rationale for the action and the possible consequences of refusal. The woman herself is the decision-maker, unless incapacitated. Documentation should occur but is not the first action. This situation does not rise to the level of an ethical issue so there is no reason to call the ethics committee.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 18 OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
- Which statement is true regarding the “quality assurance” or “incident” report?
| a. |
The report assures the legal department that no problem exists. |
| b. |
Reports are a permanent part of the patient’s chart. |
| c. |
The nurse’s notes should contain, “Incident report filed, and copy placed in chart.” |
| d. |
This report is a form of documentation of an event that may result in legal action. |
ANS: D
An incident report is used when something occurs that might result in legal action, such as a patient fall or medication error. It warns the legal department that there may be a problem in a particular patient’s care. Incident reports are not part of the patient’s chart; thus the nurses’ notes should not contain any reference to them.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 18 OBJ: Integrated Process: Communication and Documentation
MSC: Client Needs: Safe and Effective Care Environment
- Elective abortion is considered an ethical issue because
| a. |
abortion law is unclear about a woman’s constitutional rights. |
| b. |
the Supreme Court ruled that life begins at conception. |
| c. |
a conflict exists between the rights of the woman and the rights of the fetus. |
| d. |
it requires third-party consent. |
ANS: C | Chapter 1. The Concept of Stress Adaptation
Multiple Choice
- A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
- The client is experiencing severe distress and is at risk for physical and psychological illness.
- A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
- Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
- The client may view these losses as challenges and perceive them as opportunities.
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client’s life. However, positive coping mechanisms and strong social support can limit susceptibility to stress-related illnesses.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
- A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: “Perhaps this was the best thing to happen. Maybe I’ll look into pursuing an art degree.” How should the nurse characterize the client’s appraisal of the job loss stressor?
- Irrelevant
- Harm/loss
- Threatening
- Challenging
ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity
- Which client statement should alert a nurse that a client may be responding maladaptively to stress?
- “I’ve found that avoiding contact with others helps me cope.”
- “I really enjoy journaling; it’s my private time.”
- “I signed up for a yoga class this week.”
- “I made an appointment to meet with a therapist.”
ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
- A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?
- Alarm reaction stage
- Stage of resistance
- Stage of exhaustion
- Fight-or-flight stage
ANS: C
At the stage of exhaustion, the student’s exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity
- A school nurse is assessing a female high school student who is overly concerned about her appearance. The client’s mother states, “That’s not something to be stressed about!” Which is the most appropriate nursing response?
- “Teenagers! They don’t know a thing about real stress.”
- “Stress occurs only when there is a loss.”
- “When you are in poor physical condition, you can’t experience psychological well-being.”
- “Stress can be psychological. A threat to self-esteem may result in high stress levels.”
ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
- A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
- Meditation
- Problem-solving training
- Relaxation
- Journaling
ANS: B
The student must assess his or her situation and determine the best course of action. Problem-solving training, by providing structure and objectivity, can assist in decision making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
- An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
- Encourage the student to use the alternative coping mechanism of relaxation exercises.
- Complete the problem-solving process for the client.
- Work through the problem-solving process with the client.
- Encourage the client to keep a journal.
ANS: C
During times of high anxiety and stress, clients will need more assistance in problem-solving and decision making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
- A school nurse is assessing a distraught female high school student who is overly concerned because her parents can’t afford horseback riding lessons. How should the nurse interpret the student’s reaction to her perceived problem?
- The problem is endangering her well-being.
- The problem is personally relevant to her.
- The problem is based on immaturity.
- The problem is exceeding her capacity to cope.
ANS: B
Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that other adolescents experience.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
- Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a nurse expect to assess?
- An achieved state of relaxation
- An achieved insight into one’s feelings
- A demonstration of appropriate role behaviors
- An enhanced ability to problem-solve
ANS: A
Meditation produces relaxation by creating a special state of consciousness through focused concentration.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
- A distraught, single, first-time mother cries and asks a nurse, “How can I go to work if I can’t afford childcare?” What is the nurse’s initial action in assisting the client with the problem-solving process?
- Determine the risks and benefits for each alternative.
- Formulate goals for resolution of the problem.
- Evaluate the outcome of the implemented alternative.
- Assess the facts of the situation.
ANS: D
Before any other steps can be taken, accurate information about the situation must be gathered and assessed.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity | Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion
MULTIPLE CHOICE
1. A nurse is selecting a family theory to assess a patient’s family dynamics. Which family theory best describes a series of tasks for the family throughout its life span?
| a. |
Interactional theory |
| b. |
Developmental systems theory |
| c. |
Structural-functional theory |
| d. |
Duvall’s developmental theory |
ANS: D
Duvall’s developmental theory describes eight developmental tasks of the family throughout its life span. Interactional theory and structural-functional theory are not family theories. Developmental systems theory is an outgrowth of Duvall’s theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others.
DIF:Cognitive Level: UnderstandREF:p. 17
TOP:Integrated Process: Nursing Process: Assessment
MSC:Area of Client Needs: Health Promotion and Maintenance
2.Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
| a. |
Interactional theory |
| b. |
Developmental systems theory |
| c. |
Family stress theory |
| d. |
Duvall’s developmental theory |
ANS: C
Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of Duvall’s theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. Duvall’s developmental theory describes eight developmental tasks of the family throughout its life span.
DIF:Cognitive Level: UnderstandREF:p. 16
TOP:Integrated Process: Nursing Process: Assessment
MSC:Area of Client Needs: Health Promotion and Maintenance
3.Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together?
| a. |
Blended |
| b. |
Nuclear |
| c. |
Binuclear |
| d. |
Extended |
ANS: D
An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children.
DIF:Cognitive Level: RememberREF:p. 18
TOP:Integrated Process: Nursing Process: Planning
MSC:Area of Client Needs: Health Promotion and Maintenance
4.A nurse is assessing a family’s structure. Which describes a family in which a mother, her children, and a stepfather live together?
| a. |
Blended |
| b. |
Nuclear |
| c. |
Binuclear |
| d. |
Extended |
ANS: A
A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children. An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling.
DIF:Cognitive Level: UnderstandREF:p. 18
TOP:Integrated Process: Nursing Process: Assessment
MSC:Area of Client Needs: Health Promotion and Maintenance
5.Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to:
| a. |
be praised less often. |
| b. |
be more achievement oriented. |
| c. |
be more popular with the peer group. |
| d. |
identify with peer group more than parents. |
ANS: B
Firstborn children, like only children, tend to be more achievement oriented. Being praised less often, being more popular with the peer group, and identifying with peer groups more than parents are characteristics of later-born children.
DIF:Cognitive Level: ApplyREF:p. 29
TOP:Integrated Process: Nursing Process: Implementation
MSC:Area of Client Needs: Health Promotion and Maintenance
6.The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent would indicate a correct understanding of the teaching?
| a. |
“My marital relationship can have a positive or negative effect on the role transition.” |
| b. |
“If an infant has special care needs, the parents’ sense of confidence in their new role is strengthened.” |
| c. |
“Young parents can adjust to the new role easier than older parents.” |
| d. |
“A parent’s previous experience with children makes the role transition more difficult.” |
ANS: A
If parents are supportive of each other, they can serve as positive influences on establishing satisfying parental roles. When marital tensions alter caregiving routines and interfere with the enjoyment of the infant, then the marital relationship has a negative effect. Infants with special care needs can be a significant source of added stress. Older parents are usually more able to cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for each other and other children. Parents who have previous experience with parenting appear more relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth and development.
DIF:Cognitive Level: UnderstandREF:p. 17
TOP:Integrated Process: Nursing Process: Evaluation
MSC:Area of Client Needs: Health Promotion and Maintenance
7.When assessing a family, the nurse determines that the parents exert little or no control over their children. What is this style of parenting called?
| a. |
Permissive |
| b. |
Dictatorial |
| c. |
Democratic |
| d. |
Authoritarian |
ANS: A
Permissive parents avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. The parents exert little or no control over their children’s actions. Dictatorial or authoritarian parents attempt to control their children’s behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents combine permissive and dictatorial styles. They direct their children’s behavior and attitudes by emphasizing the reasons for rules and negatively reinforcing deviations. They respect the child’s individual nature.
DIF:Cognitive Level: RememberREF:p. 20
TOP:Integrated Process: Nursing Process: Diagnosis
MSC:Area of Client Needs: Health Promotion and Maintenance
8.When discussing discipline with the mother of a 4-year-old child, the nurse should include which instruction?
| a. |
Children as young as 4 years old rarely need to be punished. |
| b. |
Parental control should be consistent. |
| c. |
Withdrawal of love and approval is effective at this age. |
| d. |
One should expect rules to be followed rigidly and unquestioningly. |
ANS: B
For effective discipline, parents must be consistent and must follow through with agreed-on actions. Realistic goals should be set for this age group. Parents should structure the environment to prevent unnecessary difficulties. Requests for behavior change should be phrased in a positive manner to provide direction for the child. Withdrawal of love and approval is never appropriate or effective. Discipline strategies should be appropriate to the child’s age, temperament, and severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old.
DIF:Cognitive Level: ApplyREF:p. 20
TOP:Integrated Process: Teaching/Learning
MSC:Area of Client Needs: Health Promotion and Maintenance
9.Which is most characteristic of the physical punishment of children, such as spanking?
| a. |
Psychological impact is usually minimal. |
| b. |
Children rarely become accustomed to spanking. |
| c. |
Children’s development of reasoning increases. |
| d. |
Misbehavior is likely to occur when parents are not present. |
ANS: D
Through the use of physical punishment, children learn what they should not do. When parents are not around, it is more likely that children will misbehave because they have not learned to behave well for their own sake, but rather out of fear of punishment. Spanking can cause severe physical and psychological injury and interfere with effective parent-child interaction. Children do become accustomed to spanking, requiring more severe corporal punishment each time. The use of corporal punishment may interfere with the child’s development of moral reasoning.
DIF:Cognitive Level: UnderstandREF:p. 20
TOP:Integrated Process: Teaching/Learning
MSC:Area of Client Needs: Health Promotion and Maintenance
10.A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption should the nurse use in planning a response?
| a. |
Telling the child is an important aspect of their parental responsibilities. |
| b. |
The best time to tell the child is between ages 7 and 10 years. |
| c. |
It is not necessary to tell the child who was adopted so young. |
| d. |
It is best to wait until the child asks about it. |
ANS: A
It is important for the parents not to withhold information about the adoption from the child. It is an essential component of the child’s identity. There is no recommended best time to tell children. It is believed that children should be told young enough so they do not remember a time when they did not know. It should be done before the children enter school to keep third parties from telling the children before the parents have had the opportunity.
DIF:Cognitive Level: UnderstandREF:p. 22
TOP:Integrated Process: Teaching/Learning
MSC:Area of Client Needs: Health Promotion and Maintenance
11.A parent of a school-age child is going through a divorce. The parent tells the school nurse the child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as which implication?
| a. |
Indication of maladjustment |
| b. |
Common reaction to divorce |
| c. |
Lack of adequate parenting |
| d. |
Unusual response that indicates need for referral |
ANS: B
Parental divorce affects school-age children in many ways. In addition to difficulties in school, they often have profound sadness, depression, fear, insecurity, frequent crying, loss of appetite, and sleep disorders. This is not an indication of maladjustment, suggestive of lack of adequate parenting, or an unusual response that indicates need for referral in school-age children after parental divorce.
DIF:Cognitive Level: ApplyREF:p. 24
TOP:Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Psychosocial Integrity
12.A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, “I want to go back to work, but I don’t want Eric to suffer because I’ll have less time with him.” The nurse’s most appropriate answer would be which statement?
| a. |
“I’m sure he’ll be fine if you get a good babysitter.” |
| b. |
“You will need to stay home until Eric starts school.” |
| c. |
“You should go back to work so Eric will get used to being with others.” |
| d. |
“Let’s talk about the child care options that will be best for Eric.” |
ANS: D
Let’s talk about the child care options that will be best for Eric is an open-ended statement that will assist the mother in exploring her concerns about what is best for both her and Eric. I’m sure he’ll be fine if you get a good babysitter, You will need to stay home until Eric starts school, and You should go back to work so Eric will get used to being with others are directive statements. They do not address the effect of her working on Eric.
DIF:Cognitive Level: ApplyREF:p. 27
TOP:Integrated Process: Communication and Documentation
MSC: Area of Client Needs: Psychosocial Integrity
13.Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
| a. |
Race |
| b. |
Culture |
| c. |
Ethnicity |
| d. |
Social group |
ANS: B
Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of humankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups.
DIF:Cognitive Level: RememberREF:p. 29
TOP:Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Psychosocial Integrity
14.Which term best describes the emotional attitude that one’s own ethnic group is superior to others?
| a. |
Culture |
| b. |
Ethnicity |
| c. |
Superiority |
| d. |
Ethnocentrism |
ANS: D
Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serves as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not include ethnicity.
DIF:Cognitive Level: UnderstandREF:p. 30
TOP:Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Psychosocial Integrity
MULTIPLE RESPONSE
1.Dunst, Trivette, and Deal identified the qualities of strong families that help them function effectively. Which qualities are included? (Select all that apply.)
| a. |
Ability to stay connected without spending time together |
| b. |
Clear set of family values, rules, and beliefs |
| c. |
Adoption of one coping strategy that always promotes positive functioning in dealing with life events |
| d. |
Sense of commitment toward growth of individual family members as opposed to that of the family unit |
| e. |
Ability to engage in problem-solving activities |
| f. |
Sense of balance between the use of internal and external family resources |
ANS: B, E, F
A clear set of family rules, values, and beliefs that establishes expectations about acceptable and desired behavior is one of the qualities of strong families that help them function effectively. Strong families also are able to engage in problem-solving activities and to find a balance between internal and external forces. Strong families have a sense of congruence among family members regarding the value and importance of assigning time and energy to meet needs. Strong families also use varied coping strategies. The sense of commitment is toward the growth and well-being of individual family members, as well as the family unit.
DIF:Cognitive Level: UnderstandREF:p. 19
TOP:Integrated Process: Nursing Process: Diagnosis
MSC:Area of Client Needs: Health Promotion and Maintenance
2.A nurse is conducting a teaching session on the use of time-out as a discipline measure to parents of toddlers. Which are correct strategies the nurse should include in the teaching session? (Select all that apply.)
| a. |
Time-out as a discipline measure cannot be used when in a public place. |
| b. |
A rule for the length of time-out is 1 minute per year. |
| c. |
When the child misbehaves, one warning should be given. |
| d. |
The area for time-out can be in the family room where the child can see the television. |
| e. |
When the child is quiet for the specified time, he or she can leave the room. |
ANS: B, C, E
A rule for the length of time-out is 1 minute per year of age; use a kitchen timer with an audible bell to record the time rather than a watch. When the child misbehaves, one warning should be given. When the child is quiet for the duration of the time, he or she can then leave the room. Time-out can be used in public places and the parents should be consistent on the use of time-out. Implement time-out in a public place by selecting a suitable area or explain to children that time-out will be spent immediately on returning home. The time-out should not be spent in an area from which the child can view the television. Select an area for time-out that is safe, convenient, and unstimulating but where the child can be monitored, such as the bathroom, hallway, or laundry room.
DIF:Cognitive Level: ApplyREF:p. 21
TOP:Integrated Process: Teaching/Learning
MSC:Area of Client Needs: Health Promotion and Maintenance
3.Divorced parents of a preschool child are asking whether their child will display any feelings or behaviors related to the effect of the divorce. The nurse is correct when explaining that the parents should be prepared for which types of behaviors? (Select all that apply.)
| a. |
Displaying fears of abandonment |
| b. |
Verbalizing that he or she “is the reason for the divorce” |
| c. |
Displaying fear regarding the future |
| d. |
Ability to disengage from the divorce proceedings |
| e. |
Engaging in fantasy to understand the divorce |
ANS: A, B, E
A child 3 to 5 years of age (preschool) may display fears of abandonment, verbalize feelings that he or she is the reason for the divorce, and engage in fantasy to understand the divorce. He or she would not be displaying fear regarding the future until school age, and the ability to disengage from the divorce proceedings would be characteristic of an adolescent.
DIF:Cognitive Level: ApplyREF:p. 24
TOP:Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Teaching and Learning
COMPLETION | Test Bank Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition
Chapter 01: Maternity and Women’s Health Care Today
Foundations of Maternal-Newborn & Women’s Health Nursing, 7th Edition
MULTIPLE CHOICE
1. A nurse educator is teaching a group of nursing students about the history of family-centered
maternity care. Which statement should the nurse include in the teaching session?
a. The Sheppard-Towner Act of 1921 promoted family-centered care.
b. Changes in the pharmacologic management of labor prompted family-centered care.
c. Demands by physicians for family involvement in childbirth increased the practice
of family-centered care.
d. Parental requests that infants be allowed to remain with them rather than in a
nursery initiated the practice of family-centered care.
ANS: D
As research began to identify the benefits of early, extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of
rooming-in and finally to family-centered maternity care. The Sheppard-Towner Act provided
funds for state-managed programs for mothers and children but did not promote
family-centered care. The changes in pharmacologic management of labor were not a factor in
family-centered maternity care. Family-centered care was a request by parents, not physicians.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance
2. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits the amount of parent-infant interaction?” Which answer should the nurse provide for these parents in order to assist them in choosing an appropriate birth setting?
a. Birth center
b. Homebirth
c. Traditional hospital birth
d. Labor, birth, and recovery room
ANS: C
In the traditional hospital setting, the mother may see the infant for only short feeding periods,
and the infant is cared for in a separate nursery. Birth centers are set up to allow an increase in parent-infant contact. Home births allow the greatest amount of parent-infant contact. The labor, birth, recovery, and postpartum room setting allows for increased parent-infant contact.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance
3. Which statement best describes the advantage of a labor, birth, recovery, and postpartum
(LDRP) room?
a. The family is in a familiar environment.
b. They are less expensive than traditional hospital rooms.
c. The infant is removed to the nursery to allow the mother to rest.
d. The woman’s support system is encouraged to stay until discharge.
ANS: D
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Sleeping equipment is provided in a private room. A hospital setting is never a familiar
environment to new parents. An LDRP room is not less expensive than a traditional hospital
room. The baby remains with the mother at all times and is not removed to the nursery for
routine care or testing. The father or other designated members of the mother’s support system
are encouraged to stay at all times.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
4. Which nursing intervention is an independent function of the professional nurse?
a. Administering oral analgesics
b. Requesting diagnostic studies
c. Teaching the patient perineal care
d. Providing wound care to a surgical incision
ANS: C
Nurses are now responsible for various independent functions, including teaching, counseling,
and intervening in nonmedical problems. Interventions initiated by the physician and carried
out by the nurse are called dependent functions. Administrating oral analgesics is a dependent
function; it is initiated by a physician and carried out by a nurse. Requesting diagnostic
studies is a dependent function. Providing wound care is a dependent function; however, the
physician prescribes the type of wound care through direct orders or protocol.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Safe and Effective Care Environment
5. Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to
have a cesarean birth”?
a. “Everything will be OK.”
b. “Don’t worry about it. It will be over soon.”
c. “What concerns you most about a cesarean birth?”
d. “The physician will be in later and you can talk to him.”
ANS: C
The response, “What concerns you most about a cesarean birth” focuses on what the patient is
saying and asks for clarification, which is the most therapeutic response. The response,
“Everything will be ok” is belittling the patient’s feelings. The response, “Don’t worry about
it. It will be over soon” will indicate that the patient’s feelings are not important. The
response, “The physician will be in later and you can talk to him” does not allow the patient to
verbalize her feelings when she wishes to do that.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Psychosocial Integrity
6. In which step of the nursing process does the nurse determine the appropriate interventions for
the identified nursing diagnosis?
a. Planning
b. Evaluation
c. Assessment
d. Intervention
ANS: A
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The third step in the nursing process involves planning care for problems that were identified
during assessment. The evaluation phase is determining whether the goals have been met.
During the assessment phase, data are collected. The intervention phase is when the plan of
care is carried out.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
7. Which goal is most appropriate for the collaborative problem of wound infection?
a. The patient will not exhibit further signs of infection.
b. Maintain the patient’s fluid intake at 1000 mL/8 hour.
c. The patient will have a temperature of 98.6F within 2 days.
d. Monitor the patient to detect therapeutic response to antibiotic therapy.
ANS: D
In a collaborative problem, the goal should be nurse-oriented and reflect the nursing
interventions of monitoring or observing. Monitoring for complications such as further signs
of infection is an independent nursing role. Intake and output is an independent nursing role.
Monitoring a patient’s temperature is an independent nursing role.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
8. Which nursing intervention is written correctly?
a. Force fluids as necessary.
b. Observe interaction with the infant.
c. Encourage turning, coughing, and deep breathing.
d. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
ANS: D
Interventions might not be carried out if they are not detailed and specific. “Force fluids” is
not specific; it does not state how much or how often. Encouraging the patient to turn, cough,
and breathe deeply is not detailed or specific. Observing interaction with the infant does not
state how often this procedure should be done. Assisting the patient to ambulate for 10
minutes within a certain timeframe is specific.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
9. The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which
response by the nurse would be the most therapeutic?
a. “You’re afraid to take the baby home?”
b. “Don’t you have a mother who can come and help?”
c. “You should read the literature I gave you before you leave.”
d. “I was scared when I took my first baby home, but everything worked out.”
ANS: A
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This response uses reflection to show concern and open communication. The other choices are
blocks to communication. Asking if the patient has a mother who can come and assist blocks
further communication with the patient. Telling the patient to read the literature before leaving
does not allow the patient to express her feelings further. Sharing your own birth experience is
inappropriate.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Psychosocial Integrity
10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to
tissue trauma, secondary to vaginal birth, as evidenced by patient stating pain of 8 on a scale
of 10. Which expected outcome is correctly stated for this problem?
a. Patient will state that pain is a 2 on a scale of 10.
b. Patient will have a reduction in pain after administration of the prescribed
analgesic.
c. Patient will state an absence of pain 1 hour after administration of the prescribed
analgesic.
d. Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration of
the prescribed analgesic.
ANS: D
The outcome should be patient-centered, measurable, realistic, and attainable and within a
specified timeframe. Patient stating that her pain is now 2 on a scale of 10 lacks a timeframe.
Patient having a reduction in pain after administration of the prescribed analgesic lacks a
measurement. Patient stating an absence of pain 1 hour after the administration of prescribed
analgesic is unrealistic.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Physiologic Integrity
11. Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
a. Risk for anxiety related to upcoming birth
b. Risk for imbalanced nutrition related to NPO status
c. Risk for altered family processes related to new addition to the family
d. Risk for injury (maternal) related to altered sensations and positional or physical
changes
ANS: D
The nurse should determine which problem needs immediate attention. Risk for injury is the
problem that has the priority at this time because it is a safety problem. Risk for anxiety,
imbalanced nutrition, and altered family processes are not the priorities at this time.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Safe and Effective Care Environment | Test Bank for Public Health Science and Nursing Practice Caring For Populations by Savage
Chapter 10: Mental Health
MULTIPLE RESPONSE
1.According to Healthy People 2020, which of the following are characteristics of mental health?
Select all that apply.
| A. |
Engaging in productive activities |
| B. |
Having fulfilling relationships |
| C. |
Experiencing alterations in thinking |
| D. |
Adapting to change |
| E. |
Coping with challenges |
ANS: A, B, D, E
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 225-226
Heading: Introduction
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Knowledge [Remembering]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| 1. |
Mental health is a state of successful performance of mental function, including engagement in productive activities. |
| 2. |
Mental health is a state of successful performance of mental function, including being able to form fulfilling relationships with other people. |
| 3. |
This is incorrect; it is an example of a mental disorder. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior that are associated with distress or impaired functioning. |
| 4. |
Mental health is a state of successful performance of mental function, including the ability to adapt to change. |
| 5. |
Mental health is a state of successful performance of mental function, including the ability to cope with challenges. |
PTS:1CON:Promoting Health
MULTIPLE CHOICE
2.In 2010, approximately how many people in the United States reported experiencing mental disorders in the previous year?
| A. |
15% |
| B. |
50% |
| C. |
30% |
| D. |
25% |
ANS: D
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
pp. 226-227
Heading: Epidemiology of Mental Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
| B |
This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
| C |
This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
| D |
In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
PTS:1CON:Promoting Health
3.A student nurse is studying stress and mental health. The student nurse learns that ____ is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events.
| A. |
Intervention |
| B. |
Support |
| C. |
Resilience |
| D. |
Therapy |
ANS: C
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 229-231
Heading: Protective Factors: Building Resilience
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Trauma; Stress; Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Preventive and treatment interventions are useful tools to build on an individual’s natural resilience to promote positive outcomes. |
| B |
This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Support from family, friends, and community is an important part of strengthening an individual’s resilience. |
| C |
Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. |
| D |
This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Therapy is an important part of an overall treatment plan, in conjunction with intervention, support, and an individual’s capacity for resilience. |
PTS: 1 CON: Trauma | Stress | Promoting Health | Nursing Roles
4.____ addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder.
| A. |
Indicated prevention |
| B. |
Selective prevention |
| C. |
Universal prevention |
| D. |
Both 1 and 2 |
ANS: A
Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
pp. 232-233
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Institute of Medicine Model of Prevention
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. |
| B |
Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence. |
| C |
Universal prevention refers to prevention interventions provided to the entire population, not just those who may be at risk. The interventions include but are not limited to public service announcements provided to the public at large through billboards, media messages (print and electronic), or general health education programs. |
| D |
Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence. |
PTS:1CON:Promoting Health
5.The public health nurse (PHN) recognizes that which of the following are used as screening tools for depression?
| A. |
Patient Health Questionnaire 2 |
| B. |
Center for Epidemiological Studies Depression Scale (CESD-10) |
| C. |
Brief Symptom Checklist-18 of the My Mood Monitor (M-3) |
| D. |
Both 1 and 2 |
ANS: D
Objective: 5. Describe systems approaches to the promotion of mental health and the prevention and treatment of mental health disorders.
p. 232
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Measure of Mental Health: Health-Related Quality of Life
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Mood; Assessment
Difficulty: Moderate
|
Feedback |
| A |
Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. |
| B |
Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. |
| C |
This is incorrect. Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. Screening tools for anxiety disorders include the Brief Symptom Checklist-18 of the My Mood Monitor (M-3). |
| D |
Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. |
PTS:1CON:Promoting Health | Mood | Assessment
6.During a course on mental disorders, a PHN learns that the term serious mental illness (SMI) refers to diagnosable mental disorders that may disrupt a person’s ability to function and may qualify that person for support services. The PHN also notes that the mental disorders that can lead to SMI include:
| A. |
Mild depression |
| B. |
Panic disorder |
| C. |
Schizophrenia |
| D. |
Both 2 and 3 |
ANS: D
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
pp. 225-226
Heading: Introduction
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition; Mood; Stress; Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Major depression, however, is one of the mental disorders that can lead to SMI. |
| B |
Both panic disorder and schizophrenia, among other mental disorders, can lead to SMI. |
| C |
Both schizophrenia and panic disorder, among other mental disorders, can lead to SMI. |
| D |
The mental disorders that can lead to SMI include major depression, panic disorder, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and borderline personality disorder. |
PTS: 1 CON: Cognition | Mood | Stress | Promoting Health | Nursing Roles
7.While studying the prevalence of mental health disorders worldwide, a PHN learns about the World Mental Health Survey, which is used to determine estimates of human capital costs and prevalence of mental disorders in a wide range of countries. The survey was developed by
| A. |
The Centers for Disease Control and Prevention (CDC) |
| B. |
The World Health Organization (WHO) |
| C. |
The Institute of Medicine (IOM) |
| D. |
The World Health Assembly |
ANS: B
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
p. 227
Heading: Epidemiology of Mental Disorders > Surveillance of Mental Health Disorders
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The CDC conducts many types of surveys on the prevalence of mental disorders but the organization did not develop the World Mental Health Survey. |
| B |
The WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. |
| C |
This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The IOM is involved in screening for mental health disorders and addresses the need for appropriate behavioral health treatment in its report, Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. |
| D |
This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The World Health Assembly issued a resolution on mental health that aims to reduce the global burden of mental disorders and improve overall mental health worldwide. |
PTS: 1 CON: Promoting Health | Nursing Roles
8.Which ethnic group has the highest 12-month prevalence of a mental disorder?
| A. |
Hispanics |
| B. |
African Americans |
| C. |
Asian Americans |
| D. |
Non-Hispanic whites |
ANS: D
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
pp. 227-228
Heading: Epidemiology of Mental Disorders > Prevalence of Mental Health Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Knowledge [Remembering]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 16% for Hispanics. |
| B |
This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 15% for African Americans. |
| C |
This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 9% for Asian Americans. |
| D |
Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21%. |
PTS:1CON:Promoting Health
9.A PHN learns in a behavioral health class that the relationship between physiology and mental health plays an important role in mental disorders. Which of the following physiological factors may contribute to the development of mental disorders?
| A. |
Conditions that affect brain chemistry, such as medication side effects or toxins |
| B. |
Physical trauma |
| C. |
1 and 2 |
| D. |
Unstable family life |
ANS: C
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 228-229
Heading: Behavioral, Biological, Environmental, and Socioeconomic Risk Factors > Individual Level Risk Factors for Mental Disorders
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Application]
Concept: Cognition; Trauma; Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
Both conditions that affect brain chemistry and physical trauma are the physiological factors that may contribute to the development of mental disorders. |
| B |
Both physical trauma and conditions that affect brain chemistry are physiological factors that may contribute to the development of mental disorders. |
| C |
Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. |
| D |
This is incorrect. Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. An unstable family life is not a physiological factor, although it may also contribute to the development of mental disorders. |
PTS:1CON:Cognition | Trauma | Promoting Health
10.Which of the following community environment factors play a role in the development of mental disorders?
| A. |
Living in high crime areas |
| B. |
Poverty |
| C. |
Both 1 and 2 |
| D. |
Family instability |
ANS: C
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
p. 229
Heading: Behavioral, Biological, Environmental, and Socioeconomic Risk Factors > Community-Level Risk Factors for Mental Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Easy
|
Feedback |
| A |
Living in high crime areas is a factor, along with poverty. |
| B |
Both poverty and living in high crime areas play a role in the development of mental disorders. |
| C |
Both poverty and living in high crime areas play a role in the development of mental disorders. |
| D |
This is incorrect. Although family instability often contributes to the development of mental disorders, it is not considered a community environment factor. |
PTS:1CON:Promoting Health
11.____ is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable.
| A. |
Indicated prevention |
| B. |
Stigma |
| C. |
Risk factors |
| D. |
Transinstitutionalization |
ANS: B
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 231-232
Heading: Culture, Stigma, and Mental Health Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. |
| B |
Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. |
| C |
This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Risk factors increase an individual’s chance of developing a mental disorder. |
| D |
This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Transinstitutionalization refers to the growing number of mentally ill persons who are homeless, in jail, in shelters, or in other facilities instead of being home or in a hospital. |
PTS:1CON:Promoting Health
12.A nurse interested in working with persons with mental disorders who live in poverty understands that the most effective treatment involves multiple sectors of society, such as government agencies, grass roots groups, nonprofits, and businesses, working in tandem. This interrelationship is called:
| A. |
Indicated prevention |
| B. |
Intersectoral strategies |
| C. |
Health-Related Quality of Life |
| D. |
Institute of Medicine Model of Prevention |
ANS: B
Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
p. 233
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Promotion of Mental Health and Policy
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Collaboration
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. |
| B |
Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. |
| C |
This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Health-Related Quality of Life is the self-perceived impact of physical and emotional health on overall quality of life. |
| D |
This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. The Institute of Medicine Model of Prevention is a framework for mental disorders that clearly separates prevention into three categories with specific interventions at each level. |
PTS: 1 CON: Promoting Health | Collaboration
13.A recent graduate nurse working in an urban labor and delivery unit had a patient who experienced a difficult labor. The mother, suffering from postpartum depression (PPD), committed suicide a year after giving birth. Although the nurse knew the basics about PPD, the nurse immediately studied the condition in depth and learned that PPD:
| A. |
Can be triggered by a massive hormone drop following delivery |
| B. |
Can intensify to cause delusions |
| C. |
Occurs soon after delivery |
| D. |
All of the above |
ANS: D
Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
pp. 233-235
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Secondary Prevention: Screening for Mental Disorders
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Pregnancy; Mood; Violence; Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
| B |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
| C |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
| D |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
PTS: 1 CON: Pregnancy | Mood | Violence | Promoting Health | Nursing Roles
14.A nurse working in labor and delivery requested permission from the nurse manager to conduct a quality improvement project to screen patients that might be susceptible to PPD. After completing the project, which of the following screening guidelines did the unit incorporate?
| A. |
All patients will be screened for PPD when they are admitted to the labor and delivery unit. |
| B. |
Patients at high risk are referred to the attending obstetrician. |
| C. |
Before being discharged, all new mothers will complete a questionnaire specific to PPD symptoms. |
| D. |
All of the above |
ANS: D
Objective: Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
pp. 233-235
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Secondary Prevention: Screening for Mental Disorders
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Pregnancy; Mood; Promoting Health; Assessment; Quality Improvement
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
| B |
This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
| C |
This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
| D |
Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
PTS:1
CON: Pregnancy | Mood | Promoting Health | Assessment | Quality Improvement
15.A PHN treats a patient who may be depressed. To verify suspicions, the PHN checks ____, the definitive clinical guide for diagnosing mental disorders and providing consistency and accuracy in the screening for mental disorders.
| A. |
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) |
| B. |
The Center for Epidemiological Studies Depression Scale (CESD-10) |
| C. |
Patient Health Questionnaire 2 |
| D. |
Brief System Checklist-18 of the My Mood Monitor |
ANS: A |
