| Content | Test Bank for Foundations of Maternal-Newborn and Women's Health Nursing 6th Edition
Table of Contents
Chapter 01: Maternity and Women’s Health Care Today(FREE)
Chapter 02: The Nurse’s Role in Maternity and Women’s Health Care(FREE)
Chapter 03: Ethical, Social, and Legal Issues(FREE)
Chapter 04: Reproductive Anatomy and Physiology
Chapter 05: Hereditary and Environmental Influences on Childbearing
Chapter 06: Conception and Prenatal Development
Chapter 07: Physiologic Adaptations to Pregnancy
Chapter 08: Psychosocial Adaptations to Pregnancy
Chapter 09: Nutrition for Childbearing
Chapter 10: Antepartum Fetal Assessment
Chapter 11: Perinatal Education
Chapter 12: Processes of Birth
Chapter 13: Nursing Care During Labor and Birth
Chapter 14: Intrapartum Fetal Surveillance
Chapter 15: Pain Management During Childbirth
Chapter 16: Nursing Care During Obstetric Procedures
Chapter 17: Postpartum Physiologic Adaptations
Chapter 18: Postpartum Psychosocial Adaptations
Chapter 19: Normal Newborn: Processes of Adaptation
Chapter 20: Assessment of the Normal Newborn
Chapter 21: Care of the Normal Newborn
Chapter 22: Infant Feeding
Chapter 23: Home Care of the Infant
Chapter 24: The Childbearing Family with Special Needs
Chapter 25: Complications of Pregnancy
Chapter 26: Concurrent Disorders During Pregnancy
Chapter 27: Intrapartum Complications
Chapter 28: Postpartum Maternal Complications
Chapter 29: High-Risk Newborn: Complications Associated with Gestational Age and Development
Chapter 30: High-Risk Newborn: Acquired and Congenital Conditions
Chapter 31: Family Planning
Chapter 32: Infertility
Chapter 33: Preventive Care for Women
Chapter 34: Women’s Health Problems |
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• We offer a free sample so you know exactly what to expect | Solution Manual for Nursing Diagnosis Handbook 11th Edition by Ackley
Ackley: Nursing Diagnosis Handbook, 11th Edition
Table of Contents 41 cases
Lecture Notes
Problem-Based Learning/Critical Thinking
Case Study - Restless Leg Syndrome
Case Scenario
Abdul Malek is a 21 year old college student. He attends the local state university and is a junior studying graphic design. Three (3) weeks into his fall semester, Abdul’s professors notice that he is falling asleep in class and often looks restless. Abdul taps his foot and squirms around in his seat. Abdul, who is usually an excellent student, has failed his first test in his Graphic Design II course. His professor asks him to see his advisor because the fear is that Abdul has become chemically impaired. His advisor sends Abdul to the student health services and his case is reviewed by the nurse.
Nursing Assessment
Abdul is a well-developed 22 year old male with a BMI of 20. His vital signs are: blood pressure 104/78; temperature 98.4 degrees F.; heart rate – 64 BPM; respiratory rate – 16 per minute. A nutritional history confirms a well-balanced diet with the exclusion of pork products. Abdul had been working out every day at the University gym but reports that he is currently “too tired” to do so. Abdul denies drug or alcohol use and this is confirmed by serum analysis. Abdul complains about sleeping poorly and feeling as if, “I am moving all night.” He states that he often wakes up his dorm mate and feels badly about that. The nurse reclines Abdul on the examination table and checks his deep tendon reflexes (DTRs) which are all 2 . The nurse asks Abdul to relax and dims the lights while she consults with the primary care practitioner. While the nurse is out of the examination room Abdul dozes and when the nurse returns the nurse observes Abdul’s right leg jerking several times before she arouses him.
- ASSESS
- Identify significant symptoms by underlining them in the assessment.
- List those symptoms that indicate the client has a health problem (those you have underlined).
- falling asleep in class
- often looks restless
- taps his foot
- squirms around in his seat
- failed his first test
- “too tired”
- complains about sleeping poorly
- “I am moving all night”
- often wakes up
- dozes
- right leg jerking several times
- Group the symptoms that are similar.
- falling asleep in class
- often looks restless
- taps his foot
- squirms around in his seat
- failed his first test
- complains about sleeping poorly
- dozes
- “too tired”
- “I am moving all night”
- often wakes up
- right leg jerking several times
|
Chapter 05: Comfort and Sedation
Sole: Introduction to Critical Care Nursing, 7th Edition
MULTIPLE CHOICE
1.Nociceptors differ from other nerve receptors in the body in that they:
| a. |
adapt very little to continual pain response. |
| b. |
inhibit the infiltration of neutrophils and eosinophils. |
| c. |
play no role in the inflammatory response. |
| d. |
transmit only the thermal stimuli. |
ANS: A
Nociceptors are stimulated by mechanical, chemical, or thermal stimuli. Nociceptors differ from other nerve receptors in the body in that they adapt very little to the pain response. The body continues to experience pain until the stimulus is discontinued or therapy is initiated. This is a protective mechanism so that the body tissues being damaged will be removed from harm. Nociceptors usually initiate inflammatory responses near injured capillaries. As such, the response promotes infiltration of injured tissues with neutrophils and eosinophils.
DIF: Cognitive Level: Remember/Knowledge REF: p. 54
OBJ:Discuss the physiology of pain and anxiety.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
2.A postsurgical patient is on a ventilator in the critical care unit. The patient has been tolerating the ventilator well and has not required any sedation. On assessment, the nurse notes the patient is tachycardic and hypertensive with an increased respiratory rate of 28 breaths/min. The patient has been suctioned recently via the endotracheal tube, and the airway is clear. The patient responds appropriately to the nurse’s commands. The nurse should:
| a. |
assess the patient’s level of pain. |
| b. |
decrease the ventilator rate. |
| c. |
provide sedation as ordered. |
| d. |
suction the patient again. |
ANS: A
Pulse, respirations, and blood pressure frequently result from activation of the sympathetic nervous system by the pain stimulus. Because the patient is postoperative, the patient should be assessed for the presence of pain and need for pain medication. Decreasing the ventilator rate will not help in this situation. Providing sedation may calm the patient but will not solve the problem if the physiological changes are from pain. The patient has just been suctioned and the airway is clear. There is no need to suction again.
DIF: Cognitive Level: Analyze/Analysis REF: p. 55
OBJ: Describe the positive and negative effects of pain and anxiety in critically ill patients.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
3.The assessment of pain and anxiety is a continuous process. When critically ill patients exhibit signs of anxiety, the nurse’s first priority is to
| a. |
administer antianxiety medications as ordered. |
| b. |
administer pain medication as ordered. |
| c. |
identify and treat the underlying cause. |
| d. |
reassess the patient hourly to determine whether symptoms resolve on their own. |
ANS: C
When patients exhibit signs of anxiety or agitation, the first priority is to identify and treat the underlying cause, which could be hypoxemia, hypoglycemia, hypotension, pain, or withdrawal from alcohol and drugs. Treatment is not initiated until assessment is completed. Medication may not be needed if the underlying cause can be resolved.
DIF: Cognitive Level: Apply/Application REF: p. 70 | Table 5-11
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
4.Both the electroencephalogram (EEG) monitor and the Bispectral Index Score (BIS) or Patient State Index (PSI) analyzer monitors are used to assess patient sedation levels in critically ill patients. The BIS and PSI monitors are simpler to use because they
| a. |
can be used only on heavily sedated patients. |
| b. |
can be used only on pediatric patients. |
| c. |
provide raw EEG data and a numeric value. |
| d. |
require only five leads. |
ANS: C
The BIS and PSI have very simple steps for application, and results are displayed as raw EEG data and the numeric value. A single electrode is placed across the patient’s forehead and is attached to a monitor. These monitors can be used in both children and adults and in patients with varying levels of sedation.
DIF: Cognitive Level: Understand/Comprehension REF: p. 60
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
5.The nurse is caring for a patient who requires administration of a neuromuscular blocking agent to facilitate ventilation with nontraditional modes. The nurse understands that neuromuscular blocking agents provide:
| a. |
antianxiety effects. |
| b. |
complete analgesia. |
| c. |
high levels of sedation. |
| d. |
no sedation or analgesia. |
ANS: D
Neuromuscular blocking (NMB) agents do not possess any sedative or analgesic properties. Patients who receive NMBs must also receive sedatives and pain medication.
DIF: Cognitive Level: Remember/Knowledge REF: p. 72
OBJ: Discuss assessment and management challenges in subsets of critically ill patients.
TOP:Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
6.The patient is receiving neuromuscular blockade. Which nursing assessment indicates a target level of paralysis?
| a. |
Glasgow Coma Scale score of 3 |
| b. |
Train-of-four yields two twitches |
| c. |
Bispectral index of 60 |
| d. |
CAM-ICU positive |
ANS: B
A train-of-four response of two twitches (out of four) using a peripheral nerve stimulator indicates adequate paralysis. The Glasgow Coma Scale does not assess paralysis; it is an indicator of consciousness. The bispectral index provides an assessment of sedation. The CAM-ICU is a tool to assess delirium.
DIF: Cognitive Level: Remember/Knowledge REF: p. 73
OBJ: Discuss assessment and management challenges in subsets of critically ill patients.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
7.The nurse is concerned that the patient will pull out the endotracheal tube. As part of the nursing management, the nurse obtains an order for
| a. |
arm binders or splints. |
| b. |
a higher dosage of lorazepam. |
| c. |
propofol. |
| d. |
soft wrist restraints. |
ANS: D
The priority in caring for agitated patients is safety. The least restrictive methods of keeping the patient safe are appropriate. If possible, the tube or device causing irritation should be removed, but if that is not possible, the nurse must prevent the patient from pulling it out. Restraints are associated with an increased incidence of agitation and delirium. Therefore, restraints should not be used unless as a last resort for combative patients. The least amount of sedation is also recommended; therefore, neither increasing the dosage of lorazepam nor adding propofol is indicated and would be likely to prolong mechanical ventilation.
DIF: Cognitive Level: Apply/Application REF: p. 61
OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment
8.The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is
| a. |
analgesia. |
| b. |
anticonvulsant therapy. |
| c. |
paralysis. |
| d. |
sedation. |
ANS: C
These agents cause respiratory muscle paralysis. They do not provide analgesia or sedation. They do not have anticonvulsant properties.
DIF: Cognitive Level: Remember/Knowledge REF: p. 72
OBJ: Discuss assessment and management challenges in subsets of critically ill patients.
TOP:Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
9.The most important nursing intervention for patients who receive neuromuscular blocking agents is to
| a. |
administer sedatives in conjunction with the neuromuscular blocking agents. |
| b. |
assess neurological status every 30 minutes. |
| c. |
avoid interaction with the patient, because he or she won’t be able to hear. |
| d. |
restrain the patient to avoid self-extubation. |
ANS: A
Neuromuscular blocking agents cause paralysis only; they do not cause sedation. Therefore, concomitant administration of sedatives is essential. Neurological status is monitored according to unit protocol. Nurses should communicate with all critically ill patients, regardless of their status. If the patient is paralyzed, restraining devices may not be needed.
DIF: Cognitive Level: Apply/Application REF: p. 72
OBJ: Discuss assessment and management challenges in subsets of critically ill patients.
TOP:Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
10.The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:
| a. |
Confusion Assessment Method (CAM-ICU). |
| b. |
FACES assessment tool. |
| c. |
Glasgow Coma Scale. |
| d. |
Richmond Agitation Sedation Scale. |
ANS: D
Various sedation scales are available to assist the nurse in monitoring the level of sedation and assessing response to treatment. The Richmond Agitation Sedation Scale is a commonly used tool that has been validated. The CAM-ICU assesses for delirium. The FACES scale assesses pain. The Glasgow Coma Scale assesses neurological status.
DIF: Cognitive Level: Remember/Knowledge REF: p. 59 | Table 5-5
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
11.The nurse is caring for a patient receiving intravenous ibuprofen for pain management. The nurse recognizes which laboratory assessment to be a possible side effect of the ibuprofen?
| a. |
Creatinine: 3.1 mg/dL |
| b. |
Platelet count 350,000 billion/L |
| c. |
White blood count 13, 550 mm3 |
| d. |
ALT 25 U/L |
ANS: A
Ibuprofen can result in renal insufficiency, which may be noted in an elevated serum creatinine level. Thrombocytopenia (low platelet count) is another possible side effect. This platelet count is elevated. An elevated white blood count indicates infection. Although ibuprofen is cleared primarily by the kidneys, it is also important to assess liver function, which would show elevated liver enzymes, not low values such as shown here.
DIF: Cognitive Level: Analyze/Analysis REF: p. 71
OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
12.The nurse is assessing pain levels in a critically ill patient using the Behavioral Pain Scale. The nurse recognizes __________ as indicating the greatest level of pain.
| a. |
brow lowering |
| b. |
eyelid closing |
| c. |
grimacing |
| d. |
relaxed facial expression |
ANS: C
The Behavioral Pain Scale issues the most points, indicating the greatest amount of pain, to assessment of facial grimacing.
DIF: Cognitive Level: Understand/Comprehension REF: p. 58 | Table 5-3
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
13.The nurse wishes to assess the quality of a patient’s pain. Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
| a. |
“Is the pain constant or intermittent?” |
| b. |
“Is the pain sharp, dull, or crushing?” |
| c. |
“What makes the pain better? Worse?” |
| d. |
“When did the pain start?” |
ANS: B
If the patient can describe the pain, the nurse can assess quality, such as sharp, dull, or crushing. The other responses relate to continuous or intermittent presence, what provides relief, and duration.
DIF: Cognitive Level: Understand/Comprehension REF: p. 56
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
14.The nurse is assessing the patient’s pain using the Critical Care Pain Observation Tool. Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?
| a. |
Absence of vocal sounds |
| b. |
Fighting the ventilator |
| c. |
Moving legs in bed |
| d. |
Relaxed muscles in upper extremities |
ANS: B
Fighting the ventilator is rated with the greatest number of points for compliance with the ventilator, and could indicate pain or anxiety. Absence of vocal sounds (e.g., no crying) and relaxed muscles do not indicate pain and are not given a point value. The patient may be moving the legs as a method of range of motion, not necessarily in response to pain. The patient needs to be assessed for restlessness if the movement is excessive.
DIF: Cognitive Level: Apply/Application REF: p. 59 | Table 5-4
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
15.The nurse is caring for four patients on the progressive care unit. Which patient is at greatest risk for developing delirium?
| a. |
36-year-old recovering from a motor vehicle crash; being treated with an evidence-based alcohol withdrawal protocol. |
| b. |
54-year-old postoperative aortic aneurysm resection with a 40 pack-year history of smoking |
| c. |
86-year-old from nursing home with dementia, postoperative from colon resection, still being mechanically ventilated |
| d. |
95-year-old with community-acquired pneumonia; family has brought in eyeglasses and hearing aid |
ANS: C
From this list, the 86-year-old postoperative nursing home resident is at greatest risk due to advanced age, cognitive impairment, and some degree of respiratory failure. The 96-year-old has been provided eyeglasses and a hearing aid, which will decrease the risk of delirium. Smoking is a possible risk for delirium. The 36-year-old is receiving medications as part of an alcohol withdrawal protocol, which should decrease the risk for delirium.
DIF: Cognitive Level: Analyze/Analysis REF: p. 61 | Table 5-8
OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
16.The nurse is caring for a patient with hyperactive delirium. The nurse focuses interventions toward keeping the patient:
| a. |
comfortable. |
| b. |
nourished. |
| c. |
safe. |
| d. |
sedated. |
ANS: C
The greatest priority in managing delirium is to keep the patient safe. Sedation may contribute to the development of delirium. Comfort and nutrition are important, but they are not priorities.
DIF: Cognitive Level: Understand/Comprehension REF: p. 61
OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment
17.The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?
| a. |
Arrange for the patient’s dog to be brought into the unit (per protocol). |
| b. |
Provide aromatherapy with scents such as lavender that are known to help anxiety. |
| c. |
Secure the harpist to come and play soothing music for an hour every afternoon. |
| d. |
Wheel the patient out near the unit aquarium to observe the tropical fish. |
ANS: A
Nonpharmacological approaches are helpful in reducing stress and anxiety, and each of these activities has the potential for improving the patient’s well-being. The patient is likely to benefit most from the presence of his or her own dog rather than the other activities, however; if unit protocol does not allow the patient’s own dog, the nurse should investigate the use of therapy animals or the other options.
DIF: Cognitive Level: Apply/Application REF: p. 64
OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention
MSC: NCLEX Client Needs Category: Psychological Integrity
18.The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia (PCA)?
| a. |
Patient with a C4 fracture and quadriplegia |
| b. |
Patient with a femur fracture and closed head injury |
| c. |
Postoperative patient who had elective bariatric surgery |
| d. |
Postoperative cardiac surgery patient with mild dementia |
ANS: C
The patient undergoing bariatric surgery (an elective procedure) is the best candidate for PCA as this patient should be awake, cognitively intact, and will have the acute pain related to the surgical procedure. The quadriplegic would be unable to operate the PCA pump. The cardiac surgery patient with mild dementia may not understand how to operate the pump. Likewise, the patient with the closed head injury may not be cognitively intact.
DIF: Cognitive Level: Analyze/Analysis REF: p. 71 | Box 5-6
OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention
MSC: NCLEX Client Needs Category: Physiological Integrity
19.The nurse is caring for a patient receiving a benzodiazepine intermittently. The nurse understands that the best way to administer such drugs is to:
| a. |
administer around the clock, rather than as needed, to ensure constant sedation. |
| b. |
administer the medications through the feeding tube to prevent complications. |
| c. |
give the highest allowable dose for the greatest effect. |
| d. |
titrate to a predefined endpoint using a standard sedation scale. |
ANS: D
The best approach for administering benzodiazepines (and all sedatives) is to administer and titrate to a desired endpoint using a standard sedation scale. Administering around the clock as well as giving the highest allowable dose without basing it on an assessment target may result in excessive sedation. For greatest effect, most benzodiazepines are given intravenously.
DIF: Cognitive Level: Apply/Application REF: p. 72
OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention
MSC: NCLEX Client Needs Category: Physiological Integrity
20.The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient. Which statement by the nurse indicates understanding of management of this patient?
| a. |
“Alcohol withdrawal is common; we see it all of the time in the trauma unit.” |
| b. |
“There is no way to assess for alcohol withdrawal.” |
| c. |
“This patient will require less pain medication.” |
| d. |
“We have initiated the alcohol withdrawal protocol.” |
ANS: D
The most important treatment of alcohol withdrawal syndrome is prevention. Many units have protocols that are initiated early to prevent the syndrome. Alcohol withdrawal syndrome is common; however, this statement does not indicate knowledge of management. The patient experiencing alcohol withdrawal may exhibit a variety of symptoms, such as disorientation, agitation, and tachycardia. Patients with substance abuse require increased dosages of pain medications.
DIF: Cognitive Level: Understand/Comprehension REF: p. 74
OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
1.Nonpharmacological approaches to pain and/or anxiety that may best meet the needs of critically ill patients include: (Select all that apply.)
| a. |
anaerobic exercise. |
| b. |
art therapy. |
| c. |
guided imagery. |
| d. |
music therapy. |
| e. |
animal therapy. |
ANS: C, D, E
Guided imagery is a powerful technique for controlling pain and anxiety, especially that associated with painful procedures. Similar to guided imagery, a music therapy program offers patients a diversionary technique for pain and anxiety relief. Likewise animal therapy has many benefits for the critically ill patient. Anaerobic exercise is not a nonpharmacological approach for managing pain and anxiety. Most critically ill patients are not able to participate in art therapy.
DIF: Cognitive Level: Remember/Knowledge REF: pp. 62-64
OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
2.Which of the following statements regarding pain and anxiety are true? (Select all that apply.)
| a. |
Anxiety is a state marked by apprehension, agitation, autonomic arousal, and/or fearful withdrawal. |
| b. |
Critically ill patients often experience anxiety, but they rarely experience pain. |
| c. |
Pain and anxiety are often interrelated and may be difficult to differentiate because their physiological and behavioral manifestations are similar. |
| d. |
Pain is defined by each patient; it is whatever the person experiencing the pain says it is. |
| e. |
While anxiety is unpleasant, it does not contribute to mortality or morbidity of the critically ill patient. |
ANS: A, C, D
Pain is defined by each patient, anxiety is associated with marked apprehension, and pain and anxiety are often interrelated. Critically ill patients commonly have both pain and anxiety. Anxiety does increase both morbidity and mortality in critically ill patients, especially those with cardiovascular disease.
DIF: Cognitive Level: Understand/Comprehension REF: p. 53
OBJ: Define pain and anxiety. TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
3.Which of the following factors predispose the critically ill patient to pain and anxiety? (Select all that apply.)
| a. |
Inability to communicate |
| b. |
Invasive procedures |
| c. |
Monitoring devices |
| d. |
Nursing care |
| e. |
Preexisting conditions |
ANS: A, B, C, D, E
All of these factors predispose the patient to pain or anxiety.
DIF: Cognitive Level: Remember/Knowledge REF: pp. 53-54
OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
4.Choose the items that are common to both pain and anxiety. (Select all that apply.)
| a. |
Cyclical exacerbation of one another |
| b. |
Require good nursing assessment for proper treatment |
| c. |
Response only to real phenomena |
| d. |
Subjective in nature |
| e. |
Perception may be influenced by prior experience |
ANS: A, B, D, E
Both pain and anxiety are subjective in nature. One can exacerbate the other in a vicious cycle that often requires good nursing assessment to manage the precipitating problem and break the cycle. Anxiety is a response to a real or perceived fear. Pain is a response to real or “phantom” phenomenon but always involves transmission of nerve impulses. Both relate to the patient’s perceptions of pain and fear. Previous experiences of both pain and/or anxiety can influence the patient’s perception of both. Anxiety is a response to real or perceived fear, and pain is a response to a real or “phantom” phenomenon.
DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-54
OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
5.Anxiety differs from pain in that: (Select all that apply.)
| a. |
it is confined to neurological processes in the brain. |
| b. |
it is linked to reward and punishment centers in the limbic system. |
| c. |
it is subjective. |
| d. |
there is no actual tissue injury. |
| e. |
it can be increased by noise and light. |
ANS: A, B, D, E
Unlike pain, anxiety is linked to the reward and punishment centers in the limbic system of the brain. It is totally neurological and does not involve tissue injury. Like pain, it is a subjective phenomenon. Noise, light, and other stimuli can increase the intensity of anxiety. Both anxiety and pain are subjective in nature.
DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-55
OBJ:Discuss the physiology of pain and anxiety.
TOP: Nursing Process Step: Assessment
6.Factors in the critical care unit that may predispose the client to increased pain and anxiety include: (Select all that apply.)
| a. |
an endotracheal tube. |
| b. |
frequent vital signs. |
| c. |
monitor alarms. |
| d. |
room temperature. |
| e. |
hostile environment. |
ANS: A, B, C, D, E
Anxiety is likely to result from loss of control, the inability to communicate, continuous noise and lighting, excessive stimulation (including repeated vital sign measurements), lack of mobility, and uncomfortable room temperatures. Increased anxiety levels often lead to increased pain perception. Environments that are perceived as hostile also contribute.
DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-54
OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
7.In the healthy individual, pain and anxiety: (Select all that apply.)
| a. |
activate the sympathetic nervous system (SNS). |
| b. |
decrease stress levels. |
| c. |
help remove one from harm. |
| d. |
increase performance levels. |
| e. |
limit sympathetic nervous system activity. |
ANS: A, C, D
In the healthy person, pain and anxiety are adaptive mechanisms used to increase performance levels or to remove one from potential harm. The “fight or flight” response occurs in response to pain and/or anxiety and involves the activation of the sympathetic nervous system. Pain and anxiety, however, can induce significant stress. The SNS is activated, not limited, by pain and/or anxiety.
DIF: Cognitive Level: Remember/Knowledge REF: p. 55
OBJ: Describe the positive and negative effects of pain and anxiety in critically ill patients.
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
8.The nurse is caring for a patient who is intubated and on a ventilator following extensive abdominal surgery. Although the patient is responsive, the nurse is not able to read the patient’s lips as the patient attempts to mouth the words. Which of the following assessment tools would be the most appropriate for the nurse to use when assessing the patient’s pain level? (Select all that apply.)
| a. |
The FACES scale |
| b. |
Pain Intensity Scale |
| c. |
The PQRST method |
| d. |
The Visual Analogue Scale |
| e. |
The CAM tool |
ANS: A, D | Test Bank For Essentials of Psychiatric Mental Health Nursing 8th Morgan
Chapter 1: Mental Health and Mental Illness
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A nurse is assessing a client who experiences occasional feelings of sadness because of the recent
death of a beloved pet. The client’s appetite, sleep patterns, and daily routine have not changed.
How would the nurse interpret the client’s behaviors?
1. The client’s behaviors demonstrate mental illness in the form of depression.
2. The client’s behaviors are inappropriate, which indicates the presence of mental
illness.
3. The client’s behaviors are not congruent with cultural norms.
4. The client’s behaviors demonstrate no functional impairment, indicating no mental
illness.
____ 2. At which point would the nurse determine that a client is at risk for developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in daily
functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
____ 3. A client has been given a diagnosis of human immunodeficiency virus (HIV). Which statement
made by the client does the nurse recognize as the bargaining stage of grief?
1. “I hate my partner for giving me this disease I will die from!”
2. “If I don’t do intravenous (IV) drugs anymore, God won’t let me die.”
3. “I am going to support groups and learn more about the disease.”
4. “Can you please re-draw the test results, I think they may be wrong?”
____ 4. A nurse notes that a client is extremely withdrawn, delusional, and emotionally exhausted. The
nurse assesses the client’s anxiety as which level?
1. Mild anxiety
2. Moderate anxiety
3. Severe anxiety
4. Panic anxiety
____ 5. A psychiatric nurse intern states, “This client’s use of defense mechanisms should be eliminated.”
Which is a correct evaluation of this nurse’s statement?
1. Defense mechanisms can be appropriate responses to stress and need not be
eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and
should always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged and not completely eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK
Copyright © 2020 F. A. Davis Company
____ 6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The
client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best
response?
1. “It is just a routine part of our assessment. All clients are asked these same
questions.”
2. “Why are you concerned about these types of questions?”
3. “Psychological factors, like excessive stress, have been found to affect medical
conditions.”
4. “We can skip these questions, if you like. It isn’t imperative that we complete this
section.”
____ 7. A client who is being treated for chronic kidney disease complains to the health-care provider that
he does not like the food available to him while hospitalized. The health-care provider insists that
the client strictly adhere to the diet plan. What action can be expected is the client uses the defense
mechanism of displacement?
1. The client assertively confronts the health-care provider.
2. The client insists on being discharged and goes for a long, brisk walk.
3. The client snaps at the nurse and criticizes the nursing care provided.
4. The client hides his anger by explaining the logical reasoning for the diet to his
spouse.
____ 8. A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize
this behavior as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation
____ 9. Which nursing statement regarding the concept of psychosis is most accurate?
1. Individuals experiencing psychoses are aware that their behaviors are maladaptive.
2. Individuals experiencing psychoses experience little distress.
3. Individuals experiencing psychoses are aware of experiencing psychological
problems.
4. Individuals experiencing psychoses are based in reality.
____ 10. When under stress, a client routinely uses alcohol to excess. When the client’s husband finds her
drunk, the husband yells at the client about her chronic alcohol abuse. Which action alerts the
nurse to the client’s use of the defense mechanism of denial?
1. The client hides liquor bottles in a closet.
2. The client yells at her son for slouching in his chair.
3. The client burns dinner on purpose.
4. The client says to the spouse, “I don’t drink too much!”
____ 11. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which
statement by the wife would indicate to a nurse that the client is in the acceptance stage of grief?
1. “If only we could have tried again, things might have worked out.”
2. “I am so mad that the children and I had to put up with him as long as we did.”
3. “Yes, it was a difficult relationship, but I think I have learned from the
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK
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experience.”
4. “I have a difficult time getting out of bed most days.”
____ 12. According to Maslow’s hierarchy of needs, which client action would demonstrate the highest
achievement in terms of mental health?
1. Maintaining a long-term, faithful, intimate relationship
2. Achieving a sense of self-confidence
3. Possessing a feeling of self-fulfillment and realizing full potential
4. Developing a sense of purpose and the ability to direct activities
____ 13. According to Maslow’s hierarchy of needs, which situation on an inpatient psychiatric unit would
require priority intervention by a nurse?
1. A client rudely complaining about limited visiting hours
2. A client exhibiting aggressive behavior toward another client
3. A client stating that no one cares
4. A client verbalizing feelings of failure
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 14. Which describes a defense mechanism an individual may use to relieve anxiety in a stressful
situation? (Select all that apply.)
1. Homework
2. Smoking
3. Itching
4. Nail biting
5. Sleeping
____ 15. The nurse is reviewing the DSM-5 definition of a mental health disorder and notes the definition
includes a disturbance in which areas? (Select all that apply.)
1. Cognition
2. Physical
3. Emotional regulation
4. Behavior
5. Developmental
Completion
Complete each statement.
16. _______________________ is a diffuse apprehension that is vague in nature and is associated
with feelings of uncertainty and helplessness.
17. _______________________ is a subjective state of emotional, physical, and social responses to
the loss of a valued entity.
Other
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK
Copyright © 2020 F. A. Davis Company
18. Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in the
proper sequence, using comma and space format, such as: 1, 2, 3, 4.)
1. Bargaining
2. Denial
3. Acceptance
4. Depression
5. Anger | 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 |
