Test Bank Essentials of Psychiatric Mental Health Nursing (5th Edition By Varcarolis)

Test Bank Essentials of Psychiatric Mental Health Nursing (5th Edition By Varcarolis)

The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses on nursing diagnoses. A psychiatric nursing textbook or behavioral health reference manual may not contain diagnostic criteria. DIF: Cognitive Level: Application (Applying) REF: 12 TOP:Nursing Process: Analysis| Nursing Process: Diagnosis MSC:NCLEX:Safe, Effective Care Environment 7. A 40-year-old adult living with parents states, Im happy but I dont socialize much. My work is routine. When new things come up, my boss explains them a few times to make sure I understand. At home, my parents make decisions for me, and I go along with them. A nurse should identify interventions to improve this patients: a. self-concept. b. overall happiness. c. appraisal of reality. d. control over behavior. ANS: A The patient feels the need for multiple explanations of new tasks at work and, despite being 40 years of age, allows both parents to make all decisions. These behaviors indicate a poorly developed self-concept. Although the patient reports being happy, the subsequent comments refute that self-appraisal. The patients comments do not indicate that he/she is out of touch with reality. The patients needs are broader than control over own behavior. DIF: Cognitive Level: Application (Applying) REF: 11 TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity 8. A patient tells a nurse, I have psychiatric problems and am in and out of hospitals all the time. Not one of Test Bank: Essentials of Psychiatric Mental HealthNursing (5th Edition by Varcarolis) 9 my friends or relatives has these problems. Select the nurses best response. a. Comparing yourself with others has no real advantages. b. Why do you blame yourself for having a psychiatric illness? c. Mental illness affects 50% of the adult population in any given year. d. It sounds like you are concerned that others dont experience the same challenges as you. ANS: D Mental illness affects many people at various times in their lives. No class, culture, or creed is immune to the challenges of mental illness. The correct response also demonstrates the use of reflection, a therapeutic communication technique. It is not true that mental illness affects 50% of the population in any given year. Asking patients if they blame themselves is an example of probing. DIF: Cognitive Level: Application (Applying) REF: 11 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 9. A critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and a nursing diagnosis. Select the psychiatric nurses best response. a. No functional difference exists between the two diagnoses. Both serve to identify a human deviance. b. The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural variables. c. The DSM-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis considers past and present responses to actual mental health problems. d. The DSM-5 diagnosis influences the medical treatment; the nursing diagnosis offers a framework to identify interventions for problems a patient has or may experience. ANS: D The medical diagnosis, defined according to the DSM-5, is concerned with the patients disease state, causes, and cures, whereas the nursing diagnosis focuses on the patients response to stress and possible caring interventions. Both the DSM-5 and a nursing diagnosis consider culture. Nursing diagnoses also consider potential problems. DIF: Cognitive Level: Application (Applying) REF: 16 TOP:Nursing Process: Implementation MSC:NCLEX:Safe, Effective Care Environment 10. The spouse of a patient diagnosed with schizophrenia says, I dont understand why childhood experiences have anything to do with this disabling illness. Select the nurses response that will best help the spouse understand this condition. a. Psychological stress is actually at the root of most mental disorders. b. We now know that all mental illnesses are the result of genetic factors. c. It must be frustrating for you that your spouse is sick so much of the time. d. Although this disorder more likely has a biological rather than psychological origin, the support and involvement of caregivers is very important. ANS: D Many of the most prevalent and disabling mental disorders have been found to have strong biological influences. Helping the spouse understand the importance of his or her role as a caregiver is also important. Empathy is important but does not increase the spouses level of knowledge about the cause of the patients condition. Not all mental illnesses are the result of genetic factors. Psychological stress is not at the root of most mental disorders. DIF: Cognitive Level: Application (Applying) REF: 14 TOP:Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 11. Which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary patient care planning session? a. All mental illnesses are culturally determined. b. Schizophrenia and bipolar disorder are cross-cultural disorders. c. Symptoms of mental disorders are constant from culture to culture. d. Some symptoms of mental disorders may reflect a persons cultural patterns. Test Bank: Essentials of Psychiatric Mental HealthNursing (5th Edition by Varcarolis) 10 ANS: D A nurse who understands that a patients symptoms are influenced by culture will be able to advocate for the patient to a greater degree than a nurse who believes that culture is of little relevance. All mental illnesses are not culturally determined. Schizophrenia and bipolar disorder are cross-cultural disorders, but this understanding has little relevance to patient advocacy. Symptoms of mental disorders change from culture to culture. DIF: Cognitive Level: Application (Applying) REF: 18 TOP: Nursing Process: Planning MSC: NCLEX: Safe, Effective Care Environment 12. A patients history shows intense and unstable relationships with others. The patient initially idealizes an individual and then devalues the person when the patients needs are not met. Which aspect of mental health is a problem? a. Effectiveness in work b. Communication skills c. Productive activities d. Fulfilling relationships ANS: D The information provided centers on relationships with others, which are described as intense and unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data are not present to describe work effectiveness, communication skills, or activities. DIF: Cognitive Level: Application (Applying) REF: 12 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 13. In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill? a. Person who is usually pessimistic but strives to meet personal goals b. Wealthy person who gives $20 bills to needy individuals in the community c. Person with an optimistic viewpoint about life and getting his or her own needs met d. Person who attends a charismatic church and describes hearing Gods voice ANS: D