Chapter 1Â
1. The nurse is assessing the factors contributing to the well-being of a newly admittedÂ
client. Which of the following would the nurse identify as having a positive impact onÂ
the individual's mental health?Â
A) Not needing others for companionshipÂ
B) The ability to effectively manage stressÂ
C) A family history of mental illnessÂ
D) Striving for total self-relianceÂ
2. Which of the following is true regarding mental health and mental illness?Â
A) Behavior that may be viewed as acceptable in one culture is always unacceptable inÂ
other cultures.Â
B) It is easy to determine if a person is mentally healthy or mentally ill.Â
C) In most cases, mental health is a state of emotional, psychological, and social wellnessÂ
evidenced by satisfying interpersonal relationships, effective behavior and coping,Â
positive self-concept, and emotional stability.Â
D) Persons who engage in fantasies are mentally ill.Â
3. A client grieving the recent loss of her husband asks if she is becoming mentally illÂ
because she is so sad. The nurse's best response would be...Â
A) “You may have a temporary mental illness because you are experiencing so muchÂ
pain.â€
B) “You are not mentally ill. This is an expected reaction to the loss you haveÂ
experienced.â€
C) “Were you generally dissatisfied with your relationship before your husband's death?â€
D) “Try not to worry about that right now. You never know what the future brings.â€
4. The nurse consults the DSM for which of the following purposes?Â
A) To devise a plan of care for a newly admitted clientÂ
B) To predict the client's prognosis of treatment outcomesÂ
C) To document the appropriate diagnostic code in the client's medical recordÂ
D) To serve as a guide for client assessmentÂ
5. Which of the following would be a reason for a student nurse to use the DSM-5?
A) Identifying the medical diagnosisÂ
B) Choose clients' treatmentÂ
C) Evaluate treatmentsÂ
D) Understand the reason for the admission and the nature of psychiatric illnesses.Â
6. Legislation enacted in 1963 was largely responsible for which of the following shifts inÂ
care for the mentally ill?Â
A) The widespread use of community-based servicesÂ
B) The advancement in pharmacotherapiesÂ
C) Increased access to hospitalizationÂ
D) Improved rights for clients in long-term institutional careÂ
7. Which one of the following is a result of federal legislation?Â
A) Making it easier to commit people for mental health treatment against their will.Â
B) Making it more difficult to commit people for mental health treatment against theirÂ
will.Â
C) State mental institutions being the primary source of care for mentally ill persons.Â
D) Improved care for mentally ill persons.Â
8. The goal of the 1963 Community Mental Health Centers Act was to...Â
A) ensure clients' rights for the mentally illÂ
B) deinstitutionalize state hospitalsÂ
C) provide funds to build hospitals with psychiatric unitsÂ
D) treat people with mental illness in a humane fashionÂ
9. The creation of asylums during the 1800s was meant to...Â
A) improve treatment of mental disordersÂ
B) provide food and shelter for the mentally illÂ
C) punish people with mental illness who were believed to be possessedÂ
D) remove dangerous people with mental illness from the communityÂ
10. Which of the following is a major problem with large state institutions? Select all thatÂ
apply.Â
A) Attendants were accused of abusing the residentsÂ
B) Stigma associated with residence in an insane asylumÂ
C) Clients were geographically isolated from family and communityÂ
D) Increasing financial costs to individual residentsÂ
E) Clients were not given proper nutrition or clothed properlyÂ
11. A significant change in the treatment of people with mental illness occurred in theÂ
1950s when...Â
A) community support services were established.Â
B) legislation dramatically changed civil commitment procedures.Â
C) the Patient's Bill of Rights was enacted.Â
D) psychotropic drugs became available for use.Â
12. Before the period of the enlightenment, treatment of the mentally ill included...Â
A) creating large institutions to provide custodial care.Â
B) focusing on religious education to improve their souls.Â
C) placing the mentally ill on display for the public's amusement.Â
D) providing a safe refuge or haven offering protection.Â
13. The first training of nurses to work with persons with mental illness was in 1882 inÂ
which state?Â
A) CaliforniaÂ
B) IllinoisÂ
C) MassachusettsÂ
D) New YorkÂ
14. What is meant by the term "revolving door effect" in mental health care?Â
A) An overall reduction in incidence of severe mental illnessÂ
B) Shorter and more frequent hospital stays for persons with severe and persistent mentalÂ
illnessÂ
C) Flexible treatment settings for mentally illÂ
D) Most effective and least expensive treatment settingsÂ
15. Which of the following statements by the nurse to the client's family is true ofÂ
treatment of people with mental illness in the United States today?Â
A) Substance abuse is effectively treated with brief hospitalization.Â
B) Financial resources are reallocated from state hospitals to community programs andÂ
support.Â
C) Only one in four people needing mental health services are receiving those services.Â
D) Emergency department visits by persons who are acutely disturbed are declining.Â
16. The case manager is providing an educational seminar for the nursing staff, sheÂ
includes objectives from Healthy People 2020. Which of the following is the priority ofÂ
the objectives for mental health?Â
A) Improved inpatient careÂ
B) Primary prevention of emotional problemsÂ
C) Stress reduction and managementÂ
D) Treatment of mental illnessÂ
17. Which is a positive aspect of treating clients with mental illness in a community-basedÂ
care?Â
A) “You will not be allowed to go out with your friends while in the program.â€
B) “You will have to have supervision when you want to go anywhere else in theÂ
community.â€
C) “You will be able to live in your own home while you still see a therapist regularly.â€
D) “You will have someone in your home at all times to ask questions if you have anyÂ
concerns.â€
18. One of the unforeseen effects of the movement toward community mental healthÂ
services is...Â
A) fewer clients suffering from persistent mental illnesses.Â
B) an increased number of hospital beds available for clients seeking treatment.Â
C) an increased number of admissions to available hospital services.Â
D) Longer hospital stays for people needing mental health services.Â
19. Which is included in Healthy People 2020 objectives?Â
A) To decrease the incidence of mental illnessÂ
B) To increase the number of people who are identified, diagnosed, treated, and helped toÂ
live healthier livesÂ
C) To provide mental health services only in the communityÂ
D) To decrease the numbers of people who are being treated for mental illnessÂ
20. A client diagnosed with a mild anxiety disorder has been referred to treatment in aÂ
community mental health center. Treatment most likely provided at the centerÂ
includes...Â
A) medical management of symptoms.Â
B) daily psychotherapy.Â
C) constant staff supervision.Â
D) psychological stabilization.Â
21. There are many areas of practice in psychiatric mental health nursing. One of those isÂ
advanced-level practice. Which of the following is considered an advanced-levelÂ
function?Â
A) Case managementÂ
B) CounselingÂ
C) EvaluationÂ
D) Health teachingÂ
22. Nursing education has become broad in practice settings. The addition of PsychiatricÂ
nursing became a requirement in nursing education in 1950 by whom?Â
A) State Boards of NursingÂ
B) American Nurses AssociationÂ
C) National League of NursingÂ
D) Nurse Practice ActÂ
23. A new graduate nurse has accepted a staff position at an inpatient mental healthÂ
facility. The graduate nurse can expect to be responsible for basic-level functions,Â
including...Â
A) providing clinical supervision.Â
B) using effective communication skills.Â
C) adjusting client medications.Â
D) directing program development.Â
24. Which of the following is one of the American Nurses Association standards ofÂ
practice for psychiatric–mental health nursing?Â
A) Prescriptive authority is granted to psychiatric–mental health registered nurses.Â
B) All aspects of Standard 5: Implementation may be carried out by psychiatric–mentalÂ
health registered nurses.Â
C) Some aspects of Standard 5: Implementation may only be carried out byÂ
psychiatric–mental health advanced practice nurses.Â
D) Psychiatric–mental health advanced practice nurses are the only ones who may provideÂ
milieu therapy.Â
25. The nurse knows that mental health issues are constantly changing. Which of theÂ
following is a standard of professional performance to keep in current practice?Â
A) AssessmentÂ
B) EducationÂ
C) PlanningÂ
D) ImplementationÂ
26. Which of the following is a standard of practice?Â
A) Quality of careÂ
B) Outcomes identificationÂ
C) CollegialityÂ
D) Performance appraisalÂ
27. A student appears very nervous on the first day of clinical in a psychiatric setting. TheÂ
student reviews the instructor's guidelines and appropriately takes which of theÂ
following actions? Select all that apply.Â
A) Tells the client about personal events and interestsÂ
B) Discusses the anxious feelings with the instructorÂ
C) Assumes that the client's unwillingness to talk to a student nurse is a personal insult orÂ
failureÂ
D) Builds rapport with the patient before asking personal questionsÂ
E) Consults the instructor if a shocking situation arisesÂ
F) Gravitates to clients that the student may know personallyÂ
28. The appropriate action for a student nurse who says the wrong thing is to...Â
A) pretend that the student nurse did not say it.Â
B) restate it by saying, “That didn't come out right. What I meant was...â€
C) state that it was a joke.Â
D) ignore the error, since no one is perfect.Â
29. The newly licensed RN has been hired at the local hospital in the Geri-Psych unit.Â
Today is her first day of orientation to this facility. What would be the nurse's priorityÂ
action if a client becomes aggressive?Â
A) assist other staff on the unit to take down the client safelyÂ
B) maintain a safe distance from the clientÂ
C) keep the client secluded from othersÂ
D) reinforce boundaries when aggression is seen to maintain a safe environmentÂ
30. The Geri-Psych nurse understands that the DSM-5 describes all mental disorders withÂ
specific criteria. The DSM-5 has the following purposes: Select all that apply.Â
A) to provide the practitioner with standards of care for all clients.Â
B) to provide a standardized nomenclature and language for all mental healthÂ
professionals.Â
C) to provide standards for hospital and community based institutions.Â
D) to present defining characteristics or symptoms that differentiate specific diagnoses.Â
E) to assist in identifying the underlying causes of disorders.Â
31. If a client states, "I carry this lucky rabbit's foot for luck, my dad did too, and it reallyÂ
works," which statement by the nurse reflects respect for the client's belief?Â
A) "A rabbit's foot has never brought me luck. I don't know why people carry them."Â
B) "Yes, the rabbit's foot can bring luck to some."Â
C) "I can accept that you feel it is lucky, so let's get to our activities for the day."Â
D) "It is not appropriate to harm small animals for their parts."Â
32. A client with schizophrenia has been non-compliant with medications. The clientÂ
requires frequent admissions to the psychiatric unit for acute psychotic episodes. WhatÂ
is this process called?Â
A) escalated admissionsÂ
B) revolving doorÂ
C) deinstitutionalizationÂ
D) boardingÂ
33. What organization developed and maintains standards of practice that are used toÂ
determine safe quality care, and that can be used legally, if incorporated into the stateÂ
practice act or nurse's rules and regulations, that guide the nursing profession?Â
A) APNA (American Psychiatric Nurses Association)Â
B) DSM-5 (Diagnostic and Statistical Manual of Mental Disorders-5th ed.)Â
C) ANA (American Nurses Association)Â
D) USDHHS (U. S. Department of Health and Human Services)Â
Answer Key
1. BÂ
2. CÂ
3. BÂ
4. DÂ
5. DÂ
6. AÂ
7. BÂ
8. BÂ
9. BÂ
10. A, C, EÂ
11. DÂ
12. CÂ
13. CÂ
14. BÂ
15. CÂ
16. DÂ
17. CÂ
18. CÂ
19. BÂ
20. AÂ
21. CÂ
22. CÂ
23. BÂ
24. CÂ
25. BÂ
26. BÂ
27. B, D, EÂ
28. BÂ
29. BÂ
30. B, D, EÂ
31. CÂ
32. BÂ
33. C