Chapter 01: Practicing the Science and the Art of Psychiatric Nursing MULTIPLE

CHOICE

1. Which outcome, focused on recovery, would be expected in the plan of care for a patient

living in the community and diagnosed with serious and persistent mental illness? Within 3

months, the patient will: a. deny suicidal ideation.

b. report a sense of well-being.

c. take medications as prescribed.

d. attend clinic appointments on time.

ANS: B

Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving

role performance.

The goal of recovery is to empower the individual with mental illness to achieve a sense of

meaning and satisfaction in life and to function at the highest possible level of wellness. The

incorrect options focus on the classic medical model rather than recovery.

DIF: Cognitive Level: Application (Applying) REF: 2

TOP: Nursing Process: Outcomes Identification

MSC: NCLEX: Health Promotion and Maintenance

2. In the shift-change report, an off-going nurse criticizes a patient who wears heavy

makeup. Which comment by the nurse who receives the report best demonstrates

advocacy?

a. This is a psychiatric hospital. Craziness is what we are all about.

b. Lets all show acceptance of this patient by wearing lots of makeup too.

c. Your comments are inconsiderate and inappropriate. Keep the report objective.

d. Our patients need our help to learn behaviors that will help them get along in society.

ANS: D

Accepting patients needs for self-expression and seeking to teach skills that will contribute

to their well-being demonstrate respect and are important parts of advocacy. The on-

coming nurse needs to take action to ensure that others are not prejudiced against the

patient. Humor can be appropriate within the privacy of a shift report but not at the

expense of respect for patients. Judging the off-going nurse in a critical way will create

conflict.

Nurses must show compassion for each other.

DIF: Cognitive Level: Application (Applying) REF: 8

TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 3. A

nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which

statement is an example of attending?

a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.

b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.

c. You will feel better after we get some antidepressant medication started for you.

d. Id like to sit with you a while so you may feel more comfortable talking with me.

ANS: D

Attending is a technique that demonstrates the nurses commitment to the relationship and

reduces feelings of isolation. This technique shows respect for the patient and

demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.

DIF: Cognitive Level: Application (Applying) REF: 8

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 4. A patient is

hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select

the nurses most caring comment.

a. Lets discuss some means of coping other than suicide when you have these feelings.

b. I understand why youre so depressed. When I got divorced, I was devastated too.

c. You should forget about your marriage and move on with your life.

d. How did you get so depressed that hospitalization was necessary?

Test Bank: Essentials of Psychiatric Mental Health Nursing (3rd Edition by Varcarolis) 3

ANS: A

The nurses communication should evidence caring and a commitment to work with the

patient. This commitment lets the patient know the nurse will help. Probing and advice are

not helpful or therapeutic interventions.

DIF: Cognitive Level: Application (Applying) REF: 6

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 5. A patient

shows the nurse an article from the Internet about a health problem. Which characteristic

of the web sites address most alerts the nurse that the site may have biased and prejudiced

information?

a. Address ends in .org.

b. Address ends in .com.

c. Address ends in .gov.

d. Address ends in .net.

ANS: B

Financial influences on a site are a clue that the information may be biased. .com at the end

of the address indicates that the site is a commercial one. .gov indicates that the site is

maintained by a government entity.

.org indicates that the site is nonproprietary; the site may or may not have reliable

information, but it does not profit from its activities. .net can have multiple meanings.

DIF: Cognitive Level: Comprehension (Understanding) REF: 5