Chapter 1: Practicing the Science and Art of Psychiatric Nursing Test Bank MULTIPLE CHOICE 1. Which outcome, focused on recovery, would be expected in the plan of care for a patient living in the community 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 REF: Pages: 2-3 TOP: Nursing Process: Outcomes Identification MSC: NCLEX: Health Promotion and Maintenance 2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurse‘s most caring comment. a. ―Let‘s discuss some means of coping other than suicide when you have these feelings.‖ b. ―I understand why you‘re 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?‖ ANS: A The nurse‘s 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 REF: Pages: 6-8 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 3. 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. ―Let‘s 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 REF: Page: 8 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment 4. A nurse assesses a newly admitted patient with depression. Which statement is an example of ―attending‖? a. ―We all have stress in life. Being in a psychiatric hospital isn‘t 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. ―I‘d 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 nurse‘s 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 nontherapeutic. DIF: Cognitive Level: Application REF: Page: 8 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity 5. A patient shows the nurse an article from the Internet about a health