Chapter 01: Mental Health and Mental Illness Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach, 9th Edition MULTIPLE CHOICE 1. The scope of practiced for an advanced nurse practitioner would include which intervention? a. Conducting a mental health assessment. b. Prescribing psychotropic medication. c. Establishing a therapeutic relationship. d. Individualizing a nursing care plan. ANS: B In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and clinical nurse specialists who have taken special courses on prescribing medication. The nurse prepared at the basic level is permitted to perform mental health assessments, establish relationships, and provide individualized care planning. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing skills.” Select the best response by the mental health nurse. a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-toclient ratios must be better because of the nature of the clients’ problems.” b. “Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.” c. “That’s a misconception. Psychiatric nurses frequently use high technology monitoring equipment and manage complex intravenous therapies.” d. “Psychiatric nurses do not have to deal with as much pain and suffering as medical–surgical nurses do. That appeals to me.” ANS: B The practice of psychiatric nursing requires a different set of skills than medical–surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help clients with medical as well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse–client ratios and workloads in psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical pain and suffering. PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental illness, a group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Recovery b. Attending c. Advocacy d. Evidence-based practice Test bank Varcarolis' Foundations of Psychiatric-Mental Health Nursing 9th Edition 2 ANS: C An advocate defends or asserts another’s cause, particularly when the other person lacks the ability to do that for self. Examples of individual advocacy include helping clients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the human condition. Since funding is necessary to deliver quality programming for persons with mental illness, the letterwriting campaign advocates for that cause on behalf of clients who are unable to articulate their own needs. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment 4. A family has a long history of conflicted relationships among the members. Which family member’s comment best reflects a mentally healthy perspective? a. “I’ve made mistakes but everyone else in this family has also.” b. “I remember joy and mutual respect from our early years together.” c. “I will make some changes in my behavior for the good of the family.” d. “It’s best for me to move away from my family. Things will never change.” ANS: C The correct response demonstrates the best evidence of a healthy recognition of the importance of relationships. Mental health includes rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a higher level of mental health. The other incorrect responses show blaming and avoidance. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 5. Which assessment finding most clearly indicates that a client may be experiencing a mental illness? a. reporting occasional sleeplessness and anxiety. b. reporting a consistently sad, discouraged, and hopeless mood. c. being able to describe the difference between “as if” and “for real.” d. experiencing difficulty making a decision about whether to change jobs. ANS: B The correct response describes a mood alteration, which reflects mental illness. The distracters describe behaviors that are mentally healthy or within the usual scope of human experience. PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was achieved for an adult client? a. being willing to work towards achieving ideals and meeting demands. b. behaving without considering the consequences of personal actions. c. aggressively meeting personal needs without considering the rights of others. d. seeking help from others to avoid assuming responsibility for major areas of own life.