Test Bank Varcarolis Essentials of Psychiatric Mental Health Nursing 3e 2017 PDF

Preview

Summary

Test bank of mental health Varcarolis textbook...

Description

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

1

TableofContents TableofContents Chapter01:PracticingtheScienceandtheArtofPsychiatricNursing Chapter02:MentalHealthandMentalIllness Chapter03:TheoriesandTherapies Chapter04:BiologicalBasisforUnderstandingPsychopharmacology Chapter05:SettingsforPsychiatricCare Chapter06:LegalandEthicalBasisforPractice Chapter07:NursingProcessandQSEN:TheFoundationforSafeandEffectiveCare Chapter08:CommunicationSkills:MediumforAllNursingPractice Chapter09:TherapeuticRelationshipsandtheClinicalInterview Chapter10:TraumaandStress-RelatedDisorders Chapter11:Anxiety,AnxietyDisorders,andObsessive-CompulsiveDisorders Chapter12:SomaticSystemDisordersandDissociativeDisorders Chapter13:PersonalityDisorders Chapter14:EatingDisorders Chapter15:MoodDisorders:Depression Chapter16:BipolarSpectrumDisorders Chapter17:SchizophreniaSpectrumDisordersandOtherPsychoticDisorders Chapter18:NeurocognitiveDisorders Chapter19:Substance-RelatedandAddictiveDisorders Chapter20:CrisisandMassDisaster Chapter21:Child,Partner,andElderViolence Chapter22:SexualViolence Chapter23:SuicidalThoughtsandBehavior Chapter24:Anger,Aggression,andViolence Chapter25:CarefortheDyingandThoseWhoGrieve Chapter26:ChildrenandAdolescents Chapter27:Adults Chapter28:OlderAdults

1 2 7 12 20 28 35 43 51 58 67 74 85 94 103 111 121 131 142 151 163 171 179 186 195 204 213 221 230

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

2

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 TOP:NursingProcess:EvaluationMSC:NCLEX:HealthPromotionandMaintenance 6.Anursesays,WhenIwasinschool,Ilearnedtocallupsetpatientsbynametogettheirattention;however, readadescriptiveresearchstudythatsaysthatthisapproachdoesnotwork.Iplantostopcallingpatientsby name.Whichstatementisthebestappraisalofthisnursescomment? a.Onedescriptiveresearchstudyrarelyprovidesenoughevidencetochangepractice. b.Staffnursesapplynewresearchfindingsonlywiththehelpfromclinicalnursespecialists. c.Newresearchfindingsshouldbeincorporatedintoclinicalalgorithmsbeforeusingtheminpractice. d.Thenursemisinterpretedtheresultsofthestudy.Classictenetsofpracticedonotchange. ANS:A Descriptiveresearchfindingsprovideevidenceforpracticebutmustbeviewedinrelationtootherstudies beforepracticechanges.Onestudyisnotenough.Descriptivestudiesarelowonthehierarchyofevidence. Clinicalalgorithmsuseflowchartstomanageproblemsanddonotspecifyoneresponsetoaclinicalproblem. Classictenetsofpracticeshouldchangeasresearchfindingsprovideevidenceforchange. DIF:CognitiveLevel:Analysis(Analyzing)REF:3 TOP:NursingProcess:EvaluationMSC:NCLEX:HealthPromotionandMaintenance 7.Twonursingstudentsdiscusscareerplansaftergraduation.Onestudentwantstoenterpsychiatricnursing. Theotherstudentasks,Whywouldyouwanttobeapsychiatricnurse?Alltheydoistalk.Youwillloseyour skills.Selectthebestresponsebythestudentinterestedinpsychiatricnursing. a.Psychiatricnursespracticeinsaferenvironmentsthanotherspecialties.Nurse-to-patientratiosmustbe betterbecauseofthenatureofpatientsproblems. b.Psychiatricnursesusecomplexcommunicationskills,aswellascriticalthinking,tosolvemultidimensional problems.Imchallengedbythosesituations. c.IthinkIwillbegoodinthementalhealthfield.Idonotlikeclinicalrotationsinschool,soIdonotwantto continuethemafterIgraduate. d.Psychiatricnursesdonothavetodealwithasmuchpainandsufferingasmedicalsurgicalnurses.That appealstome. ANS:B Thepracticeofpsychiatricnursingrequiresadifferentsetofskillsthanmedicalsurgicalnursing,although substantialoverlapdoesexist.Psychiatricnursesmustbeabletohelppatientswithmedicalandmentalhealth problems,reflectingtheholisticperspectivethesenursesmusthave.Nurse-patientratiosandworkloadsin psychiatricsettingshaveincreased,similartootherspecialties.Psychiatricnursinginvolvesclinicalpractice,

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

4

notsimplydocumentation.Psychosocialpainisrealandcancauseasmuchsufferingasphysicalpain. DIF:CognitiveLevel:Application(Applying)REF:3 TOP:NursingProcess:ImplementationMSC:NCLEX:Safe,EffectiveCareEnvironment 8.Whichresearchevidencewouldmostinfluenceagroupofnursestochangetheirpractice? a.Expertcommitteereportofrecommendationsforpractice b.Systematicreviewofrandomizedcontrolledtrials c.Nonexperimentaldescriptivestudy d.Criticalpathway ANS:B Researchfindingsaregradedusingahierarchyofevidence.Asystematicreviewofrandomizedcontrolled trialsisLevelAandprovidesthestrongestevidenceforchangingpractice.Expertcommittee recommendationsanddescriptivestudieslendlesspowerfulandinfluentialevidence.Acriticalpathwayisnot evidence;itincorporatesresearchfindingsaftertheyhavebeenanalyzed. DIF:CognitiveLevel:Comprehension(Understanding)REF:3 TOP:NursingProcess:PlanningMSC:NCLEX:Safe,EffectiveCareEnvironment 9.AbillintroducedinCongresswouldreducefundingforthecareofpeoplediagnosedwithmentalillnesses. Agroupofnurseswriteletterstotheirelectedrepresentativesinoppositiontothelegislation.Whichrolehave thenursesfulfilled? a.Advocacy b.Attending c.Recovery d.Evidence-basedpractice ANS:A Anadvocatedefendsorassertsanotherscause,particularlywhentheotherpersonlackstheabilitytodothat forhimselforherself.Examplesofindividualadvocacyincludehelpingpatientsunderstandtheirrightsor makedecisions.Onacommunityscale,advocacyincludespoliticalactivity,publicspeaking,andpublication intheinterestofimprovingtheindividualswithmentalillness;theletter-writingcampaignadvocatesforthat causeonbehalfofpatientswhoareunabletoarticulatetheirownneeds. DIF:CognitiveLevel:Comprehension(Understanding)REF:8 TOP:NursingProcess:ImplementationMSC:NCLEX:Safe,EffectiveCareEnvironment 10.Aninformalgroupofpatientsdiscusstheirperceptionsofnursingcare.Whichcommentbestindicatesa patientsperceptionthathisorhernurseiscaring? a.MynursealwaysasksmewhichtypeofjuiceIwanttohelpmeswallowmymedication. b.Mynurseexplainedmytreatmentplantomeandaskedformyideasabouthowtomakeitbetter. c.MynursetoldmethatifItakeallthemedicinesthedoctorprescribesIwillgetdischargedsoon. d.Mynursespendstimelisteningtometalkaboutmyproblems.ThathelpsmefeellikeImnotalone. ANS:D Caringevidencesempathicunderstanding,aswellascompetency.Ithelpschangepainandsufferingintoa sharedexperience,creatingahumanconnectionthatalleviatesfeelingsofisolation.Theincorrectoptionsgive examplesofstatementsthatdemonstrateadvocacyorgivingadvice. DIF:CognitiveLevel:Application(Applying)REF:3 TOP:NursingProcess:EvaluationMSC:NCLEX:PsychosocialIntegrity 11.ApatientwhoimmigratedtotheUnitedStatesfromHonduraswasdiagnosedwithschizophrenia.The patienttookanantipsychoticmedicationfor3weeksbutshowednoimprovement.Whichresourceshouldthe treatmentteamconsultforinformationonmoreeffectivemedicationsforthispatient? a.Clinicalalgorithm b.Clinicalpathway c.Clinicalpracticeguideline

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

5

d.InternationalStatisticalClassificationofDiseasesandRelatedHealthProblems(ICD) ANS:A Aclinicalalgorithmisaguidelinethatdescribesdiagnosticand/ortreatmentapproachesdrawnfromlarge databasesofinformation.Theseguidelineshelpthetreatmentteammakedecisionscognizantofanindividual patientsneeds,suchasethnicorigin,age,orgender.Aclinicalpathwayisamapofinterventionsand treatmentsrelatedtoaspecificdisorder.Clinicalpracticeguidelinessummarizebestpracticesaboutspecific healthproblems.TheICDclassifiesdiseases. DIF:CognitiveLevel:Application(Applying)REF:5 TOP:NursingProcess:EvaluationMSC:NCLEX:Safe,EffectiveCareEnvironment 12.Whichhistoricalnursingleaderhelpedfocuspracticetorecognizetheimportanceofscienceinpsychiatric nursing? a.AbrahamMaslow b.HildegardPeplau c.KrisMartinsen d.HarrietBailey ANS:B Althoughalltheseleadersincludedscienceasanimportantcomponentofpractice,HildegardPeplaumost influenceditsdevelopmentinpsychiatricnursing.Maslowwasnotanurse,buthistheoriesinfluencehow nursesprioritizeproblemsandcare.Baileywroteatextbookinthe1930sonpsychiatricnursinginterventions. KrisMartinsenemphasizedtheimportanceofcaringinnursingpractice. DIF:CognitiveLevel:Knowledge(Remembering)REF:4 TOP:NursingProcess:N/AMSC:NCLEX:PsychosocialIntegrity 13.Anurseconsistentlystrivestodemonstratecaringbehaviorsduringinteractionswithpatients.Which reactionbyapatientindicatesthisnurseiseffective?Apatientreportsfeeling: a.distrustfulofothers. b.connectedwithothers. c.uneasyaboutthefuture. d.discouragedwitheffortstoimprove. ANS:B Apatientislikelytorespondtocaringwithasenseofconnectednesswithothers.Theabsenceofcaringcan makepatientsfeeldistrustful,disconnected,uneasy,anddiscouraged. DIF:CognitiveLevel:Comprehension(Understanding)REF:7 TOP:NursingProcess:EvaluationMSC:NCLEX:PsychosocialIntegrity MULTIPLERESPONSE 1.Anexperiencednursesaystoanewgraduate,WhenyouvepracticedaslongasIhave,youwillinstantly knowhowtotakecareofpsychoticpatients.Whatisthenewgraduatesbestanalysisofthiscomment?Select allthatapply. a.Theexperiencednursemayhavelostsightofpatientsindividuality,whichmaycompromisetheintegrityof practice. b.Newresearchfindingsmustbecontinuallyintegratedintoanursespracticetoprovidethemosteffective care. c.Experienceprovidesmentalhealthnurseswiththetoolsandskillsneededforeffectiveprofessionalpractice. d.Experiencedpsychiatricnurseshavelearnedthebestwaystocareforpsychoticpatientsthroughtrialand error. e.Effectivepsychiatricnursesshouldbecontinuallyguidedbyanintuitivesenseofpatientsneeds. ANS:A,B Evidence-basedpracticeinvolvesusingresearchfindingstoprovidethemosteffectivenursingcare.Evidence iscontinuallyemerging;therefore,nursescannotrelysolelyonexperience.Theeffectivenursealsomaintains

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

6

respectforeachpatientasanindividual.Overgeneralizationcompromisesthatperspective.Intuitionandtrial anderrorareunsystematicapproachestocare. DIF:CognitiveLevel:Application(Applying)REF:2 TOP:NursingProcess:EvaluationMSC:NCLEX:Safe,EffectiveCareEnvironment 2.Whichpatientstatementsidentifyqualitiesofnursingpracticewithhightherapeuticvalue?(Selectallthat apply.)Mynurse: a.talksinlanguageIcanunderstand. b.helpsmekeeptrackofmymedications. c.iswillingtogotosocialactivitieswithme. d.letsmedowhateverIchoosewithoutinterfering. e.looksatmeasawholepersonwithdifferentneeds. ANS:A,B,E Eachcorrectanswerdemonstratescaringisanexampleofappropriatenursingfoci:communicatingatalevel understandabletothepatient,usingholisticprinciplestoguidecare,andprovidingmedicationsupervision. Theincorrectoptionssuggestalaissez-faireattitudeonthepartofthenurse,whenthenurseshouldinstead providethoughtfulfeedbackandhelppatientstestalternativesolutionsorviolateboundaries. DIF:CognitiveLevel:Application(Applying)REF:6 TOP:NursingProcess:ImplementationMSC:NCLEX:PsychosocialIntegrity

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

7

Chapter02:MentalHealthandMentalIllness MULTIPLECHOICE 1.An86-year-old,previouslyhealthyandindependent,fallsafteranepisodeofvertigo.Whichbehaviorby thispatientbestdemonstratesresilience?Thepatient: a.says,Iknewthiswouldhappeneventually. b.stopsattendingherweeklywateraerobicsclass. c.refusestouseawalkerandsays,Idontneedthatsillything. d.says,Maybesomephysicaltherapywillhelpmewithmybalance. ANS:D Resiliencyistheabilitytorecoverfromoradjusttomisfortuneandchange.Thecorrectresponseindicatesthat thepatientishopefulandthinkingpositivelyaboutwaystoadapttothevertigo.SayingIknewthiswould happeneventuallyanddiscontinuinghealthyactivitiessuggestahopelessperspectiveonthehealthchange. Refusingtouseawalkerindicatesdenial. DIF:CognitiveLevel:Comprehension(Understanding)REF:14 TOP:NursingProcess:AssessmentMSC:NCLEX:PsychosocialIntegrity 2.Apatientisadmittedtothepsychiatrichospital.Whichassessmentfindingbestindicatesthatthepatienthas amentalillness?Thepatient: a.describescopingandrelaxationstrategiesusedwhenfeelinganxious. b.describesmoodasconsistentlysad,discouraged,andhopeless. c.canperformtasksattemptedwithinthelimitsofownabilities. d.reportsoccasionalproblemswithinsomnia. ANS:B Apatientwhoreportshavingaconsistentlynegativemoodisdescribingamoodalteration.Theincorrect optionsdescribementallyhealthybehaviorsandcommonproblemsthatdonotindicatementalillness. DIF:CognitiveLevel:Application(Applying)REF:11 TOP:NursingProcess:AssessmentMSC:NCLEX:PsychosocialIntegrity 3.Thegoalforapatientistoincreaseresiliency.Whichoutcomeshouldanurseaddtotheplanofcare? Within3days,thepatientwill: a.describefeelingsassociatedwithlossandstress. b.meetownneedswithoutconsideringtherightsofothers. c.identifyhealthycopingbehaviorsinresponsetostressfulevents. d.allowotherstoassumeresponsibilityformajorareasofownlife. ANS:C Thepatientsabilitytoidentifyhealthycopingbehaviorsindicatesadaptive,healthybehavioranddemonstrates anincreasedabilitytorecoverfromseverestress.Describingfeelingsassociatedwithlossandstressdoesnot movethepatienttowardadaptation.Theremainingoptionsaremaladaptivebehaviors. DIF:CognitiveLevel:Analysis(Analyzing)REF:14 TOP:NursingProcess:OutcomesIdentification MSC:NCLEX:PsychosocialIntegrity 4.Whichorganizationactivelyseekstoreducethestigmaassociatedwithmentalillnessthroughpublic presentationssuchasInOurOwnVoice(IOOV)? a.AmericanPsychiatricAssociation(APA) b.NationalAllianceonMentalIllness(NAMI) c.UnitedStatesDepartmentofHealthandHumanServices(USDHHS) d.NorthAmericanNursingDiagnosisAssociationInternational(NANDA-I) ANS:B Stigmarepresentsthebiasandprejudicecommonlyheldregardingmentalillness.NAMIactivelyseeksto

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

8

dispelmisconceptionsaboutmentalillness.NANDA-Idefinesapprovednursingdiagnoses.TheAPA publishestheDSM5.TheUSDHHS...