Question 1

How is the DSM-5 useful in the practice of psychiatric nursing? Select all that apply.

Accepted Answer

A)   It informs the nurse of accurate and reliable medical diagnosis.
B)   It represents progress toward a more holistic view of mind-body.
C)   It provides a framework for interdisciplinary communication.
D)   It provides a template for nursing care plans.
E)   It provides a framework for communication with the client. A,B,C

Question 2

A nurse is assessing 15-year-old identical twins who respond very differently to stress.One twin becomes anxious and irritable,while the other withdraws and cries.How should the nurse explain these different responses to stress to the parents?

Accepted Answer

A)   Reactions to stress are relative rather than absolute; individual responses to stress vary.
B)   It is abnormal for identical twins to react differently to similar stressors.
C)   Identical twins should share the same temperament and respond similarly to stress.
D)   Environmental influences weigh more heavily than genetic influences on reactions to stress. A

Question 3

Which client should the nurse anticipate to be most receptive to psychiatric treatment?

Accepted Answer

A)   A Jewish, female journalist
B)   A Baptist, homeless male
C)   A Catholic, black male
D)   A Protestant, Swedish business executive A

Question 4

Which nursing statement about the concept of neuroses is most accurate?

Accepted Answer

A)   "An individual experiencing neurosis is unaware that he or she is experiencing distress."
B)   "An individual experiencing neurosis feels helpless to change his or her situation."
C)   "An individual experiencing neurosis is aware of psychological causes of his or her behavior."
D)   "An individual experiencing neurosis has a loss of contact with reality."

Question 5

During an intake assessment,a nurse asks both physiological and psychosocial questions.The client angrily responds,"I'm here for my heart,not my head problems." Which is the nurse's best response?

Accepted Answer

A)   "It's just a routine part of our assessment. All clients are asked these same questions."
B)   "Why are you concerned about these types of questions?"
C)   "Psychological factors, like excessive stress, have been found to affect medical conditions."
D)   "We can skip these questions, if you like. It isn't imperative that we complete this section."

Question 6

Which of the following are identified as psychoneurotic responses to severe anxiety as they appear in the DSM-5?

Accepted Answer

A)   Somatic symptom disorders
B)   Grief responses
C)   Psychosis
D)   Bipolar disorder

Question 7

An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions.What behavior would be expected from this employee?

Accepted Answer

A)   The employee assertively confronts the boss
B)   The employee leaves the staff meeting to work out in the gym
C)   The employee criticizes a coworker
D)   The employee takes the boss out to lunch

Question 8

A new psychiatric nurse states,"This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement?

Accepted Answer

A)   Defense mechanisms can be self-protective responses to stress and need not be eliminated.
B)   Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated.
C)   Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not eliminated.
D)   Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

Question 9

Which is the most significant consequence of the excessive use of defense mechanisms?

Accepted Answer

A)  The superego will be suppressed.
B)   Emotions will be experienced intensely.
C)   Learning and the ability to grow will be enhanced.
D)   Problem-solving will be limited.

Question 10

At what point should the nurse determine that a client is at risk for developing a mental disorder?

Accepted Answer

A)   When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B)   When maladaptive responses to stress are coupled with interference in daily functioning
C)   When the client communicates significant distress
D)   When the client uses defense mechanisms as ego protection

Question 11

Devastated by a divorce from an abusive husband,a wife completes grief counseling.Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

Accepted Answer

A)   "If only we could have tried again, things might have worked out."
B)   "I am so mad that the children and I had to put up with him as long as we did."
C)   "Yes, it was a difficult relationship, but I think I have learned from the experience."
D)   "I still don't have any appetite and continue to lose weight."

Question 12

A client has a history of excessive drinking,which has led to multiple arrests for driving under the influence (DUI).The client states,"I work hard to provide for my family.I don't see why I can't drink to relax." The nurse recognizes the use of which defense mechanism?

Accepted Answer

A)   Projection
B)   Rationalization
C)   Regression
D)   Sublimation

Question 13

Which should the nurse recognize as a DSM-5 disorder?

Accepted Answer

A)  Obesity
B)   Generalized anxiety disorder
C)   Hypertension
D)   Grief

Question 14

A teenage boy is attracted to a female teacher.Without objective evidence,a school nurse overhears the boy state,"I know she wants me." This statement reflects which defense mechanism?

Accepted Answer

A)   Displacement
B)   Projection
C)   Rationalization
D)   Sublimation

Question 15

According to Maslow's hierarchy of needs,which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

Accepted Answer

A)  A client rudely complaining about limited visiting hours
B)   A client exhibiting aggressive behavior toward another client
C)   A client stating that no one cares
D)   A client verbalizing feelings of failure

Question 16

Which nursing statement about the concept of psychoses is most accurate?

Accepted Answer

A)   "Individuals experiencing psychoses are aware that their behaviors are maladaptive."
B)   "Individuals experiencing psychoses experience little distress."
C)   "Individuals experiencing psychoses are aware of experiencing psychological problems."
D)   "Individuals experiencing psychoses are based in reality."

Question 17

The nurse is preparing to provide medication instruction for a patient.Which of the following understandings about anxiety will be essential to effective instruction?

Accepted Answer

A)   Learning is best when anxiety is moderate to severe.
B)   Learning is enhanced when anxiety is mild.
C)   Panic level anxiety helps the nurse teach better.
D)   Severe anxiety is characterized by intense concentration and enhances the attention span.

Question 18

Which should the nurse recognize as an example of the defense mechanism of repression?

Accepted Answer

A)  A student aware of the need to study for tomorrow's test goes to a movie instead.
B)   A woman whose son was killed in Iraq does not believe the military report.
C)   A man who is unhappily married goes to school to become a marriage counselor.
D)   A woman was raped when she was 12 and no longer remembers the incident.

Question 19

Which of the following statements should a nurse recognize as true about defense mechanisms? Select all that apply.

Accepted Answer

A)   They are employed when there is a threat to biological or psychological integrity.
B)   They are controlled by the id and deal with primal urges.
C)   They are used in an effort to relieve mild to moderate anxiety.
D)   They are protective devices for the superego.
E)   They are mechanisms that are characteristically self-deceptive.

Question 20

A nurse is assessing a client who appears to be experiencing moderate anxiety during questioning.Which symptoms might the client demonstrate? Select all that apply.

Accepted Answer

A)   Fidgeting
B)   Laughing inappropriately
C)   Palpitations
D)   Nail biting
E)   Extremely limited attention span

Exam 2: Mental Health/Mental Illness: Historical and Theoretical Concepts