Question 1

A major difference between coping resources and coping mechanisms is that:

Accepted Answer

A)   coping resources are adaptive, whereas coping mechanisms are usually maladaptive.
B)   coping resources are assets, whereas coping mechanisms can be assets or liabilities.
C)   individuals have multiple coping resources, but coping mechanisms are limited in number.
D)   available coping resources are more predictive of outcome than are the coping mechanisms used. B

Question 2

Nursing diagnoses:

Accepted Answer

A)   provide a way for all health professionals to view a patient holistically and to combat the problem of mind-body dualism.
B)   complement medical diagnoses and are best described as the patient's behavioral response to stress.
C)   offer an alternative to health professionals who wish to use complementary treatment modalities in lieu of traditional medical treatment.
D)   contribute little in the everyday clinical setting but do provide nurses with a common language to use for research on outcomes of standard nursing interventions. B

Question 3

A patient has decided to resign from a job that involved many daily hassles.Using Caplan's theory of response to stress,the patient can be seen to be using:

Accepted Answer

A)   behavior that adjusts the patient's appraisal of the stress.
B)   behavior that allows the patient to escape from the stressful environment.
C)   intrapsychic behavior in order to defend against unpleasant emotional arousal.
D)   intrapsychic behavior to come to terms with the event by internal readjustment. B

Question 4

Precipitating stressors are stimuli that:

Accepted Answer

A)   society views as being deviant or troublesome.
B)   the family views as disruptive or burdensome.
C)   the patient views as challenging, threatening, or demanding.
D)   the nurse views as noxious, overwhelming, or culturally unacceptable.

Question 5

A patient states,"Sometimes I hear voices when no one else is in the room telling me that people are plotting to hurt me." This patient is experiencing impairment of which criterion of mental health?

Accepted Answer

A)   Autonomy
B)   Integration
C)   Reality perception
D)   Environmental mastery

Question 6

The nurse initiates the nursing process for the purpose of managing the psychiatric care for a patient with a maladaptive stress response when:

Accepted Answer

A)   admission orders have been written by the admitting physician.
B)   diagnostic tests rule out the presences of any organic pathology.
C)   the patient relationship with the nurse has been established.
D)   the nurse makes initial contact with the patient.

Question 7

A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening.The immediate nursing goal for the patient is the:

Accepted Answer

A)   patient will be stabilized.
B)   illness will go into remission.
C)   patient will completely recover.
D)   patient will achieve optimal wellness.

Question 8

A nurse documents that a patient is appropriately emotionally responsive,in control,and expresses a unified philosophy of life.This implies that the patient has met the mental health criterion of:

Accepted Answer

A)   autonomy.
B)   integration.
C)   reality perception.
D)   environmental mastery.

Question 9

A delusional patient believes that the accidental death of a child was actually caused by aliens.He has become severely anxious believing he is also in danger.During the acute stage of treatment,the expected outcome of nursing care is the:

Accepted Answer

A)   patient will experience symptom relief.
B)   nurse will validate the patient's strengths.
C)   patient will identify vulnerabilities that led to the symptoms.
D)   nurse will focus on the patient's quality of life and well-being.

Question 10

The spouse of a patient with major depressive disorder tells a nurse,"I feel hopeless about my spouse's condition.It's not like a physical illness that he can recover from." Which response will best reassure the spouse?

Accepted Answer

A)   "That's not true. People with mental illness get well more than 90% of the time."
B)   "While your concerns about your spouse's recovery are understandable, great strides have been made with the use of new antidepressants."
C)   "It's not right to try to make comparisons between the effectiveness of treatment of mental and physical illnesses. It's like comparing apples and oranges."
D)   "New studies show that treatment of depression is effective 65% to 80% of the time, whereas treatments for heart disease and cancer are often only 40% effective."

Question 11

A nurse caring for a patient wonders how the patient's functioning has been evaluated in the past.To learn this,the nurse would look in the medical record on the DSM-IV-TR Axis:

Accepted Answer

A)   I.
B)   II.
C)   IV.
D)   V.

Question 12

Which individual would a nurse consider to be at the highest risk for the onset of stress-related problems?

Accepted Answer

A)   A patient whose beloved parent died 3 months ago and who has lost a job because of corporate restructuring. The patient states, "Living with loss and the threat of loss makes me feel helpless."
B)   A patient who was passed over for promotion and quit to start a new business. The patient states, "This is just one of a series of challenges I've faced in my life."
C)   A patient who is graduating from college and will be married in one month. The patient states, "I'm anticipating the changes these events will make in my life."
D)   A married patient whose new business is growing slowly and who plans to adopt a child. The patient says, "I think I'm in control of my destiny."

Question 13

A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening.A nurse assesses the patient's treatment stage as:

Accepted Answer

A)   crisis.
B)   acute.
C)   maintenance.
D)   health promotion.

Question 14

A comparison of the nursing and medical models of care shows that:

Accepted Answer

A)   nurses assess disease states and causes.
B)   physicians assess risk factors and vulnerability.
C)   nursing intervention focuses on curative treatments.
D)   nursing diagnoses focus on the effectiveness of coping responses.

Question 15

Which statement can a nurse use to best describe the Stuart Stress Adaptation Model to someone who is unfamiliar with it?

Accepted Answer

A)   "The model recognizes the limitations of the nursing process and organizes treatment along critical pathways."
B)   "The model bases psychiatric nursing practice on principles derived from nursing science and establishes generic goals for each discrete stage of psychiatric treatment."
C)   "The model integrates biopsychosociocultural, environmental, and legal-ethical aspects of psychiatric nursing care into a unified framework for practice throughout the care continuum."
D)   "The model is based primarily on the medical model and organizes psychiatric nursing practice according to discrete treatment stages, selected treatment settings, and legal mandates."

Question 16

A nurse caring for a patient suspects that the patient has a personality disorder in addition to presenting with maladaptive stress response.To confirm this,the nurse would look in the patient's medical record on the DSM-IV-TR Axis:

Accepted Answer

A)   I.
B)   II.
C)   IV.
D)   V.

Question 17

The greatest barrier to treatment for the mentally ill can be minimized by:

Accepted Answer

A)   possessing adequate insurance coverage.
B)   implementing effective treatment modalities.
C)   employing sufficient numbers of mental health practitioners.
D)   formulating appropriate, accurate assessment tools for diagnosis.

Question 18

A patient was diagnosed with bipolar disorder and hospitalized.The symptoms went into remission,and the patient was recently discharged to the community.During this stage of treatment the expected outcome will be that the patient will:

Accepted Answer

A)   be safe from harm.
B)   experience symptom relief.
C)   demonstrate improved functioning.
D)   attain an optimal quality of life in the community.

Question 19

Which criterion of mental health is a nurse assessing when exploring a patient's sense of self-determination,balance between dependence and independence,and acceptance of the consequences of behavior?

Accepted Answer

A)   Autonomy
B)   Integration
C)   Reality perception
D)   Environmental mastery

Question 20

A nurse assessing a patient is interested in the patient's appraisal of a recent divorce as a stressor.To obtain this information,it is important for the nurse to gather data about which of the patient's responses.(Select all that apply.)

Accepted Answer

A)   Affective
B)   Behavioral
C)   Physiological
D)   Cognitive
E)   Ethical

Exam 3: The Stuart Stress Adaptation Model of Psychiatric Nursing Care

A major difference between coping resources and coping mechanisms is that:

Nursing diagnoses:

A patient has decided to resign from a job that involved many daily hassles.Using Caplan's theory of response to stress,the patient can be seen to be using:

Precipitating stressors are stimuli that:

A patient states,"Sometimes I hear voices when no one else is in the room telling me that people are plotting to hurt me." This patient is experiencing impairment of which criterion of mental health?

The nurse initiates the nursing process for the purpose of managing the psychiatric care for a patient with a maladaptive stress response when:

A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening.The immediate nursing goal for the patient is the:

A nurse documents that a patient is appropriately emotionally responsive,in control,and expresses a unified philosophy of life.This implies that the patient has met the mental health criterion of:

A delusional patient believes that the accidental death of a child was actually caused by aliens.He has become severely anxious believing he is also in danger.During the acute stage of treatment,the expected outcome of nursing care is the:

The spouse of a patient with major depressive disorder tells a nurse,"I feel hopeless about my spouse's condition.It's not like a physical illness that he can recover from." Which response will best reassure the spouse?

A nurse caring for a patient wonders how the patient's functioning has been evaluated in the past.To learn this,the nurse would look in the medical record on the DSM-IV-TR Axis:

Which individual would a nurse consider to be at the highest risk for the onset of stress-related problems?

A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening.A nurse assesses the patient's treatment stage as:

A comparison of the nursing and medical models of care shows that:

Which statement can a nurse use to best describe the Stuart Stress Adaptation Model to someone who is unfamiliar with it?

A nurse caring for a patient suspects that the patient has a personality disorder in addition to presenting with maladaptive stress response.To confirm this,the nurse would look in the patient's medical record on the DSM-IV-TR Axis:

The greatest barrier to treatment for the mentally ill can be minimized by:

A patient was diagnosed with bipolar disorder and hospitalized.The symptoms went into remission,and the patient was recently discharged to the community.During this stage of treatment the expected outcome will be that the patient will:

Which criterion of mental health is a nurse assessing when exploring a patient's sense of self-determination,balance between dependence and independence,and acceptance of the consequences of behavior?

A nurse assessing a patient is interested in the patient's appraisal of a recent divorce as a stressor.To obtain this information,it is important for the nurse to gather data about which of the patient's responses.(Select all that apply.)