Kneisl 3e TIF CH05

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 5
Question 1
Type: MCSA
Which statement indicates the psychiatricmental health nurse understands the basic principles of symbolic
interactionism in working with clients?
1. Clients with mental disorders are unlikely to understand the personal meaning of their experiences.
2. I try to avoid interventions that ignore the personal meaning of experiences to my clients.
3. Clients with altered brain chemistry need frequent reassurance that they should not worry about their
condition.
4. After my first year of working in mental health, I was able to develop standardized interventions for clients
with the same diagnoses.
Correct Answer: 2
Rationale 1: Because all behavior has meaning, the nurse must develop interventions that recognize personal
meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this
premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in
their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have
personal understandings of their life experience even if they have altered brain structure and chemistry and
stressful environments.
Copyright 2012 by Pearson Education, Inc.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: Discuss the major ideas of interactionism.
Question 2
Type: MCSA
Concepts of interactionism are evidenced in which of the following statements the nurse makes to the parent of an
adolescent hospitalized for an overdose of cocaine and Valium?
1. Peer pressure is usually responsible for these accidental overdoses.
2. All behavior has meaning, so we will focus on trying to understand the meaning of the drug use as well as the
occurrence of overdose.
3. Use of Valium probably means your child accidentally overdosed by trying to treat the effects of cocaine.
4. Adolescence is such a painful time. Rehabilitation programs give kids a chance to get away from their
everyday pressures.
Correct Answer: 2
Rationale 1: To understand clients actions, the psychiatricmental health nurse must identify the meanings those
actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life
stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatric
mental health nurses take into account the social and cultural environment of each client and not make
generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that
is unsubstantiated or reflects the nurses personal point of view.
Global Rationale:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Question 3
Type: MCSA
A grieving widow tells a psychiatricmental health nurse, I feel so tired and alone. The nurse who incorporates
an understanding of symbolic interactionism in practice would not suggest which of the following to the client?
1. You had a terrible loss. Feeling tired and alone must be very difficult for you.
2. I would like to hear more about how you are feeling now.
3. Try to get plenty of rest. Most people who suffer losses like yours need more sleep than usual to cope
effectively.
4. You seem sad. Can I sit with you for a while?
Correct Answer: 3
Rationale 1: Giving advice and suggesting that the meaning of the widows loss is typical invalidates the persons
unique experience, a basic premise of symbolic interactionismthat people interpret the world in their own way.
Other responses indicate an understanding that a clients actions and feelings are important and unique, and set the
stage to help the person begin to exert control over feelings and life.
Global Rationale:
Client Need Sub:
Question 4
Type: MCSA
The nurse received the change-of-shift report on a 74-year-old woman admitted for depression. She has aphasia
from a recent stroke and communicates minimally by using pencil and paper. Her college-age grandson moved in
with her to help with meals and household chores and a home health aide provides daily assistance with ADLs
and medications. For the past week, she has refused to bathe, eats poorly, and has stopped writing. Which of the
following statements best demonstrates that the nurse has the ability to plan holistic care for this client?
1. The clients psychobiologic health, rehabilitation, self-care potential, and discharge arrangements are
interrelated.
2. Reliance on the grandson and home health aide have decreased her feelings of self-worth and caused this
episode of depression.
3. The clients quality of life and prognosis are primarily related to her aphasia and inability to communicate.
4. Sudden life changes, such as a stroke, usually lead to depression in older clients.
Correct Answer: 1
Rationale 1: A holistic assessment of a client accounts for the interrelated effects of the clients social and cultural
environment as well as psychobiological health. Nurses must not assume they understand the meaning that
symptoms have to the clients quality of life, capacity to improve, or need for independence. While life changes at
any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order
to plan effectively.
Global Rationale:
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Question 5
Type: MCSA
Which statement best describes a holistic-interactional approach to nursing care for clients with mental disorders?
1. Clients with psychotic symptoms rarely indicate an interest in creative activities.
2. Medication is the only treatment required to manage affective symptoms for clients with mood disorders.
3. Developing comfortable relationships with clinicians is the major factor in maintaining mental health.
4. I always try to understand the complex relationship between a clients psychobiologic health and expressions
of self-esteem.
Correct Answer: 4
Rationale 1: Healing and caring must be approached in a holistic manner. With all disorders, the holisticinteractional approach to nursing must include an understanding of both biological and psychological
interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included
as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships.
Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.
Global Rationale:
Client Need Sub:
Question 6
Type: MCSA
When planning care for clients on the mental health unit, the nurse using principles of humanism would consider
which of the following?
1. Clinical interventions are most effective when they focus on the current actions, feelings, and concerns of
clients.
2. Clients rely on providers to develop solutions for their problems.
3. Emotional stress has a relationship to physical symptoms.
4. The mindbody relationship focuses on biological explanations of illness.
Correct Answer: 3
Rationale 1: A humanistic-interactional view indicates physical and mental factors are interrelated and that a
change in one may result in a change in another. Principles of humanism stress that people have the power or
potential to solve their own problems and are not passive recipients of care given by psychiatric professionals.
People are influenced by their past and the full range of life experiences, not simply by the present situation.
Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.
Global Rationale:
Client Need Sub:
Learning Outcome: Discuss the major principles of humanism.
Question 7
Type: MCSA
The psychiatricmental health nurse understands that the philosophy underlying humanistic practice means which
of the following?
1. Nurses must develop interests related to human beings, wherever they live and whatever their status or culture,
in order to work for change within social and political systems.
2. The nurse must be cautious about empowering clients as they may make poor choices that impede their
progress.
3. The model for intervention and change requires that the nurse feel comfortable confronting clients when they
resist treatment goals.
4. Client and family education about the mental disorder and its treatment must be provided only when clients are
stable enough to accept their illness.
Correct Answer: 1
Rationale 1: The humanistic perspective on mental disorders implies an expanded role for psychiatricmental
health nurses who understand diversity and are prepared to work for change within social and political systems.
The model for intervention and change is one of negotiation and advocacy, not directive interventions.
Empowerment is a basic concept as the responsibility for change rests with the client who is viewed as
accountable for his or her own behavior. Humanism contends that people have the potential to solve their own
problems, thus, clients and families must be involved in treatment from the beginning. This requires the nurse to
provide timely and complete psychoeducational information.
Global Rationale:
Client Need Sub:
Question 8
Type: MCSA
A nurse educator is teaching a group of students about humanism. The educator knows that humanism is a
philosophy of service to benefit humanity through applying which of the following concepts?
1. Science is the core consideration of humanistic philosophy.
2. Caring practices and compassion must be approached holistically.
3. Limitations of life in todays world have little effect on planning effective interventions.
4. Mental health clients must rely on clinicians for difficult decision-making and care.
Correct Answer: 2
Rationale 1: In humanistic philosophy, healing and caring are approached holistically. The philosophy accounts
for well-being within the limitations of life in todays world. Humanism purports that service to benefit humanity
is accomplished through reason, science, and democracy. Clients are not passive recipients of care but rather have
the potential to solve their own problems. They need to be supported and empowered to develop new perspectives
and make self-directed choices.
Global Rationale:
Client Need Sub:
Question 9
Type: MCSA
Which statement made by a nurse indicates an understanding of the basic premises of psychobiology?
1. All mental disorders can now be fully classified and cured with biological interventions.
2. By focusing on the biologic sciences, we will diminish the art of psychiatricmental health nursing.
3. Because of the advances in psychobiology, the role of psychiatricmental health nurses focuses primarily on
medication monitoring.
4. Genetics, immunology, biorhythms, brain structure, and brain biochemistry all influence mental disorders.
Correct Answer: 4
Rationale 1: Psychobiologic theory is growing rapidly and encompasses fields such as genetics, immunology, and
brain chemistry and structure. Nurses do not give up humanistic, psychosocial, and interactional premises simply
because of the breakthroughs being made in psychobiology. The psychobiologic model uses classification but also
includes notions that the disease follows a predictable course, not necessarily cure. To bring a contemporary
holistic perspective to care, nurses must integrate knowledge of psychobiology with social and humanistic
knowledge.
knowledge.
knowledge.
knowledge.
Global Rationale:
Client Need Sub:
Learning Outcome: Describe the influence of the knowledge explosion in psychobiology.
Question 10
Type: MCSA
A nurse on a medical unit overhears a discussion about the failure of psychobiologic interventions for clients with
mental disorders. Which statement could be made to counteract that supposition?
1. There is a current moratorium on development of new drugs to correct biochemical imbalances in the brain.
2. Contemporary research findings indicate that the field of psychobiology and effective interventions is growing
rapidly.
3. There are subjective reports that exposure to bright light and white noise provides effective treatment for
mental disorders.
4. Restriction of nutrients and non-nutrients is no longer believed to affect behavior.
Correct Answer: 2
Rationale 1: There are major breakthroughs in psychobiologic knowledge of the brain, the mind, the spirit, and
behavior. Research has generated new understanding of how genetics, immunology, biorhythms, brain structure,
and brain biochemistry influence mental disorders. New drugs are being tested and prescribed and psychobiologic
interventions such as exposure to bright light and white noise have been shown to affect behavior. Psychobiologic
interventions have become commonplace.
Global Rationale:
Cognitive Level: Creating
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Question 11
Type: MCSA
Which of the following statements best reflects the nurses comprehensive understanding of medical
psychobiologic theories?
1. Psychobiologic explanations of mental disorders do little to decrease the stigma associated with mental illness.
2. Individuals suffering from emotional disturbances have complex personalities that require changes in their
motivation and willingness to comply with treatment.
3. Mental disorders rarely respond to physical or somatic treatments.
4. Mental disorders have characteristic structural, biochemical, and mental symptoms that can be diagnosed, run a
characteristic course, and have a particular prognosis for recovery.
Correct Answer: 4
Rationale 1: Psychobiologic theory views mental illnesses as having characteristic structural, biochemical, and
mental symptoms that can be diagnosed, classified and labeled, running a characteristic course, and having a
particular prognosis for recovery. They respond to physical or somatic treatments, including drugs, chemicals,
hormones, diet, or surgery. Psychobiologic explanations are beginning to offset the myths that mental disorders
result from a lack of willpower or from flawed moral character and have reduced the stigma associated with them.
mental symptoms that can be diagnosed, classified, and labeled, running a characteristic course, and having a
Global Rationale:
Client Need Sub:
Question 12
Type: MCSA

Which of the following statements made by the nursing student best summarizes the medicalpsychobiologic
position on mental disorders?
1. Factors related to mental disorders can include excesses or deficiencies of brain neurotransmitters as well as
alterations in biologic rhythms, including the sleepwake cycle and genetic predispositions.
2. Mental illnesses with an organic cause have an unpredictable course and poor prognosis.
3. Mental disorders rarely respond to physical or somatic treatments without careful monitoring of progress by
clinicians in medical settings.
4. Biological interventions such as hormones, diet, and medications must be changed frequently as they are only
effective for short periods of time.
Correct Answer: 1
Rationale 1: Psychobiologic theories view the cause of mental illness as organic and as a deficit in central
nervous system functioning. Reimbursement for treatment is the primary reason hospital care is utilized. Mental
disorders respond to physical or somatic treatments unlinked to treatment settings. Intervention efficacy is based
on diagnosis and course of a disease process, not on a time-limited prediction. Mental disorders follow a
predictable course and are responsive to treatment when based on accurate diagnosis.
Global Rationale:
Client Need Sub:
Question 13
Type: MCSA
When meeting with a client for the first time, the psychiatricmental health nurse applying psychobiological
principles is most likely to make which of the following statements?
1. Your abnormal behavior is directly related to living in an unsupportive environment.
2. You have a brain lesion and can expect to be hospitalized many times over the course of your life.
3. We are thoroughly assessing your symptoms because an accurate diagnosis is the basis of your treatment.
4. It is fairly certain that your children will feel stigmatized by their peers.
Correct Answer: 3
Rationale 1: Individuals with mental disorders have an illness characterized by structural, biochemical, and
mental symptoms that can be diagnosed, classified, and labeled. Accurate assessment and diagnosis are required
for treatment. The nurse who links environmental cause to symptoms in an initial meeting is not demonstrating
knowledge of psychobiologic principles. The course and prognosis of a mental illness must be determined after an
accurate diagnosis is made. Psychobiologic explanations of mental disorders often decrease the stigma associated
with them.
with them.
with them.
with them.
Global Rationale:
Client Need Sub:

Question 14
Type: MCSA
In comparing the major features of psychiatric theories, the nurse correctly concludes that:
1. Medicalpsychobiologic and psychoanalytic theories focus on the individual client.
2. Socialinterpersonal and medicalpsychobiologic theories seek to change behavior through pharmacology.
3. Socialinterpersonal and medicalpsychobiologic theories are in direct opposition to the other.
4. Cognitive behavioral and psychoanalytic theories share the premise that behavior stems from the unconscious
and requires the client to develop insight.
Correct Answer: 1
Rationale 1: Medicalpsychobiologic theory focuses on the individuals genetics, immunology, biorhythms, brain
structure, and brain biochemistry and psychoanalytic theory focuses on individual insight. Cognitive behavioral
theory focuses on conscious feelings, thoughts, and meanings to develop interventions while psychoanalytic
theory focuses on the role of the unconscious in developing insight. Socialinterpersonal theory focuses on self
and social systems while psychobiologic theories focus on psychopharmacology and other biologic therapies.
Socialinterpersonal and medicalpsychobiologic theories can be used holistically to understand the full range of
a persons health and response to illness.
Global Rationale:
Client Need Sub:
Learning Outcome: Explain how the premises of human interactionism and psychobiology relate to psychiatric
mental health nursing.
Question 15
Type: MCSA
Sullivans interpersonal theory focusing on the clients relationships with others and modes of interacting with
others is most similar to the theory developed by:
1. Emil Kraepelin.
2. Karl Menninger.
3. B. F. Skinner.
4. Sigmund Freud.
Correct Answer: 2
Rationale 1: Menninger viewed normal personality functioning and psychopathology in terms of general systems
theory, a school of interpersonal theory. Skinners work is associated with cognitive behaviorist treatment not
interpersonal approaches. Kraepelins descriptive diagnostic classification system was the first comprehensive
medical model and the basis of psychobiological theories. Sigmund Freuds emphasis was on intrapsychic rather
than interpersonal processes.
Global Rationale:
Client Need Sub:
Question 16
Type: MCSA
The nurse who applies a conceptual framework that integrates the biologic and social sciences with the physical
sciences in assessing clients is using:
1. Ericksons eight stages of development.
2. The medical model.
3. Social interactionism.
4. General systems theory.
Correct Answer: 4
Rationale 1: General systems theory, when applied to people, provides a conceptual framework for integrating
the biologic and social sciences with the physical sciences. The medical model of care focuses on diagnostic
categorization and medical treatments. Social interactionism stresses the general climate in the clients
environment and attempts to understand the social and cultural conditions influencing behavior. Eriksons
developmental theory of personality highlights tasks that individuals must accomplish in order to advance
developmentally.
developmentally.
developmentally.
developmentally.
Global Rationale:
Client Need Sub:
Question 17
Type: MCSA
When providing orientation to a group of students, the psychiatricmental health nurse describes use of an
eclectic clinical approach with newly admitted clients with a diagnosis of schizophrenia. Which of the following
statements most accurately reflects the therapeutic value of an eclectic approach?
1. There is limited scientific evidence about treatment for schizophrenia, so a variety of medications and
interventions must be tried over time.
2. Nurses do not need a philosophy of care to direct their practice.
3. It is difficult to determine a final plan of care for new clients with psychotic disorders.
4. Strategies from one or a combination of psychiatric theories are used to determine interventions and evaluation
criteria for working with each client.
Correct Answer: 4
Rationale 1: Eclectic approaches use one psychiatric theory or a combination of psychiatric theories to determine
what assessment information, interventions, approaches, and evaluation criteria are needed for any given client.
An eclectic approach does not indicate indecision or use of interventions that are unsupported by evidence. An
eclectic approach does not indicate a nurse is aphilosophical, but rather demonstrates that a range of theories are
used to understand the best way to approach assessing and planning care for different clients.
Global Rationale:
Client Need Sub:
Question 18
Type: MCSA
A holistic view of the mindbody relationship is best demonstrated by which of the nurses comments to a student
nurse?
1. My view is that clients have physical problems that have emotional consequences and psychological issues
that cause physical problems.
2. Psychiatric clients often blame their problems on the side effects of the medications.
3. Clients come and go so quickly, we cant always complete a thorough physical exam.
4. We might as well be working on a medical unit. We focus mostly on medication management now.
Correct Answer: 1
Rationale 1: The humanisticinteractional view is that physical and mental factors are interrelated and that a
change in one may result in a change in another. Healing and caring must be approached in a holistic manner. The
nurse must help clients deal with the biologic aspects of their illness as well as emotional patterns and aspects of
biologic experiences. Nurses must incorporate humanistic and interactional approaches and not simply rely only
on psychopharmacology. Our practice and research must integrate high tech and high touch, nature and
nurture, the biologic sciences, and the behavioral sciences.
Global Rationale:
Client Need Sub:
Question 19
Type: MCSA
The nursing student is studying the psychoanalytic theory. The student knows that which one of the following
statements is not consistent with the psychoanalytic theory?
1. The structural model of the mind contends that the id, ego, and superego have specific interrelated functions.
2. Psychic determinism means that no behavior is accidental.
3. Psychoanalysis deals with the conscious mind.
4. Psychoanalytic therapy focuses on a dynamic view of mental phenomena rather than on the classification of
illness.
Correct Answer: 3

Rationale 1: Psychoanalysis is a powerful method for studying the unconscious. Freud introduced the structural
model of the mind which includes the id, ego, and superego which allies [interrelates] with the ego to control
impulses of the id. Freuds work shifted the focus of psychiatry from classification to a dynamic view of mental
phenomena. Psychic determinism states that no human behavior is accidental.
Global Rationale:
Cognitive Level: Applying
Client Need Sub:
Learning Outcome: Compare and contrast the assumptions and key ideas of medicalpsychobiologic,
psychoanalytic, cognitivebehavioral, and socialinterpersonal theories.
Question 20
Type: MCSA
The nurse educator knows the approach that helps a client develop insight is aligned with which of the following
theories?
1. Cognitive behavioral theory
2. Psychoanalytic theory
3. Socialinterpersonal theories
4. Medicalpsychobiologic theory
Correct Answer: 2
Rationale 1: Psychoanalysis is a method for studying the unconscious through clarifying the meaning of events,
feelings, and behavior and thereby gaining insight about them. Medicalpsychobiological theory views the cause
of mental illness as organic, located in the central nervous system, following a predictable course, and treated
based on accurate diagnosis. Cognitive behavioral theory focuses on the present rather than the past. Social
interpersonal theories focus on crucial social processes and cultural variation involving the development,
identification, and resolution of disturbed human responses.
Global Rationale:
Client Need Sub:
Question 21
Type: MCSA
Which statement indicates that the nurse understands the developmentalinterpersonal perspective of the selfsystem?
1. A persons sense of security is primarily derived from doing well in school.
2. Security is only achieved when a child discovers his or her autonomy.
3. Feelings of self-worth are established during infancy.
4. Childhood experiences influence the way people view and understand themselves.
Correct Answer: 4
Rationale 1: The self is a construct built from the childs experiences. To feel secure, the self requires feelings of
approval and prestige as protection against anxiety across all developmental stages.
Global Rationale:
Client Need Sub:
Question 22
Type: MCSA
In explaining cognitive behavioral theory to a student, the nurse would not describe the concept of:
1. Reinforcement.
2. Psychic determinism.
3. Conditioned response.
4. Shaping.
Correct Answer: 2
Rationale 1: Psychic determinism is associated with psychoanalytic theory. Shaping, reinforcement, and
conditioned responses are concepts linked to cognitive behavioral theory.
Global Rationale:
Client Need Sub:
Question 23
Type: MCSA
A nursing student is preparing a presentation on Eriksons developmental theory. The student wants to include in
the presentation that Eriksons eight developmental stages are most closely aligned with:
1. Cognitive behaviorist concepts.
2. Maslows theory of self-actualization and hierarchy of needs.
3. Freuds psychosexual stages.
4. Sullivans stages of interpersonal development.
Correct Answer: 4
Rationale 1: Like Eriksons developmental theory, Sullivan believed that learning and development occur across
the lifespan and that people can relearn tasks previously unaccomplished at earlier stages of life. Freud believed
all developmental tasks were accomplished by a certain age, and unaccomplished tasks left individuals fixated at a
particular stage causing lifelong psychiatric problems. Cognitive behaviorist concepts do not account for
developmental tasks. Maslow proposed an order of basic human needs that were not linked to developmental
stages or tasks. According to Maslow, physiologic needs must be met before higher-level needs such as selfesteem and self-actualization.
Global Rationale:
Client Need Sub:
Question 24
Type: MCSA
Nursing roles associated with shifts in the delivery of psychiatric services to social and community settings would
not include:
1. Leading community support groups for couples receiving genetic counseling.
2. Providing case management as part of an interdisciplinary team.
3. Participating as a member of a community board for social planning activities.
4. Providing individual therapy in a private practice setting.
Correct Answer: 4
Rationale 1: Traditional private practice is not associated with population or community-based levels of service,
particularly groups previously neglected, or suffering from the effects of long-term institutionalization. Case
management, participation in social planning, and providing supportive interventions and community support to
various populations are all part of the shift of services from private to community settings.
Global Rationale:
Client Need Sub:
Question 25
Type: MCSA
The humanistic perspective on mental disorders implies that psychiatricmental health nurses function in
expanded roles. Which statement does not reflect this perspective?
1. Psychiatricmental health nurses are prepared to work for change within social and political systems.
2. Psychiatricmental health nursing focuses on the client and does not deal with social or political consequences.
3. Psychiatricmental health nurses develop philosophic and ethical frameworks to guide and evaluate the
political outcomes of therapeutic intervention.
4. Psychiatricmental health nursing is involved in social goals that advance health holistically.
Correct Answer: 2
Rationale 1: Psychiatricmental health nursing includes client-oriented activities as well as involvement in social
goals that advance health holistically. Because psychiatricmental health nursing has political consequences,
nurses must be prepared to influence social and political systems, and contribute to development and evaluation of
ethical frameworks to evaluate outcomes of therapeutic intervention at individual and system levels.
Global Rationale:
Client Need Sub:
Learning Outcome: Discuss the implications of each theory for the practice of psychiatricmental health
nursing.
Question 26
Type: MCSA
The heart of the psychiatricmental health nurses therapeutic and caring role is characterized by:
1. Bringing unconscious childhood traumas into awareness.
2. Focusing on basic life issues of eating, sleeping, grooming, and hygiene as they relate to mental functioning.
3. Using the nurseclient relationship to support the client in exploring new definitions and actions for life
situations.
4. Providing educational information about the clients mental illness.
Correct Answer: 3
Rationale 1: The humanistic use of self includes helping clients redefine their experiences in more satisfying
ways, learn new patterns of coping with stress, and generally enhancing the quality of their lives and social
worlds. Focusing on physical functioning is part of, but not the essence of, the therapeutic relationship. Unless
educated in psychoanalysis, nurses do not focus on uncovering unconscious experiences. Psychoeducation is part
of the nursing role, but not the main focus of the nurseclient therapeutic relationship.
Global Rationale:
Client Need Sub:
nursing.
Question 27
Type: MCSA
The psychiatricmental health nurses scope of practice includes:
1. Developing a comfortable relationship with the client.
2. Establishing a routine for clients to manage basic life issues of eating, sleeping, grooming, and hygiene.
3. Identifying client reasons for failure to comply with recommended treatments.
4. Exploring the meaning of life experiences such as birth and death, losses, life course changes, and human
rights.
Correct Answer: 4
Rationale 1: The nurses key role is to help clients examine a full range of life experiences in more satisfying
ways, learn new patterns of coping with stress, and generally enhance the quality of their lives and social worlds.
Focusing on failure of compliance undervalues concepts of human choice and empowerment within the nurse
client relationship. The goal of the nurseclient relationship is to create a therapeutic rather than a comfortable
relationship. The scope of the nurses role includes understanding and facilitating exploration of client issues
related to basic functions rather than assuming that issues need to be managed and understood separate from the
holistic view of the person.
Global Rationale:
Client Need Sub:
nursing.
Question 28
Type: MCSA
A middle-aged parent goes to the emergency room for symptoms of dizziness, headache, and suicidal ideation.
The nurse assesses the patient for substance use, employment, child-rearing stressors, relationships with
coworkers, recurring physical symptoms, and marital problems. The nurse is:
1. Failing to focus on the seriousness of the primary presenting problem.
2. Establishing rapport that will decrease the likelihood of suicide.
3. Doing more than the nurses share of the interdisciplinary assessment.
4. Formulating a holisticinteractional assessment needed to interpret clinical data.
Correct Answer: 4
Rationale 1: The nurse must conduct a holistic assessment and synthesize factors from many aspects of an
individuals life to determine an effective plan of care. The nurse functions as an autonomous member of the
mental health team and assumes a broad range of responsibilities within the RN scope of practice. Belief that
developing rapport will decrease suicidal ideation indicates a knowledge deficit regarding the phenomenon of
depression/suicidal ideation, and an unrealistic perspective on the role of the nurse. Predetermining what the
presenting problem is before making a thorough holistic assessment indicates that the nurse does not understand
the complexity of the human condition.
Global Rationale:
Client Need Sub:
nursing.
Question 29
Type: MCSA
The psychiatricmental health nurse is asked to prepare an educational conference for unlicensed staff working in
a day treatment program for hyperactive children with borderline intelligence. Using fundamental concepts of
cognitive behaviorist theory, which of the following conference exercises would the nurse include?
1. Have a contest to choose the best staff-designed time-out room where children can comfortably spend
significant periods alone.
2. Include sessions for staff to practice talking with parents about the benefits of having their child transferred to
an institutional setting where he or she would have access to highly trained experts.
3. Ask staff to work in teams to develop a token economy program that uses a prescribed daily routine and
reinforcers for the children.
4. Show a brief movie that demonstrates the simplicity of using behavior modification.
Correct Answer: 3
Rationale 1: In token economies, clients follow prescribed schedules for daily living in which they are rewarded
for desired behavior by token reinforcers, such as food, candy, and verbal approval. Time-outs are only used for
short periods of isolation to decease undesired behavior. Children with hyperactivity or borderline intelligence can
be treated in the home when parents are taught how to use effective approaches. Treatment no longer requires the
presence of highly trained experts. Behavior modification is complex, and nonprofessional staff must be taught
the effective use of behaviorist principles to eliminate chronic, maladaptive behavior.
Global Rationale:
Client Need Sub:
nursing.
Question 30
Type: MCSA
The psychiatricmental health nurse is asked to consult with an emergency room nurse about a client who has
been refusing to cooperate with lab work for over four hours. The client appears frightened, answers questions
reluctantly, and has no family present. Which response of the psychiatricmental health nurse demonstrates a
humanisticinteractional approach to the situation?
1. Have you asked if the client wants to have a friend or family member to be here?
2. Have you offered medication for anxiety?
3. Give the client some time alone to decide whether or not to accept treatment.
4. I would ask for a full psychiatric evaluation before discharge.
Correct Answer: 1
Rationale 1: Since all behavior has meaning, appearance and non-verbal cues suggest the client is fearful and
potentially alienated. The offer to include someone from the clients larger support system recognizes the need for
safety, security, and feeling connected with others. Suggesting medication for anxiety is premature without further
assessment and underscores that the client is not in control of his or her emotions. The statement that a full
psychiatric evaluation is needed suggests that the client has a larger problem which has not been unsubstantiated
by a holistic assessment, further stigmatizing the client. Allowing the client to remain isolated overlooks the
opportunity to develop a relationship where shared understanding can develop.
Global Rationale:
Client Need Sub:
nursing.


Kneisl 3e TIF CH05

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Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

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Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

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