Question 1

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

Accepted Answer

Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology.One of the diagnostic criteria is a high level of anxiety about health concerns or illness.

Question 2

Which statement reflects a student nurse's accurate understanding of the concepts of mental health and mental illness?

Accepted Answer

The student nurse should understand that mental health and mental illness are multidimensional and culturally defined.It is important for nurses to be aware of cultural norms when evaluating a client's mental state.

Question 3

When under stress,a client routinely uses an excessive amount of alcohol.Finding her drunk,her husband yells at her about the chronic alcohol abuse.Which reaction should the nurse recognize as the use of the defense mechanism of denial?

Accepted Answer

The nurse should associate the client statement "I don't drink too much!" with the use of the defense mechanism of denial.The client who refuses to acknowledge the existence of a real situation and the feelings associated with it is using the defense mechanism of denial.

Question 4

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

The nurse should know that defense mechanisms serve the purpose of reducing anxiety during times of stress.A client with no defense mechanisms may have a lower tolerance for stress,predisposing him or her to anxiety disorders.Defense mechanisms should be confronted when they impede the client from developing healthy coping skills.

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

The nurse should attempt to educate the client on the negative effects of excessive stress on medical conditions.It is not appropriate to skip either physiological or psychosocial questions,as this would lead to an inaccurate assessment.

Question 6

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

Responses to stress are variable among individuals and may be influenced by perception,past experience,and environmental factors in addition to genetic factors.

Question 7

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

Accepted Answer

The nurse should anticipate that the client of Jewish culture would place a high importance on preventative health care and would consider mental health as equally important as physical health.Women are also more likely than men to seek treatment for mental health problems.

Question 8

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

The nurse should recognize that the client is using rationalization,a common defense mechanism.The client is attempting to make excuses and create logical reasons to justify unacceptable feelings or behaviors.

Question 9

A fourth-grade boy teases and makes jokes about a cute girl in his class.This behavior should be identified by a nurse as indicative of which defense mechanism?

Accepted Answer

The nurse should identify that the boy is using reaction formation as a defense mechanism.Reaction formation is the attempt to prevent undesirable thoughts from being expressed by expressing opposite thoughts or behaviors.Displacement refers to transferring feelings from one target to another.Rationalization refers to making excuses to justify behavior.Projection refers to the attribution of unacceptable feelings or behaviors to another person.Sublimation refers to channeling unacceptable drives or impulses into more constructive,acceptable activities.

Question 10

A mental health technician asks the nurse,"How do psychiatrists determine which diagnosis to give a patient?" Which of these responses by the nurse would be most accurate?

Accepted Answer

The DSM-5 is an organized manual describing mental disorders and the criteria that determine whether a given diagnosis is appropriate.It is published by the American Psychiatric Association (APA).It intends to facilitate accurate and reliable medical diagnosis and treatment.Item C describes nursing rather than medical diagnosis.

Question 11

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

Mild anxiety sharpens the senses,increases the perceptual field,and results in heightened awareness of the environment.Learning is enhanced.As anxiety increases,attention span decreases and learning becomes more difficult.

Question 12

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

Accepted Answer

The nurse should understand that the client with psychoses experiences little distress,because of his or her lack of awareness of reality.The client with psychoses is unaware that his or her behavior is maladaptive or that he or she has a psychological problem.

Question 13

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

The nurse should recognize that the client is in the acceptance stage of grief.During this stage of the grief process,the client would be able to focus on the reality of the loss and its meaning in relation to life.

Question 14

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

The client using the defense mechanism of displacement would criticize a coworker after being confronted by the boss.Displacement refers to transferring feelings from one target to a neutral or less-threatening target.

Question 15

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

Accepted Answer

The nurse should understand that the concept of neuroses includes the following characteristics.The client feels helpless to change his or her situation,the client is aware that he or she is experiencing distress,the client is aware the behaviors are maladaptive,the client is unaware of the psychological causes of the distress,and the client experiences no loss of contact with reality.

Question 16

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

Accepted Answer

The nurse should immediately intervene when a client exhibits aggressive behavior toward another client.Safety and security are considered lower-level needs according to Maslow's hierarchy of needs and must be fulfilled before other,higher-level needs can be met.Clients who complain,have feelings of failure,or state that no one cares are struggling with higher-level needs such as the need for love and belonging or the need for self-esteem.

Question 17

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

Accepted Answer

The nurse should determine that the client is at risk for mental disorder when responses to stress are maladaptive and interfere with daily functioning.The DSM-5 indicates that in order to be diagnosed with a mental disorder,there must be significant disturbance in cognition,emotion,regulation,or behavior that reflects a dysfunction in the psychological,biological or developmental processes underlying mental functioning.These disorders are usually associated with significant distress or disability in social,occupational,or other important activities.The client's ability to communicate distress would be considered a positive attribute.

Question 18

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

The nurse should determine that the client's statement reflects the defense mechanism of projection.Projection refers to the attribution of one's unacceptable feelings or impulses to another person.When the client "passes the blame" of the undesirable feelings,anxiety is reduced.Displacement refers to transferring feelings from one target to another.Rationalization refers to making excuses to justify behavior.Sublimation refers to channeling unacceptable drives or impulses into more constructive,acceptable activities.

Question 19

A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet.The client's appetite,sleep patterns,and daily routine have not changed.How should the nurse interpret the client's behaviors?

Accepted Answer

The nurse should assess that the client's daily functioning is not impaired.The client who experiences feelings of sadness after the loss of a pet is responding within normal expectations.Without significant impairment,the client's distress does not indicate a mental illness.

Question 20

A nurse is performing a mental health assessment on an adult client.According to Maslow's hierarchy of needs,which client action would demonstrate the highest achievement in terms of mental health?

Accepted Answer

The nurse should identify that the client who possesses a feeling of self-fulfillment and realizes his or her full potential has achieved self-actualization,the highest level on Maslow's hierarchy of needs.

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