Question 1

2-Which indicates a client is likely demonstrating a mental disorder?

Accepted Answer

1.This is incorrect. The client is expressing normal behaviors related to mild anxiety appropriate to a situation, in this case an examination. Mild anxiety can be beneficial to improve performance.
2.This is correct. The client is unable to concentrate, and job performance has been negatively impacted. This demonstrates a possible mental disorder.
3.This is incorrect. Fidgeting behavior over a short-term period is a common psychological adaptive response to mild anxiety. This does not suggest a mental disorder.
4.This is incorrect. Smoking or increasing smoking over a few days is a common response to stress and suggests mild anxiety, which does not suggest a mental disorder.

Question 2

A mental health nurse is speaking with parents who are concerned about their teenage children's responses to stress. One child becomes anxious and irritable and the other withdraws and cries. Which is the nurse's best response?

Accepted Answer

1.This is correct. Responses to stress are variable among individuals and may be influenced by perception, past experiences, environmental factors, and genetic factors.
2.This is incorrect. Responses to stress vary among individuals; even those within the same family will have different stress responses.
3.This is incorrect. Children, like adults, will demonstrate various responses to stress, depending on factors such as environment, past experiences, and perceptions.
4.This is incorrect. Responses to stress depend on genetic factors, perception, past experiences, and environmental factors.

Question 3

Which best describes the impact that the National Mental Health Act of 1946 had on care for the mentally ill in the United States?

Accepted Answer

1.This is incorrect. Hippocrates work around 400 BC and work during the Middle Ages reduced the perception that those with mental illness were demonized.
2.This is correct. The National Mental Health Act of 1946 helped provide funding for educating mental health professionals who could provide care to the mentally ill.
3.This is incorrect. A system of hospitals for the mentally ill was developed largely due to the work of Dorothea Dix during the19th century.
4.This is incorrect. The first hospital for the mentally ill was opened in the mid-18th century.

Question 4

The nurse recognizes that a client is mildly anxious when beginning a session that incudes client teaching. Which is the most appropriate interpretation of the situation?

Accepted Answer

1.This is incorrect. Waiting until the client is more anxious will reduce learning. Mild anxiety enhances learning.
2.This is correct. Mild anxiety sharpens the senses, increases the perceptual field, and results in heightened awareness of the environment. Learning is enhanced.
3.This is incorrect. With no anxiety present, the client does not have heightened awareness or increases in perceptions, which may reduce learning, compared with a state of mild anxiety.
4.This is incorrect. The presence of mild anxiety does have an impact on perception and awareness, is likely to enhance learning, and does need to be considered when interacting with a client.

Question 5

Which psychoneurotic responses to severe anxiety are identified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)?

Accepted Answer

1.This is correct. 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.
2.This is incorrect. Grief reaction is not a psychoneurotic response to severe anxiety identified in the DSM-5.
3.This is incorrect. Psychosis is not a psychoneurotic response to severe anxiety identified in the DSM-5.
4.This is incorrect. Bipolar disorder is not a psychoneurotic response to severe anxiety identified in the DSM-5.

Question 6

A supervisor openly disagrees with an employee's suggestions during a staff meeting. Which response by the employee would demonstrate the defense mechanism of displacement?

Accepted Answer

1.This is incorrect. Assertively confronting the supervisor is not an example of displacement.
2.This is incorrect. Abruptly leaving the staff meeting is not an example of displacement.
3.This is correct. Displacement refers to transferring feelings from one target to a neutral or less-threatening target. Angrily criticizing a coworker after the disagreement with the supervisor is an example of the defense mechanism of displacement.
4.This is incorrect. Working to become a supervisor may demonstrate the defense mechanism of identification. It is not an example of displacement.

Question 7

A high school student is attracted to a female teacher. The student is uncomfortable with his feelings and says to his friend, "I know she wants me." Which defense mechanism is the student demonstrating?

Accepted Answer

1.This is incorrect. Displacement refers to transferring feelings from one target to another.
2.This is correct. 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.
3.This is incorrect. Rationalization refers to making excuses to justify behavior.
4.This is incorrect. Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable activities.

Question 8

An eighth-grade boy is uncomfortable with his feelings for an older girl and interest in her. He teases the girl whenever he gets a chance and makes jokes about her appearance. The school nurse identifies the boy as using which defense mechanism?

Accepted Answer

1.This is incorrect. Displacement refers to transferring feelings from one target to another.
2.This is incorrect. Projection refers to the attribution of unacceptable feelings or behaviors to another person.
3.This is correct. The boy is using the defense mechanism of reaction formation. Reaction formation is the attempt to prevent undesirable thoughts from being expressed by expressing opposite thoughts or behaviors.
4.This is incorrect. Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable activities.

Question 9

Which disorder does the nurse recognize as a disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)?

Accepted Answer

1.This is incorrect. Morbid obesity is a medical disorder. The DSM-5 delineates diagnostic criteria for psychiatric disorders.
2.This is correct. The DSM-5 identifies several mental health disorders that are related to anxiety, including generalized anxiety disorder, somatic symptom disorder, and dissociative disorders.
3.This is incorrect. Essential hypertension is a medical disorder. The DSM-5 delineates diagnostic criteria for psychiatric disorders.
4.This is incorrect. Bereavement is considered a normal response to loss and is not included in the DSM-5. The DSM-5 delineates diagnostic criteria for psychiatric disorders.

Question 10

When the general population cannot understand the motivation behind one's behavior, which would be the appropriate term to use?

Accepted Answer

1.This is incorrect. Anxiety is a feeling of discomfort and apprehension related to fear of impending danger.
2.This is incorrect. Defense mechanisms are protective devices used to relieve mild to moderate anxiety.
3.This is incorrect. Cultural relativity is the understanding that rules, conventions, and understandings are based on one's culture.
4.This is correct. Incomprehensibility relates to the inability of the general population to understand the motivation behind one's behavior.

Question 11

Which behaviors indicate a client is experiencing moderate anxiety? Select all that apply.

Accepted Answer

1.This is correct. Gastric discomfort occurs with moderate anxiety.
2.This is incorrect. Urinary frequency occurs with severe anxiety.
3.This is incorrect. Palpitations are symptoms of severe anxiety.
4.This is correct. Moderate anxiety may result in an increased focus on self.
5.This is incorrect. Feelings of dread are symptomatic of severe anxiety.

Question 12

For which reasons is the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) useful in the practice of psychiatric-mental health nursing? Select all that apply.

Accepted Answer

1.This is correct. The DSM-5 is useful in the practice of psychiatric-mental health nursing because it provides information about accurate and reliable psychiatric diagnoses.
2.This is correct. The DSM-5 encourages a holistic view of mind and body and provides a framework for interdisciplinary communication.
3.This is correct. The DSM-5 provides a framework for interdisciplinary communication.
4.This is incorrect. The DSM-5 does not provide templates for nursing care plans.
5.This is incorrect. The DSM-5 does not provide a framework for communication with the client.

Question 13

Meditation has been shown to be an effective stress management technique. Which finding indicates meditation has been effective?

Accepted Answer

1.This is correct. Meditation produces relaxation by creating a special state of consciousness through focused concentration.
2.This is incorrect. Meditation does not necessarily result in attaining insight into one's feelings.
3.This is incorrect. Meditation does not help to demonstrate appropriate role behaviors.
4.This is incorrect. Meditation does not necessarily enhance one's ability to solve problems.

Question 14

The client is hospitalized with coronary artery disease and demonstrates other conditions often associated with diseases of adaptation, including headaches and depression. Currently, the client is demonstrating anxiety and states he is
"really worried" about his spouse. Which is the most appropriate nursing response to the situation?

Accepted Answer

1.This is incorrect. Informing the client that he needs to learn something new at this time will likely increase his stress and is not helpful to the immediate situation.
2.This is incorrect. Teaching the client mediation is not appropriate at this time, when he is expressing the anxiety and concerns about his spouse.
3.This is correct. Interpersonal communication can assist the nurse to understand the client's concerns and allows the client to reduce the escalation of stress at this time.
4.This is incorrect. While this may be helpful in some situations, it is not something that can address the client's immediate needs.

Question 15

Place the selected steps of the problem-solving process in the correct order.
1. Determine risks and benefits of each option.
2. Formulate goals to resolve the stressful situation.
3. Implement a second alternative.
4. Study the alternatives for dealing with the situation.

Accepted Answer

Problem-solving is an adaptive coping strategy in which an individual views the situation objectively and applies a decision-making model. The steps of the problem-solving process are: (1) Assessing the facts of the situation; (2) formulating goals for resolution of the stressful situation; (3) studying the alternatives for dealing with the situation; (4) determining the risks and benefits of each alternative; (5) selecting an alternative; (6) implementing the selected alternative; (7) evaluating the outcome of the alternative implemented; and (8) if the first choice is ineffective, selecting and implementing a second option.

Quiz 1: Mental Health and Mental Illness: Historical and Theoretical Concepts