Question 1

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

Accepted Answer

Coping resources include economic assets,abilities,skills,defensive techniques,social supports,and motivation.Coping mechanisms can be defined as any effort directed at stress management and include problem-focused,cognitive-focused,and emotion-focused mechanisms that can be constructive (assets) or destructive (liabilities).

Question 2

An adolescent who belongs to a neighborhood gang has been caught both lying and stealing by a parent.After psychiatric testing determines that the adolescent is able to adequately test reality and has no symptoms of a major psychiatric disorder,the most likely finding will be that the child's behavior demonstrates:

Accepted Answer

Alternative or deviant social behaviors are not necessarily indicative of illness.

Question 3

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

These factors relate directly to autonomy,the condition that allows for definition and control over a domain.

Question 4

Precipitating stressors are stimuli that:

Accepted Answer

Precipitating stressors are stimuli that the individual perceives as challenging,threatening,or demanding.Dealing with them requires extra energy and produces a state of tension and stress.

Question 5

A nurse states,"I don't understand why the Stuart Stress Adaptation Model uses both the health/illness and adaptation/maladaptation continua." The best reply is:

Accepted Answer

The correct option mimics the explanation provided by the author of the text.

Question 6

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

The answer is the only option that addresses comparative treatment efficacy,providing data that show that there are physical illnesses with poorer treatment results than the mental illness that the spouse is experiencing.The remaining options do not attempt to provide a response to the spouse's original statement regarding the comparison between physical and mental illnesses.

Question 7

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

Accepted Answer

The Stuart Stress Adaptation Model is holistic,views nature as ordered on a social hierarchy,regards adaptation/maladaptation as distinct from health/illness,relates nursing activities to levels of prevention and the four stages of treatment,is based on standards of psychiatric nursing care and professional performance,and can be used across psychiatric settings throughout the care continuum.

Question 8

On the basis of predictions from the Global Burden of Disease Study,mental health professionals should be most concerned with increasing primary prevention efforts for:

Accepted Answer

The study predicted that by the year 2020,major depressive disorder would become the second leading factor in disease burden worldwide.

Question 9

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

Accepted Answer

The initial barrier to a patient seeking mental health treatment is insufficient or nonexistent health care insurance coverage for the treatment of mental illness.While the other options are factors that have a positive effect on mental health care delivery,they become relevant only after a patient seeks and/or begins treatment.

Question 10

Which predisposing factors most influence mental illness?

Accepted Answer

Predisposing factors include biological,psychological,and sociocultural components.Predisposing factors are those that place a person at risk for development of a stress-related disorder.

Question 11

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

Accepted Answer

The patient who has lost a parent and a job is dealing with two stressful life events that are socially undesirable.The patient's cognitive appraisal of the stressors is that of loss and threat of loss.The patient gives no indication of psychological hardiness.The other people described are dealing with change they perceive as challenging but to which they are committed and over which they have some control.These factors indicate psychological hardiness.

Question 12

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

Caplan described four phases of an individual's responses to stressful events.The patient's behavior is representative of Phase 1.

Question 13

Nursing diagnoses:

Accepted Answer

Responses to stress,whether actual or potential,are the subject of nursing diagnoses.Nursing diagnoses complement rather than replace medical diagnoses.

Question 14

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

Accepted Answer

Nursing diagnosis is concerned with the adaptive/maladaptive continuum of human responses; medical diagnosis is concerned with the health/illness continuum of health problems.Nurses assess risk factors and look for vulnerabilities; physicians assess disease states and look for causes.Nursing intervention consists of caregiving activities; medical intervention consists of curative treatments.

Question 15

A nurse taking the history of a patient diagnosed with depression discovers that the patient has a number of life strains and daily hassles.The patient and patient's spouse argue frequently,the teenage children in the family are rebellious,and there is seldom enough money to meet all the bills.In what way is this information relevant?

Accepted Answer

Research suggests that daily hassles may be better predictors of psychological and physical health than major life events.The more frequent and intense the hassles people reported,the poorer was their overall mental and physical health.

Question 16

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

Reality perception is the individual's ability to test assumptions about the world with empirical thought.Hallucinations and delusions indicate problems with reality perception.

Question 17

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

Integration refers to a balance between what is expressed and what is repressed and a regulation of moods and emotions,and it includes the characteristics mentioned in the question.

Question 18

A patient mentions,"No one else I know is mentally ill." What reply would help the patient understand the extent of mental illness?

Accepted Answer

The question asks for a reply relevant to the extent of mental illness.Denying the patient's expressed concern or minimizing that concern is not therapeutic.

Question 19

A patient in the emergency room of a local community hospital is crying uncontrollably and repeating over and over,"He will hurt me if I don't get away from him.You have to help me,please." Which of the following interventions reflects attention to care in the manner advocated by the assumptions stated in the Stuart Stress Adaptation Model?

Accepted Answer

The primary responsibility of the psychiatric nurse according to the fifth assumption of the Stuart Stress Adaptation Model is to use the nursing process,standards of care,and professional performance,which,in this case,should start with a nursing assessment.The remaining options are specific interventions that are determined to be appropriate by the assessment data.

Question 20

A patient newly diagnosed with Chron's disease shares she is spending several hours each week on the Internet seeking information about the illness.The nurse can correctly hypothesize that this patient is initially:

Accepted Answer

Social response to stress and illness involves the search for meaning,which is a period of time in which people seek information about their problem.It is only after a search for meaning that the patient can begin devising a coping strategy.

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