Question 1

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

Rationale: 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 2

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

Accepted Answer

Rationale: The nurse should define the concept of neurosis with 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 3

A nurse is assessing a client who appears to be experiencing some anxiety during questioning.Which symptoms might the client demonstrate that would indicate anxiety? (Select all that apply.)

Accepted Answer

Rationale: The nurse should assess that fidgeting,laughing inappropriately,and nail biting are indicative of heightened stress levels.The client would not be diagnosed with mental illness unless there is significant impairment in other areas of daily functioning.Other indicators of more serious anxiety are restlessness,difficulty concentrating,muscle tension,and sleep disturbance.

Question 4

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

Accepted Answer

Rationale: 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 to seek treatment for mental health problems than men.

Question 5

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

Accepted Answer

Rationale: 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 6

_______________________ is a subjective state of emotional,physical,and social responses to the loss of a valued entity.

Accepted Answer

Rationale: The definition of grief is a subjective state of emotional,physical,and social responses to the loss of a valued entity.Townsend considers this a core concept.

Question 7

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

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

Question 8

How would a nurse best complete the new DSM-5 definition of a mental disorder? "A health condition characterized by significant dysfunction in an individual's cognitions,or behaviors that reflects a disturbance in the

Accepted Answer

Rationale: "A health condition characterized by significant dysfunction in an individual's cognitions,or behaviors that reflects a disturbance in the psychological,biological,or developmental process underlying mental functioning",is the new DSM 5 definition of a mental disorder.

Question 9

Which nursing statement regarding the concept of psychosis is most accurate?

Accepted Answer

Rationale: The nurse should understand that the client with psychosis experiences little distress owing to his or her lack of awareness of reality.The client with psychosis is unaware that his or her behavior is maladaptive or that he or she has a psychological problem.

Question 10

A psychiatric nurse intern states,"This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement?

Accepted Answer

Rationale: The nurse should determine that defense mechanisms can be appropriate during times of stress.The client with no defense mechanisms may have a lower tolerance for stress,thus leading to anxiety disorders.Defense mechanisms should be confronted when they impede the client from developing healthy coping skills.

Question 11

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

Rationale: The nurse should evaluate that the client is in the acceptance stage of grief because 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 12

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

Accepted Answer

Rationale: The nurse should determine that the client is at risk for mental illness when responses to stress are maladaptive and interfere with daily functioning.The DSM-5 indicates that in order to be diagnosed with a mental illness,daily functioning must be significantly impaired.The client's ability to communicate distress would be considered a positive attribute.

Question 13

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

Rationale: 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.

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

Rationale: The nurse should expect that the client using the defense mechanism 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

A nurse is assessing a set of 15-year-old identical twins who respond very differently to stress.One twin becomes anxious and irritable,and the other withdraws and cries.How should the nurse explain these different stress responses to the parents?

Accepted Answer

Rationale: The nurse should explain to the parents that,although the twins have identical DNA,there are several other factors that affect reactions to stress.Mental health is a state of being that is relative to the individual client.Environmental influences and temperament can affect stress reactions.

Question 16

_______________________ is a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness.

Accepted Answer

Rationale: The definition of anxiety is a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness.Townsend considers this a core concept.

Question 17

When under stress,a client routinely uses alcohol to excess.Finding her drunk,her husband yells at the client about her chronic alcohol abuse.Which action alerts the nurse to the client's use of the defense mechanism of denial?

Accepted Answer

Rationale: The client's statement "I don't drink too much!" alerts the nurse to the use of the defense mechanism of denial.The client is refusing to acknowledge the existence of a real situation and the feelings associated with it.

Question 18

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

Rationale: 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.

Quiz 1: Mental Health and Mental Illness