Deck 1: The Strength and Structure of Psychiatric Mental Health Nursing; Theoretical Basis for Psychiatric-Mental Health Nursing Practice and Process

Question 1

The nurse is teaching staff at a community mental health clinic about what constitutes a mental disorder. Which comment by staff indicates to the nurse the need for further teaching?

A) "Experiencing pain and suffering may imply a mental disorder."
B) "Being unable to function in everyday life is consistent with a mental disorder."
C) "Experiencing distressful symptoms may imply a mental disorder."
D) "Grieving after a loss may signal a mental disorder."

Answer 1

D

Question 2

During the evaluation of the effectiveness of the nurse's discharge teaching, which client report would indicate to the nurse that the client understands the leading cause of disability and decrement in health? The client reports a need to incorporate strategies to prevent:

A) Obesity.
B) Cancer.
C) Depression.
D) Anxiety.

Answer 2

C

Question 3

The nurse is assessing a client in the home. Given the nurse's knowledge of the top 10 causes of disability worldwide, choose the priority area for data collection.

A) Mood and patterns of alcohol usage
B) Social interactions and history of abuse
C) Irrational fears and quality of communication
D) Memory and childhood history

Answer 3

A

Question 4

The nurse is serving on a community task force to implement strategies to address Healthy People 2010 mental health problems. To evaluate the effectiveness of community interventions specific to Healthy People 2010, the nurse will want to measure which of the following?
Select all that apply.

A) Incidence of serious mental illness among homeless adults
B) Adolescent suicide rates
C) Number of employers who provide exercise programs for employees
D) High school drop-out rates
E) Emergency Department visits

Question 5

The psychiatric nurse is reflecting on the treatment and care of the mentally ill throughout history. Which of the following philosophical beliefs most guided treatment of the mentally ill during 17^th century Europe?

A) The mentally ill were possessed by evil spirits that inflicted emotional suffering.
B) The body's humors were responsible; blood, bile, and phlegm must be balanced.
C) Madness was best overcome by discipline and brutality.
D) The mentally ill were divinely inspired and should be treated with care and benevolence.

Question 6

The nurse plans to implement health promotion activities at the local senior citizen center. To meet the goal of promoting knowledge related to maximizing mental health and functional ability, the nurse's teaching is guided by World Health Organization research and should include discussion of which priority area specific to the leading causes of mental disability?

A) Over-the-counter medications
B) Dementia
C) Alcohol
D) Social isolation

Question 7

The nurse is planning teaching regarding major mental health problems in the United States and goals to be achieved by the end of the decade. The nurse's teaching should be guided by:

A) The U.S. Surgeon General's report on mental health and mental illness.
B) Healthy People 2010.
C) The Global Burden of Disease study.
D) Current World Health Organization research.

Question 8

When describing a client's behavior, the nurse used the Latin term delusion. Given the use of this term, which of these interpretations of the client's behavior is correct? The client is exhibiting a(n):

A) Intense sadness.
B) Extreme anger.
C) False belief.
D) Loss of intellect.

Question 9

The nurse is using the Healthy People 2010 report to plan mental health teaching to a group of adolescents. Given the nurse's use of this report, the nurse's teaching should include:

A) Discussion of responsible behavior and choices.
B) Strategies to promote normal grieving.
C) Stress management techniques.
D) Strategies to prevent suicide.

Question 10

The industrial nurse is planning programs to address mental health problems identified in the Healthy People 2010 report. Specific to this report, the nurse should include which of the following with company employees at the worksite?

A) Substance abuse education
B) Depression screening
C) Stress management
D) Abuse screening

Question 11

The school nurse is assessing the adolescent who is experiencing adjustment problems in school. Given the nurse's knowledge of the mental health problems identified in the Healthy People 2010 report, the nurse should assess which of the following areas?
Select all that apply.

A) Educational testing
B) Mood and suicidal ideation
C) Psychiatric history
D) Height and weight
E) Alcohol and drug use

Question 12

The client has frequently presented to the clinic with multiple physical complaints. The multiple physical complaints would warrant the nurse to screen the client for:

A) Chronic illness.
B) Mental disorder.
C) Deviant behavior.
D) Hospitalization.

Question 13

The nursing assistant asks the psychiatric nurse the location of the first asylum for the mentally ill. Which nursing response is appropriate?

A) "This is not part of your role on this unit."
B) "The first asylum for the mentally ill was in Morocco."
C) "The first asylum for the mentally ill was St. Mary of Bethlehem (Bedlam)."
D) "Why do you want to know this?"

Question 14

The nurse is planning care for the client who presents with frequent reports of multiple physical complaints. Given knowledge of the leading causes of mental disability, the nurse should plan to include further data collection in which of the following priority areas?

A) History of family violence
B) Relationships with others
C) Clarity of thought processes
D) Alcohol usage

Question 15

The home health nurse is caring for a number of clients with chronic illnesses. Given World Health Organization (WHO) research, the nurse realizes that the client with which of the following is at greatest risk for mental disability?

A) Psychotic disorders
B) Panic disorder
C) Anxiety disorders
D) Bipolar disorder

Question 16

A co-worker in the long-term care setting is planning programs to address mental health issues of elders and asks the nurse where to access the Healthy People 2010 report. The nurse's correct response is which of the follow?

A) American Psychiatric Nurses' Association
B) World Health Organization
C) United States Surgeon General
D) United States Department of Health and Human Services

Question 17

The psychiatric nurse states that today's nursing practice is based on contemporary theories concerning the etiology of mental disorder. Given this theoretical basis, the nurse would most likely give priority to which of the following assessments?
Select all that apply.

A) Psychotropic medications
B) Family history of mental disorder
C) Family communication patterns
D) Early childhood interactions
E) PET and CT scans

Question 18

During the nursing assessment of the adult client, the nurse finds the client's beliefs and actions related to common health practices to be "bizarre." Which action would be most appropriate for the nurse to take at this time?

A) Repeat the assessment later in the day.
B) Write a nursing diagnosis to address the "bizarre" beliefs and actions.
C) Communicate the findings to the health care team.
D) Inquire as to the culture with which the client identifies.

Question 19

During an admission assessment on an adult unit, the nurse is thinking that the client's beliefs and actions regarding commonly accepted health practices are "bizarre." To help establish the presence of a mental disorder, the nurse should first collect information about the client's:
Select all that apply.

A) Family history.
B) Culture.
C) Age.
D) Psychiatric history.
E) Occupational history.

Question 20

The nurse is sharing client assessment data with the multidisciplinary health care team. Which comment by the nurse is irrelevant and indicates a misunderstanding of the concept of a mental disorder?

A) "The client reports a loss of interest in usual pleasurable activities and commitments."
B) "The client reports significant emotional distress about the current situation."
C) "The client denies thoughts of harming self or others."
D) "The client has some very inappropriate religious ideas and spiritual beliefs."

Question 21

The psychiatric nurse is asked to explain the primary focus in the assessment and treatment of mental illnesses during the mid-20^th century. Given this request, the nurse would emphasize beliefs and actions related to:

A) Decay of intellect or of the nervous system.
B) Faulty life habits and interactions.
C) Social dimension and drug treatment.
D) Classification of symptoms.

Question 22

The nurse is teaching a group of students the various historical explanations of mental illness. Which statement by the students indicates understanding of the nurse's teaching regarding the era of magico-religious explanations?

A) "Mental illnesses were influenced by the moon; hence, the term lunacy."
B) "The insane were believed to be divinely inspired and care was generally benevolent and kindly."
C) "Mental and physical illness were the result of superhuman forces that inflicted suffering."
D) "Mental illnesses were caused by imbalances in body humors: blood, bile, and phlegm."

Question 23

Given prevalence statistics of the five psychiatric disorders that comprise the top 10 causes of disability worldwide, the nurse chooses which of the following as a priority screening for clients?

A) Bipolar disorder
B) Alcohol abuse
C) Schizophrenia
D) Depression

Question 24

When reading historical psychiatric texts, which behavioral description indicates that the nurse understands the correct use of the 18^th century term hallucination?

A) Fixed idea
B) Bizarre actions
C) False belief
D) False perception

Question 25

The new nurse states that the client's beliefs and actions related to common health practices are "bizarre" and must indicate some type of deviant behavior. In planning a response, the nurse is guided by:

A) The knowledge that beliefs and behaviors are only deviant if the client thinks there is a problem.
B) The need for further assessment to determine the duration of the beliefs and actions.
C) A definition of deviance that covers all clinical situations.
D) The knowledge that beliefs and behaviors are judged by cultural and social considerations.

Question 26

Due to a staff member's absence, the nurse is reviewing staff assignments for the day. Which task can the nurse delegate to the psychosocial rehabilitation worker?

A) Comparison of physician's orders with the medication records
B) Assessment of a long-term client
C) Conflict resolution teaching to a small group of clients
D) Routine medication administration to a stable client

Question 27

The psychiatric-mental health nurse is working with the new graduate nurse who is orienting to the psychiatric unit. Which comment by the new graduate indicates to the nurse that further clarification of the generalist nursing role is needed?

A) "I am a little nervous about conducting psychotherapy with clients."
B) "I am doing some reading on how to incorporate complementary interventions into treatment plans."
C) "I will spend time each day evaluating the effectiveness of the therapeutic milieu."
D) "I would feel better if you would look at my documentation that addresses progress toward treatment goals."

Question 28

When planning nursing care, the nurse understands that the main value of having knowledge of a variety of nursing theories is to:

A) Build the skill and effectiveness of the nurse's practice.
B) Promote consideration and use of nursing research.
C) Enhance collaboration and understanding between the nurse and the mental health care team.
D) Implement individualized nursing interventions depending on what is best for the client's situation.

Question 29

The nurse is planning a brief presentation about the "first American psychiatric nurse." Who will the nurse research?

A) Linda Richards
B) Harriet Bailey
C) Gwen Tudor (Will)
D) Hildegard Peplau

Question 30

If psychiatric nurses used Orem's theory for structuring much of their nursing practice, a major focus area for assessment would be the client's ability to:

A) Adapt and function to meet various role expectations.
B) Enter into a therapeutic one-to-one relationship with the nurse.
C) Care about self and participate in self-healing.
D) Implement self-care to meet psychosocial needs.

Question 31

The nurse is admitting a client to the psychiatric unit. Which nursing action is correct?

A) Instruct the client that the mental health team will decide what the client needs to do in treatment.
B) Discuss with the client information that is to be shared with family members and the mental health team.
C) Alert the client that the psychiatrist will do all the intake assessment so as to maximize the efficiency of the team.
D) Instruct the client that all information gathered during the assessment will be shared with the mental health team.

Question 32

The client asks the nurse if certain changes can be made in the unit milieu. Which action by the nurse indicates understanding of the nursing role in the therapeutic milieu? The nurse:

A) Refers the client's requests to the psychiatric social worker.
B) Refers the client's requests to the psychosocial rehabilitation worker.
C) Instructs the client that no changes can be made.
D) Discusses the desired changes with the client.

Question 33

The nurse is reflecting on the nursing role within the mental health team. The nurse understands that the main purpose of delivering care using a multidisciplinary team is to:

A) Maximize the efficiency of the health care team with each team member learning from the others.
B) Increase the opportunity for interpersonal interaction between the client, family, and team members.
C) Make the best use of the different abilities of mental health team members in order to facilitate client progress.
D) Facilitate the case management process by delivering care using a multidisciplinary health care team.

Question 34

The nursing student is asked which historical event was most significant in the development of psychiatric nursing as a specialty and psychotherapeutic roles for nurses. Which response by the nursing student indicates understanding of important events related to development of the psychiatric nursing role?

A) Release of the report Nursing for the Future
B) Passage of the National Mental Health Act
C) Publication of Commonsense Psychiatry
D) Passage of the Community Mental Health Centers Act

Question 35

The nurse is planning activities to enhance collaboration within the mental health care team. Which activities will be helpful toward this goal?
Select all that apply.

A) Discussion of decisions that can be made autonomously
B) Discussion of decisions that require team unity
C) Identification of ways to ignore individual power bases
D) Review of interpersonal communication skills
E) Identification of ways to minimize diversity among team members

Question 36

The nurse is asked if Florence Nightingale had any impact on the role of the nurse in psychiatric-mental health nursing. What is the nurse's correct response?

A) "Yes, Nightingale was among the first to note that the influence of nurses has psychological components."
B) "No, Nightingale focused her ideas on nursing education rather than direct client care."
C) "Yes, Nightingale developed the idea of the therapeutic relationship."
D) "No, Nightingale emphasized the physical environment for healing."

Question 37

The nurse assesses that the client has problems choosing productive, safe leisure activities. Which member of the mental health team should the nurse consult with?

A) Occupational therapist
B) Recreational therapist
C) Clinical psychologist
D) Attending psychiatrist

Question 38

The client's treatment plan includes teaching related to possible side effects of psychotropic medications. Which member of the mental health team should plan to implement the teaching?

A) The psychiatrist
B) The psychosocial rehabilitation worker
C) The primary therapist
D) The nurse

Question 39

The nursing student asks the nurse the reason that knowledge of nursing theories is important. The nurse should respond that nurses use nursing theories to:
Select all that apply.

A) Organize assessment data.
B) Generate goals.
C) Generate nursing actions.
D) Plan interventions.
E) Evaluate outcomes.

Question 40

The psychiatric-mental health nurse is asked to develop an intervention for the nursing unit based on Watson's theory of caring. Given this assignment, which intervention is most appropriate for the nurse to implement?

A) One-to-one debriefing sessions each week with individual unit nurses and the unit manager
B) Clarification of values and cultural beliefs that might pose barriers to caring for clients
C) Identification of additional coping skills for new nurses on the unit
D) Discussion of the impact of recent changes in hospital policy on the nursing staff

Question 41

If the nurse was assessing the client from primarily a 19^th century perspective, in which dimension
Would the nurse most likely focus data collection?

A) Spiritual
B) Emotional
C) Physical
D) Social

Question 42

The psychiatric-mental health nurse is planning a personal program of continuing education in order to better meet the challenges of the future in psychiatric nursing practice. What areas should be included in the nurse's plan for continuing education?
Select all that apply.

A) Genetic research
B) Physical health of psychiatric clients
C) Psychiatric nursing care in nontraditional settings
D) Psychopharmacology
E) Psychobiology

Question 43

The psychiatric-mental health nurse is reflecting on professional role activities and is referred to the standards of professional performance. To which organization should the nurse look for guidance?

A) North American Nursing Diagnosis Association
B) American Nurses Association
C) National League for Nursing
D) American Nurses Credentialing Center

Question 44

The nurse is writing a scholarly paper on early nursing leaders who made major contributions to the development of the multifaceted psychiatric nursing role of today. When writing the paper, the nurse should include which of the following nurses?
Select all that apply.

A) Frances Sleeper
B) Hildegard Peplau
C) Linda Richards
D) Gwen Tudor (Will)
E) Florence Nightingale

Question 45

Upon the client's arrival on the patient care unit, the nurse begins implementation of the nursing process. By using the nursing process, the nurse's practice is most reflective on which nursing theorist?

A) Ida Jean Orlando
B) Dorothea Orem
C) Hildegard Peplau
D) Jean Watson

Question 46

The nurse is reflecting on psychiatric nursing care in the 19^th century. Which nursing diagnosis is most consistent with the focus of psychiatric nursing care during the 19^th century?

A) Self-care deficit
B) Altered thought processes
C) Anxiety
D) Ineffective individual coping

Question 47

The nurse is part of a mental health team and is having some role issues regarding how best to facilitate client progress toward therapeutic goals. What is the priority action by the nurse in order to aid the work of the team as they assist the client?

A) Recognize that conflict is natural and expected.
B) Acknowledge the diversity of the mental health team.
C) Determine personal values, biases, and goals .
D) Attend all mental health team meetings.

Question 48

The unit manager is consistently advocating for self-awareness among the psychiatric-mental health nursing staff in order to promote quality care. From which theoretical base is the unit manager operating?

A) Sister Callista Roy's adaptation theory
B) Martha Rogers's principles of homeodynamics
C) Jean Watson's theory of human caring
D) Dorothea Orem's theory of self-care

Question 49

The nurse is writing a care plan for a client with schizophrenia. Which of the following interventions demonstrates that the nurse is working from the Medical model?

A) The client will learn techniques that will interrupt hallucinations.
B) The client will learn about the therapeutic effects of medications.
C) The nurse will teach the client appropriate social behaviors in group and one-on-one interactions.
D) The nurse will ask the client to identify responsible ways to manage delusional material.

Question 50

The charge nurse is reviewing the care plans for the clients on the unit. In several care plans, the nurse has noted that the words noncompliant and manipulative have been used to describe those clients with severe mental illness. The nurse plans on discussing this with the staff at the next unit meeting. Which of the following responses will demonstrate the charge nurse's personal accountability to the staff?

A) "While these terms might be accurate, they are not appropriate to use in a care plan."
B) "If you use these terms regularly, you will need to reassess your reasons for working in psychiatric settings."
C) "How might these terms reflect negativity and stigma towards persons with mental illness?"
D) "Does the use of these terms reflect an underlying level of stress on the unit that I should be aware of?"

Question 51

The nurse is interviewing a Native American client who acknowledges seeing "spirits." Which of the following actions will be most important for the nurse to take to assist in assessing this client's symptoms?

A) Consult the physician regarding how best to evaluate this symptom.
B) Observe the client's behavior to determine how the client expresses this symptom.
C) Obtain a profile of the client's cultural norms on which to interpret this symptom.
D) Carefully question the client's family to prevent aggravating this symptom.

Question 52

The client says to the nurse, "It's my right to refuse medications." Which statement best reflects the nurse's ability to create a mutual understanding?

A) "Can you tell me what concerns you have about medications?"
B) "If you refuse your medications, you will just get sick again."
C) "Refusing your medications is your right, but it won't get you out of here."
D) "Can you tell my why you're so angry that you will refuse your medications?"

Question 53

The nurse is caring for a client with depression who is withdrawn. Which of the following statements suggests that the nurse is able to challenge his or her dogmatic beliefs?

A) "I understand that clients with depression have anger turned inward."
B) "I realize that if clients would just change their negative thoughts, they wouldn't be depressed."
C) "I realize that clients with depression are not just avoiding their problems."
D) "I understand that if clients would just develop strong interests, they wouldn't be depressed."

Question 54

A nurse is seeking consultation on strategies to cope with the potential for burnout while working on a psychiatric unit. Which of the following strategies demonstrates the nurse's ability to reduce the occurrence of burnout?

A) Pursue personal needs for social interactions during days off.
B) Focus on paperwork when the stress of listening to the clients becomes too much.
C) Maintain an accurate awareness of each client's needs throughout inpatient stays.
D) Take breaks often to relieve internal stress signals.

Question 55

A female client has made the decision to leave her husband who abuses alcohol. She states she is very depressed. Which of the following statements best demonstrates the nurse's empathy?

A) "I am very sorry you are going through this difficult time. I wish things could be different."
B) "I can understand that you are feeling depressed right now. It must have been a very difficult decision to make. I'll sit here with you for a while."
C) "It is sad thing to break up a marriage. It's a shame that it didn't work out for you."
D) "I know you are feeling very depressed right now. I felt the same way when I left my husband. From my experience, you are doing the right thing."

Question 56

An adolescent who is pregnant asks the nurse on the psychiatric unit, "Do you think I should give my baby up for adoption?" Which of the following responses best reflects the nurse's empathy?

A) "Why would you want to give the baby up for adoption?"
B) "What do you feel would be the best thing for you to do?"
C) "It would probably be best for you and the baby."
D) "It seems you will feel guilty if you gave your baby away."

Question 57

The charge nurse has just given a presentation about the importance of practicing self-care. Which of the following staff behaviors will the nurse find concerning?

A) Requesting to be alone during break time
B) Calling the unit on days off to inquire about clients' progress
C) Verbalizing feelings about a client's situation
D) Giving feedback to a fellow staff member about derogatory comments

Question 58

A client approaches the nurse grimacing, talking in a whisper, and waving his arms. Which of the following actions best demonstrates the nurse's ability to develop a therapeutic relationship?

A) Ignore the client to convey disapproval of the behavior.
B) Confront the client about the behavior to encourage insight.
C) Assist the client to leave the area to prevent distress to others.
D) Greet the client by name to demonstrate caring.

Question 59

A nurse is taking a class on providing culturally competent care for clients with severe mental illnesses. Which response best reflects the nurse's self-awareness of the sociocultural factors influencing his or her beliefs?

A) "I have been through therapy, so I know what to expect from clients with mental illnesses."
B) "When I was growing up, my parents believed that mental illnesses were the work of evil spirits."
C) "My father was a psychiatrist, so I am very knowledgeable about how to work with mental illnesses."
D) "All that I need to understand about the culture of mental illness is available on the internet."

Question 60

During a staff meeting, a nurse makes the following remark about the clients on the unit, "These clients are just trying to avoid the problems of life. They just need to go out and work." Which of the following responses best demonstrates the charge nurse's respectful attitude toward this nurse?

A) "I agree that most clients are just avoiding life, but our mission is to provide care."
B) "It is not our responsibility to determine whether clients have problems or not."
C) "You seem to be having trouble accepting the fact that clients can lose emotional control of their lives. Why don't we talk about this as a group?"
D) "When you say that our clients are just avoiding life problems, it sounds like you are frustrated by the needs our clients express. Am I hearing you correctly?"

Question 61

The nurse is caring for a client with depression. Which nursing intervention best demonstrates the nurse's availability to the client?

A) Assist the client with the activities of daily living.
B) Be honest with the client about medication effects.
C) Provide privacy when interviewing the client.
D) Let the client know that time heals all sorrow.

Question 62

A client comes to the nurse's station yelling, "I have to call the FBI. The bombs are set to destroy Washington, D.C. at 1:00 pm. Please help me. It will be your fault if I don't call." Which intervention best demonstrates the nurse's sensitivity?

A) Share your concerns that the client's request is unreasonable.
B) Assist the client to become aware that this is a delusional belief.
C) Switch the topic of conversation to defuse the client's underlying agitation.
D) Listen carefully for the underlying emotion expressed by the client's request.

Question 63

A nurse has completed orientation to a locked psychiatric unit. Which statement best demonstrates that the nurse is prepared to fulfill the professional role?

A) "I know there is a fine line between the clients and the staff."
B) "I can maintain proper distance by engaging in therapeutic interventions."
C) "I will ask for support from colleagues when I need it."
D) "I took a course in self-defense so I can take care of myself."

Question 64

The nurse has just taken a continuing education class on assertive communication techniques. Which response best demonstrates that the nurse understands assertive behavior?

A) "Yes, they always ignore staff requests."
B) "It would be selfish to ask for time off."
C) "I will demand a change in my schedule."
D) "No, I cannot work for you on Sunday."

Question 65

Which intervention best demonstrates practicing with detached concern?

A) Sitting quietly with a client who is sobbing uncontrollably
B) Providing a critical perspective of the client's feelings
C) Setting rigid boundaries to separate the nurse's experience from the client's
D) Sharing personal beliefs and opinions in order to enhance connection with the client

Question 66

The nurse is planning care for a client who has been withdrawn and isolated for the last three days. Which action will best demonstrate the nurse's empathy for this client?

A) Explore the client's feelings of anger related to powerlessness.
B) Focus on the client's strengths to enhance self-esteem.
C) Encourage the client's attendance and participation in groups.
D) Approach the client regularly and spend time with the client.

Question 67

The nurse receives the shift report on a newly admitted client with a history of drug abuse and prostitution. Prior to hospitalization, the client's parental rights were terminated. Which of the following actions best demonstrates the nurse's ability to enhance self-knowledge?

A) The nurse will examine his or her own feelings with regard to this client.
B) The nurse will review the current literature pertaining to drug addiction.
C) The nurse will ignore the challenge to his or her self-view.
D) The nurse will ask for guidance from the charge nurse.

Question 68

The nurse is admitting a client who is from Kenya to the psychiatric unit. Which of the following actions will demonstrate cultural competence?

A) Ask a family member to stay during the assessment interview.
B) Follow the admission assessment form.
C) Talk with the client to determine fluency in English.
D) Arrange for an interpreter to assist.

Question 69

The nurse is planning care for an Asian client who is Buddhist. Which of the following actions is most important for the nurse to take to provide culturally relevant mental health care?

A) Develop a thorough understanding of Buddhist religion.
B) Explain western medical ideas to assist cultural adaptation.
C) Seek clarification of this client's health beliefs.
D) Use standard nursing interventions for this client.

Question 70

A family member caring for a relative with dementia complains of exhaustion. Which of the following responses best conveys respect for this family member's situation?

A) "I experienced the same thing with my mother. What about getting a housekeeper?"
B) "It sounds like you are overwhelmed. You may benefit from respite care services."
C) "It sounds like your home situation is too demanding. What about seeking individual therapy to cope with your issues?"
D) "Caring for a person with dementia is too much for one person. You should place your relative in a nursing home."

Question 71

The nurse is working with a client who becomes upset and tells the nurse, "I've decided to give up on finishing my bachelor's degree." Which response best reflects the nurse's belief that the client is able to find the solution to this concern?

A) "You don't need to make a decision about this right now."
B) "It sounds like you feel it is too much for you to finish now."
C) "It is probably too much for you to handle right now."
D) "If you put your mind to it, you could finish the program."

Question 72

When evaluating the findings of a research publication, one of the questions a nurse needs to grapple with is which of the following?

A) "Are there any alternative explanations for the outcomes?"
B) "What are the credentials of the author?"
C) "Do I agree with the findings?"
D) "Was the author's research funding adequate?"

Question 73

Identifying appropriate research subjects using the nursing diagnosis system is important because:

A) It ensures the selection of clients with a consensually defined problem in living.
B) Nursing diagnosis is superior to other diagnostic systems.
C) It is necessary to use nursing diagnosis if we want to conduct nursing research.
D) Nursing diagnosis is more accurate than other diagnostic systems.

Question 74

The strongest evidence-base for practice is agreed to be:

A) Regulatory agency standards.
B) Qualitative studies.
C) Randomized clinical trials.
D) The consensus of experts.

Question 75

The Transtheoretical Model (TTM) of change asserts that:

A) Change occurs when a logical need for change is presented.
B) Successful change involves action and thought only before the change.
C) Once change occurs, no additional intervention is necessary.
D) Progression of change is not linear.

Question 76

Which of the following represents research evidence that is classified from weakest evidence to strongest evidence?

A) Case report; randomized controlled trial; non-randomized controlled trial
B) Randomized controlled trial; case report; consensus of experts
C) Randomized controlled trial; pretest and posttest; non-randomized trial
D) Case report; randomized controlled trial; systematic review of all relevant randomized, controlled trials

Question 77

Which of the following is the best source of research evidence?

A) Practice standards in academic healthcare organizations
B) Evidence-based nursing sites online
C) Trial and error over an extended period of time
D) Nursing journals

Question 78

In adopting evidence-based practice, the nurse:

A) Acknowledges that the process of change is identical for healthcare providers and consumers.
B) Acknowledges that the process of change for healthcare providers is different from the process of change for consumers.
C) Assumes that change can be immediate.
D) Acknowledges that once change occurs, it is permanent.

Question 79

The nursing student states that evidence-based nursing interventions require the use of the most advanced technology. The nursing instructor knows that more teaching is necessary because evidence-based nursing implementations are based on:

A) Regulatory agency guidelines.
B) Research evidence, clinical expertise, and client preference.
C) What you were taught in nursing school supplemented by more recent literature.
D) The opinions of experts in the field.

Question 80

In order to carry out evidence-based interventions in smoking cessation, it is important for the nurse to know that:

A) Smoking accentuates psychiatric symptoms.
B) Smoking increases medication side effects.
C) Smoking rates among the psychiatric population are two to four times the rate of the general population.
D) Smoking increases social isolation.