Deck 2: Mental Health and Mental Illness: Historical and Theoretical Concepts

Question 1

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

A)Defense mechanisms are self-protective responses to stress and do not need to be eliminated.
B)Defense mechanisms are maladaptive attempts of the ego to manage anxiety and should always be eliminated.
C)Defense mechanisms are used by individuals with weak ego integrity and should not be eliminated.
D)Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

Answer 1

Defense mechanisms are self-protective responses to stress and do not need to be eliminated.

Question 2

A client routinely uses an excessive amount of alcohol when under stress.When her husband arrived home one day and found her intoxicated,he began yelling at her about her chronic alcohol abuse.Which of the wife's actions does the nurse recognize as the defense mechanism of denial?

A)Hiding liquor bottles in a closet
B)Yelling at her son for slouching
C)Intentionally burning dinner
D)Stating "I don't drink too much!"

Answer 2

Stating "I don't drink too much!"

Question 3

Which indicates to the nurse a client is at risk for developing a mental disorder?

A)Expresses thoughts,feelings,and behaviors included among Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition (DSM-5)criteria
B)Demonstrates impaired daily functioning and maladaptive responses to stress
C)Communicates significant distress that has not interfered with important activities
D)Employs various defense mechanisms to protect the ego from anxiety

Answer 3

Demonstrates impaired daily functioning and maladaptive responses to stress

Question 4

A woman devastated by the divorce from her abusive husband has been receiving grief counseling.The nurse determines the client is in the acceptance stage of grief when the client states which of the following?

A)"If only we could have tried again,things might have worked out."
B)"I am so angry that my children and I put up with him as long as we did."
C)"It was a difficult marriage,but I think I learned from the experience."
D)"I still am not sleeping,don't have any appetite,and am losing weight."

Question 5

For which would the nurse be required to employ Maslow's Hierarchy of Needs to determine if immediate intervention due to an unfulfilled lower level is needed?

A)A client rudely complaining about limited visiting hours
B)A client exhibiting aggressive behavior toward another client
C)A client stating expressing feelings of sadness and loneliness
D)A client verbalizing feelings of failure and hopelessness

Question 6

A nurse is performing a mental health assessment on an adult client.The nurse recognizes which action demonstrates the client has achieved the highest level of functioning according to Maslow's Hierarchy of Needs?

A)Maintenance of a long-term,faithful,intimate relationship
B)A high level of self-confidence and autonomy
C)A feeling of self-fulfillment and realization of full potential
D)Development of a sense of purpose and the ability to direct activities

Question 7

A fourth-grade boy teases a girl in his class and makes jokes about her.The school nurse identifies the boy is using which defense mechanism?

A)Displacement
B)Projection
C)Reaction formation
D)Sublimation

Question 8

A supervisor openly disagrees with an employee's suggestions during a staff meeting.The employee's behavior represents the defense mechanism of displacement when he does which of the following actions?

A)Assertively confronts the supervisor
B)Abruptly leaves the staff meeting
C)Angrily criticizes a coworker
D)Takes the supervisor to lunch

Question 9

Which demonstrates use of the ego defense mechanism of regression?

A)A mother blames the teacher for her child's failure in school.
B)A teenager becomes hysterical after seeing a friend killed in a car accident.
C)A woman decides to marry a man exactly like her beloved father.
D)An adult throws a temper tantrum when he does not get his own way.

Question 10

A male high school student is attracted to a female teacher.The school nurse overhears the student say,"I know she wants me." The nurse recognizes the student is using which defense mechanism?

A)Displacement
B)Projection
C)Rationalization
D)Sublimation

Question 11

The nurse recognizes which principle underlies effective patient teaching?

A)Moderate to severe anxiety increases patient learning.
B)Mild anxiety enhances patient learning.
C)Panic-level anxiety improves nurses' teaching.
D)Severe anxiety intensifies concentration and enhances attention.

Question 12

Which psychoneurotic responses to severe anxiety are identified in the DSM-5?

A)Somatic symptom disorders
B)Grief reactions
C)Psychosis
D)Bipolar disorder

Question 13

A mental health nurse is speaking with parents who are concerned about their 15-year-old identical twins' responses to stress.One twin becomes anxious and irritable,while the other withdraws and cries.Which is the nurse's best response?

A)"Individual responses to stress are affected by many factors and can vary."
B)"Identical twins should not react differently when experiencing stress."
C)"Identical twins should have similar dispositions and responses to stress."
D)"Environmental factors influence reactions to stress more than genetic factors."

Question 14

Teaching regarding the concepts of mental health and mental illness is effective when the student nurse states which of the following?

A)"The concepts are rigid and based in religious beliefs."
B)"The concepts are multidimensional and culturally defined."
C)"The concepts are universal and unchanging."
D)"The concepts are fixed and unidimensional."

Question 15

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.The nurse determines the client's behaviors:

A)Demonstrate major depression and indicate mental illness.
B)Are clinically significant and indicate serious mental illness.
C)Are not congruent with cultural norms and indicate mental illness.
D)Show daily function is not impaired and do not indicate mental illness.

Question 16

During an intake assessment,the nurse asks a client physiological and psychosocial questions.The client angrily responds,"I'm here for my heart problems,not for my head." Which is the nurse's best response?

A)"We ask all clients these questions."
B)"Why are you concerned about these questions?"
C)"Psychological stress can affect medical conditions."
D)"We can skip these questions if you prefer."

Question 17

Which is the most significant consequence of excessive use of regression?

A)The superego is suppressed.
B)Emotions are experienced intensely.
C)Learning and personal growth are enhanced.
D)Problem-solving is limited.

Question 18

The nurse is interviewing a client with a history of excessive drinking and multiple arrests for impaired driving.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 client is using which defense mechanism?

A)Projection
B)Rationalization
C)Regression
D)Sublimation

Question 19

A mental health technician asks the nurse,"How do psychiatrists determine which diagnosis to give a patient?" Which is the nurse's best response?

A)"Psychiatrists use criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders."
B)"Psychiatrists are required to follow hospital policy to diagnose mental disorders."
C)"Psychiatrists make diagnoses based on the patient's behavior and other factors."
D)"Psychiatrists use one of the 10 diagnostic labels from the American Medical Association."

Question 20

Which statement demonstrates the nurse understands an individual's experience of neurosis?

A)"The individual is unaware he or she is experiencing distress."
B)"The individual feels helpless to change his or her situation."
C)"The individual is aware of psychological causes of his or her behavior."
D)"The individual has lost contact with reality."

Question 21

The nurse recognizes which statements regarding cultural aspects of mental illness are accurate? Select all that apply.

A)Local or cultural norms define pathological behavior.
B)The higher the socioeconomic class,the greater the recognition of mental illness behaviors.
C)Psychiatrists typically see patients when the family can no longer deny the illness.
D)The greater the cultural distance from mainstream society,the greater the likelihood the illness will be treated with sensitivity and compassion.

Question 22

Which of the following believed mental illness was curable?

A)Benjamin Rush
B)Dorothea Dix
C)Florence Nightingale
D)Linda Richards

Question 23

For which reasons is the DSM-5 useful in the practice of psychiatric nursing? Select all that apply.

A)It informs the nurse of accurate and reliable psychiatric diagnoses.
B)It represents progress toward a more holistic view of mind and body.
C)It provides a framework for interdisciplinary communication.
D)It provides a template for psychiatric nursing care plans.
E)It provides a framework for communication with the client.

Question 24

Most cultures label behavior as mental illness based on which of the following criteria?

A)Incomprehensibility and cultural relativity
B)Strength of character and ethics
C)Goal directedness and high energy
D)Creativity and good coping skills

Question 25

Which of the following were attributed to mental illness prior to the influence of Middle Eastern countries? Select all that apply.

A)Supernatural forces
B)Medical conditions
C)Disequilibrium of humors
D)Personality
E)Demons

Question 26

Which of the following does the nurse recognize as an example of the defense mechanism of repression?

A)A student who goes to a movie instead of studying for tomorrow's math test
B)A woman who does not believe the military report that her son was killed in Iraq
C)A man who is unhappily married goes to school to become a marriage counselor
D)A woman who was raped when she was 12 years old does not remember it

Question 27

A mental health nurse is assessing a client.Which behaviors indicate the client is experiencing moderate anxiety? Select all that apply.

A)Fidgeting
B)Laughing inappropriately
C)Palpitations
D)Nail biting
E)Extremely limited attention span

Question 28

The nurse is caring for a client admitted to the palliative care unit.The client's spouse has been at the client's bedside since the client was admitted.One week ago,the spouse began to visit 2 or 3 hours a day.The nurse understands the spouse is experiencing which of the following?

A)Anticipatory grief
B)Bereavement
C)Depression
D)Resolution

Question 29

The nurse recognizes which statements regarding defense mechanisms are true? Select all that apply.

A)They are employed when there is a threat to biological or psychological integrity.
B)They are controlled by the id and deal with primal urges.
C)They are used to relieve mild to moderate anxiety.
D)They are protective devices for the superego.
E)They are mechanisms that are characteristically self-deceptive.

Question 30

Which disorder does the nurse recognize as a disorder in the DSM-5?

A)Morbid obesity
B)Generalized anxiety disorder
C)Essential hypertension
D)Bereavement

Question 31

Which of the following is determined by the degree to which thoughts,feelings,and behaviors interfere with an individual's functioning?

A)Anxiety
B)Defense mechanisms
C)Mental health
D)Adaptation

Question 32

Which of the following are included in Jaboda's indicators of mental health? Select all that apply.

A)Acceptance
B)Creativity
C)Environmental mastery
D)Fulfillment
E)Integration

Question 33

A nurse is educating a patient about the difference between mental health and mental illness.Which statement indicates teaching was effective?

A)"Mental health is characterized by an absence of stressors."
B)"Mental health is reflected by successful adaptation to stressors."
C)"Mental health is incongruence between feelings and behavior."
D)"Mental health is included in the diagnostic categories in the DSM-5."

Question 34

The mental health nurse is conducting an intake interview with a couple seeking marital counseling.The nurse recognizes the husband is using the ego defense mechanism of projection when he exhibits which of the following?

A)Stamps his feet and demands his wife honor her vows
B)Ignores his wife's continued absence from the home
C)Accuses his wife of infidelity and betrayal
D)Takes out his frustration by verbally abusing his coworkers