Psychiatric and Mental Health Nursing
Midterm Exam
Course Introduction
Psychiatric and Mental Health Nursing explores the principles and practices of caring for individuals with mental health disorders across the lifespan. The course examines psychiatric assessment, therapeutic communication, and evidence-based interventions for a variety of mental illnesses and behavioral health issues. Students will develop skills to promote mental wellness, manage crisis situations, and support recovery while addressing ethical, cultural, and legal considerations in mental health care. The course emphasizes interdisciplinary collaboration, advocacy, and self-care strategies for nurses working within mental health settings.
Recommended Textbook
Foundations of Mental Health Care 6th Edition by Michelle Morrison Valfre
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33 Chapters
803 Verified Questions
803 Flashcards
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Page 2
Chapter 1: The History of Mental Health Care
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Sample Questions
Q1) During the mid-1500s,behaviors associated with mental illness were more accurately recorded by professionals.This practice led to ______________ for different abnormal behaviors.
A)Classifications
B)Diagnosing
C)Treatment
D)Education
Answer: A
Q2) In the 1930s,what mental health disorder was electroconvulsive therapy (ECT)most often used to treat?
A)Schizophrenia
B)Bipolar disorder
C)Severe depression
D)Violent behavior
Answer: C
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Chapter 2: Current Mental Health Care Systems
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Sample Questions
Q1) Nearly __________ of all countries in the world have no clear governmental policy that addresses mental health issues.
A)7%
B)26%
C)50%
D)75%
Answer: C
Q2) When arranging community resource linkages for a client and her children who are victims of domestic violence,which resource is the most immediately appropriate?
A)Adult education program
B)Family recreation center
C)Mediation group
D)Women's shelter
Answer: D
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Page 4
Chapter 3: Ethical and Legal Issues
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Sample Questions
Q1) If a client is involuntarily committed to a mental health care facility indefinitely,the law requires that the case must be reviewed every:
A)3 months
B)6 months
C)12 months
D)15 months
Answer: C
Q2) Twenty-three states have enacted mental health parity laws.The most accurate description of these laws is that they require insurance companies to:
A)Include coverage for mental illness
B)Include coverage for substance abuse treatment
C)Include coverage for mental illness that is equal to coverage for physical illness
D)Include coverage for outpatient therapy for individuals with substance abuse
Answer: C
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Chapter 4: Sociocultural Issues
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Sample Questions
Q1) It is important for the nurse to be familiar with the religious practices of clients cared for most often in a particular region because attitudes toward health and illness,death and burial,food,and procreation have a strong impact on a client's beliefs and practices.The nurse knows that the religion practiced most often around the world is:
A)Buddhism
B)Jehovah's Witness
C)Christianity
D)Ahmadiyya
Q2) Cultural assessments allow the health care provider to understand the unique beliefs a client may have regarding mental illness and how they cope.Key areas to assess include which of the following? (Select all that apply. )
A)Communication
B)Space and territory
C)Biological orientation
D)Defense mechanisms
E)Social orientation
Q3) A __________ is a simplified or standardized belief or conception regarding people who belong to another culture.
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6
Chapter 5: Theories and Therapies
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Sample Questions
Q1) Good problem-solving is necessary for the mentally healthy individual.Place the steps of the problem-solving process in order.(Separate letters by a comma and space as follows: A,B,C,D,E,F,G)
A)Examine all possible options
B)Examine outcomes of the option's application
C)State the problem
D)Evaluate and revise actions based on outcomes
E)Collect information about the problem
F)Choose the best option,and apply it to the problem
G)Identify the causes or patterns of the problem
Q2) A client is granted permission to watch a favorite television show in the evening because she participated in an occupational therapy activity.Her therapist bases this on ______ theory.
A)Psychoanalytic
B)Humanistic
C)Behavioral
D)Developmental
Q3) Freud believed that an individual's personality developed through stages of sexual instinct from birth to adulthood.This is known as the __________ theory of personality development.
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Chapter 6: Complementary and Alternative Therapies
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Q1) Which CAM therapy would a nurse be most concerned about if used by a client being treated with antipsychotic medications?
A)Biologically based practices
B)Body-based practices
C)Mind-body practices
D)Technology-based practices
Q2) The Food and Drug Administration (FDA)does not impose the same guidelines on __________ as it does on prescription drugs.
A)Chiropractic treatment
B)Dietary supplements
C)Homeopathic treatments
D)Hypnotic therapy
Q3) Color therapy has been found to be especially effective in the treatment of:
A)Seasonal affective disorder
B)Bipolar disorder
C)Drug addiction
D)Generalized anxiety disorder
Q4) CAM is an acronym for __________.
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8
Chapter 7: Psychotherapeutic Drug Therapy
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Sample Questions
Q1) Valium is administered to a client anxious about impending surgery.Which of the following side effects is the client at risk for?
A)Seizures
B)Falls
C)Hypertensive crisis
D)Tachycardia
Q2) A male client with the diagnosis of depression is taking a monoamine oxidase inhibitor (MAOI).Which is the most important teaching point the nurse must include in his care plan?
A)Avoid foods high in sodium content
B)Avoid alcoholic beverages
C)Ensure that protein intake is 60 grams per day
D)Take a potassium supplement
Q3) The nurse is aware that he or she may be administering the new antianxiety medication pregabalin (Lyrica)to clients without an anxiety disorder for the purpose of treating:
A)Depression
B)Psychotic episodes
C)Neuropathic pain
D)Bipolar disorder
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Chapter 8: Principles and Skills of Mental Health Care
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Sample Questions
Q1) An adult female client becomes combative with the nurse during routine medication administration.What is the nurse's primary responsibility in this situation?
A)To ensure that the client takes her medications
B)To ensure that the client is placed in physical restraints to protect the safety of the staff and other clients
C)To ensure that chemical restraints are used in the future until the client displays more appropriate and compliant behavior
D)To ensure that the client is kept safe while trying to protect staff safety and to reason with the client to try to de-escalate the combative behavior
Q2) A client is believed to have adapted to a situation when he or she exhibits which characteristic?
A)The client has become accustomed to his or her surroundings.
B)The client has shown improvement in behavior as evidenced by the ability to carry out activities normal to his or her life.
C)The client has accepted his or her current behavior patterns.
D)The client has established a trusting relationship with the caregivers who are providing care.
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Page 10
Chapter 9: Mental Health Assessment Skills
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Sample Questions
Q1) Short-term memory loss is seen in which of the following disorders? (Select all that apply. )
A)Depression
B)Dissociative disorder
C)Conversion disorder
D)Alzheimer's
E)Anxiety
Q2) During the mental status examination,the nurse observes that the client rapidly changes from one idea to another related thought.Which disordered thinking process is the client displaying?
A)Delusions
B)Perseveration
C)Confabulation
D)Flight of ideas
Q3) A client with a history of delusions demonstrates which of the following behaviors?
A)Shifts from laughing to crying with no apparent cause
B)Insists the government is out to harm him
C)Has trouble remembering what he had for breakfast
D)Expresses a constant fear of dying
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Chapter 10: Therapeutic Communication
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Sample Questions
Q1) The nursing student is assigned a client to interview and is asked to practice the therapeutic communication technique of sharing perceptions.Which statement made by the student nurse best describes this technique?
A)"I noticed that you pace the halls,and you have a tense look on your face.I sense that you are anxious about something."
B)"Can you tell me more about how you feel when you are arguing with your daughter?"
C)"I would like to talk with you about your plan of care."
D)"Tell me if I understand you correctly."
Q2) __________ is the transferring between people of information,including ideas,beliefs,feelings,and attitudes.
Q3) During the process of communication,a chain of events occurs as soon as the message is sent.Steps in this chain include transmission,perception,and evaluation.Place these steps in proper order.
A)Transmission
B)Perception
C)Evaluation
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Page 12
Chapter 11: The Therapeutic Relationship
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Sample Questions
Q1) A female client with obsessive-compulsive disorder is undergoing treatment in an outpatient setting and is attending group therapy sessions.She is working on controlling the compulsion of touching her head three times every time she talks.To maintain the therapeutic relationship established with the client,by which action can the nurse show acceptance?
A)Ignoring the compulsion during the group therapy session and talking with the client privately about the behavior
B)Asking the group to remind the client every time she touches her head to help her consciously stop the compulsion
C)Pointing out the compulsion to the group each time the client exhibits the behavior
D)Asking the client to stop talking during the group session until she has learned to control her compulsion
Q2) A therapeutic relationship has four phases.Place these phases in proper order.
A)Orientation
B)Termination
C)Preparation
D)Working
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Chapter 12: The Therapeutic Environment
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Sample Questions
Q1) The nurse should monitor the temperature of the environment of a client who becomes easily agitated,with awareness that increased temperatures sometimes may cause the client to become:
A)Calm
B)Confused
C)Cooperative
D)More distressed
Q2) The nurse is aware that during the admission process to a mental health facility,the anxious client:
A)Is acutely aware of his or her surroundings
B)Often forgets some of what is said in the unfamiliar surroundings
C)Has a keen memory in his or her heightened state of awareness
D)Frequently has no recollection of what is said by the staff during admission
Q3) Bright colors in the environment of the client are often:
A)Depressing
B)Stimulating
C)Calming
D)Frightening
Q4) __________ refers to the process of achieving one's full potential in life.
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Chapter 13: Problems of Childhood
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Q1) The school nurse meets with the parents of a 7-year-old child who frequently shows a lack of respect for his teacher and the rules of the classroom.His parents report that he fights with his siblings and has tried to run away from home when they have attempted to take away privileges.Based on this assessment,what does the nurse understand about his future?
A)He is experiencing a normal developmental task and will grow out of it.
B)His prognosis for recovery will be good if he is not punished.
C)Due to his age,his future prognosis is poor.
D)He should be allowed to set his own limits.
Q2) The parents of a 9-year-old boy have been told by the child's teacher that he exhibits symptoms of attention-deficit/hyperactivity disorder (ADHD).Which specific behaviors may the child exhibit for this diagnosis to be made? (Select all that apply. )
A)Frequently interrupts or intrudes on others
B)Is easily distracted by outside stimuli
C)Has feelings of restlessness or frequently fidgets with hands and/or feet
D)Exhibits an excellent short-term memory
E)Often leaves tasks incomplete
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Page 15
Chapter 14: Problems of Adolescence
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Sample Questions
Q1) The child in early adolescence experiences developmental issues with his or her identity as evidenced by:
A)Feeling stable with his or her self-esteem
B)Conforming to group norms
C)Being very self-centered
D)Being idealistic
Q2) Personality disorders in the adolescent are characterized by:
A)Onset usually in middle childhood
B)Impulsivity
C)Flexibility
D)High self-esteem
Q3) By the ages of 14 to 17,teens are able to demonstrate problem-solving skills using concepts,generalizations,and being flexible in planning actions and goals.What is this an example of?
A)Concrete operations
B)Pre-operational thinking
C)Operational thinking
D)Abstract thinking
Q4) Adolescence is defined as beginning at age __________ years and ending at age ____________ years.
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Chapter 15: Problems of Adulthood
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Sample Questions
Q1) The parents of a 21-year-old who attended church services on a consistent basis are concerned when their child returns home from college and announces she is converting to another religion.This individual is most likely experiencing:
A)A personality disorder
B)The need to challenge a value and belief system
C)Instability due to dysfunctional parenting
D)Regression to an unresolved developmental task
Q2) An adult female calls a crisis hotline stating that she moved a few months ago to seek a new job "in a big city." She is crying and says that she doesn't think she can stand being so lonely anymore but doesn't want to move back to her small hometown and face her family and friends as a "failure." What is the nurse's first response?
A)"Would you like me to call your family to assist you in deciding what is best for you to do?"
B)"I am sure you will make friends once you find a steady job that you like."
C)"Can you tell me what you mean by your statement that you don't think you can stand being lonely anymore?"
D)"Let me give you a list of some social groups that might be of interest to you."
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Page 17
Chapter 16: Problems of Late Adulthood
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Sample Questions
Q1) The nurse is completing an admission interview with an older adult on a busy medical unit.What action is most appropriate for the nurse to take?
A)Complete the admission interview with the client's son
B)Shout at the client so he or she can hear
C)Provide pen and paper and let the client write his answers
D)Allow the client time to respond to the questions regarding health history
Q2) It is important for the nurse to be aware that __________% of individuals over 45 years old take prescription medications,over-the-counter medications,or a combination of these medications.
A)35
B)55
C)75
D)95
Q3) __________ refers to a state of wholeness or quality of one's character.
Q4) Although __________ is often a desire of older adults,it can bring loss of income and loss of opportunities for socialization.
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18
Chapter 17: Cognitive Impairment, Alzheimers Disease, and Dementia
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Sample Questions
Q1) Which of the following is an effective communication technique that should be included in the teaching plan for the family members of a woman in whom Alzheimer's disease has been diagnosed recently?
A)Use simple,familiar words,along with short and simple sentences.
B)If the client tends to pace a lot,be sure to encourage her to sit during interactions.
C)If she doesn't understand the communication,change key words.
D)Use hand gestures when speaking to try to explain what is being said.
Q2) An elderly woman is brought to the clinic by her daughter.The client states that she has had a cold for several days.Her daughter states that her mother has been confused about when her routine medications are to be taken and that her mother has never experienced confusion about her medications before.Based on this information,it is important that the nurse ask the client whether:
A)There is a history of mental illness in the family.
B)She has been given a diagnosis of a mental health disorder in the past.
C)She can recall her last visit to a physician.
D)She has taken any over-the-counter medications for her cold.
Q3) __________ refers to thinking and thought processes.
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Page 19
Chapter 18: Managing Anxiety
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Sample Questions
Q1) When a client has a mild level of anxiety,his or her emotional response is:
A)Relaxed and calm
B)Energized
C)Feeling overloaded
D)Helplessness with loss of control
Q2) A client has constant thoughts about locking his front door every time he leaves his house.This client is experiencing a/an:
A)Compulsion
B)Phobia
C)Obsession
D)Anxiety reaction
Q3) The treatment team and a male client in whom obsessive-compulsive disorder associated with hand washing has been diagnosed decide on a treatment plan for the disorder.The nurse begins to implement the plan by having the client gradually extend the time between hand washes.This intervention is an example of which type of therapy?
A)Behavior modification
B)Desensitization
C)Flooding
D)Pharmacological therapy
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Page 20
Chapter 19: Illness and Hospitalization
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Sample Questions
Q1) A male client has been diagnosed recently with a chronic illness.His family tells the nurse that they have noticed that he has not been attending his weekly card game night with his friends and does not return their calls.What reaction is this client most likely experiencing?
A)Anxiety
B)Withdrawal
C)Shock
D)Anger
Q2) A business owner is hospitalized after suffering a heart attack.The staff finds him very demanding and angry toward all personnel and noncompliant in his therapy and treatment plan.What is the best strategy for the nurse to employ with this patient?
A)Give him an ultimatum to cooperate or face a longer recovery period.
B)Allow him to continue this behavior due to his role outside the hospital.
C)Provide him with necessary information to actively participate in goal setting.
D)Request that a health care provider with a stronger personality take care of him.
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Chapter 20: Loss and Grief
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Sample Questions
Q1) The client is 21 years old and has just been given the diagnosis of terminal cancer.She is coping with a(n)____ loss.
A)Expected
B)Imagined
C)Internal
D)Temporary
Q2) Persons may refuse to acknowledge that a loss has occurred during the first stage of:
A)Crisis
B)The grieving process
C)The rage reaction
D)The denial process
Q3) The group best able to accept their losses and grow from their experiences is:
A)Adults
B)Toddlers
C)Adolescents
D)School-age children
Q4) __________ occurs when an individual who has experienced a loss is working through or resolving his or her grief.
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Chapter 21: Depression and Other Mood Disorders
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Sample Questions
Q1) Severe,prolonged depression affects a person's risk for physical illness by ____ the risk.
A)Decreasing
B)Increasing
C)Not affecting
D)Having little effect on
Q2) The goal of treatment during the first phase of depression is to:
A)Develop a plan for treatment
B)Reduce uncooperative behaviors
C)Help the client to adjust to antidepressants
D)Reduce symptoms and inappropriate behaviors
Q3) During the continuation phase of therapy,a client with a diagnosis of depression asks,"What is the goal of therapy during this 4- to 9-month period?" What is the nurse's best response?
A)"We are going to work together to try to reduce your symptoms."
B)"Our goal is to determine the cause of your depression and cure it."
C)"We want to prevent you from ever having any depressive episodes in the future."
D)"Our goal is to prevent you from relapsing and experiencing distressing emotional states."
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Page 23
Chapter 22: Physical Problems, Psychological Sources
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Q1) The client complains of severe back pain and is excused from work.Later,he is seen water skiing and jogging.These behaviors describe:
A)Malingering
B)Somatization
C)Hypochondriasis
D)A factitious disorder
Q2) The physiological stress response has an effect on:
A)Many body systems
B)Only the nervous system
C)The gastrointestinal system
D)The cardiovascular and respiratory systems
Q3) People who are able to recognize and defuse their stressors early ____ suffer from the physical effects of stress.
A)Never
B)Often
C)Always
D)Seldom
Q4) __________ is the biochemical fight-or-flight response that is a survival tool against stressors.
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Chapter 23: Eating and Sleeping Disorders
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Q1) The medical term for a sleep test is __________.
Q2) A client with a diagnosis of anorexia is admitted to an inpatient setting.Which therapeutic intervention is used with caution prior to stabilization and weight gain?
A)Establish rapport and trust
B)IV or tube feeding
C)Administering antidepressants
D)Daily weights
Q3) Which of the following conditions are eating disorders? (Select all that apply. )
A)Pica
B)Purging
C)Cataplexy
D)Binge eating
E)Hypersomnia
Q4) The average age for onset of anorexia nervosa is:
A)13 years old
B)17 years old
C)33 years old
D)40 years old
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25
Chapter 24: Dissociative Disorders
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Q1) Dissociative fugue is identified by which characteristics? (Select all that apply. )
A)Presence of two or more distinct personalities
B)Sudden travel with inability to recall the past
C)Behave normally during travel but confused by own identity
D)May assume a new life
Q2) A "spell" is a culturally defined mental health disorder or a dissociative "state" seen in African Americans,Europeans,and Americans from southern U.S.cultures.This "state" is characterized by:
A)Sudden collapsing with eyes open and inability to see,while still hearing and understanding,without being able to move
B)Seizure activity and coma for up to 12 hours preceded by extreme excitement or irrational behavior
C)A state in which spirit possession interferes with daily activities
D)Communication with deceased relatives or spirits that occurs during a trancelike state
Q3) When a person is unable to bring his various childhood identifications into one effective adult personality,the individual is said to have identity _______________.
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Chapter 25: Anger and Aggression
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Q1) Level one interventions for potentially assaultive clients should be practiced as:
A)Therapy
B)Control methods
C)Assessment measures
D)Preventive measures
Q2) Which of the following psychosocial nursing diagnoses are related to anger and aggression? (Select all that apply. )
A)Anxiety
B)Violence,risk for other-directed
C)Hopelessness
D)Violence,risk for self-directed
E)Coping ineffective,individual
F)Fear
Q3) The __________ theory explains aggression and violence as being caused by physical or chemical differences among people.
Q4) __________ typically express anger and/or aggression with temper tantrums.
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Chapter 26: Outward-Focused Emotions: Violence
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Q1) While an abused woman cannot be categorized to fit a specific profile,which of the following traits is most commonly identified?
A)Trusting nature
B)Assertive personality
C)Accomplished in nontraditional female career
D)Suspicious nature
Q2) Whenever there is a history of unexplained lethargy,fussiness,or irritability in an infant,caregivers should suspect ____ syndrome.
A)Shaken baby
B)Drugged baby
C)Depressed infant
D)Feeding disorder
Q3) Eating disorders,substance abuse,delinquent behaviors,posttraumatic stress disorder,and suicide most commonly are seen as the result of abuse in this population: A)Children
B)Adolescents
C)Adults
D)Elderly
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Chapter 27: Inward-Focused Emotions: Suicide
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Q1) An adult female whose fiancé recently called off the wedding attempts suicide by taking an overdose of sleeping medication.Immediately after taking the medication,she calls friends and family to tell them what she has done.Her friends and family activate the emergency response system,and she is taken to the emergency department and is admitted to a mental health facility for monitoring.She is exhibiting signs and symptoms most evident of which suicidal motivational category?
A)Cry for help
B)Relieving distress
C)Preoccupation with suicide
D)Refusal to accept a diminished style of life
Q2) Bob drives fast everywhere he goes,especially when he is drinking.Last night,he was arrested for gambling and loud behavior.Bob is engaging in ____ behavior.
A)Adaptive
B)Suicidal
C)Direct self-destructive
D)Indirect self-destructive
Q3) __________ is a term that is used to describe a form of active suicidal behavior,such as gestures,threats,or attempts to end one's own life.
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29
Chapter 28: Substance-Related Disorders
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Q1) For a substance-related disorder to be diagnosed,the pattern of substance use must lead to:
A)Significant costs involved with the habit
B)Significant disturbances in social functioning
C)Significantly impaired functioning and distress
D)Significant physical changes related to the abused substance
Q2) The drug most often abused by adolescents is:
A)Alcohol
B)Cocaine
C)Tobacco
D)Marijuana
Q3) The school nurse reports that a student who was brought to her appears to be tense and angry,and her speech is rapid.She denies use of illegal substances.What does the nurse suspect the student has ingested?
A)Ibuprofen
B)Penicillin
C)Ritalin
D)Valium
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Chapter 29: Sexual Disorders
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Q1) A female client is suffering from vaginismus.The nurse is aware that this is a type of:
A)Paraphilia
B)Sexual dysfunction
C)Psychosexual disorder
D)Gender identity disorder
Q2) Experiencing sexual excitement from wearing the clothing of the opposite sex is defined as:
A)Cross-acting
B)Transvestism
C)Transsexuality
D)Sexual dysfunction
Q3) The end of the continuum that is marked by sexual actions harmful to self or others in some manner is known as:
A)Adaptive
B)Homosexual
C)Maladaptive
D)Functional
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31
Chapter 30: Personality Disorders
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24 Flashcards
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Sample Questions
Q1) The central feature of one of our most pressing mental health problems today is a pervasive pattern of disregard for,and violation of,the rights of others.This personality disorder is called:
A)Avoidant
B)Paranoid
C)Dependent
D)Antisocial
Q2) Behavioral theorists see personality disorders as the result of:
A)Social stressors
B)Conditioned responses
C)Neurophysical problems
D)An imbalance among the three forces of the personality
Q3) An individual with an __________ personality disorder relies on deceit and manipulation to get his or her way.
Q4) Paranoid personality disorders are diagnosed more often in:
A)Men
B)Women
C)Children
D)Adolescents
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Chapter 31: Schizophrenia and Other Psychoses
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Sample Questions
Q1) Schizophrenia is a complex syndrome of maladaptive thoughts and behaviors that affects human functioning in the emotional,spiritual,intellectual,and __________ areas of an individual's life.
Q2) Schizophrenia affects approximately __________% of the world's population.
A)1
B)5
C)9
D)13
Q3) The client interprets the proverb "A rolling stone gathers no moss" as "As long as the rock keeps moving,it won't turn green." This is an example of:
A)Mutism
B)Flight of ideas
C)Concrete thinking
D)Loose association
Q4) __________ are central nervous system alterations that are characterized by abnormal,involuntary movement disorders caused by antipsychotic medications and leading to an imbalance between two major neurotransmitters (dopamine and acetylcholine)in portions of the brain.
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33
Chapter 32: Chronic Mental Health Disorders
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22 Flashcards
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Sample Questions
Q1) Persons with chronic mental health problems have much higher rates of:
A)Apathy
B)Suicide
C)Homicide
D)Physical illness
Q2) A male client is experiencing hallucinations.The intervention that would be most helpful in controlling the hallucinations is:
A)Actively listening to his concerns
B)Establishing a trusting relationship
C)Encouraging appropriate behaviors
D)Teaching him to use distraction techniques when experiencing hallucinations
Q3) The client has been diagnosed with depression for a long time.He recently started using cocaine to help relieve his depression.The most accurate description of these behaviors is a(n):
A)Addiction
B)Dual diagnosis
C)Fear of failure
D)Poor prognosis
Q4) Adolescents in whom diabetes is diagnosed have high rates of depression and
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Chapter 33: Challenges for the Future
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Sample Questions
Q1) In the United States today,the seriously mentally ill constitute (Select all that apply):
A)The neglected,the abused,and the confined
B)A large segment of jail and prison populations
C)More than half of all homeless persons
D)More than one third of the homeless population
E)The main pool of workers covered under the ADA
Q2) The __________ is the member of the mental health treatment team who has advanced certified nursing assistant training and provides care in both inpatient and community settings.
Q3) Historically,the homeless population has primarily consisted of:
A)Families
B)African American men over 40 years of age
C)White male adults with an average age of 50 years
D)Individuals in their 30s with mental and physical disabilities
Q4) A person is considered __________ according to the Americans with Disabilities Act (ADA)if he has a mental or physical impairment that significantly limits one or more major life activities.
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