Psychosocial Nursing Midterm
Exam
Course Introduction
Psychosocial Nursing focuses on the development of knowledge and skills necessary for nursing care of individuals, families, and communities experiencing mental health challenges. The course emphasizes understanding the psychological, social, and cultural factors that influence health and illness, as well as effective communication, therapeutic relationships, and evidence-based interventions. Students learn to assess mental health status, apply psychiatric nursing principles, and collaborate with interdisciplinary teams to support patient advocacy, recovery, and holistic well-being across the lifespan.
Recommended Textbook
Foundations of Mental Health Care 6th Edition by Michelle Morrison Valfre
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803 Verified Questions
803 Flashcards
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Page 2
Chapter 1: The History of Mental Health Care
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Q1) In 1841,_______________ surveyed asylums,jails,and almshouses throughout the United States,Canada,and Scotland and is credited with bringing about public awareness and reform for the care of the mentally ill.
A)Sigmund Freud
B)John Cade
C)Florence Nightingale
D)Dorothea Dix
Answer: D
Q2) Mental health is said to be influenced by which of the following factors? (Select all that apply. )
A)Diet and nutritional intake
B)Inherited characteristics
C)Activities of daily living
D)Childhood nurturing
E)Life circumstances
Answer: B,D,E
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Chapter 2: Current Mental Health Care Systems
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Sample Questions
Q1) A male client with a diagnosis of bipolar disorder is admitted to an inpatient unit during a severe manic episode.As a result of guidelines implemented by the Health Care Financing Administration in 1983,the client's Medicare will pay for his stay in this unit for:
A)The length of time necessary for his condition to be stabilized
B)Up to 6 months with appropriate documentation
C)A pre-determined length of time based on the diagnosis
D)2 to 4 weeks
Answer: C
Q2) The home care nurse is providing care to an older adult client with a diagnosis of depression who is caring for his wife with Alzheimer's disease.He states that he hardly has enough energy to cook and clean the house.The couple has no children,and no relatives live within a close distance.Which community agency would be of greatest benefit to this client?
A)A recreational club
B)An adult education program
C)A day care center for the elderly
D)Meals on Wheels
Answer: D
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Chapter 3: Ethical and Legal Issues
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Q1) The nurse often assists in the process of obtaining informed consent from the client for treatment and/or procedures.Who has the responsibility of providing information to the client so he can give informed consent?
A)Social worker
B)Nurse
C)Physician
D)Facility's legal representative
Answer: C
Q2) The psychiatrist asks the nurse to perform a procedure that she is not familiar with,and the nurse is unsure whether this is something within the scope of practice.Where can the nurse find the answer to her question?
A)National nurse practice act
B)State nurse practice act
C)Regional nurse practice act
D)Community nurse practice act
Answer: B
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Chapter 4: Sociocultural Issues
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Q1) Which client communication problem can the nurse most easily correct?
A)Age differences
B)Altered cognition
C)Cultural differences
D)Gender differences
Q2) A __________ is a simplified or standardized belief or conception regarding people who belong to another culture.
Q3) A Navajo Native American is traveling across the country and becomes ill.He visits a hospital emergency department and appears very uncomfortable in the surroundings.The nurse knows that traditional Navajo Native Americans typically receive health care in:
A)Homes
B)Small hospitals
C)Physicians' offices
D)Outpatient clinics
Q4) When a person believes that there is a power greater or higher than any human being,he is referring to his __________.
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6
Chapter 5: Theories and Therapies
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Q1) 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
Q2) Humanistic theories are important to health care because these theories serve as the foundation for the concept of:
A)Assertiveness training
B)Behaviorism
C)Holistic care
D)Behavior modification
Q3) Freud's psychoanalytical theory states that an adult is more likely to be mentally healthy if there is a balance between which parts of the mind? (Select all that apply).
A)Id
B)Ego
C)Superego
D)Conscience
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Page 7
Chapter 6: Complementary and Alternative Therapies
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Q1) Which theory best describes energy medicine?
A)There is a harmony within the body,nature,and the world.
B)The body has a natural ability to heal itself.
C)There is a vital,life-force energy that flows through an individual's body.
D)The mind and spirit affect body functions and influence illness.
Q2) Which of the following principles best describes the beliefs of naturopathic practitioners? (Select all that apply. )
A)Treatment of the whole person should occur.
B)Prevention of diseases/disorders is a key concept.
C)The doctor is the teacher.
D)Use of wavelengths is beneficial for client treatment.
Q3) 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
Q4) New approaches to mental health care that include telemedicine,telephone counseling,and radio psychiatry are known as _______________ approaches.
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Chapter 7: Psychotherapeutic Drug Therapy
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Q1) 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
Q2) Psychotropic medications can cause a parasympathetic and/or sympathetic response from the autonomic nervous system.Which of the following is considered a sympathetic response?
A)Pupil dilation
B)Increased saliva production
C)Decreased heart rate
D)Constricted airway
Q3) When educating a client being treated with lithium,which item(s)in his or her diet should be monitored or avoided?
A)Fresh fruit
B)Whole milk
C)Hot dogs and ham
D)Fresh vegetables
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Chapter 8: Principles and Skills of Mental Health Care
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Q1) A recently widowed 74-year-old male is seen in the mental health clinic for sleep disorders and depression.Which of the following nursing actions demonstrate caring?
(Select all that apply. )
A)Providing a private place to interview the client
B)Delegating other tasks to a colleague while speaking to the client
C)Addressing the client as "honey" to provide comfort
D)Asking about the client's daily activities and hobbies during the interview
E)Listening intently to the client's responses and not being distracted by his nonverbal communication
Q2) An adult female client is exhibiting behavior that the nurse interprets as anger toward another client.What is the nurse's best action?
A)Continue to monitor the client's behavior and document it as anger directed toward another client
B)Talk with the client about the observations made,and ask whether she was displaying anger toward the other client
C)Ask the other client if she felt that the client was angry at her
D)Ask the client to write in a journal the emotions she was feeling at that time
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Chapter 9: Mental Health Assessment Skills
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Q1) 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
Q2) During the mental status assessment,the nurse hands the client a piece of paper that reads "Please raise your left hand." If the client follows the command,the nurse has just assessed which ability of the client?
A)Abstract thinking
B)Reading
C)General knowledge
D)Memory
Q3) List the five steps of the nursing process in proper order.
Q4) __________ is how the client displays his or her emotions through facial,vocal,or gestural behavior.
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11
Chapter 10: Therapeutic Communication
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Q1) While the nurse is talking with a female client,the client becomes silent for several seconds.Which is the nurse's best response?
A)To interpret this action as an indication that the client is finished with the conversation
B)To ask the client a question so the interaction can continue
C)To remain silent and be attentive to the client's nonverbal communication
D)To tell the client that help can be more effective if she shares her feelings
Q2) Which nurse responses could block effective communication with a client? (Select all that apply. )
A)"This is what I think you should say "
B)"Don't stress over it.Everything will turn out fine."
C)"Why did you do that?"
D)"Most people in your circumstance "
Q3) When practicing therapeutic communication with a client,the nurse demonstrates which of the following listening skills?
A)Finishing the client's sentences to indicate listening
B)Not clarifying messages to avoid interrupting
C)Avoiding taking notes to detract from listening
D)Changing the environment to decrease distractions
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Chapter 11: The Therapeutic Relationship
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Q1) The acronym TEACH represents the components of a therapeutic relationship: __________,__________,__________,__________,and __________.
Q2) During the preparation phase of a therapeutic relationship with a client,what is the main task to be completed by the nurse?
A)To establish with the client the purpose of the relationship
B)To gather and review all possible information regarding the client
C)To build trust with the client
D)To obtain agreement from the client to work in conjunction with the nurse
Q3) The characteristic of genuineness helps in establishing a therapeutic relationship with a client.Which nurse response is the best example of a display of genuineness to a client who is going through a difficult divorce?
A)"I know exactly how you feel.My husband and I divorced 2 years ago because of his infidelity."
B)"Divorcing my husband was the best thing I ever did."
C)"I have friends who have gone through a divorce.It must be difficult for you."
D)"I am sorry that you have to go through this difficult time."
Q4) __________ refers to the ability of the nurse to establish a meaningful connection with a client.
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Page 13
Chapter 12: The Therapeutic Environment
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Q1) __________ refers to the process of achieving one's full potential in life.
Q2) The nurse can assist a client best in meeting his or her needs for self-esteem and/or self-actualization by:
A)Setting rules and regulations
B)Allowing the client to set rules and regulations for the inpatient unit
C)Informing the client what the treatment team has decided regarding the plan of care
D)Allowing the client to make choices involving his or her care when appropriate
Q3) Crisis stabilization provides care to clients in treatment settings with the purpose of reestablishing homeostasis;it usually lasts for:
A)1 to 2 days
B)2 to 4 days
C)4 to 6 days
D)6 to 8 days
Q4) Bright colors in the environment of the client are often:
A)Depressing
B)Stimulating
C)Calming
D)Frightening
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14
Chapter 13: Problems of Childhood
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Q1) Due to the proximal to distal physical development of the child,which of the following motor skills is able to be accomplished by the toddler?
A)Tying shoes
B)Buttoning a shirt
C)Eating finger foods
D)Cutting food with a fork and knife
Q2) A 10-year-old male client is 20 pounds overweight.Which intervention by the nurse is the most effective in this situation?
A)Place the client on a strictly controlled calorie-restricted diet
B)Talk to the client about why he is so overweight
C)Teach the client and his parents about healthy eating habits and choices
D)Make a list of foods that are to be restricted in the client's diet
Q3) Adult disorders such as chronic anxiety and depression often are associated with childhood:
A)Illnesses
B)Fears
C)Education
D)Abuse
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15
Chapter 14: Problems of Adolescence
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Q1) Adolescents who become chemically dependent progress through four stages.Place these stages in order of occurrence.
A)Burnout
B)Active seeking
C)Preoccupation
D)Experimentation
Q2) Adolescence is defined as beginning at age __________ years and ending at age ____________ years.
Q3) Internal developmental problems are seen as a causative factor for some behavioral and family problems during adolescence.Psychological developmental issues that can lead to problems during late adolescence (17 to 20 years old)include:
A)Wide mood swings
B)Tendency to withdraw when upset
C)Intense daydreaming
D)Concealing of anger
Q4) Obesity is defined as body weight that is __________% above average,based on the individual's height and build.
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Chapter 15: Problems of Adulthood
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Sample Questions
Q1) When the nursing care plan for a client with a mental health disorder is developed,what is the most likely reason that interventions are ineffective and goals are not met?
A)The client sees his goals as less important.
B)The client's family is not supportive.
C)The client's disorder is difficult to treat.
D)The client's medications are being adjusted.
Q2) __________% of the adult population in the United States has a mental health disorder.
A)5
B)11
C)25
D)39
Q3) AFRAIDS is a condition that most likely would be seen in:
A)The homosexual population
B)Sexually promiscuous heterosexuals
C)Individuals in a heterosexual monogamous relationship
D)Persons who have a chemical dependency on illegal intravenous drugs
Q4) Adulthood is defined as beginning at age __________ years and ending at age ____________ years.
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Chapter 16: Problems of Late Adulthood
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Q1) A 55-year-old man is extremely fearful of the effects of growing old.He is experiencing:
A)Ageism
B)Gerontophobia
C)An age phobia
D)Elder phobia
Q2) The nurse is caring for a 79-year-old client with dementia.The client worked as an obstetrics nurse before retiring.Despite her dementia,she still remembers terms and procedures and basic nursing care interventions from her past career.This is an example of:
A)Working memory
B)Reasoning
C)Information processing
D)Crystallized intelligence
Q3) It is projected that by 2050,the population of those aged 65 and over will be _______ million.
A)83.7
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Chapter 17: Cognitive Impairment, Alzheimers Disease, and Dementia
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Q1) __________ refers to thinking and thought processes.
Q2) The daughter of an elderly nursing home resident is crying outside her father's room.When the nurse comforts her,she states,"It is so hard to come here to visit when my father doesn't even know who I am." The nurse knows the client is in which stage of Alzheimer's disease?
A)Early stage
B)Intermediate stage
C)Severe stage
D)End stage
Q3) The causes of confusion are grouped into five categories known as the five D's.These categories consist of damage,delirium,dementia,depression,and __________.
Q4) Vascular dementia is more common in individuals living in:
A)The United States
B)Japan
C)France
D)Australia
Q5) __________ is a progressive,degenerative disease that affects the brain and causes impaired memory,cognition,and behavior.
Page 19
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Chapter 18: Managing Anxiety
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Q1) A male client has had agoraphobia for several years.In the past 2 years,he has not left his home,and he only speaks to people on the phone occasionally.Which nursing diagnosis has the highest priority in this situation?
A)Social isolation
B)Thought processes,disturbed
C)Coping,ineffective individual
D)Powerlessness
Q2) Which of the following activities are examples of addictive behaviors? (Select all that apply. )
A)Gambling
B)Shopping
C)Working
D)Excessive sexual activity
E)Flashbacks
Q3) Symptoms of obsessive-compulsive disorder can occur in children as young as:
A)3 years old
B)5 years old
C)7 years old
D)9 years old
Q4) __________ refers to a vague,uneasy feeling of uncertainty and helplessness.
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Chapter 19: Illness and Hospitalization
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Q1) If illness or hospitalization results in a change in physical appearance,it is likely to have a strong impact on the person's:
A)Attitude
B)Body image
C)Confidence
D)Acceptance of the problem
Q2) For most people,being hospitalized is seen as a/n:
A)Crisis
B)Annoyance
C)Chance to rest
D)Expensive hotel
Q3) A female client admitted to a mental health facility for depression is frequently asking for help in deciding which foods to choose for her meals as well as which activities she should participate in.Which stage of illness is she experiencing?
A)Dependency
B)Symptoms
C)Recovery and rehabilitation
D)Sick role
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21
Chapter 20: Loss and Grief
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Q1) To assist them with their grief experiences,many health care facilities offer caregivers who work with dying clients:
A)Extra income
B)Support groups
C)Time off from work
D)Peer evaluation groups
Q2) The client lost her husband of 50 years 10 months ago.She now sees every day as a gray fog with no light.She has begun to experience changes in eating,sleeping,and activity levels;angry,hostile moods;and an inability to concentrate or complete work tasks.What is the client experiencing?
A)Complicated grief
B)A normal grief reaction
C)Complicated depression
D)Bereavement-related depression
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
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Page 22
Chapter 21: Depression and Other Mood Disorders
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Q1) Which statements regarding depression are correct? (Select all that apply. )
A)It occurs in all age groups.
B)It rarely occurs in the elderly.
C)It occurs in men more often than in women.
D)It occurs in women more often than in men.
E)It is rarely seen but is severe when it occurs.
F)It is common in those who must cope with illness.
G) It is one of the most common and treatable mental disorders
Q2) A disorder defined as daily moderate depression that lasts longer than 2 years is called a(n)____ disorder.
A)Anxiety
B)Bipolar
C)Dysthymic
D)Major depressive
Q3) The moods of adolescents:
A)Are stable
B)Vary widely
C)Develop slowly
D)Are not related to growth and development
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Page 23
Chapter 22: Physical Problems, Psychological Sources
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Q1) The client recently witnessed a horrific auto accident.Now she is complaining of double vision,loss of balance,and a constant "lump in her throat." She is exhibiting the signs and symptoms of:
A)Anxiety reaction
B)Behavioral disorder
C)Conversion disorder
D)Posttraumatic stress reaction
Q2) Most psychosomatic problems and somatoform disorders begin in:
A)Puberty
B)Adulthood
C)Childhood
D)Adolescence
Q3) __________ is the biochemical fight-or-flight response that is a survival tool against stressors.
Q4) 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
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Chapter 23: Eating and Sleeping Disorders
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Q1) The medical term for a sleep test is __________.
Q2) The persistent eating of nonfood items such as clay,laundry starch,insects,leaves,or pebbles that lasts for longer than 1 month is called:
A)Pica
B)Bulimia
C)Rumination
D)Regurgitation
Q3) The inability to fall asleep or stay asleep is called:
A)Insomnia
B)Narcolepsy
C)Hypersomnia
D)Nocturnal myoclonus
Q4) Sleep terrors usually occur only once a night,during stages 3 and 4 of NREM sleep.They are often accompanied by which physical sign?
A)Intense stress
B)Sexual arousal
C)Physical strength
D)Intense motor activity
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Chapter 24: Dissociative Disorders
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Q1) During a home visit,the client tells the nurse that she feels that her medication is no longer helping her dissociative diagnosis of depersonalization disorder because she has noticed that she is not thinking clearly,is having difficulty with her memory and judgment,and is often disoriented to the time.The nurse knows that the doctor must be contacted and that this client most likely will be:
A)Admitted to a long-term care agency because she is a threat to herself
B)Admitted to a state-psychiatric facility for an extended period for intense therapy
C)Referred to a group home setting for better supervision
D)Admitted to the hospital for evaluation and possible adjustment of her medications
Q2) Those who care for individuals with dissociative disorders must be aware that they often will try to __________ the staff members who are caring for them.
A)Manipulate
B)Harm
C)Date
D)Persecute
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Chapter 25: Anger and Aggression
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Q1) 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
Q2) Children in preadolescence have started to channel aggression through which positive activity?
A)Fights in schoolyards
B)Organized sports
C)Joining gangs
D)Verbal abuse
Q3) __________ is a forceful attitude or action that does not take into consideration others' feelings or needs and may be expressed verbally,physically,or symbolically.
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) Which signs and/or symptoms should alert the caregiver to a child who is suffering from neglect?
A)Bruises and welts at various stages of healing
B)Consistently dirty,hungry,and inappropriately dressed
C)Child has torn,stained,or bloody underclothing
D)Any fracture in a child younger than 2 years of age or fractures at various stages of healing in a child of any age
Q2) __________ refers to a sudden occurrence of physical force that causes harm or injury to another person.
Q3) The theory that cites poverty,unemployment,and crime as sources of violence is known as the ____ theory.
A)Feminist
B)Sociological
C)Anthropological
D)Psychiatric/mental illness
Q4) __________ refers to abuse or battering of a family member by another family member.
Q5) The theory that implies that aggressive and violent behaviors are learned through role modeling of other people is known as the:
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Chapter 27: Inward-Focused Emotions: Suicide
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Q1) Suicide attempts by ____ are more successful because one out of every two attempts results in death.
A)Adolescents
B)Older adults
C)Young adults
D)Middle-aged adults
Q2) Self-protective responses are seen in behaviors that meet basic: A)Goals
B)Needs
C)Wants
D)Demands
Q3) Standard interventions implemented in a mental health facility to prevent a client from attempting suicide are called __________.
Q4) Which are facts about suicide? (Select all that apply. )
A)Suicide occurs most often in lower socioeconomic classes.
B)Depression is a high risk factor for attempting suicide.
C)Giving away important possessions is a sign of suicidal thoughts.
D)It is harmful to discuss the subject of suicide with clients.
E)Suicidal threats are serious only if the client conveys the planned method.
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Chapter 28: Substance-Related Disorders
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Q1) Which of the following persons is said to have a dual diagnosis?
A)The anorexic adolescent suffering from depression
B)The school-age child suffering from a learning disorder and asthma
C)The older adult suffering from hypertension and diabetes
D)The young adult suffering from psychosis who smokes marijuana regularly
Q2) When the body physically needs or is dependent on a substance,the individual is said to be __________ to the substance.
Q3) Abused substances are those chemicals that alter the person's perception by affecting the:
A)Central nervous system
B)Autonomic nervous system
C)Cardiorespiratory system
D)Peripheral nervous system
Q4) __________ is a processed stimulant that reaches the brain immediately and produces an intense but short-lived high.
A)Heroin
B)Opioids
C)Cocaine
D)Crack
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Chapter 29: Sexual Disorders
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Sample Questions
Q1) The primary nursing diagnoses for a client who is experiencing problems with sexuality are sexual dysfunction and __________.
Q2) By the time they enter school,it is thought that most children identify with:
A)Same-sex peers
B)Opposite-sex peers
C)The same-sex parent
D)The opposite-sex parent
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
Q4) The client confides in the nurse that intercourse has been painful since she became menopausal.What is the nurse's most therapeutic response?
A)"Don't worry;it will pass."
B)"Are you still sexually active?"
C)"Perhaps we can discuss this with your doctor."
D)"I understand how difficult it is to discuss sex."
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Chapter 30: Personality Disorders
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Sample Questions
Q1) The client is unable to make a decision by herself.She clings to her husband and quickly moves to fill his requests.Although she sometimes appears angry,her emotions are not expressed.The client's diagnosis is:
A)Neuroticism
B)Paranoid personality disorder
C)Dependent personality disorder
D)Narcissistic personality disorder
Q2) Personality disorders that are considered to be in the erratic cluster include (Select all that apply):
A)Antisocial
B)Borderline
C)Paranoid
D)Histrionic
E)Avoidant
F)Obsessive-compulsive
G)Narcissistic
Q3) An individual with an __________ personality disorder relies on deceit and manipulation to get his or her way.
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32
Chapter 31: Schizophrenia and Other Psychoses
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Sample Questions
Q1) A female client with a psychotic disorder is experiencing olfactory hallucinations.Most likely,she would be complaining of:
A)A vision that is disturbing to her
B)A sound that is disturbing to her
C)A smell that is disturbing to her
D)A sense of touch that is disturbing to her
Q2) The onset of schizophrenia most commonly occurs during the decade of age in the:
A)Teens
B)20s
C)30s
D)40s
Q3) The police bring a man to the emergency department because he is wandering the streets yelling to people.He attempted to attack the police officer because he accused him of "being a part of that plot to kill the president and me." Which category of schizophrenia is he exhibiting?
A)Paranoid
B)Catatonic
C)Disorganized
D)Residual
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Page 33
Chapter 32: Chronic Mental Health Disorders
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Sample Questions
Q1) The client finds fault in every success she has.She is afraid to try anything new because she "just knows" that she will fail because she is mentally ill.Her behaviors demonstrate:
A)Low self-esteem
B)Suicidal ideation
C)Low abstraction abilities
D)Altered thought processes
Q2) The experience and suffering of living with mental illness:
A)Decreases as one grows older
B)Is unique to each person
C)Follows a predictable course
D)Is common to all mentally ill persons
Q3) The child has not developed the ability to respond to others.He cannot communicate his needs.He may remain dependent upon others throughout his life.He is most accurately described as having:
A)Autism
B)Anxiety
C)Mental retardation
D)Attention-deficit disorder
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Page 34
Chapter 33: Challenges for the Future
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Sample Questions
Q1) A woman whose culture believes her depression is the result of being possessed by the spirit of a deceased relative is considered to have a(an):
A)Impaired coping mechanism
B)Culture-bound disorder
C)Medically diagnosed disorder
D)Projection based disorder
Q2) Adults with chronic mental illness account for approximately __________ of the homeless population.
A)Forty percent
B)One-third
C)One-half
D)Fifty percent
Q3) The nurse who advocates for a health-oriented approach to clients is likely to encourage the development of which outcome?
A)The client will maintain compliance in medication administration
B)The client will adjust to the limitations of chronic illness
C)The client will keep in mind his limitations as a barrier to achievement of goals
D)The client will focus on continued progress and improvements in planning goals
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