Basic Concepts of Psychiatric-Mental Health Nursing 8th edition Shives Test Bank

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  • Published: 2011
  • ISBN-10: 1605478873
  • ISBN-13: 978-1605478876

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basic concepts of psychiatric-mental health nursing 8th edition test bank

Chapter 1- Self-Awareness

1. On the first day of a psychiatric-mental health nursing clinical, a student nurse is assigned to work with a 24-year-old male client who is being treated for major depression due to a recent diagnosis of AIDS. Which of the following questions of the nurse would reflect prejudice regarding the client?
A) “Does depression often occur when young people get a diagnosis of AIDS?”
B) “What is the physiological reason that depression might happen in conjunction with this diagnosis?”
C) “Does the client’s family know he is depressed and in treatment? I haven’t seen any visitors since he was admitted.”
D) “Why do gay men seem to get depressed more often? Could it be related to IV drug abuse?”
Ans: D
Feedback:
Prejudice is a judgment or opinion (“preconceived notion”) that has been made or formed before any knowledge or facts have been gathered. In option D, the student has already assumed that because the client has AIDS, he is gay and also may use IV drugs, and therefore, the student’s question reflects prejudice. Asking a question regarding the development of depression following a diagnosis of AIDS in young people, investigating the physiologic reason for depression occurring in a client diagnosed with AIDS, and determining if the client’s family has knowledge of the depression are all relevant questions posed by the student nurse.
2. Which of the following would be the most therapeutic student nurse response to the client’s question, “Hi. What is your name?”
A) “My name is Dorothy, and I am a student nurse at Oakdale University School of Nursing.”
B) “Why do you ask?”
C) “It is interesting that you would ask about my name. What is your name?”
D) “I would like to tell you; however, it is against the policy at Oakdale Hospital to reveal personal information.”
Ans: A
Feedback:
There are clinical situations in which it is unadvisable to provide personal information about oneself. However, other situations merit the cautious sharing of personal information; this is one. Providing her name gives the student credibility and establishes trust. To withhold this type of information would make the client uncomfortable and possibly suspicious of the student.
3. The student nurse is beginning her first day of clinical in a mental health unit. The nurse realizes that therapeutic communication can occur even if the nurse is not certain of how to initiate the conversation. This is because?
A) It does not matter what you say to the client.
B) Sincerity, honesty, respect, and caring are the most important elements in communication and will overcome anything you may say that could be nontherapeutic.
C) Psychiatric-mental health clients do not really understand what you say most of the time anyway.
D) Clients in most mental health settings are cognitively impaired.
Ans: B
Feedback:
Sincerity, honesty, respect, and caring are hallmarks of being an effective psychiatric-mental health care provider. If the student nurse is sincere and honest, shows respect for the client, and displays a caring attitude, the staff and clients will give the student their trust.
4. A Hispanic man employed as a sales representative goes into a local department store to pick up a gift for his wife. As he walks around the store, the security guard appraises the man’s race, comes up to him, and says, “You need to leave the store because of your suspicious behavior.” This is an example of
A) Cultural isolation
B) Dislocation
C) Prejudice
D) Discrimination
Ans: D
Feedback:
Discrimination occurs when there is treatment or consideration that is based on class or category rather than on individual merit. In this case, the man has been treated differently (asked to leave) based on his race, because there is no other defining characteristic or behavior that he is exhibiting that would lead to his expulsion from the store.
5. A mental health nurse has been assigned to a client diagnosed with schizophrenia. Upon entering the room, the client yells, “Get out of here, you little brat! You’re bigger than my kid sister, who is horrible!” The initial action of the nurse would include which of the following?
A) Sit down on the client’s bed and initiate a conversation.
B) Run out of the client’s room yelling, “I need some help here!”
C) Tell the client that her behavior is not acceptable and will not be tolerated.
D) Slowly back out of the client’s room, and summon for help.
Ans: D
Feedback:
Nursing staff and clinicians are experienced in assessing the client’s potential for violence and have specific protocols to utilize when this occurs. The nurse should be familiar with these protocols. The nurse should neither try to confront the client nor create a disruption. Initiating any type of conversation when the client is confrontational would not be appropriate. Running from the room and yelling may cause increased agitation in this client. Telling the client that her behavior is unacceptable does not resolve the current situation. The most appropriate nursing action in this situation would be to leave the client’s room and summon help.
6. Which of the following is a characteristic of an introvert?
A) Outgoing personality
B) Relates easily to people
C) Exhibits leadership qualities
D) Prefers to be a follower
Ans: D
Feedback:
An introvert is a quiet individual who relates better to the inner world of ideas, thoughts, and feelings. He or she prefers to be a follower and usually lets other initiate and direct interactions. An extrovert is an outgoing person who relates more easily to people and things in the environment, likes to take charge of situations, and has little difficulty socializing.
7. When caring for a depressed client, the nurse made a comment that all depressed people are weak. This is categorized as which type of attitude displayed by the nurse?
A) Affective incongruence
B) Judgmental
C) Jealous
D) Open-minded
Ans: B
Feedback:
Persons who display judgmental attitudes are often inflexible and run the risk of neglecting the perception of others, possibly arriving at an opinion based on their values without enough facts or enough regard for what other people may feel or think. Affective incongruence occurs when the client’s mood is not congruent with the situation. The nurse in this instance is not being open-minded or conveying jealousy.
8. One of the students completing her mental health clinical states that “All those people seem very crazy.” It is important that the student display which type of attitude when dealing with mentally ill clients?
A) Biased
B) Judgmental
C) Introverted
D) Open-minded
Ans: D
Feedback:
Individuals who display an open-minded attitude do not make decisions until they are aware of all the facts of the situation. It is especially important to be open-minded when dealing with clients from various cultures and ethnic backgrounds. The student is displaying a judgmental or biased opinion of the mentally ill. Introversion is a personality trait.
9. Frequently, psychiatric clients are stereotyped by the public. Which of the following is a common stereotype of this client population?
A) Calm
B) Self-centered
C) Violent
D) Wealthy
Ans: C
Feedback:
Psychiatric clients are often stereotyped or categorized by the public as being poor, violent, confused, or unable to care for themselves.
10. A student nurse is caring for a client with schizophrenia from the local prison who has been incarcerated for illegal drug manufacture and solicitation. The student nurse is overheard stating that “I can’t take care of him; he is probably gay and a drug addict.” The student nurse is best described as being which of the following?
A) Introverted
B) Extroverted
C) Prejudiced
D) Open-minded
Ans: C
Feedback:
The student is exhibiting prejudice in this situation. Prejudice is described as feelings of intolerance about persons who are hospitalized in psychiatric-mental health care facilities. Introvert and extrovert are types of personality traits. The student is not being open-minded regarding this client.
11. A nursing student is aware that all psychiatric clients are vulnerable to being stigmatized and stereotyped, a phenomenon that is particularly common when members of the public judge what?
A) Clients who have been diagnosed with depression
B) People with schizophrenia
C) Older adults with anxiety disorders
D) Women who become depressed after giving birth
Ans: B
Feedback:
Research suggests that individuals labeled mentally ill, regardless of the specific psychiatric diagnosis or level of disability, are stigmatized or disgraced more severely than those with other health conditions. Furthermore, some studies suggest that individuals with psychotic disorders, such as schizophrenia, are judged more harshly than people with depression or anxiety disorders.
12. Mr. Ho has seen a progressive decline in his mood, ability to concentrate, and energy level in recent months. Despite his wife’s prompting, he is reluctant to seek care. The nurse should recognize which of the following factors that is known to underlie individuals’ reluctance to seek psychiatric care?
A) The prohibitive cost of psychiatric treatment
B) Increasing social stigma around seeking psychiatric care
C) Withdrawal of FDA approval for many previously common psychiatric medications
D) The perceived lack of effectiveness of psychiatric treatment
Ans: D
Feedback:
Although seeking professional help for mental health problems is now more accepted by Americans, the public’s belief in the effectiveness of mental health treatment and the likelihood of recovery without treatment has changed very little over the past ten years. Therefore, many individuals who would benefit from mental health services choose not to pursue them or fail to fully participate once treatment has begun.
13. Kim, a nursing student, is admittedly nervous about beginning her upcoming clinical rotation in a psychiatric setting. Reflection on which of the following questions may aid Kim’s readiness for this new care setting?
A) “Why do I have to do this clinical rotation if my goal is to work in obstetrics?”
B) “What do I envision about these clients that makes me uneasy?”
C) “What should I do when I encounter clients who may never recover from their mental illness?”
D) “What if I pick up some of the poor coping strategies that psychiatric clients use?”
Ans: B
Feedback:
Identify one’s specific fears and apprehensions around providing care in the psychiatric setting that can foster the self-awareness that is necessary to provide good care. Expressing resentment for the rotation will benefit neither the student nor the clients she cares for. Fears of “catching” mental illness or worrying about what to do with clients who are unlikely to recover are concerns that need to be addressed, but neither question promotes self-awareness.
14. During his psychiatric clinical placement as a nursing student, David has been surprised by the intensity of emotion that he feels when interacting with a client who has been hospitalized with depression. He attributes this to the fact that his own father struggled with depression for many years and ultimately committed suicide when David was in his teens. How should David’s clinical instructor understand these events?
A) Recognizing the relationship between David’s family history and his present feelings indicates self-awareness.
B) David is at risk of dealing with his depressed client in a prejudiced or judgmental way because of his history.
C) David is failing to carry himself in an open-minded way in his clinical interactions, and it is tainting the care he provides.
D) There is a high risk that David will himself become depressed because of the combination of family history and present exposure to the illness.
Ans: A
Feedback:
David is showing self-awareness by making the link between what he is currently feeling and experiencing and the factors in his own life that may contribute to those feelings. Therefore, the other options are incorrect.
15. Which of the following nursing students most clearly exhibits open-mindedness?
A) Jeremy tells himself that all clients’ behaviors and thought processes are equally valid and beneficial.
B) Kristin realizes that there is nothing that she can do to make a person think or act in a different way.
C) Ravi consciously tries to refrain from making judgments until he has gathered as many facts as possible.
D) Jerome knows that he does not have the right to ask a client to do something that he himself would not want to do.
Ans: C
Feedback:
Individuals who display an open-minded attitude do not make decisions until they are aware of all the facts pertaining to a certain situation. Open-mindedness does not mean that every action and thought are beneficial, that a nurse is powerless to effect change in a client, or that the nurse must be willing to perform any necessary intervention on himself or herself.
16. A nurse who is considered to be judgmental may do what?
A) Be more efficient and effective at making clinical decisions under pressure
B) Choose interventions based on his or her own values
C) Be better able to discern symptoms and signs from personality traits
D) Be paralyzed by fear when interacting with mentally ill clients
Ans: B
Feedback:
Persons who display judgmental attitudes are often inflexible and run the risk of neglecting the perception of others, possibly arriving at an opinion based on their own values without enough facts or enough regard for what other people may feel or think. Being judgmental does not enhance decision-making or clinical judgment. It is more likely to foster overconfidence than fear.
17. Gina is having her clinical orientation on the psychiatric unit of the hospital where she will be starting a clinical placement. Surprised at learning the long average length of stay on the unit, she has asked her instructor how she and her classmates will be received as “new faces” on the unit. How should Gina’s instructor respond?
A) “Don’t worry. People with mental illness are often oblivious to the people around them.”
B) “You’ll be very susceptible to abuse or manipulation during the first few weeks, but you’re expected to navigate those challenges.”
C) “Many of the clients will recognize right away that you’re new, but they’ll be told ahead of time that you’re coming.”
D) “You’ll find that most of the clients on the unit won’t acknowledge the fact that you’re new here.”
Ans: C
Feedback:
While many students are understandably nervous about being recognized as new by clients, they are normally informed ahead of time that students will be coming. Clients are usually very aware of who they interact with. No care provider is expected to endure abuse.
18. During her first day on the psychiatric unit, Jennifer has entered a client’s room after shift report. The moment she enters the client’s room, the client asks, “Well, who do we have here?” How should Jennifer respond?
A) “I’m Jennifer Wilcox. How are you?”
B) “I’m the student who’s going to be working with you today.”
C) “I’m Jennifer, and I’ll be working with the RN until the end of the shift.”
D) “My name’s Jennifer and I’m a student nurse.”
Ans: D
Feedback:
It is important to introduce yourself to clients using your name and your title.
19. A client on the psychiatric unit of the hospital has sensed a student’s nervousness and confronted her, saying, “You don’t have a bloody clue what you’re doing, do you?” How could the student respond in a way that demonstrates emotional stability?
A) By detaching herself from her emotional response to this accusatory statement
B) By responding in a similar tone
C) By acknowledging the validity of the client’s statement
D) By trying not to show undue emotion when responding to the client
Ans: D
Feedback:
Emotional stability is not the same as blocking or detaching from emotions. Rather, it is responding to emotional situations without undue emotion. Validating the client’s statement and matching the tone would both be inappropriate responses.
20. Which of the following traits is most likely to inhibit the quality of care that a nurse provides in a psychiatric setting?
A) Introversion
B) Emotional stability
C) Extroversion
D) Judgmental
Ans: D
Feedback:
Introversion and extroversion are two different personality orientations, but neither is more valid than the other. Emotional stability is an asset, while being judgmental inhibits care.

basic concepts of psychiatric-mental health nursing 8th edition test bank