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

Question 1

Which of the following are identified as psychoneurotic responses to severe anxiety as they appear in the DSM-5?

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

Answer 1

Somatic symptom disorders

Question 2

Which statement reflects a student nurse's accurate understanding of the concepts of mental health and mental illness?

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

Answer 2

"The concepts are multidimensional and culturally defined."

Question 3

When under stress,a client routinely uses an excessive amount of alcohol.Finding her drunk,her husband yells at her about the chronic alcohol abuse.Which reaction should the nurse recognize as the use of the defense mechanism of denial?

A) Hiding liquor bottles in a closet
B) Yelling at their son for slouching in his chair
C) Burning dinner on purpose
D) Saying to the spouse, "I don't drink too much!"

Answer 3

Saying to the spouse, "I don't drink too much!"

Question 4

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

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

Question 5

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

A) "It's just a routine part of our assessment. All clients are asked these same questions."
B) "Why are you concerned about these types of questions?"
C) "Psychological factors, like excessive stress, have been found to affect medical conditions."
D) "We can skip these questions, if you like. It isn't imperative that we complete this section."

Question 6

A nurse is assessing 15-year-old identical twins who respond very differently to stress.One twin becomes anxious and irritable,while the other withdraws and cries.How should the nurse explain these different responses to stress to the parents?

A) Reactions to stress are relative rather than absolute; individual responses to stress vary.
B) It is abnormal for identical twins to react differently to similar stressors.
C) Identical twins should share the same temperament and respond similarly to stress.
D) Environmental influences weigh more heavily than genetic influences on reactions to stress.

Question 7

Which client should the nurse anticipate to be most receptive to psychiatric treatment?

A) A Jewish, female journalist
B) A Baptist, homeless male
C) A Catholic, black male
D) A Protestant, Swedish business executive

Question 8

A client has a history of excessive drinking,which has led to multiple arrests for driving under the influence (DUI).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 use of which defense mechanism?

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

Question 9

A fourth-grade boy teases and makes jokes about a cute girl in his class.This behavior should be identified by a nurse as indicative of which defense mechanism?

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

Question 10

A mental health technician asks the nurse,"How do psychiatrists determine which diagnosis to give a patient?" Which of these responses by the nurse would be most accurate?

A) Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
B) Hospital policy dictates how psychiatrists diagnose mental disorders.
C) Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
D) The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Question 11

The nurse is preparing to provide medication instruction for a patient.Which of the following understandings about anxiety will be essential to effective instruction?

A) Learning is best when anxiety is moderate to severe.
B) Learning is enhanced when anxiety is mild.
C) Panic level anxiety helps the nurse teach better.
D) Severe anxiety is characterized by intense concentration and enhances the attention span.

Question 12

Which nursing statement about the concept of psychoses is most accurate?

A) "Individuals experiencing psychoses are aware that their behaviors are maladaptive."
B) "Individuals experiencing psychoses experience little distress."
C) "Individuals experiencing psychoses are aware of experiencing psychological problems."
D) "Individuals experiencing psychoses are based in reality."

Question 13

Devastated by a divorce from an abusive husband,a wife completes grief counseling.Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

A) "If only we could have tried again, things might have worked out."
B) "I am so mad that the children and I had to put up with him as long as we did."
C) "Yes, it was a difficult relationship, but I think I have learned from the experience."
D) "I still don't have any appetite and continue to lose weight."

Question 14

An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions.What behavior would be expected from this employee?

A) The employee assertively confronts the boss
B) The employee leaves the staff meeting to work out in the gym
C) The employee criticizes a coworker
D) The employee takes the boss out to lunch

Question 15

Which nursing statement about the concept of neuroses is most accurate?

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

Question 16

According to Maslow's hierarchy of needs,which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

A)A client rudely complaining about limited visiting hours
B) A client exhibiting aggressive behavior toward another client
C) A client stating that no one cares
D) A client verbalizing feelings of failure

Question 17

At what point should the nurse determine that a client is at risk for developing a mental disorder?

A) When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
B) When maladaptive responses to stress are coupled with interference in daily functioning
C) When the client communicates significant distress
D) When the client uses defense mechanisms as ego protection

Question 18

A teenage boy is attracted to a female teacher.Without objective evidence,a school nurse overhears the boy state,"I know she wants me." This statement reflects which defense mechanism?

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

Question 19

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.How should the nurse interpret the client's behaviors?

A) The client's behaviors demonstrate mental illness in the form of depression.
B) The client's behaviors are extensive, which indicates the presence of mental illness.
C) The client's behaviors are not congruent with cultural norms.
D) The client's behaviors demonstrate no functional impairment, indicating no mental illness.

Question 20

A nurse is performing a mental health assessment on an adult client.According to Maslow's hierarchy of needs,which client action would demonstrate the highest achievement in terms of mental health?

A)Maintaining a long-term,faithful,intimate relationship
B) Achieving a sense of self-confidence
C) Possessing a feeling of self-fulfillment and realizing full potential
D) Developing a sense of purpose and the ability to direct activities

Question 21

A nurse is assessing a client who appears to be experiencing moderate anxiety during questioning.Which symptoms might the client demonstrate? Select all that apply.

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

Question 22

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

A)A student aware of the need to study for tomorrow's test goes to a movie instead.
B) A woman whose son was killed in Iraq does not believe the military report.
C) A man who is unhappily married goes to school to become a marriage counselor.
D) A woman was raped when she was 12 and no longer remembers the incident.

Question 23

Which of the following statements should a nurse recognize as true about defense mechanisms? 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 in an effort to relieve mild to moderate anxiety.
D) They are protective devices for the superego.
E) They are mechanisms that are characteristically self-deceptive.

Question 24

Which of the following are cultural aspects of mental illness? Select all that apply.

A) Local or cultural norms define pathological behavior.
B) The higher the social 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 the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Question 25

Most cultures label behavior as mental illness on the basis of 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 26

A nurse is educating a patient about the difference between mental health and mental illness.Which statement by the patient reflects an accurate understanding of mental health?

A) Mental health is the absence of any stressors.
B) Mental health is successful adaptation to stressors in the internal and external environment.
C) Mental health is incongruence between thoughts, feelings, and behavior
D) Mental health is a diagnostic category in the DSM-5.

Question 27

Which is an example 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 wants 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 28

Which should the nurse recognize as a DSM-5 disorder?

A)Obesity
B) Generalized anxiety disorder
C) Hypertension
D) Grief

Question 29

A husband accuses his wife of infidelity.Which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?

A)The husband cries and stamps his feet,demanding that his wife be true to her marriage vows.
B) The husband ignores the wife's continued absence from the home.
C) The husband has already admitted to having an affair with a coworker.
D) The husband takes out his marital frustrations through employee abuse.

Question 30

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

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

Question 31

Which is the most significant consequence of the excessive use of defense mechanisms?

A)The superego will be suppressed.
B) Emotions will be experienced intensely.
C) Learning and the ability to grow will be enhanced.
D) Problem-solving will be limited.