Test Bank to Accompany 

PSYCHIATRIC-MENTAL HEALTH NURSING
An Interpersonal Approach

Second Edition

Jeffrey S. Jones
Joyce J. Fitzpatrick
Vickie L. Rogers

Editors

			ISBN: 978-0-8261-3298-7

Copyright © 2017 Springer Publishing Company, LLC

All rights reserved.

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ISBN: 978-0-8261-3298-7

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The Instructor’s Manual is designed to assist your instructional efforts in the classroom. Listed are key terms from each chapter as well as expected learning outcomes. The hyperlinks for each chapter are designed to allow the student to view film(s) that augment the main themes of the topic. Various films and/or additional hyperlinks have been recommended for use by the instructor that also allows further exposure to the chapter content. Questions and answers from the case studies presented in Chapters 11 to 19 are also provided to enhance critical thinking skills for students.

Contents
1.	Mental Health Trends and the Historical Role of the Psychiatric-Mental Health Nurse
2. 	Interpersonal Relationships: The Cornerstone of Psychiatric Nursing
3. 	The Value of the Use of Dialogue and Self in Recovery
4. 	Boundary Management
5. 	Critical Thinking, Clinical Decision Making, and the Interpersonal Relationship
6. 	Crisis and Crisis Intervention
7. 	Psychiatric Case Management
8. 	Known Risk Factors for Prevalent Mental Illness and Nursing Interventions for Prevention
9. 	Systems Concepts and Working in Groups
10. 	Theories of Mental Health and Illness: Psychodynamic, Social, Cognitive, Behavioral, Humanistic, and Biological Influences
11. 	Schizophrenia Spectrum and other Psychotic Disorders
12. 	Bipolar and Related (Mood) Disorders
13. 	Anxiety Disorders, Obsessive-Compulsive-Related Disorders, and Trauma- and Stress-Related Disorders
14. 	Personality Disorders
15. 	Substance-Related and Addictive Disorders
16. 	Neurocognitive Disorders
17. 	Impulse Control Disorders 
18. 	Sexual Dysfunctions, Paraphilic Disorders and Gender Dysphoria 
19. 	Feeding and Eating Disorders
20. 	Psychological Problems of Physically Ill Persons 
21. 	Working With Children 
22. 	Mental Health Concerns Regarding Adolescents 
23. 	Issues Specific to the Elderly 
24. 	Victims and Victimizers 
25. 	Psychiatric-Mental Health Nursing Across the Continuum of Care 
26. 	Vulnerable Populations and the Role of the Forensic Nurse 
27. 	Cultural, Ethnic, and Spiritual Concepts
28. 	Ethical and Legal Principles 
29. 	Policy, Policy Making, and Politics for Professional Psychiatric Nurses

Chapter 1
Mental Health Trends and the Historical Role of the Psychiatric-Mental Health Nurse
	1.	A nurse is giving a presentation about the historical development of modern mental health care. Which of the following should be emphasized as a consequence of 18th- and 19th-century reforms?
A.	Medications were developed that treated mental illness
B.	Care of the mentally ill became more humane
C.	Sigmund Freud developed psychoanalytic theory
D.	Mental illness became viewed as a result of demonic possession
Answer: B
	2.	Following is a list of significant events in the evolution of mental health care. Place the events in the order in which they occurred.
A.	Establishment of the National Institute of Mental Health
B.	Development of medications that address neurotransmitter uptake
C.	Publication of Surgeon General’s Report on Mental Health
D.	Deinstitutionalization of the mentally ill
Answer: A, D, B, C
	3.	Match the following individuals with their accomplishments.

3.1	Florence Nightingale	A.	Wrote the first psychiatric-mental health nursing textbook	
3.2	Harriet Bailey	B.	Advocated for patient self-care and independence	
3.3	Effie Taylor	C.	Became first American psychiatric-mental health nurse 	
3.4	Linda Richards	D.	Established first nursing program for psychiatric-mental health nurses	
Answer: 3.1–B; 3.2–A; 3.3–D; 3.4–C
	4.	In accepting a job on an inpatient unit, a nurse learns that the work environment emphasizes milieu management to facilitate treatment. Which of the following can the nurse expect?
A.	Nurses will be responsible for adjusting light and noise levels to create a less stressful environment
B.	Nurses will facilitate therapeutic group meetings
C.	Nurses will work within a self-managed team framework
D.	Nurses will devote most of their time to working one-on-one with patients
Answer: A

	5.	Which of the following are contemporary settings in which a psychiatric-mental health nurse might expect to work?
A.	Residential facilities
B.	Disaster response teams
C.	Schools
D.	All of the aforementioned
Answer: D
	6.	When it is said that the psychiatric-mental health care nurse adopts a “holistic” view of the patient, what is the best interpretation of this perspective?
A.	The nurse considers the patient’s mental and emotional state primary and physical health secondary
B.	The nurse has a master’s degree and advanced certification
C.	The nurse takes into account the needs of the patient within the context of the patient’s family and community
D.	The nurse does not participate in administering medications to patients but is constrained to nonpharmacological treatments
Answer: C
	7.	A psychiatric-mental health clinical nurse specialist (CNS) or nurse practitioner (NP) might engage in which of the following activities (select all that apply)?
A.	Prescribing psychopharmacological medication
B.	Individual psychotherapy
C.	Diagnostic screening
D.	Research
E.	Program development
Answers: A, B, D
	8.	A nurse is preparing a presentation on health care careers for a group of prospective nursing students. The presentation should state that a nurse with a bachelor’s degree can perform all of the following tasks EXCEPT:
A.	Patient intake screening
B.	Psychotherapy
C.	Administration of medication
D.	Milieu management
Answer: B
	9.	The first nurse to strongly emphasize the importance of meeting both the client’s physical needs as well as emotional needs was?
A.	Linda Richards 
B.	Luella Parsons
C.	Martha Rogers
D.	Joycelyn Elders
Answer: A
	10.	As a result of nurse theorists such as Peplau and Travelbee, ________________ was now considered an important part of the patient’s recovery.
A.	Medication
B.	Therapeutic communication
C.	Physical therapy
D.	Activities therapy
Answer: B

	11.	Milieu management has to do with?
A.	Discharge planning
B.	The doctor–nurse relationship
C.	Awareness of the setting/environment
D.	Efficient ways of charting
Answer: C
	12.	When practicing basic level of psychiatric-mental health nursing, the American Nurses Credential Center (ANCC) recognizes the preferred level of preparation as the:
A.	Associate degree
B.	Diploma degree
C.	Master’s degree
D.	Bachelor’s degree
Answer: D
	13.	The first advanced psychiatric nursing role was that of the:
A.	Clinical nurse specialist
B.	Certified nurse practitioner
C.	Clinical nurse leader
D.	Certified nurse midwife
Answer: A
	14.	During the 1990s there was a major shift in psychiatric-mental health treatment in that:
A.	Patients now had complete control over their care
B.	Medication became the first line of treatment and therapy became secondary
C.	Nurses now conducted most of the therapy groups on psychiatric units
D.	Psychiatric inpatient stays lengthened to accommodate insurance requirements
Answer: B
	15.	Any nurse practicing psychiatric-mental health nursing will be held specifically accountable to:
A.	National League for Nursing Guidelines for Practice
B.	Scope and Standards of Practice for Psychiatric Nurse Practitioners
C.	ANA’s Psychiatric-Mental Health Nursing: Scope and Standards of Practice
D.	American Psychiatric Association Code of Ethics
Answer: C
	16.	Which goal is part of the Federal Government’s Healthy People 2020 initiative?
A.	Reduce the suicide rate
B.	Reduce the proportion of persons who experience major depressive episodes
C.	Increase the proportion of homeless adults with mental health problems who receive mental health services
D.	All of the aforementioned
Answer: D

Chapter 2
Interpersonal Relationships: The Cornerstone 
of Psychiatric Nursing
	1.	A nursing student would demonstrate understanding of the interpersonal relationship (IPR) as the cornerstone of nursing when the student cites which of the following as key components of the IPR (select all that apply)?
A.	Intelligence
B.	Understanding of oneself
C.	Ability to speak persuasively
D.	Putting other people’s feelings first
E.	Verbal and nonverbal communication
Answers: B, E
	2.	Match the following activities to the phase of Peplau’s interpersonal process in which they most appropriately occur.

2.1.	The nurse and patient understand the patient’s health care needs and the role the nurse will fulfill in meeting those needs.	A.	Identification 	
2.2.	The nurse explains the likely time frame of the therapeutic relationship while maintaining focus on the patient.	B.	Exploitation	
2.3.	The nurse evaluates the patient’s readiness to end the therapeutic relationship, taking care not to end the relationship prematurely.	C.	Orientation	
2.4.	The patient progresses from being relatively dependent on the nurse to independence.	D.	Resolution	
Answer: 2.1–A; 2.2–C; 2.3–D; 2.4–B
	3.	With which one of the following statements is a nurse showing an awareness of self-conducive to establishing a therapeutic relationship with a patient?
A.	“I come from a cultural background and have had previous experiences that influence my perception and expectations of the therapeutic relationship.”
B.	“I have the appropriate credentials to perform my role and am very knowledgeable about this patient’s diagnosis.”
C.	“I can convey a strong sense of my personality and values to the patient so that the patient knows what to expect from me.” 
D.	“I am able to set aside and even eliminate all my biases so that they do not affect the care I give patients.”
Answer: A
	4.	A nurse is treating a patient with bipolar disorder. Put the following activities in the order in which they would most appropriately occur, according to Peplau’s original model of the interpersonal process.
A.	The nurse validates the patient’s understanding of her medication schedule and the supportive resources available in the community.
B.	The nurse presents himself as a capable health care professional whom the patient can trust.
C.	The patient and nurse discuss how the patient can best manage the side effects of prescribed medication and how the patient can recognize the onset of a depressive or manic episode and get assistance if needed.
D.	The patient describes her recent actions, which include emptying her bank account and engaging in high-risk sexual behavior, and her current state of mind, which she says is “dark” and “hopeless.”
Answer: B, D, C, A
	5.	A patient admitted with a diagnosis of acute depression asks the nurse, “Am I always going to feel this way?” The nurse considers how much information to give the patient about the medication that has been prescribed and the range of possible outcomes of the treatment. The nurse is in which of the following roles, according to Peplau?
A.	Counselor
B.	Teacher
C.	Resource person
D.	Leader
Answer: C
	6.	A patient describes having lost his job several months ago and feeling very worried about money as well as ashamed about being unemployed. His girlfriend also recently broke up with him due to his financial problems. The patient has been sending out resumes and plans to attend a professional conference next week, but is so nervous about going he feels panicked. Which level on Travelbee’s continuum of suffering most closely describes this patient?
A.	Transitory feeling of displeasure
B.	Extreme anguish
C.	Malignant phase of despairful not caring
D.	Terminal phase of apathetic indifference
Answer: B
	7.	Travelbee’s model of the nurse–patient relationship has been most readily applied to which of the following (select all that apply)?
A.	Patients with personality disorders
B.	Patients with schizoaffective disorders
C.	Patients with depressive disorders
D.	Patients in institutional settings
E.	Patients who are terminally ill
Answers: C, E
	8.	Before meeting with a patient who has arrived for her initial appointment at the clinic, a nurse reviews the patient’s intake form. The nurse is in which stage of Travelbee’s model?
A.	Empathy
B.	Original encounter
C.	Sympathy
D.	Orientation
Answer: B

	9.	_____________ is considered the founder of modern psychiatric-mental health nursing.
A.	Peplau
B.	Travelbee
C.	Nightingale
D.	Mahoney
Answer: A
	10.	Peplau’s 1952 book Interpersonal Relationships in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing was considered unique because:
A.	She used her own money to get it published
B.	It was one the first books to be written by a nurse without a physician co-author
C.	She invited Sigmund Freud to write the introduction
D.	It became required reading in medical schools
Answer: B
	11.	Peplau’s original theory of interpersonal relations between the nurse and the patient describes __________ phases.
A.	3
B.	2
C.	4
D.	6
Answer: C
	12.	Peplau described roles a nurse may find himself or herself in when working with a patient. “Clients seeing those who care for them as they would others who have cared for them in their lives, i.e., mother, father, sister, wife, etc.” would best identify which role?
A.	Leader
B.	Teacher
C.	Counselor
D.	Surrogate
Answer: D
	13.	Joyce Travelbee developed her human-to-human relationship theory because;
A.	She felt she witnessed a lack of compassion on the part of her nursing colleagues and that the time was right for professional nursing to undergo a “humanistic revolution.”
B.	She was influenced by another nurse theorist, Ide Jean Orlando, who emphasized the need for nurses to view the patient as a whole, not just a disease entity.
C.	She admired the work of Victor Frankl, who felt that all life, even the most desperate of situations, had meaning and it was these situations that gave a person a reason to live.
D.	All of the aforementioned
Answer: D
	14.	Travelbee’s theory has three main concepts. They are:
A.	Aggression, death, survival
B.	Resilience, attachment, forgiveness
C.	Human being, suffering, and hope
D.	Idealization, transference, counter-transference
Answer: C

	15.	Travelbee felt that if a person’s suffering is left to go on for too long that it may result in:
A.	Release and spiritual rebirth
B.	Terminal phase of apathetic indifference
C.	Break from reality and psychosis
D.	Reengagement with the family system
Answer: B
	16.	According to Travelbee, only when a nurse has experienced the original encounter, emerging identities, empathy, and sympathy for the patient can they then truly develop __________.
A.	Rapport
B.	Subjectivity
C.	Extreme anguish
D.	Love
Answer: A