Varcarolis’ Foundations of Psychiatric Mental Health Nursing A Clinical Approach 7th Edition By Margaret Jordan Halter Test Bank

Description

Varcarolis’ Foundations of Psychiatric Mental Health Nursing A Clinical Approach 7th Edition By Margaret Jordan Halter Test Bank

Content

UNIT ONE: FOUNDATIONS IN THEORY 1. Mental Health and Mental Illness 2. Relevant Theories and Therapies for Nursing Practice 3. Biological Basis for Understanding Psychiatric Disorders and Treatment

UNIT TWO: FOUNDATIONS FOR PRACTICE 4. Settings for Psychiatric Care 5. Cultural Implications for Psychiatric Mental Health Nursing 6. Legal and Ethical Guidelines for Safe Practice

UNIT THREE: PSYCHOSOCIAL NURSING TOOLS 7. The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing 8. Therapeutic Relationships 9. Communication and the Clinical Interview 10. Understanding and Managing Responses to Stress

UNIT FOUR: PSYCHOBIOLOGICAL DISORDERS 11. Childhood and Neurodevelopmental Disorders 12. Schizophrenia and Schizophrenia Spectrum Disorders 13. Bipolar and Related Disorders 14. Depressive Disorders 15. Anxiety and Obsessive-Compulsive Related Disorders 16. Trauma, Stressor-Related, and Dissociative Disorders 17. Somatic Symptom Disorders 18. Feeding, Eating, and Elimination Disorders 19. Sleep-Wake Disorders 20. Sexual Dysfunction, Gender Dysphoria, and Paraphilias 21. Impulse Control Disorders 22. Substance Related and Addictive Disorders 23. Neurocognitive Disorders 24. Personality Disorders 25. Suicide

UNIT FIVE: TRAUMA INTERVENTIONS 26. Crisis and Disaster 27. Anger, Aggression, and Violence 28. Child, Older Adult, and Intimate Partner Violence 29. Sexual Assault

UNIT SIX: INTERVENTIONS FOR SPECIAL POPULATIONS 30. Psychosocial Needs of the Older Adult 31. Serious Mental Illness 32. Forensic Psychiatric Nursing

UNIT SEVEN: OTHER INTERVENTION MODALITIES 33. Therapeutic Groups 34. Family Interventions 35. Integrative Care

Chapter 02: Relevant Theories and Therapies for Nursing Practice

MULTIPLE CHOICE

1. A parent says, “My 2-year-old child refuses toilet training and shouts ‘No!’ when given directions. What do you think is wrong?” Select the nurse’s best reply.

a.	“Your child needs firmer control. It is important to set limits now.”
b.	“This is normal for your child’s age. The child is striving for independence.”
c.	“There may be developmental problems. Most children are toilet trained by age 2.”
d.	“Some undesirable attitudes are developing. A child psychologist can help you develop a plan.”

ANS: B

This behavior is typical of a child around the age of 2 years, whose developmental task is to develop autonomy. The distracters indicate the child’s behavior is abnormal.

PTS:1DIF:Cognitive Level: Apply (Application)

REF: Page 22-23 (Table 2-2) TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

2. A 26-month-old displays negative behavior, refuses toilet training, and often says, “No!” Which stage of psychosexual development is evident?

a.	Oral	c.	Phallic
b.	Anal	d.	Genital

ANS: B

The anal stage occurs from age 1 to 3 years and has as its focus toilet training and learning to delay immediate gratification. The oral stage occurs between birth and 1 year. The phallic stage occurs between 3 and 5 years, and the genital stage occurs between age 13 and 20 years.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 21-22 (Table 2-1) TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

3. A 26-month-old displays negative behavior, refuses toilet training, and often says, “No!” Which psychosocial crisis is evident?

a.	Trust versus mistrust	c.	Industry versus inferiority
b.	Initiative versus guilt	d.	Autonomy versus shame and doubt

ANS: D

The crisis of autonomy versus shame and doubt relates to the developmental task of gaining control of self and environment, as exemplified by toilet training. This psychosocial crisis occurs during the period of early childhood. Trust versus mistrust is the crisis of the infant. Initiative versus guilt is the crisis of the preschool and early-school-aged child. Industry versus inferiority is the crisis of the 6- to 12-year-old child.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 22-23 (Table 2-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

4. A 4-year-old grabs toys from siblings and says, “I want that now!” The siblings cry, and the child’s parent becomes upset with the behavior. According to Freudian theory, this behavior is a product of impulses originating in which system of the personality?

a.	Id	c.	Superego
b.	Ego	d.	Preconscious

ANS: A

The id operates on the pleasure principle, seeking immediate gratification of impulses. The ego acts as a mediator of behavior and weighs the consequences of the action, perhaps determining that taking the toy is not worth the mother’s wrath. The superego would oppose the impulsive behavior as “not nice.” The preconscious is a level of awareness. This item relates to an audience response question.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF:Page 20-21TOP:Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

5. The parent of a 4-year-old rewards and praises the child for helping a younger sibling, being polite, and using good manners. The nurse supports this use of praise related to these behaviors. These qualities are likely to be internalized and become part of which system of the personality?

a.	Id	c.	Superego
b.	Ego	d.	Preconscious

ANS: C

The superego contains the “thou shalts,” or moral standards internalized from interactions with significant others. Praise fosters internalization of desirable behaviors. The id is the center of basic instinctual drives, and the ego is the mediator. The ego is the problem-solving and reality-testing portion of the personality that negotiates solutions with the outside world. The preconscious is a level of awareness from which material can be retrieved easily with conscious effort.  This item relates to an audience response question.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF:Page 20-21TOP:Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

6. A nurse supports a parent for praising a child behaving in a helpful way. When this child behaves with politeness and helpfulness in adulthood, which feeling will most likely result?

a.	Guilt	c.	Humility
b.	Anxiety	d.	Self-esteem

ANS: D

The individual will be living up to the ego ideal, which will result in positive feelings about self. The other options are incorrect because each represents a negative feeling.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 21 | Page 28 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

7. An adult says, “I never know the answers,” and “My opinion doesn’t count.” Which psychosocial crisis was unsuccessfully resolved for this adult?

a.	Initiative versus guilt	c.	Autonomy versus shame and doubt
b.	Trust versus mistrust	d.	Generativity versus self-absorption

ANS: C

These statements show severe self-doubt, indicating that the crisis of gaining control over the environment was not met successfully. Unsuccessful resolution of the crisis of initiative versus guilt results in feelings of guilt. Unsuccessful resolution of the crisis of trust versus mistrust results in poor interpersonal relationships and suspicion of others. Unsuccessful resolution of the crisis of generativity versus self-absorption results in self-absorption that limits the ability to grow as a person.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 22-23 (Table 2-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

8. Which patient statement would lead the nurse to suspect unsuccessful completion of the developmental task of infancy?

a.	“I have very warm and close friendships.”
b.	“I’m afraid to allow anyone to really get to know me.”
c.	“I’m always absolutely right, so don’t bother saying more.”
d.	“I’m ashamed that I didn’t do things correctly in the first place.”

ANS: B

According to Erikson, the developmental task of infancy is the development of trust. The correct response is the only statement clearly showing lack of ability to trust others. Warm, close relationships suggest the developmental task of infancy was successfully completed; rigidity and self-absorption are reflected in the belief one is always right; and shame for past actions suggests failure to resolve the crisis of initiative versus guilt.

PTS:1DIF:Cognitive Level: Apply (Application)

REF: Page 22-23 (Table 2-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

9. A patient is suspicious and frequently manipulates others. To which psychosexual stage do these traits relate?

a.	Oral	c.	Phallic
b.	Anal	d.	Genital

ANS: A

The behaviors in the stem develop as the result of attitudes formed during the oral stage, when an infant first learns to relate to the environment. Anal-stage traits include stinginess, stubbornness, orderliness, or their opposites. Phallic-stage traits include flirtatiousness, pride, vanity, difficulty with authority figures, and difficulties with sexual identity. Genital-stage traits include the ability to form satisfying sexual and emotional relationships with members of the opposite sex, emancipation from parents, a strong sense of personal identity, or the opposites of these traits.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 21-22 (Table 2-1) TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

10. A patient expresses a desire to be cared for by others and often behaves in a helpless fashion. Which stage of psychosexual development is most relevant to the patient’s needs?

a.	Latency	c.	Anal
b.	Phallic	d.	Oral

ANS: D

Fixation at the oral stage sometimes produces dependent infantile behaviors in adults. Latency fixations often result in difficulty identifying with others and developing social skills, resulting in a sense of inadequacy and inferiority. Phallic fixations result in having difficulty with authority figures and poor sexual identity. Anal fixation sometimes results in retentiveness, rigidity, messiness, destructiveness, and cruelty. This item relates to an audience response question.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 21-22 (Table 2-1) TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance