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NURS 355 (MENTAL HEALTH NURSING) FINAL
EXAM 2025 - 2026 |200Qs&As|A+GRADE ASSURED
A nurse is assessing a set of 15-year-old identical twins who respond very differently to stress. One twin becomes anxious and irritable, and the other withdraws and cries. How should the nurse explain these different stress responses 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 to stress weigh more heavily than genetic influences. a.Reactions to stress are relative rather than absolute; individual responses to stress vary Rationale:The nurse should explain to the parents that, although the twins have identical DNA, there are several other factors that affect reactions to stress. Mental health is a state of being that is relative to the individual client. Environmental influences and temperament can affect stress reactions. 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
c.Reaction formation The nurse should identify that the boy is using reaction formation as a defense mechanism. Reaction formation is the attempt to prevent undesirable thoughts from being expressed by expressing opposite thoughts or behaviors. Displacement refers to transferring feelings from one target to another. Rationalization refers to making excuses to justify behavior. Projection refers to the attribution of unacceptable feelings or behaviors to another person. Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable activities. Which nursing statement about the concept of neurosis 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 neurosis is aware of psychological causes of his or her behavior. d.An individual experiencing neurosis has a loss of contact with reality. b.An individual experiencing neurosis feels helpless to change his or her situation. The nurse should define the concept of neurosis with the following characteristics: The client feels helpless to change his or her situation, the client is aware that he or she is experiencing distress, the client is aware the behaviors are maladaptive, the client is unaware of the psychological causes of the distress, and the client experiences no loss of contact with reality.
b.The symbiotic phase The nurse should understand that this client's development was halted in the symbiotic phase of Mahler's developmental theory, which usually occurs between 1 and 5 months of age. The child has not entered into the separation- individuation phase of development, in which a child establishes the understanding of being separate from the mother. When assessing clients, a psychiatric nurse should understand that psychoanalytic theory is based on which underlying concept? a.A possible genetic basis for the client's problems b.The structure and dynamics of the personality c.Behavioral responses to stressors d.Maladaptive cognitions b.The structure and dynamics of the personality The nurse should understand that psychoanalytic theory is based on the underlying concepts of the structure and dynamics of personality. Psychoanalytic theory was developed by Sigmund Freud and explains the structure of personality in three different components: the id, the ego, and the superego. Which underlying concept should a nurse associate with interpersonal theory when assessing a client? a.The effects of social processes on personality development b.The effects of unconscious processes and personality structures c.The effects on thoughts and perceptual processes
d.The effects of chemical and genetic influences a.The effects of social processes on personality development The nurse should associate interpersonal theory with the underlying concept of effects of social process on personality development. Sullivan developed stages of personality development based on his theory of interpersonal relationships and their effect on personality and individual behavior. A father of a 5-year-old demeans and curses his child for disobedience. In turn, when upset, the child uses swear words at kindergarten. A school nurse recognizes this behavior as unsuccessful completion of which stage of development, according to Peplau? a.Learning to count on others b.Learning to delay satisfaction c.Identifying oneself d.Developing skills in participation c.Identifying oneself The nurse should identify that the child using swear words in kindergarten has not successfully completed the identifying oneself stage, according to Peplau's interpersonal theory. During this stage of early childhood, a child learns to structure self-concept by observing how other interact with him or her. A nurse is caring for a hospitalized client who is quarrelsome, opinionated, and has little regard for others. According to Sullivan's interpersonal theory, the nurse should associate the client's behaviors with a pervious deficit in which stage of development? a.Infancy
Which client statement reflects an understanding of circadian rhythms in psychopathology? a."When I dream about my mother's horrible train accident, I become hysterical." b."I get really irritable during my menstrual cycle." c."I'm a morning person. I get my best work done before noon." d."Every February, I tend to experience periods of sadness." c."I'm a morning person. I get my best work done before noon." By stating, "I am a morning person," the client demonstrates an understanding that circadian rhythms may influence a variety of regulatory functions, including the sleep-wake cycle, regulation of body temperature, and patterns of activity. Most humans follow a 24-hour cycle that is largely affected by lightness and darkness. Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level? a.Major depressive episode b.Schizophrenia c.Anorexia nervosa d.Alzheimer's disease b.Schizophrenia Although the exact mechanism is unknown, there may be some correlation between decreased levels of the hormone prolactin and schizophrenia.
A nurse understands that the abnormal secretion of growth hormone may play a role in which illness? a.Acute mania b.Schizophrenia c.Anorexia nervosa d.Alzheimer's disease c.Anorexia nervosa The nurse should understand that research has found a correlation between abnormal levels of growth hormone and anorexia nervosa. The growth hormone is responsible for growth in children, as well as continued protein synthesis throughout life. A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the production of these symptoms? a. Abnormal levels of serotonin b. Decreased levels of dopamine c. Increased levels of norepinephrine d.
To effectively care for Asian Americans clients, the nurse should be aware that older people in this culture maintain positions of authority. Obesity and alcoholism are low among Asian Americans. The balance of yin and yang is the fundamental concept of Asian health practices. Psychiatric illness is often believed to be out-of-control behavior and would be considered shameful to individuals and families. When planning client care, which folk belief that may affect health-care practices should a nurse identify as characteristic of the Latino American culture? a. The root doctor is often the first contact made when illness is encountered. b. The yin and yang practitioner is often the first contact made when illness is encountered. c. The shaman is often the first contact made when illness is encountered. d. The curandero is often the first contact made when illness is encountered d. The curandero is often the first contact made when illness is encountered The nurse should understand that it is characteristic of Latin American culture for a client to contact a curandero when illness is initially encountered. The curandero is the folk healer who is believed to have a gift from God for healing
the sick. Treatments often include supernatural rituals, prayers, magic, practical advice, and indigenous herbs. Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship? a. "I can't bear the thought of leaving here and failing." b. "I might have a hard time working with you, because you remind me of my mother." c. "I really don't want to talk any more about my childhood abuse." d. "I'm not sure that I can count on you to protect my confidentiality." c. "I really don't want to talk any more about my childhood abuse." The nurse should identify that the client statement, "I really don't want to talk any more about my childhood abuse," reflects that the client is in the working phase of the nurse-client relationship. The working phase includes overcoming resistance behaviors on the part of the client as the level of anxiety rises in response to discussion of painful issues.
Nurse: "Your father was a harsh disciplinarian." a. Restatement b. Offering general leads c. Focusing d. Accepting a. Restatement The nurse is using the therapeutic communication technique of restatement. Restatement involves repeating the main idea of what the client has said. It allows the client to know whether the statement has been understood and provides an opportunity to continue. A nurse says to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique? a. The therapeutic technique of giving advice b.
The therapeutic technique of defending c. The nontherapeutic technique of presenting reality d. The nontherapeutic technique of giving reassurance d. The nontherapeutic technique of giving reassurance The nurse's statement, "Things will look better tomorrow after a good night's sleep," is an example of the nontherapeutic communication technique of giving reassurances. Giving reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client's feelings. An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback? a. "Why did you use the client's name on your clinical worksheet?" b. "You were very careless to refer to your client by name on your clinical worksheet." c. "Surely you didn't do this deliberately, but you breeched confidentiality by using names."
CAPS scale c. MMSE The MMSE, or mini mental status exam, would be the appropriate tool to use to assess the mental acuity of a client prior to and immediately following ECT. The CIWA scale, or clinical institute withdrawal assessment scale, would be used to assess withdrawal from substances assess signs and symptoms of PTSD. The GGT test is a blood test used to assess gamma-glutamyl transferase levels, which may be an indication of alcoholism. The following NANDA-I nursing diagnostic stem was developed for a client on an inpatient unit: Risk for injury. What assessment data most likely led to the development of this problem statement? a. The client is receiving ECT and is diagnosed with Parkinsonism. b. The client has a history of four suicide attempts in adolescence. c. The client expresses hopelessness and helplessness and isolates self. d. The client has disorganized thought processes and delusional thinking. a. The client is receiving ECT and is diagnosed with Parkinsonism.
The nurse should identify that a client receiving ECT and who is diagnosed with Parkinsonism is at risk for injury. History of suicide, hopelessness, and disorganized thoughts would not lead the nurse to formulate a nursing diagnostic stem of Risk for injury. A student nurse asks an instructor how best to develop nursing outcomes for clients. Which response by the instructor most accurately answers the student's question? a. "You can us NIC, a standardized reference for nursing outcomes." b. "Look at your client's problems and set a realistic, achievable goal." c. "With client collaboration, outcomes should be based on client problems." d. "Copy your standard outcomes from a nursing care plan textbook." c. "With client collaboration, outcomes should be based on client problems." Client outcomes are most realistic and achievable when there is collaboration among the interdisciplinary team members, the client, and significant others.
a. By setting punishments for clients who violate the community rules b. By dealing with inappropriate behaviors as they occur c. By setting expectations wherein all clients are treated on an equal basis d. By interacting with professional staff members to learn about therapeutic interventions c. By setting expectations wherein all clients are treated on an equal basis A democratic form of self-government in the milieu contributes to client therapy by setting the expectation that all clients should be treated on an equal basis. Clients participate in the decision-making and problem-solving aspects that affect treatment setting. The norms, rules, and behavioral limits are established by the staff and clients. All individuals have input. A client is to undergo psychological testing. Which member of the interdisciplinary team should a nurse consult for this purpose? a. The psychiatrist b.
The psychiatric social worker c. The clinical psychologist d. The clinical nurse specialist c. The clinical psychologist The nurse should consult with the clinical psychologist to obtain psychological testing for the client. Clinical psychologists can administer, interpret, and evaluate psychological tests to assist in the diagnostic process. During a group discussion, members freely interact with each other. Which member statement is an example of Yalom's curative group factor of imparting information? a. "I found a Web site explaining the different types of brain tumors and their treatment." b. "My brother also had a brain tumor and now is completely cured." c. "I understand your fear and will be by your side during this time." d.
