Test Bank For Psychiatric Mental Health Nursing 9th by Townsend

Test Bank for Psychiatric Mental Health Nursing 9th by Townsend
Test Bank for Psychiatric Mental Health Nursing 9th

by Townsend
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-by-townsend/
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Chapter 6. Cultural and Spiritual Concepts Relevant to Psychiatric-Mental Health
Nursing
MULTIPLE CHOICE
1. Many American subcultures value punctuality, hard work, and the acquisition of material
possessions and status. The nurse recognizes that these values may contribute to which form
of mental disorders?
A. Dissociative disorders
B. Neurocognitive disorders
C. Stress-related disorders
D. Schizophrenia spectrum disorders
ANS: C
Chapter: Chapter 6, Cultural and Spiritual Concepts Relevant to Psychiatric-Mental Health
Nursing
Chapter learning objective: Identify cultural differences based on six characteristic
phenomena.
Page: 108–110
Heading: Application of the Nursing Process > Background Assessment Data > Northern
European Americans
Integrated Processes: Nursing Process: Analysis
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Culture
Difficulty: Moderate
Feedback
A This is incorrect. American subcultures that value punctuality, hard work, and
acquisition of material possessions may place this group at risk for stress-related
disorders.
B This is incorrect. American subcultures that value punctuality, hard work, and
disorders.
C This is correct. American subcultures that value punctuality, hard work, and
disorders.
D This is incorrect. American subcultures that value punctuality, hard work, and
disorders.
PTS: 1 CON: Culture
2. Which rationale is given by a nursing instructor to best explain why it is inappropriate to

classify Asian Americans as a single culture?
A. Extremes of emotional expression prevent accurate assessment of this culture.
B. Asian immigrants have been reluctant to participate in large-scale cultural
research.
C. The small size of this subpopulation makes research virtually impossible.
D. The Asian American population includes individuals from many different cultures
and countries.
ANS: D
Nursing
Chapter learning objective: Describe cultural variances, based on these six phenomena, for:
a. Northern European Americans
b. African Americans
c. American Indian and Alaska Natives
d. Asian/Pacific Islander Americans
e. Latino Americans
f. Western European Americans
g. Arab Americans
Page: 112–113
Heading: Application of the Nursing Process > Background Assessment Data > Asian Pacific
Islander Americans
Integrated Processes: Nursing Process: Evaluation
Concept: Culture
Feedback
A This is incorrect. Although some Asian Americans may have experience
difficulty expressing emotions, classification as a single culture is not
appropriate because the Asian American population includes peoples and
descendants from Japan, China, Vietnam, the Philippines, Thailand, Cambodia,
Korea, Laos, India, and the Pacific Islands.
B This is incorrect. It is not appropriate to classify the Asian American population
as a single culture because it includes peoples and descendants from Japan,
China, Vietnam, the Philippines, Thailand, Cambodia, Korea, Laos, India, and
the Pacific Islands.
C This is incorrect. Research can be conducted within any population. It is not
appropriate to classify the Asian American population as a single culture
because it includes peoples and descendants from Japan, China, Vietnam, the
Philippines, Thailand, Cambodia, Korea, Laos, India, and the Pacific Islands.
D This is correct. It is not appropriate to classify the Asian American population as
a single culture because it includes peoples and descendants from Japan, China,
Vietnam, the Philippines, Thailand, Cambodia, Korea, Laos, India, and the
Pacific Islands. There are vast differences in values, religious practices,
languages, and attitudes within the Asian American culture.
PTS: 1 CON: Culture
3. A Latin American woman refuses to participate in an assertiveness training group. Which of

the following cultural beliefs does the nurse identify has most likely influenced the client’s
decision?
A. Orientation toward the future causes the client to devalue assertiveness skills.
B. Decreased emotional expression makes it difficult for the client to be assertive.
C. Assertiveness techniques may not be aligned with the client’s definition of the
female role.
D. Religious prohibitions prevent the client from participating in assertiveness
training.
ANS: C
Nursing
e. Latino Americans
g. Arab Americans
Page: 113–114
Heading: Application of the Nursing Process > Background Assessment Data > Latino
Americans
Concept: Culture
Feedback
A This is incorrect. Latino Americans tend to be focused on the present time.
B This is incorrect. Latino Americans are frequently group oriented and often
interact with large groups of relatives. Touching and embracing are often used to
acceptably express emotion.
C This is correct. It is not uncommon for some Latin Americans to place a high
value on the male-dominated family in which the father may possesses the
ultimate authority. The woman’s refusal to participate in an assertiveness
training group may be influenced by the Latin American cultural definition of
the female role.
D This is incorrect. It is not uncommon for some Latin Americans to place a high
value on the male-dominated family in which the father may possesses the
ultimate authority. The woman’s refusal to participate in an assertiveness
training group may be influenced by the Latin American cultural definition of
the female role.
PTS: 1 CON: Culture
4. When working with clients of any culture, which action should the nurse avoid?
A. Maintaining eye contact to avoid being rude and making the client uncomfortable
B. Assuming that all individuals within a culture or ethnic group are similar
C. Supporting the client to participate in cultural and spiritual rituals
D. Using an interpreter to obtain health information during an assessment
ANS: B
Nursing
Chapter learning objective: Apply the nursing process in the care of individuals from various
cultural groups.
Page: 106
Heading: Cultural Concepts
Integrated Processes: Nursing Process: Implementation
Concept: Culture
Difficulty: Easy
Feedback
A This is incorrect. Not all cultures interpret direct eye contact as being rude.
B This is correct. Each client should be treated as an individual. Assuming all
individuals who share a culture or ethnic group are similar constitutes
stereotyping. Many variations and subcultures exist within a culture.
C This is incorrect. Each client should be treated as an individual and encouraged
to participate in his or her cultural and spiritual rituals.
D This is incorrect. When the client and nurse do not understand the same
language, the use of an interpreter is essential. The nurse must have an
understanding of the client’s needs and expectations to provide safe,
patient-centered care.
PTS: 1 CON: Culture
5. When caring for Asian American clients, of which cultural norm should the nurse be aware?
A. Obesity and alcoholism are common problems.
B. Older people frequently maintain positions of authority within the culture.
C. Milk is a staple in the Asian American diet.
D. Asian Americans are likely to seek psychiatric help.
ANS: B
Nursing
cultural groups.
Page: 112–113
Heading: Application of the Nursing Process > Background Assessment Data > Asian
Americans
Integrated Processes: Nursing Process: Assessment
Concept: Culture
Feedback
A This is not correct. The prevalence of obesity and alcoholism is low among
Asian Americans.
B This is correct. Elderly individuals often maintain positions of authority in the
Asian American culture.
C This is incorrect. Milk is seldom consumed because many Asian Americans are
lactose intolerant.
D This is incorrect. In some Asian culture, psychiatric illness may be perceived as
merely out-of-control behavior that is considered shameful to individuals and
families.
PTS: 1 CON: Culture
6. A Native American male is admitted to the emergency department with an ulcerated toe
secondary to uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a
shaman is present. Which nursing action is best?
A. Assist the client in contacting a shaman of his choice.
B. Explain to the client that folk medicine will not heal the ulcerated toe.
C. Ask the client to explain what the shaman can do that the physician cannot.
D. Inform the client that he has the right to refuse medical treatment.
ANS: A
Nursing
cultural groups.
Page: 111–112
Heading: Application of the Nursing Process > Background Assessment Data > American
Indian and Alaska Natives
Concept: Culture
Feedback
A This is correct. The best nursing action is to assist the client to contact a shaman.
In the Native American culture, religion and health-care practices are sometimes
intertwined. The shaman, a medicine man, may confer with physicians
regarding the client’s care. It is essential for nurses to understand the effects of
cultural influences to work effectively with the diverse population.
B This is incorrect. The nurse’s statement indicates stereotyping and is
nontherapeutic.
C This is incorrect. The shaman, a medicine man, may confer with physicians
regarding the care of a client. Research supports the importance of both religion
and health-care systems in the overall wellness of some Native American
clients.
D This is incorrect. The client is requesting a shaman, a medicine man, who uses a
variety of methods to treat Native American’s health problems. The shaman and
physician often collaborate with each other. Research supports the importance of
both in the overall wellness of some Native American clients.
PTS: 1 CON: Culture
7. When planning care for a Latino American client encountering illness, the nurse identifies
access to health care may be delayed when the client contacts which of the following
practitioners first?
A. Imam
B. “Yin” and “yang” practitioner
C. Shaman
D. Curandero
ANS: D
Nursing
phenomena.
Page: 113–114
Heading: Application of the Nursing Process > Background Assessment Data > Latino
Americans
Concept: Culture
Difficulty: Easy
Feedback
A This is incorrect. The imam is the leader of worship in Islam. Many Muslims
combine spiritual medicine with medical treatment.
B This is incorrect. Some Asian cultures view illness as the result of a disruption
in the balance of the yin and yang. Food, medicines, and herbs are classified
according to their hot and cold properties and are used to restore balance
between yin and yang (cold and hot), thereby restoring health.
C This is incorrect. A shaman may be seen in the Native American culture.
D This is correct. Some Latino Americans may initially contact a curandero when
illness is 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.
PTS: 1 CON: Culture
8. Which of the following perceptions might be consistent with the belief system of a traditional
Asian American client?
A. Mental illness is out of control behavior that is a shame to the family.
B. Mental illness is a curse from God related to immoral behaviors.
C. Mental illness is cured by home remedies based on religious beliefs or cultural
traditions.
D. Mental illness may only be cured by “hot and cold” herbal remedies.
ANS: A
Nursing
e. Latino Americans
g. Arab Americans
Page: 112–113
Islander Americans
Concept: Culture
Feedback
A This is correct. Some traditional Asian Americans may view mental illness as
uncontrolled behavior that brings shame to the family. It is sometimes more
acceptable for mental distress to be expressed as a physical ailment.
B This is incorrect. Some traditional Asian Americans may view mental illness as
C This is incorrect. Some traditional Asian Americans may view mental illness as
D This is incorrect. Some traditional Asian Americans may view mental illness as
PTS: 1 CON: Culture
9. A nurse should recognize that clients who have a history of missed or late medical
appointments are most likely to espouse which approach to time and orientation?
A. Future-time oriented
B. Past-time oriented
C. Present-time oriented
D. Past- and future-time oriented
ANS: C
Nursing
phenomena.
Page: 111–112
Heading: Application of the Nursing Process > Background Assessment Data > American
Indian and Alaska Natives
Integrated Processes: Assessment
Concept: Culture
Feedback
A This is incorrect. People from cultures that are future-time oriented value
punctuality and efficiency.
B This is incorrect. People from cultures that are past-time oriented may still value
punctuality.
C This is correct. People from cultures that are present-time oriented may have a
history of missed or late medical appointments. They tend to pay less close
attention to the clock. The concept of time is casual and focused on the present.
D This is incorrect. People from cultures that are both past- and future-time
oriented may still place a value on punctuality.
PTS: 1 CON: Culture
10. During the first interview with a man from Syria who has just lost his son in a car accident,
the female nurse hugs him. Which is accurate regarding the nurse’s action?
A. It is unacceptable because it may pose a breech of cultural norms.
B. It demonstrates empathy and encourages expression of feelings.
C. It is the therapeutic technique of offering self.
D. It is an inappropriate action due to poor timing.
ANS: A
Nursing
e. Latino Americans
g. Arab Americans
h. Jewish Americans
Page: 114–115
Heading: Application of the Nursing Process > Background Assessment Data > Arab
Americans
Concept: Culture
Feedback
A This is correct. The nurse’s action is unacceptable because it may pose a breech
of cultural norms. During communication, some Arab Americans stand close
together, maintain steady eye contact, and may touch the other’s hand or
shoulder but only between members of the same sex.
B This is incorrect. The nurse’s action is unacceptable because it may pose a
breech of cultural norms. During communication, some Arab Americans stand
close together, maintain steady eye contact, and may touch the other’s hand or
C This is incorrect. The nurse’s action is unacceptable because it may pose a
D This is incorrect. The nurse’s action is unacceptable because it may pose a
PTS: 1 CON: Culture
11. A nursing instructor is teaching about cultural characteristics. Which statement by the student
indicates the need for further teaching?
A. “All cultures communicate freely within their group.”
B. “All cultures embrace light therapeutic touch.”
C. “All cultures view the importance of timeliness differently.”
D. “All cultures display biological variations.”
ANS: B
Nursing
phenomena.
Page: 107
Heading: How Do Cultures Differ? > Communication
Cognitive Level: Comprehension [Understanding]
Concept: Culture
Feedback
A This is incorrect. Not all cultures embrace light therapeutic touch. In the Native
American or Latino cultures, if a hand is offered to another, it may be accepted
with a light touch; however, in some Arab or Asian cultures, touching during
communication may be considered unacceptable.
B This is correct. Not all cultures embrace light therapeutic touch. In the Native
C This is incorrect. Not all cultures embrace light therapeutic touch. In the Native
D This is incorrect. Not all cultures embrace light therapeutic touch. In the Native
PTS: 1 CON: Culture
12. The nurse is preparing to establish a therapeutic relationship with a grieving family from
Cambodia. Which nursing intervention is best?
A. Touch each member lightly, as this enhances the communication process.
B. Direct questions to the young males of the family, as they maintain positions of
authority.
C. Speak in a clear and steady voice, maintaining an acceptable distance in personal
and social space.
D. Demonstrate empathy and remain objective, as Asians express feelings freely.
ANS: C
Nursing
phenomena.
Page: 112–113
Islander Americans
Concept: Culture
Feedback
A This is incorrect. In some Asian cultures, touching during communication may
be considered unacceptable.
B This is incorrect. In Asian cultures, the elderly maintain positions of authority.
C This is correct. In some Asian cultures, to raise one’s voice may be interpreted
as a sign of loss of control. Also, acceptable personal and social spaces are
larger than in the dominant American culture.
D This is incorrect. Some Asian Americans have a great deal of difficulty
expressing emotions.
PTS: 1 CON: Culture
13. Which of the following disease processes and cultural group are correctly matched?
A. African Americans are susceptible to lactose intolerance.
B. Asian Pacific Islander Americans have the highest susceptibility to alcoholism.
C. Arab Americans are susceptible to sickle cell disease.
D. Jewish Americans are susceptible to thalassemia.
ANS: C
Nursing
phenomena.
Page: 112–113
Islander Americans
Concept: Culture
Feedback
A This is incorrect. Lactose intolerance is common in the Asian American
population.
B This is incorrect. The incidence of alcohol dependence is low among Asians.
This may be a result of a possible genetic intolerance. American Indian and
Alaska Natives are the cultural group with the highest incidence for alcoholism.
C This is correct. Sickle cell disease and the thalassemias are common in the Arab
American population.
D This is incorrect. Genetic diseases including Tay-Sachs disease, Gaucher’s
disease, and familial dysautonomia are common in the Jewish population.
Inflammatory bowel disease (ulcerative colitis and Crohn’s disease), colorectal
cancer, and breast and ovarian cancer are also common in the Jewish population.
PTS: 1 CON: Culture
14. The psychiatric nurse is performing the admission assessment of a female client who is being
admitted for depression and anxiety. The client reports a long history of excessive alcohol use
and the recent loss of her job. When the nurse asks whether she has a religious preference or
affiliation, the client states, “I used to believe in God, but I don’t anymore. I don’t understand
how God can allow bad things to keep happening to me.” Which of the following nursing
diagnoses will the nurse include in the client’s care plan?
A. Risk for lack of faith
B. Risk for spiritual distress
C. Risk for impaired religiosity
D. Risk for impaired spirituality
ANS: B
Nursing
Chapter learning objective: Apply the six steps of the nursing process to individuals with
spiritual and religious needs.
Page: 125
Heading: Addressing Spiritual and Religious Needs Through the Nursing Process >
Planning/Implementation
Integrated Processes: Nursing Process: Planning
Core concept: Spirituality
Feedback
A This is incorrect. This is not a nursing diagnosis.
B This is correct. NANDA defines risk for spiritual distress as “vulnerable to an
impaired ability to experience and integrate meaning and purpose in life through
connectedness within self, literature, nature, and/or a power greater than oneself
which may compromise health.” Risk factors include substance abuse,
depression, anxiety, and life changes.
C This is incorrect. NANDA defines risk for spiritual distress as “vulnerable to an
impaired ability to experience and integrate meaning and purpose in life through
connectedness within self, literature, nature, and/or a power greater than oneself
which may compromise health.” The client’s risk factors include substance
abuse, depression, anxiety, and life changes.
D This is incorrect. This is not a nursing diagnosis.
PTS: 1 CON: Spirituality
15. The psychiatric nurse is developing outcomes related to the nursing diagnosis spiritual
distress. Which outcome will the nurse designate as a priority for the client?
A. Accept and incorporate change into life in a healthy manner.
B. Discuss beliefs and values about spiritual and religious issues.
C. Identify and understand the meaning and purpose in life.
D. Verbalize acceptance of self as a worthwhile human being.
ANS: C
Nursing
Chapter learning objective: Apply the six steps of the nursing process to individuals with
spiritual and religious needs.
Page: 125
Heading: Addressing Spiritual and Religious Needs Through the Nursing Process >
Diagnoses/Outcome Identification
Cognitive Level: Analysis [Analyzing]
Difficulty: Difficult
Feedback
A This is incorrect. This outcome does not address spiritual distress, which is
characterized by “an impaired ability to experience and integrate meaning and
purpose in life through connectedness within self, literature, nature, and/or a
power greater than oneself which may compromise health.”
B This is incorrect. This outcome does not address spiritual distress, which is
C This is correct. This outcome addresses spiritual distress, which is characterized
by “an impaired ability to experience and integrate meaning and purpose in life
through connectedness within self, literature, nature, and/or a power greater than
oneself which may compromise health.”
D This is incorrect. This outcome does not address spiritual distress, which is
16. Which of the following reflects that the nurse understands the concepts of religion and
spirituality?
A. Religion provides the answers to questions related to the meaning in life.
B. An individual may express his or her spirituality through religion.
C. Nonattendance to religious services indicates a lack of faith.
D. Spirituality is a set of beliefs grounded in the teachings of a spiritual leader.
ANS: B
Nursing
Chapter learning objective: Define and differentiate between spirituality and religion.
Page: 123
Heading: Religion
Feedback
A This is incorrect. This is not a characteristic of religion. Religion is defined as “a
set of beliefs, values, rites, and rituals adopted by a group of people.”
B This is correct. Religion is one way an individual’s spirituality may be
expressed. Religion is defined as “a set of beliefs, values, rites, and rituals
adopted by a group of people.”
C This is incorrect. An individual may value faith and worship even though he or
she does not attend formal religious services.
D This is incorrect. Spirituality is the “recognition or experience of a dimension of
life that is invisible, and both within us and yet beyond our material world,
providing a sense of connectedness and interrelatedness with the universe.”

MULTIPLE RESPONSE
17. Prior to interviewing a client of a different culture, which of the following questions should
the nurse consider asking? Select all that apply.
A. Would using perfume products be acceptable?
B. Who may be expected to be present during the client interview?
C. Should communication patterns be modified to accommodate this client?
D. How much eye contact should be made with the client?
E. Would hand shaking be acceptable?
ANS: B, C, D, E
Nursing
cultural groups.
Page: 116
Heading: Diagnosis/Outcome Identification
Cognitive Level: Application [Analysis]
Concept: Culture
Feedback
1. This is incorrect. The nurse should consider who might be with the client during
the interview, modifications of communication patterns, amount of eye contact,
and hand-shaking acceptability.
2. This is correct. The nurse should consider who might be with the client during
PTS: 1 CON: Culture
18. A female nurse is caring for a traditional Arab American male client. Which of the following
cultural considerations should the nurse be aware of to plan effective care? Select all that
apply.
A. Limited touch is acceptable only between members of the same sex.
B. Individuals of this culture stand far apart and do not make eye contact when
conversing.
C. Devout Muslim men may not shake hands with women.
D. The man may be considered the head of the household and women take a more
subordinate role.
E. In traditional culture, men are responsible for the education of their children.
ANS: A, C, D
Nursing
cultural groups.
Page: 114–115
Heading: Application of the Nursing Process > Background Assessment Data > Arab
American
Concept: Culture
Feedback
1. This is correct. Limited touch within this culture is sometimes acceptable only
between members of the same sex.
2. This is incorrect. When conversing, it is not uncommon for individuals of this
culture to stand close together and maintain eye contact.
3. This is correct. Devout Muslim men may not shake hands with women due to
religious beliefs.
4. This is correct. In the Arab American culture, a woman is sometimes treasted as
subordinate to a man, who may be considered the head of household.
5. This is incorrect. It is more common with Arab American cutlures for women to
have responsibilities for the education of their children.
PTS: 1 CON: Culture
19. Which of the following are correlated with an individual’s affiliation with a religious faith?
Select all that apply.
A. Decreased incidence of mental illness
B. Improved social relationships
C. Access to health care
D. Increased chance of survival following serious illness
E. Better physical and mental health
ANS: A, D, E
Nursing
Chapter learning objective: Identify clients’ spiritual and religious needs.
Page: 123
Heading: Religion
Feedback
1. This is correct. Several studies indicate a correlation between religious faith and
fewer instances of depression and mental illness.
2. This is incorrect. Several studies indicate a correlation between religious and
increased chance of survival following serious illness, fewer instances of
depression and mental illness, longer life, and overall better physical and mental
health.
3. This is incorrect. Several studies indicate a correlation between religious and
increased chance of survival following serious illness, fewer instances of
depression and mental illness, longer life, and overall better physical and mental
health.
increased chance of survival following serious illness.
better physical and mental health.
20. Which of the following indicate the effects of love on the healing process? Select all that
apply.
A. Increased production of norepinephrine reduces susceptibility to depression.
B. Decreased production of endorphins helps relieve chronic pain.
C. Decreased inflammation is due to improved immune system function.
D. Increased cortisol levels suppress the fight-or-flight syndrome.
E. Increased levels of oxytocin reduce cardiovascular stress.
ANS: A, C, E
Nursing
Chapter learning objective: Identify clients’ spiritual and religious needs.
Page: 122
Heading: Spiritual Needs > Love
Cognitive Level: Analysis [Analyzing]
Feedback
1. This is correct. Love increases the production of norepinephrine and dopamine
and may stave off depression
2. This is incorrect. Increased levels of endorphins contribute to a sense of euphoria
and help reduce pain.
3. This is correct. Love has a positive effect on the immune system resulting in
decreased inflammation and pain.
4. This is incorrect. Love decreases production of the stress hormone cortisol and
counteracts the fight-or-flight syndrome.
5. This is correct. Love encourages the production of oxytocin, the “feel good”
Test Bank for Psychiatric Mental Health Nursing 9th by Townsend
hormone, which can reduce cardiovascular stress and improve the immune
system.
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PTS: 1 CON: Culture

2. Which rationale is given by a nursing instructor to best explain why it is inappropriate to

PTS: 1 CON: Culture

3. A Latin American woman refuses to participate in an assertiveness training group. Which of

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Spirituality

PTS: 1 CON: Spirituality

PTS: 1 CON: Spirituality

PTS: 1 CON: Culture

PTS: 1 CON: Culture

PTS: 1 CON: Spirituality

PTS: 1 CON: Spirituality

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