Test Bank For Foundations of Mental Health Care 6th Edition by Morrison Valfre Full Download

Test Bank for Foundations of Mental Health Care 6th Edition by Morrison Valfre
Test Bank for Foundations of Mental Health Care 6th

Edition by Morrison Valfre
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Chapter 8: Skills and Principles of Mental Health Care
MULTIPLE CHOICE
1. An adult male client in an outpatient clinic has made great progress with conquering his
social phobias. He is considered mentally healthy because now he is able to:
a. Cope and adjust to the stressors of daily life in an acceptable manner
b. Know when to take medication to control his anxiety
c. Contact his therapist any time he is feeling extreme anxiety
d. Adjust his medication dosages according to the stressors he is dealing with
ANS: A
Coping and adjusting to stressors in an acceptable manner is a characteristic of a mentally
healthy individual. Knowing when to take medication to control anxiety and contacting
the therapist demonstrate dependency and are not characteristics of being mentally
healthy. Clients should not self-adjust medications.
DIF: Cognitive Level: Application REF: Page 72 OBJ: 1

TOP: The Mentally Healthy Adult KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
2. An adult female client becomes combative with the nurse during routine medication
administration. What is the nurse’s primary responsibility in this situation?
a. To ensure that the client takes her medications
b. To ensure that the client is placed in physical restraints to protect the safety of the
staff and other clients
c. To ensure that chemical restraints are used in the future until the client displays
more appropriate and compliant behavior
d. To ensure that the client is kept safe while trying to protect staff safety and to
reason with the client to try to de-escalate the combative behavior
ANS: D
The “Do no harm” principle of mental health care applies to this situation. Client and
staff safety are imperative. Ensuring that the client takes her medications is not of greatest
concern in this situation because this most likely would cause increased combativeness.
Physical restraints and chemical restraints are not reasonable options in the care of this
patient.

TOP: Do No Harm KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank 8-
2
3. A nurse is trying to develop trust with a client on an inpatient mental health unit. Which
action by the nurse is going to best promote development of a mutually trusting
relationship?
a. At the beginning of the shift, the nurse promises to play a game of cards with the
client at some point during that day and does so before the end of the shift.
b. The nurse promises to play a game of cards with the client on the following day.
c. The nurse leads a group discussion with clients about ways to develop trust in a
relationship.
d. The nurse gives the client written information about the medications he is taking.
8-3
Test Bank
ANS: A
Developing mutual trust is one of the principles of mental health care. The nurse most
likely would be able to carry out plans on a daily basis rather than trying to make plans
for the next day. Making plans with the client is a very effective way to develop trust, as
long as the plans can be carried out. Leading a group discussion and giving written
information are helpful to clients but are not going to promote development of trust in the
same way that making plans and carrying them out would do.

TOP: Develop Mutual Trust KEY: Nursing Process Step: Intervention
4. An adult female client is exhibiting behavior that the nurse interprets as anger toward
another client. What is the nurse’s best action?
a. Continue to monitor the client’s behavior and document it as anger directed toward
another client
b. Talk with the client about the observations made, and ask whether she was
displaying anger toward the other client
c. Ask the other client if she felt that the client was angry at her
d. Ask the client to write in a journal the emotions she was feeling at that time
ANS: B
Asking the client is an effective way of understanding the meaning of her behavior and is
one of the principles of mental health care. Documentation of the nurse’s interpretations
without clarification would not be appropriate, nor would involving another client by
asking for her interpretation of the situation. Asking the client to write in a journal is fine,
but not in this circumstance.

TOP: Explore Behaviors and Emotions KEY: Nursing Process Step: Intervention
5. A nurse and an adolescent female client develop a plan of care together that addresses the
client’s difficult relationship with her parents. The client says that her parents just don’t
understand her, and she is always getting privileges taken away for not doing things that
she is supposed to do. What is the nurse’s best action?
a. Talk with the client about how important it is that she carry through with actions
that her parents feel are important
b. Identify two priority responsibilities that are agreed upon between the client and
her parents, and monitor her ability to comply with the plan for 1 week
c. Discuss with the parents what responsibilities they feel are important, to determine
what actions should be planned with the client
d. Identify what the client feels are reasonable responsibilities
8-4
Test Bank
ANS: B
Responsibility is one of the principles of mental health care that should be fostered. It is
important to work in conjunction with all involved parties to set a realistic goal and plan
of action. Remaining options do not include all parties and do not set a realistic goal or
plan.

TOP: Encourage Responsibility
KEY: Nursing Process Step: Planning | Nursing Process Step: Intervention | Nursing Process
Step: Evaluation MSC: Client Needs: Psychosocial Integrity
6. __________ coping mechanisms are means of successfully solving a problem or reducing

one’s stress level.
a. Defensive
b. Maladaptive
c. Constructive
d. Individual
ANS: C
Constructive, or adaptive, coping mechanisms are effective because they deal with the
problem to attempt to solve it and in turn reduce stress. Defensive and maladaptive
mechanisms do not deal with the problem effectively. Individual coping mechanisms may
or may not be effective.
DIF: Cognitive Level: Knowledge REF: Page 77 OBJ: 3

TOP: Encourage Effective Adaptation KEY: Nursing Process Step: Intervention
7. A male client has learned to be successful with cognitive, or intellectual, coping

mechanisms when faced with stressors, as evidenced by his ability to:
a. Confront stressors directly
b. Negotiate when faced with the problem
c. Ignore the problem to avoid the stress it causes
d. Use successful problem-solving skills
ANS: D
Using effective problem-solving skills is considered a characteristic of cognitive, or
intellectual, coping behavior. Confrontation and negotiation are considered psychomotor,
or physical, coping behaviors. Ignoring the problem could be considered an ineffective
psychomotor coping behavior.

TOP: Encourage Effective Adaptation KEY: Nursing Process Step: Assessment
8-5
Test Bank
8. A married woman, who is the mother of two children, has been in an abusive relationship
for 4 years. She decides to leave her husband after suffering an episode of severe physical
abuse. She and her children, ages 7 and 9, arrive at a crisis intervention center. What is
the nurse’s priority intervention?
a. Offer immediate emotional support
b. Refer her to a woman’s domestic abuse center
c. Begin to develop a treatment plan for the client and her children
d. Thoroughly assess the situation from most recent to 2 weeks prior to this incident
ANS: A
All of the options are steps in the crisis intervention process, but emotional support is the
first priority for helping to reduce high anxiety levels.

TOP: Crisis Intervention KEY: Nursing Process Step: Intervention
9. A male client with bipolar disorder has been admitted to a mental health unit during a
manic phase. To provide consistency for this client, the care plan should be:
a. Revised on a daily basis by the treatment team
b. Followed by each member of the treatment team
c. Allowed to be changed by the client as necessary
d. Evaluated primarily by the physician
ANS: B
Clients with mental health disorders often are lacking consistency in their lives.
Continuity of care provided by all members of the treatment team can provide needed
consistency. Daily revision does not provide consistency, nor does allowing the client,
without working with the treatment team, to make changes to the plan of care. The entire
treatment team, rather than just the physician, should evaluate the plan of care.

TOP: Provide Consistency KEY: Nursing Process Step: Evaluation
10. A male client with the diagnosis of depression has not attended his last two group
meetings. The nurse provides a printed schedule of meeting dates and times to the client
the next time she sees him. The nurse’s actions can be described as:
a. Insight
b. Self-awareness
c. Empathy
d. Client advocacy
ANS: D
8-6
Test Bank
Advocacy is when the nurse works on behalf of the client by providing him with the tools
needed to make decisions. It is especially important to be an advocate for clients with
mental health disorders because it often is difficult for them to make informed decisions.
Insight refers to the ability to see intuitively, self-awareness is looking into and analyzing
oneself, and empathy encompasses the ability to understand and enter into another
person’s emotions. All of the options listed are skills needed if mental health care workers
are to practice effectively.

TOP: Caring KEY: Nursing Process Step: Intervention
11. An adolescent female client with anger management issues is found destroying items in
her room. What is the nurse’s most appropriate response?
a. “Stop! Why are you destroying these things?”
b. “You need to stop that behavior. Destroying hospital property is not allowed.”
c. “Why do you feel you have the right to destroy those things?”
d. “You are very disappointing to me right now.”
ANS: B
Acceptance of the client with a mental health disorder is very important, especially when
his or her behavior is not acceptable. The nurse must accept the person in this situation,
but not the behavior. The response in the correct option focuses on the inappropriate
behavior rather than on correcting the person. The other options focus on the person.

TOP: Acceptance KEY: Nursing Process Step: Intervention
12. An adolescent female client continually displays a negative attitude toward everyone she
comes into contact with and toward life in general. Which action should the nurse
implement first that will be helpful in assisting this client to develop a more positive
attitude?
a. Helping the client recognize negative thoughts, emotions, and attitudes
b. Pointing out every negative behavior that the client displays
c. Assisting the client to replace negative thoughts by frequently repeating positive
statements
d. Praising positive behavior exhibited by the client
ANS: A
The nurse must help the client to identify negative thoughts, emotions, and attitudes
before the client can concentrate on changing this behavior. Pointing out every negative
behavior would not be therapeutic, and assisting the client to replace negative thoughts
and praising positive behavior promote development of a positive attitude but do not
constitute the first step.
8-7
Test Bank

TOP: Positive Outlook KEY: Nursing Process Step: Intervention
13. A caregiver is said to be practicing __________ care not only when she takes into
consideration the client’s actual or potential problems but also when she considers the
client’s family, work responsibilities, and social aspects of life. Which of the following
best describes this caregiving concept?
a. Competent
b. Complete
c. Holistic
d. Crisis
ANS: C
Holistic care encompasses all aspects of an individual. Competent care and complete care
are essential, but neither is the best choice to answer the description in this question.
Crisis intervention components are not addressed in this scenario.
DIF: Cognitive Level: Comprehension REF: Page 73 OBJ: 3

TOP: Accept Each Client as a Whole Person
KEY: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity
14. A client is believed to have adapted to a situation when he or she exhibits which
characteristic?
a. The client has become accustomed to his or her surroundings.
b. The client has shown improvement in behavior as evidenced by the ability to carry
out activities normal to his or her life.
c. The client has accepted his or her current behavior patterns.
d. The client has established a trusting relationship with the caregivers who are
providing care.
ANS: B
Adaptation, in mental health terms, is best shown in the client’s improved behavior and
ability to carry out activities normal to his or her life; this displays effective coping skills.
The other options do not show complete adaptation.

TOP: Crisis Intervention KEY: Nursing Process Step: Evaluation
8-8
Test Bank
15. One of the goals of therapy established with a client on a mental health unit who has been
given a diagnosis of obsessive-compulsive disorder (OCD) is to improve his feelings of
stability in his environment. Much of his OCD behavior manifests as cleanliness and
control of germs. Which nursing intervention most likely would help this client to feel
more stable in his environment?
a. Encouraging visits from family members and friends
b. Rewarding him for acceptable behavior by increasing the number of times he is
allowed to clean his bathroom daily
c. Encouraging him to participate in group activities
d. Allowing him to wash his hands only for an agreed upon number of times daily
ANS: D
Setting limits for clients with mental health disorders helps them to feel more stable in
their environment because these clients often are incapable of setting limits on their own.
Encouraging family visits may be beneficial for needs of comfort and love but not for
stability. Rewarding this client by allowing him to increase the number of times he may
clean the bathroom does not provide for stability because it fosters inconsistency in rules
and routines. Encouraging group activities is beneficial for diversional purposes and love
and belonging needs but does not best address the stability issue.

TOP: Provide Consistency KEY: Nursing Process Step: Intervention
16. Which is the best way that a nursing unit manager can assist his or her staff in
maintaining a professional commitment to their job and profession?
a. Frequently offering and requiring a specific number of hours of in-service training
on new care modalities within the facility
b. Requiring out-of-facility continuing education hours twice a year
c. Encouraging staff to subscribe to nursing journals to keep up-to-date on new
information
d. Keeping nursing journals on the unit for easy access to staff
ANS: A
Professional commitment is accomplished by keeping current with developments within
one’s profession, improving therapeutic effectiveness, and seeking out new knowledge.
Offering and requiring in-service training is the easiest way to seek new knowledge and
remain current in the profession, while at the same time making the staff accountable to
attend a certain number of sessions.
DIF: Cognitive Level: Application REF: Page 81 | Page 82

OBJ: 9 TOP: Commitment
KEY: Nursing Process Step: Intervention
8-9
Test Bank
17. The nurse is working with a male client to instill a feeling of self-commitment, to
improve his self-esteem. From which of the following interventions would the client most
benefit?
a. Having the client promise himself that he will do the best he can in a particular
situation, knowing that failure is a possibility
b. Encouraging the client to do the best he can in any given situation, while
reminding him that failure is a possibility
c. Ensuring that the client limits activities to those in which he is sure to be
successful
d. Allowing the client to set goals that are nearly impossible to achieve but giving
him the opportunity to try his best to meet these goals
ANS: A
Having the client promise himself, with the knowledge that failure is a possibility, is the
most beneficial option because it is making the client active in the process and is also the
most realistic approach. Simply encouraging the client does not make the client active in
the situation. Ensuring that the client limits activities to those in which he will be
successful is too protective. Allowing the client to set nearly impossible goals is setting
him up for failure.

TOP: Risk Taking and Failure KEY: Nursing Process Step: Intervention
18. The nurse is working with a health care team with the philosophy of reality therapy. The
nurse is aware that the team’s belief is centered around:
a. Reorientation of the client to his or her environment
b. Describing clients as irresponsible rather than mentally ill
c. Looking at the client’s past in determining how it has affected present behavior
d. Accepting the client’s perceptions of right and wrong behavior in the development
of his treatment plan
ANS: B
Reality therapy focuses on responsibility and does not accept the premise of mental
illness. Reality therapists look at the present and future and do not look to the past for
excuses for behavior. Reality therapy also emphasizes the morality of behavior and does
not allow the client’s own interpretation of right and wrong.
DIF: Cognitive Level: Comprehension REF: Page 76 OBJ: 6

TOP: Encourage Responsibility KEY: Nursing Process Step: Intervention
19. Addressing a client by Mr. or Ms. and his or her last name, unless the client asks the
nurse to address him or her by another name, is an example of the therapeutic action of
__________.
8-10
Test Bank
a. Self-awareness
b. Caring
c. Empathy
d. Advocacy
ANS: B
This shows respect for an individual, which is a vital component of caring. The other
options are also important skills for mental health caregivers but are not represented in
this question.

TOP: Caring KEY: Nursing Process Step: Assessment
20. A woman goes to a late movie with her friends and gets home after midnight. She is
scheduled to play in a tennis tournament early the next morning and loses all her matches.
She blames the line judges for her loss, rather than her poor play. Which coping
mechanism best describes her response to losing the match?
a. Denial
b. Regression
c. Displacement
d. Rationalization
ANS: D
Rationalization is a coping mechanism in which a person creates a logical reason for
unwanted behavior. In this situation, being out late the night before was a likely cause for
her playing poorly, but it was easier to blame the judges than take responsibility for the
loss. The other options are also coping mechanisms, but they do not describe the response
in this scenario.

TOP: Crisis Intervention KEY: Nursing Process Step: Intervention
MULTIPLE RESPONSE
1. Identify the stages experienced by a person in a crisis. Select all that apply.
a. Recovery
b. Adaptation
c. Disorganization
d. Crisis
e. Denial
f. Reorganization
g. Perception
h. Exhaustion
8-11
Test Bank
ANS: A, C, D, E, F, G
These are the typical stages that a person in crisis experiences. The stages usually occur
in the order of perception, denial, crisis, disorganization, recovery, and reorganization.

TOP: Crisis Intervention KEY: Nursing Process Step: Assessment
2. Which of the following are signs that indicate that the mental health nurse is becoming
overly involved with a client’s care? Select all that apply.
a. Knowing when to help and when not to help a client
b. Showing greater levels of concern for one client over all other clients
c. Feeling that the nurse is the only caregiver who understands the client
d. Being committed to providing competent health care at all times
ANS: B, C
Showing greater levels of concern for one client over all other clients and the nurse’s
feeling that he or she is the only caregiver who understands the client are signs that
indicate the development of a co-dependency with a client that can result from
over-involvement of the practitioner with a particular client. The other options describe
qualities needed to provide effective health care.
DIF: Cognitive Level: Analysis REF: Page 81 OBJ: 8

TOP: Boundaries and Overinvolvement KEY: Nursing Process Step: Evaluation
3. An important component of providing good care is for health caregivers to take care of,
or nurture, themselves. Which of the following are ways that effectively assist health
caregivers to nurture themselves? Select all that apply.
a. Be supportive of colleagues
b. Recognize and accept one’s own limitations, and strive to improve
c. Take pride in oneself
d. Accept all challenges presented
e. Be responsible and accountable for one’s own actions
ANS: A, B, C, E
Caregivers are constantly serving as client advocates, but they must be careful to avoid
expending their energies without renewing energy. A caregiver cannot provide quality
health care unless he first takes care of himself. One does not have to take on all
challenges presented to him because this can be exhausting to an individual.

TOP: Principles and Practices for Caregivers
Test Bank for Foundations of Mental Health Care 6th Edition by Morrison Valfre
8-12
Test Bank
KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity
COMPLETION
1. __________ mechanisms are thoughts or actions that are used to help individuals handle
or reduce stress.
ANS:
Coping
Coping mechanisms provide a way for people to deal with stress. Coping mechanisms are
effective as long as they are not continually used by an individual when faced with
stressful situations.

TOP: Crisis Intervention KEY: Nursing Process Step: Assessment
OTHER
1. Place in proper order steps in the process of growing as a result of failure.

a. Consider one’s failure as a learning experience
b. Give oneself permission to fail
c. Understand that failure is a necessary part of change
d. Discover opportunities that are created by failure
ANS:
C, B, A, D
For a person to grow, he or she must take risks. Taking risks allows the possibility that
failure may occur. It is important to educate clients and to ensure that they understand
that failure is not a negative occurrence; rather, it provides the opportunity for change.

TOP: Risk Taking and Failure KEY: Nursing Process Step: Intervention
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DIF: Cognitive Level: Application REF: Page 72 OBJ: 1

DIF: Cognitive Level: Application REF: Page 73 OBJ: 2

DIF: Cognitive Level: Application REF: Page 74 OBJ: 3

DIF: Cognitive Level: Application REF: Page 75 OBJ: 3

DIF: Cognitive Level: Application REF: Page 75 OBJ: 3

6. __________ coping mechanisms are means of successfully solving a problem or reducing

DIF: Cognitive Level: Knowledge REF: Page 77 OBJ: 3

7. A male client has learned to be successful with cognitive, or intellectual, coping

DIF: Cognitive Level: Application REF: Page 77 OBJ: 3

DIF: Cognitive Level: Application REF: Page 77 OBJ: 5

DIF: Cognitive Level: Application REF: Page 78 OBJ: 6

DIF: Cognitive Level: Application REF: Page 79 OBJ: 9

DIF: Cognitive Level: Application REF: Page 80 OBJ: 8

DIF: Cognitive Level: Application REF: Page 82 OBJ: 10

DIF: Cognitive Level: Comprehension REF: Page 73 OBJ: 3

DIF: Cognitive Level: Application REF: Page 77 OBJ: 5

DIF: Cognitive Level: Application REF: Page 78 OBJ: 6

DIF: Cognitive Level: Application REF: Page 81 | Page 82

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DIF: Cognitive Level: Knowledge REF: Page 77 OBJ: 5

DIF: Cognitive Level: Analysis REF: Page 81 OBJ: 8

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DIF: Cognitive Level: Knowledge REF: Page 77 OBJ: 5

1. Place in proper order steps in the process of growing as a result of failure.

DIF: Cognitive Level: Application REF: Page 80 OBJ: 7

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