Chapter 27: Adults

Essentials of Psychiatric Mental Health Nursing ,2nd Edition by Elizabeth M. Varcarolis

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Chapter 27: Adults

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. Health maintenance and promotion efforts for patients with severe and persistent mental illness should include education about the importance of regular:
a. home safety inspections
b. monitoring of self-care abilities
c. screening for cancer, hypertension, and diabetes
d. determination of adequacy of a patient’s support system

 

 

ANS:  C

Individuals with severe mental illness have an increased prevalence of medical disorders. Patients should be taught the importance of regular visits to a primary care physician for screening for these illnesses. Home safety inspections are more often suggested for patients with physical impairments. Caregivers and family members usually evaluate self-care abilities, rather than the patient. Assessment of a patient’s support system is not usually considered part of health promotion and maintenance.

 

DIF:    Cognitive Level: Analysis                REF:   Pages: 505-506

TOP:   Nursing Process: Planning               MSC:  NCLEX: Health Promotion and Maintenance

 

  1. Severe and persistent mental illness is characterized as a:
a. mental illness of longer than 2 weeks’ duration
b. major chronic mental illness marked by significant functional impairments
c. mental illness accompanied by physical impairment and severe social problems
d. major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities

 

 

ANS:  B

“Severe and persistent mental illness” has replaced the phrase “chronic mental illness.” Global impairments in function are evident, including social skills. Physical impairments may be present. Severe mental illness can be treated, but remissions and exacerbations are part of the course of the illness.

 

DIF:    Cognitive Level: Comprehension     REF:   Pages: 505-506

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Health Promotion and Maintenance

 

  1. A 37-year-old is involuntarily committed to outpatient treatment after sexually molesting a 12-year-old child. The patient says, “That girl looked like she was 19 years old.” Which defense mechanism is this patient using?
a. Denial
b. Identification
c. Displacement
d. Rationalization

 

 

ANS:  D

Rationalization is used to justify upsetting behaviors by creating reasons that would allow the individual to believe that the behaviors were warranted or appropriate. The patient is justifying the molestation of a minor. Denial is used to avoid dealing with the problems and responsibilities related to one’s behaviors. Identification is incorporating the image of an emulated person and then acting, thinking, and feeling like that person. Displacement is the discharge of pent-up feelings onto something or someone else in the environment that is less threatening than the original source of the feelings.

 

DIF:    Cognitive Level: Application           REF:   Pages: 513-514

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

  1. Which nursing diagnosis is likely to apply to an individual with severe and persistent mental illness who is homeless?
a. Insomnia
b. Substance abuse
c. Chronic low self-esteem
d. Impaired environmental interpretation syndrome

 

 

ANS:  C

Many individuals with severe mental illness do not live with their families and are homeless. Life on the street or in a shelter has a negative influence on the individual’s self-esteem, making this nursing diagnosis one that should be considered. Insomnia may be noted in some patients but is not a universal problem. Substance abuse is not an approved North American Nursing Diagnosis Association (NANDA) International diagnosis. Impaired environmental interpretation syndrome refers to persistent disorientation, which is not observed in a majority of the homeless.

 

DIF:    Cognitive Level: Analysis                REF:   Pages: 507-508|Page: 514

TOP:   Nursing Process: Diagnosis| Nursing Process: Analysis

MSC:  NCLEX: Psychosocial Integrity

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