41 minute read
Chapter 03: Ethical and Legal Issues
from TEST BANK for Foundations of Mental Health Care 7th Edition Morrison-Valfre. All 33 Chapters.
by ACADEMIAMILL
Morrison-Valfre: Foundations of Mental Health Care, 7th Edition
Multiple Choice
1. A male teenage client tells the nurse that his friends like to drink alcohol occasionally to get drunk. The client’s friends see nothing wrong with their drinking habits. The client states that he was taught by his parents and agrees that underage drinking is not acceptable. Also, he has never seen his parents drunk; therefore, he refuses to drink with his friends. Which mode of transmission best describes how this client’s particular value was formed?
a. Moralizing b. Modeling c. Reward-punishment d. Laissez-faire
ANS: B
Modeling best describes how the teenage client developed this value because his parents not only discussed this issue but also behaved in a way for the teen to copy. Moralizing sets standards of right and wrong with no choices allowed; the reward-punishment model rewards valued behavior and punishes undesired behavior; and the laissez-faire model imposes no restriction or direction on choices.
DIF: Cognitive Level: Application REF: p. 22 | Table 3.1
OBJ: 1 TOP: Acquiring Values
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity a. Values clarification b. Nurse’s rights c. Beliefs d. Morals
2. A female client becomes combative when the nurse attempts to administer routine medications. The nurse would like to ignore the client but chooses to talk with the client to calm her. The nurse is successful in calming the client, and the client takes her medications. What process best describes how the nurse decided on the course of action taken?
ANS: A
Values clarification consists of the steps of choosing, prizing, and acting. This most accurately describes how the nurse made the proper decision. The nurse chose the best action, reaffirmed the choice, and then enacted the choice. The nurse’s rights were not violated, and beliefs and morals do not describe the entire decision-making process that occurred.
DIF: Cognitive Level: Application REF: p. 22 OBJ: 1
TOP: Values Clarification KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
3. Twenty-three states have enacted mental health parity laws. The most accurate description of these laws is that they require insurance companies to: a. include coverage for mental illness. b. include coverage for substance abuse treatment. c. include coverage for mental illness that is equal to coverage for physical illness. d. include coverage for outpatient therapy for individuals with substance abuse.
ANS: C
The mental health parity laws require insurance companies to include coverage for mental illness that is equal to coverage for physical illness. Only nine states include treatment for substance abuse in their parity laws.
DIF: Cognitive Level: Knowledge REF: p. 23 OBJ: 2
TOP: Client Rights KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment a. Fidelity b. Veracity c. Confidentiality d. Justice
4. The client is feeling very anxious and has requested that a prn. antianxiety medication be ordered. The nurse informs the client that the medication can be administered only every 4 hours and was given 3 hours ago. The nurse promises to give the client the medication as soon as it is due, but the nurse goes to lunch 1 hour later without giving the client the medication. Which ethical principle did the nurse violate?
ANS: A
Fidelity refers to the obligation to keep one’s word. The nurse violated this principle in this situation, which leads to mistrust from the client. Veracity is the duty to tell the truth, confidentiality is the duty of keeping the client’s information private, and justice indicates that all clients must be treated fairly, equally, and respectfully.
DIF: Cognitive Level: Application REF: p. 24 OBJ: 3
TOP: Ethical Principles
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
5. A male client is seeking help in a mental health clinic for anger management problems. He voices that he is fearful that his wife may divorce him because of his anger problem, and he is willing to do “whatever it takes” to control his anger. Later in the week, the client’s wife also seeks assistance because she is going to divorce her husband. The nurse who is caring for both of these clients tries to decide the correct action to take. The nurse is experiencing: a. a moral dilemma. b. value clarification. c. an ethical conflict (or dilemma). d. a breach of confidentiality.
ANS: C
This is an example of an ethical conflict or ethical dilemma. The nurse wants to help both clients but must maintain confidentiality for each. Use of guidelines for ethical decision-making can assist the nurse in making an ethical decision. A moral dilemma is simply a dilemma associated with making a decision between right and wrong. Value clarification is a process that helps to identify an individual’s values.
DIF: Cognitive Level: Application REF: p. 24
OBJ: 3
TOP: Ethical Conflict KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. National nurse practice act b. State nurse practice act c. Regional nurse practice act d. Community nurse practice act
6. The psychiatrist asks the nurse to perform a procedure that she is not familiar with, and the nurse is unsure whether this is something within the scope of practice. Where can the nurse find the answer to her question?
ANS: B
Each state’s board of nursing determines the scope of practice in that state through a series of regulations that are called nurse practice acts. It is the nurse’s responsibility to know his or her scope of practice. The other options do not exist.
DIF: Cognitive Level: Comprehension REF: p. 26
OBJ: 4
TOP: Legal Concepts in Health Care KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
7. Standards of nursing practice for mental health can best be described as helping to ensure: a. that certain clients receive care. b. quality and effectiveness of care. c. proper documentation. d. proper medication administration.
ANS: B
Most health care disciplines have standards of practice documented as guidelines with measurable criteria that can be used to evaluate the quality and effectiveness of care provided. All clients have the right to receive care, so standards of nursing practice would not address who receives care. Although proper documentation and proper medication administration might be part of the evaluation process, they do not provide complete evaluation of quality and effectiveness of care.
DIF: Cognitive Level: Comprehension REF: p. 23
OBJ: 4
TOP: Legal Concepts in Health Care KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
8. If a client is involuntarily committed to a mental health care facility indefinitely, the law requires that the case must be reviewed every: a. 3 months. b. 6 months. c. 12 months. d. 15 months.
ANS: C
Although the case is being reviewed constantly by the mental health care team, the court must review the indefinite commitment on a yearly basis.
DIF: Cognitive Level: Knowledge REF: p. 27 OBJ: 5
TOP: Adult Psychiatric Admissions KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. Assault b. Battery c. Privacy d. Fraud
9. A male client is being argumentative during a group therapy session. The psychiatric technician warns the client that if he does not cooperate with the nurse, he will be physically restrained and taken to his room for the remainder of the day. For which action could the technician be held liable?
ANS: A
The technician is engaging in assault, which is any act that threatens a client. Battery of a client occurs when any physical act of touching occurs without the client’s permission. Privacy refers to issues related to the body and confidentiality, and fraud is giving false information.
DIF: Cognitive Level: Application REF: p. 27 OBJ: 6
TOP: Areas of Potential Liability
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. An alert and oriented client is confined to his room after being loud and argumentative with another client in the recreation area. b. Restraints are placed on a client who has been admitted in a lethargic state because of misuse of medications and who has fallen three times since admission. c. A client is housed in a private room with visual monitors after attempting suicide at home on the previous day. d. An alert and oriented client who was admitted for a 72-hour involuntary commitment is prevented from leaving the facility 2 days after admission.
10. Which of the following circumstances, when it occurs on an inpatient mental health unit, would be considered false imprisonment?
ANS: A
The client cannot be confined to his room if he did not pose a threat to himself or others, or if no contract was made with the client regarding consequences for inappropriate behavior. All of the other options are appropriate because they follow guidelines for client safety.
DIF: Cognitive Level: Analysis REF: p. 28 OBJ: 6
TOP: Areas of Potential Liability KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. Social worker b. Nurse c. Physician d. Facility’s legal representative
11. The nurse often assists in the process of obtaining informed consent from the client for treatment and/or procedures. Who has the responsibility of providing information to the client so he can give informed consent?
ANS: C
The physician is responsible for providing the client with the information necessary to give informed consent, including expectations and risks involved. The nurse can assist by obtaining the written documentation necessary for informed consent.
DIF: Cognitive Level: Knowledge REF: p. 24 OBJ: 8
TOP: Care Providers’ Responsibilities
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. escape b. abandon c. flee d. elope
12. An important responsibility of the nurse in a mental health facility is to ensure that clients do not from the facility without a discharge order, by carefully supervising and accurately documenting client behaviors and therapeutic actions.
ANS: D
The appropriate terminology used when a client runs away from a facility without a discharge order is elopement. In the event of elopement, the caregiver can be held liable if a client becomes injured.
DIF: Cognitive Level: Knowledge REF: p. 28 OBJ: 8
TOP: Care Providers’ Responsibilities
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. Try to talk with the client to convince her not to harm the girlfriend. b. Have the client sign a contract with you stating that she will not harm the girlfriend. c. Inform the ex-husband of the intentions of the client. d. Inform the girlfriend of the intentions of the client.
13. If a female client tells the nurse of extensive plans, she has to harm the girlfriend of her ex-husband, what is the nurse’s best action?
ANS: D
Health care providers have a duty to warn others when serious harm may occur as the result of actions taken by the client. This does not breach confidentiality because providers have an obligation to protect the public as well as the client. In addition to warning the client, the nurse should inform the client’s physician and the nursing supervisor and must document the situation and actions taken. The other options are not adequate to meet the duty to warn or to prevent harm to the girlfriend.
DIF: Cognitive Level: Application REF: p. 28 OBJ: 8
TOP: Care Providers’ Responsibilities
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. Beneficence b. Autonomy c. Confidentiality d. Nonmaleficence
14. The nurse encounters a client crying in her room. Upon talking to the client, it is discovered that she is upset because a new nursing assistant made her go out for a walk with the group even though the client informed her that she waits for her daughter to go for her walk. This is a potential violation of which ethical principle?
ANS: B
Autonomy refers to the right of people to act for themselves and make personal choices. The principle of beneficence refers to actively doing good, and maleficence refers to doing no harm. Confidentiality is not violated in this situation.
DIF: Cognitive Level: Application REF: p. 24
TOP: Ethical Principles
OBJ: 1
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. Slander b. Invasion of privacy c. Assault d. Libel
15. A client preparing for discharge from an inpatient unit asks a nurse which psychiatrist she would recommend to use for follow-up as an outpatient. The nurse responds, “There are several good physicians on your list. Make sure you do not use Dr. Smith. I have heard some terrible things about his methods of treatment.” This is an example of which type of potential liability?
ANS: A Slander is verbal defamation, which is false communication, and can result in harm to the psychiatrist’s practice. Libel is written defamation, and assault is threat of bodily harm. Invasion of privacy pertains to confidential information and is not pertinent in this case.
DIF: Cognitive Level: Application REF: p. 27
TOP: Areas of Potential Liability
OBJ: 6
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
16. A client frequently wanders around the unit, and the staff frequently needs to reorient the client to the environment and remind her not to walk into the rooms of other clients on the unit. Due to short staffing, the decision is made to use a restraint device to prevent this from occurring. This action may constitute: a. assault. b. defamation. c. false imprisonment. d. negligence.
ANS: C
The application of protective devices and restraints may constitute false imprisonment. Restraints must be used only to protect the client, not for staff convenience. All less restrictive measures should first be attempted and documented.
DIF: Cognitive Level: Application REF: p. 26
OBJ: 6
TOP: Areas of Potential Liability KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
Multiple Response
1. If a person is perceived to be a threat to himself or others, who can implement an involuntary commitment to a mental health facility? (Select all that apply.)
a. Family members b. Police c. Physicians d. Social workers e. Representatives of a county administrator
ANS: B, C, E
Police, physicians, and representatives of a county administrator are the only individuals who can implement an involuntary admission to a mental health facility. An involuntary admission can last from days to years, depending on the need. A court order is necessary for extended involuntary admissions.
DIF: Cognitive Level: Knowledge REF: p. 26
TOP: Adult Psychiatric Admissions
OBJ: 5
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment a. The provider owed a duty to the client. b. The provider breached a duty to the client. c. The provider had intent to harm the client. d. The provider caused injury to the client by action or inaction. e. The provider caused loss or damage through his or her actions.
2. For a nurse or health care provider to be found negligent, what requirements must the provider’s misconduct meet? (Select all that apply.)
ANS: A, B, D, E
These four criteria must be present for an act of a health care provider to be considered negligent. Intent to harm would be considered a criminal action rather than an action of negligence.
DIF: Cognitive Level: Comprehension REF: p. 28
TOP: Areas of Potential Liability
OBJ: 7
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
Chapter 04: Sociocultural Issues
Morrison-Valfre: Foundations of Mental Health Care, 7th Edition
Multiple Choice
1. An older Asian female with a diagnosis of depression is cared for by her granddaughter. Her granddaughter is very attentive to the client’s needs, attends every therapy session, and is active in the planning and implementing of the treatment plan. The granddaughter’s valuing of her grandmother is most likely due to her: a. ethnicity. b. cultural beliefs. c. religion. d. stereotype.
ANS: B
Cultural beliefs develop over many generations and are a learned set of values, beliefs, and behaviors. Asian cultures commonly value their elderly family members. Ethnicity and religion do not explain the granddaughter’s behavior in that ethnicity describes customs and socialization patterns, and religion refers to an organized form of worship. Stereotyping is a preconceived belief about another cultural group, so it does not apply to this situation.
DIF: Cognitive Level: Application REF: p. 32
OBJ: 1
TOP: Characteristics of Culture KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Disease is defined as: a. social dysfunction. b. emotional dysfunction. c. physical dysfunction. d. intellectual dysfunction.
ANS: C
Disease differs from illness in that disease is an abnormal physical function, whereas illness refers to social, emotional, and intellectual dysfunction. Illness is affected by culture, but disease is not.
DIF: Cognitive Level: Knowledge REF: p. 34
OBJ: 4
TOP: Health and Illness Beliefs KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Physiological Integrity
3. The nurse is caring for a 20-year-old woman from Puerto Rico. The client speaks English, but she is accompanied by her mother, who does not. The client has a history of mental illness, and through the interpreter, the nurse learns that the mother, who has traditional Puerto Rican cultural beliefs, believes that the client’s mental illness is caused by: a. witchcraft. b. stress. c. chemical imbalances. d. a trance.
ANS: A
It is a common traditional Puerto Rican cultural belief that mental illness is caused by witchcraft, magic, or evil spells, as opposed to more traditional Western medicine, which believes that stress and chemical imbalances play a role in mental illness. A trance is considered a state of consciousness in some cultures.
DIF: Cognitive Level: Comprehension REF: p. 34 OBJ: 4
TOP: Health and Illness Beliefs KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Need for environmental control b. Time orientation c. Space comfort zone d. Territorial needs
4. A client is continually late for his appointment at the mental health clinic. What is a likely reason for his lack of punctuality?
ANS: B
Mental dysfunction can lead to incorrect perception of time, causing the client to be continually late. In addition, some cultures do not see schedules and specific appointment times as important, causing the client to be continually late in the eyes of the caregiver. Environmental control refers to an individual’s need to control his or her perception of the environment. Comfort zones are highly culture based, meaning that individual interpretation of personal space varies among cultures. Territorial needs provide a sense of identity and security for some clients.
DIF: Cognitive Level: Comprehension REF: p. 37 OBJ: 5
TOP: Space, Territory, and Time in Cultural Assessment
KEY: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity a. Age differences b. Altered cognition c. Cultural differences d. Gender differences
5. Which client communication problem can the nurse most easily correct?
ANS: C
The nurse can easily correct communication problems caused by cultural differences in a number of ways, including learning what cultural beliefs and practices are important to the client and being accepting of those beliefs. Communication problems due to age and gender differences and altered cognition cannot be corrected by the nurse.
DIF: Cognitive Level: Comprehension REF: p. 35 OBJ: 5
TOP: Communication in Cultural Assessment
KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity a. Extended b. Friends c. Significant others d. Nuclear
6. What is the social orientation among most middle-class American families?
ANS: D
The nuclear family is the social orientation of family that is seen most frequently in this group. The extended family is seen as the social orientation for cultures such as some Alaskan, traditional Chinese, and Mexican cultures. Friends and significant others are not identified as a social orientation of family.
DIF: Cognitive Level: Knowledge REF: p. 37 OBJ: 5
TOP: Social Organization in Cultural Assessment
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
7. It is important for the nurse to be familiar with the religious practices of clients cared for most often in a particular region because attitudes toward health and illness, death and burial, food, and procreation have a strong impact on a client’s beliefs and practices. The nurse knows that the religion practiced most often around the world is: a. Buddhism. b. Jehovah’s Witness. c. Christianity. d. Ahmadiyya.
ANS: C
More than 2 billion individuals throughout the world are practicing Christians. Although these religions are seen in large numbers worldwide, it is important for the nurse to be familiar with the religions most frequently seen in the client populations with whom he works within his own area.
DIF: Cognitive Level: Knowledge REF: p. 37 | Table 4.3
OBJ: 6 TOP: Social Organization in Cultural Assessment
KEY: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity
8. The metabolism of psychotropic medications is most likely to be affected by: a. ethnicity. b. religion. c. culture. d. values.
ANS: A
Ethnicity is a determining factor in a person’s genetic makeup. Religious and cultural practices could play a role in the metabolism of medications as a result of food or alternative treatment interactions with medications, but the metabolism is more closely related to the genetic makeup. Values have little to do with the metabolism of medications.
DIF: Cognitive Level: Knowledge REF: p. 38 | Drug Alert
OBJ: 5 TOP: Biological Factors in Cultural Assessment
KEY: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity a. Remind the client about the importance of lithium level testing. b. Make scheduled appointments for the client to get his lithium level tested. c. Give the client written information regarding the importance of lithium level testing and written instructions on how to make appointments for testing. d. Talk with the client to see if there is a reason that he is not getting his lithium levels checked as outlined in his discharge plans.
9. A Hmong man from Laos is a client at an outpatient mental health clinic and is being seen for his diagnosis of bipolar disorder. The importance of lithium testing was stressed in his discharge plans; however, it is discovered that he has had his lithium level checked only once, rather than the three scheduled times. What is the nurse’s best action?
ANS: D
In the Hmong culture, it is believed that loss of blood leads to decreased body strength, which can cause the soul to leave the body, resulting in death. If the nurse did not discuss why the client was not getting his blood levels tested and gave him additional instructions as listed in the other options, the nurse would not understand and would not be able to incorporate the client’s cultural beliefs into the plan of care. The nurse and the client can now make revisions that will be acceptable while meeting the needs of the client.
DIF: Cognitive Level: Application REF: p. 38 OBJ: 5
TOP: Biological Factors in Cultural Assessment
KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity
10. Culture includes common beliefs and practices in areas such as religion, economics, diet, health, and: a. genetics. b. occupations. c. patterns of communication. d. stereotypes.
ANS: C
In addition to shared beliefs and practices in religion, economics, diet, and health, a person’s cultural integration consists of patterns of communication, politics, art, and kinship. The other three options are not part of a person’s culture.
DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: 3
TOP: Characteristics of Culture
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Assessment a. Fragmented b. Impersonal c. Disjointed d. Personalized
11. What is the usual approach to care for individuals who practice folk medicine?
ANS: D
Folk medicine is highly personalized; the descriptors fragmented, impersonal, and disjointed more often are associated with the Western medicine approach to health care.
DIF: Cognitive Level: Knowledge REF: p. 33 OBJ: 4
TOP: Health and Illness Beliefs KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
12. A client seen in the mental health clinic feels her depression is the result of being “punished” due to becoming pregnant as an adolescent and giving the infant up for adoption against her family’s wishes. This view of her depression is considered: a. exaggerated. b. naturalistic. c. personalistic. d. stress.
ANS: C
Naturalistic illnesses are caused by impersonal factors without regard for the individual. Forces that exist outside the individual cause mental illness. Personalistic illnesses are seen as aggression or punishment directed toward a specific person.
DIF: Cognitive Level: Comprehension REF: p. 34 OBJ: 4
TOP: Health and Illness Beliefs KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. “You need to control yourself. Your husband was not injured that badly.” b. “Let me take you to a room with more privacy so we can talk.” c. “I am concerned about how you are acting right now. No one else here is acting like this.” d. “We will call the psychiatrist to see if medication can be ordered for you.”
13. The nurse in the emergency department finds a woman collapsed on the floor and crying loudly. The woman’s husband was in a car accident and is being attended to by the medical staff. Which statement by the nurse best demonstrates acting in a culturally competent manner?
ANS: B
The nurse is demonstrating cultural competence and using cross-cultural therapeutic health care skills by offering to allow the client to express herself. The nurse is imposing personal beliefs on expected behavior in the other options.
DIF: Cognitive Level: Application REF: p. 35 OBJ: 2
TOP: Cultural Assessment KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
14. A 45-year-old married man comes to the community mental health center after he is suspended from his job for fighting. Upon talking to him, the nurse discovers he and his wife recently moved to the United States and his wife needs to work to pay bills. He is angry and embarrassed that he cannot be the sole provider for his family. His behavior may be the result of: a. cultural stereotyping. b. gender role conflict. c. religious beliefs. d. territoriality conflicts.
ANS: B
Traditional roles for men and women are in conflict with societal expectations of Western society in this situation. Men tend to demonstrate more violent and abusive behaviors as mental health problems with this conflict. Cultural stereotyping is imposed by someone outside the culture, and religious and territoriality conflicts do not apply to this circumstance.
DIF: Cognitive Level: Application REF: p. 37 OBJ: 4
TOP: Social Organization: Gender Roles KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
15. A nurse preparing to interview a client in the client’s room begins to move newspapers off a chair to sit down. The client requests that the nurse sit in another chair and leave the newspapers where they were. The client is demonstrating: a. personal space. b. paranoia. c. manipulation. d. territoriality.
ANS: D
Territoriality is the need to gain control over an area of space and claim it for oneself, as it helps to provide a sense of identity, security, autonomy, and control over the environment. Personal space is the distance maintained between people. Manipulation and paranoia are not demonstrated in this case.
DIF: Cognitive Level: Application REF: p. 37 OBJ: 5
TOP: Cultural Assessment: Space, Territoriality, and Time
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
Multiple Response
1. A male client is visiting his family in the United States and experiences what his family describes as a “breakdown.” His family takes him to a stress treatment center at a local mental health clinic. The client is a follower of traditional folk medicine practices and is agitated when he learns that he must see a licensed psychiatrist. Which care provider is this client most likely accustomed to? (Select all that apply.)
a. Healers b. Shamans c. Nurse practitioners d. Spiritualists e. Lay unlicensed therapists
ANS: A, B, D, E
Individuals who practice folk medicine for care typically do not see licensed health care providers, such as nurse practitioners and physicians. Folk medicine beliefs regarding the causes of disorders and treatments are different from Western medicine beliefs.
DIF: Cognitive Level: Knowledge REF: p. 34 | Table 4.2
OBJ: 4 TOP: Health and Illness Beliefs
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity a. Immigration history b. History of arrival in the new country c. How long the refugee has been in the new country? d. Whether anyone or anything was lost in coming to the new country e. What type of medical insurance the refugee will be seeking to obtain?
2. Refugees frequently experience depression, anxiety, and stress-related disorders caused by their particular circumstances. Therefore, in addition to a cultural assessment, what is important for the nurse to assess? (Select all that apply.)
ANS: A, B, C, D
A refugee is a person who flees from his or her home or country, usually because of war or persecution in the homeland. The refugee has experienced trauma not only in his life experiences, but also in the process of fleeing from home. Therefore, a more accurate assessment can be performed if these questions are answered. The type of medical insurance obtained is of little concern to this person at this time.
DIF: Cognitive Level: Comprehension REF: p. 38 OBJ: 7
TOP: Culture and Mental Health Care KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Communication b. Space and territory c. Biological orientation d. Defense mechanisms e. Social orientation
3. Cultural assessments allow the health care provider to understand the unique beliefs a client may have regarding mental illness and how they cope. Key areas to assess include which of the following? (Select all that apply.)
ANS: A, B, C, E
The six areas of cultural assessment on various tools include: communication, environmental control, space and territory, time, social orientation, and biological factors. Defense mechanisms do not pertain to cultural assessments.
DIF: Cognitive Level: Comprehension REF: p. 35 OBJ: 5
TOP: Culture and Mental Health Care KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
Chapter 05: Theories and Therapies
Morrison-Valfre: Foundations of Mental Health Care, 7th Edition
Multiple Choice
1. A male client who has a diagnosis of generalized anxiety disorder (GAD) is seen in the emergency department with complaints of chest pain, shortness of breath, and inability to concentrate, along with feelings of overwhelming anxiety. The nurse uses Maslow’s theory to triage the client’s complaints, knowing that which complaint must be addressed first?
a. Inability to concentrate b. Shortness of breath c. Overwhelming anxiety d. Chest pain
ANS: B
According to Maslow’s hierarchy of needs, the nurse first must address shortness of breath, followed by chest pain, and then feelings of overwhelming anxiety and inability to concentrate. Even though, based on his diagnostic history, this client may be having a panic attack, the nurse cannot ignore basic needs that are not being met first.
DIF: Cognitive Level: Application REF: p. 46
TOP: Humanistic Theories and Therapies
KEY: Nursing Process Step: Implementation
MSC: Client Needs: Psychosocial Integrity
OBJ: 4 a. Id b. Ego c. Superego d. Self-control
2. According to Freud’s theory, a baby who is crying in response to wanting to be held by his mother is an example of which part of the personality’s control over behavior?
ANS: A
According to Freud, the id is the pleasure center of the brain that seeks immediate pleasure or avoids pain, without regard for possible outcomes. The ego is reality based and has more control than the id; the superego is not developed in early childhood because it includes a conscience. Self-control is not a component of Freud’s theory of personality.
DIF: Cognitive Level: Application REF: p. 41 OBJ: 2
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Young adulthood (18–25 years) b. Maturity (65 years to death) c. Middle adulthood (25–65 years) d. Puberty (12–18 years)
3. According to the theorist Erik Erikson, an individual strives to actualize his identity, is most productive, and demonstrates guidance of and concern for others with a core task of caring during which stage of psychosocial development?
ANS: C
The characteristics of striving to actualize identity, being most productive, and demonstrating guidance of and concern for others, according to Erikson, are seen during middle adulthood. Individuals who do not achieve the core task of caring become stagnant, self-indulgent, and absorbed in themselves. The core task of young adulthood is love; the core task of maturity is wisdom; and the core task of puberty is fidelity.
DIF: Cognitive Level: Comprehension REF: p. 45 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance a. Transference relationship b. Dream analysis c. Free association d. Psychoanalysis
4. During a therapy session, a client is asked to respond to a word with the first word or phrase that comes to mind. What term is commonly used to refer to this technique?
ANS: C
Free association is a technique that is used to interpret the real meaning behind word association. Dream analysis is a technique that is used to interpret the meaning of an individual’s dreams as they relate to their unconscious conflicts. Psychoanalysis is the form of therapy developed by Freud, and transference relationship is the technique used during therapy when the client transfers to the therapist emotions associated with significant people in his life.
DIF: Cognitive Level: Knowledge REF: p. 42 OBJ: 2
TOP: Psychoanalytical Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
5. Carl Jung was the founder of analytical psychotherapy; he differed from Freud in that he believed that the mind was divided into three levels: the conscious ego, the personal unconscious, and the: a. extroverted personality. b. introverted personality. c. psyche. d. collective unconscious.
ANS: D
The collective unconscious stores experiences from the person’s ancestral past and is part of what Jung believed was the third level of the mind. Extroversion and introversion were parts of the personality that Jung identified. Psyche is the mental or spiritual part of a person.
DIF: Cognitive Level: Knowledge REF: p. 43
OBJ: 2
TOP: Analytical Psychotherapy KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. id; ego b. intellectual; emotional c. anxiety; affective d. personified; cognitive
6. Jean Piaget’s theory of cognitive development identifies an interrelationship between the and the functions in the development of one’s personality.
ANS: B
Piaget believed that growth and development occurred as a result of the interrelationship between intellectual (cognitive) and emotional (affective) development. The id and the ego are part of Freud’s beliefs regarding personality development. Anxiety is a vague feeling of uneasiness. Personification is a term developed by the theorist Sullivan to describe distorted images of certain relationships that occur in development of the personality.
DIF: Cognitive Level: Comprehension REF: p. 44 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance a. Two b. Four c. Six d. Eight
7. How many stages of the human life cycle did Erik Erikson identify?
ANS: D
Erik Erikson identified eight stages of the human life cycle that form one’s personality; each stage is marked by a developmental task that must be confronted and resolved. Erikson’s theory is commonly used in health care today.
DIF: Cognitive Level: Knowledge REF: p. 44 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance a. Genital-locomotor b. Latency c. Oral-sensory d. Anal-muscular
8. A 4-year-old client in a pediatric unit is imitating the actions of the nurse. The nurse knows, according to Erik Erikson’s theory, that this child is displaying a characteristic seen during which developmental stage?
ANS: A
The genital-locomotor stage (preschool years) is characterized by exploration of the environment, cooperative play, fantasy, and imitation of adults. Initiative and guilt are core tasks of this stage. The latency stage occurs during the school-age years (6–12 years old), the oral-sensory stage occurs from birth to 1 year of age, and the anal-muscular stage occurs during early childhood.
DIF: Cognitive Level: Application REF: p. 44 | Table 5.2
OBJ: 3 TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance
9. Humanistic theories are important to health care because these theories serve as the foundation for the concept of: a. assertiveness training. b. behaviorism. c. holistic care. d. behavior modification.
ANS: C
Humanistic theories emphasize the total person, which serves as the basis of holistic care. Assertiveness training refers to teaching a person to express his needs in nonaggressive ways. Behaviorism is the belief that all behavior is learned, and behavior modification is a therapy that teaches clients new behaviors that can be used to replace dysfunctional behavior.
DIF: Cognitive Level: Comprehension REF: p. 46 OBJ: 3
TOP: Humanistic Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity a. Symbolization b. Self-actualization c. Equilibrium d. Identification
10. During a conversation with a male client, he voices that he really appreciates his family, likes his job, and enjoys groups in which he volunteers. According to Maslow’s theory, what is this client experiencing?
ANS: B
In Maslow’s hierarchy of needs theory, a person is said to have reached the highest human need of self-actualization when all basic needs are met, the individual is self-directed, and the individual has reached the highest potential. Symbolization and identification are common defense mechanisms, and equilibrium is a state wherein all body systems are in balance.
DIF: Cognitive Level: Application REF: p. 47 OBJ: 4
TOP: Humanistic Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
11. The nurse knows that the major concept of the systems theory is that individuals are viewed as functioning: a. within a set of interacting and related units. b. according to activities of attention, language, and imagery. c. according to unmet needs. d. within accepted social aspects of behavior.
ANS: A
The interacting and related units are called systems, and both open and closed systems have been identified. Activities of attention, language, and imagery are components of cognitive theories. Met and unmet needs correspond to Maslow’s hierarchy of needs theory, and social aspects of behavior are seen in sociocultural theories.
DIF: Cognitive Level: Knowledge REF: p. 48
OBJ: 5
TOP: Systems Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
12. Group therapy, which assists in relieving emotional distress and encourages psychological and behavioral changes, was developed following World War II as a result of a: a. study of the benefits of group therapy. b. decreasing number of mental health facilities. c. shortage of psychiatrists. d. grant from the federal government.
ANS: C
A shortage of psychiatrists prompted the need for group therapy in the 1940s. Mental health facilities did not begin to decrease in number until psychotherapeutic drugs were introduced in the 1950s. No federal grant was provided for group therapy.
DIF: Cognitive Level: Knowledge REF: p. 53
OBJ: 10
TOP: Group Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Adaptation model b. Interpersonal model c. Systems model d. Self-care deficit model
13. Betty Neuman developed the nursing theory that promotes nursing interventions to assist individuals in reaching and maintaining the highest level of wellness possible. What is this theory known as?
ANS: C
Betty Neuman developed this model with a focus on reducing stress as a means of assisting in reaching high-level wellness. The adaptation model was developed by Myra Levine. Peplau developed the interpersonal model, and Orem developed the self-care deficit models.
DIF: Cognitive Level: Knowledge REF: p. 52 | Table 5.4
OBJ: 9 TOP: Nursing Theories
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance a. Compensation b. Displacement c. Rationalization d. Restitution
14. Following an argument with his daughter, a father takes away her phone privileges. He later feels guilty about the argument and asks her if she would like to go shopping for new clothes. What is this defense mechanism known as?
ANS: D
Restitution involves engaging in an activity that helps to resolve feelings of guilt. Compensation is an attempt to overcome feelings of inferiority. Displacement involves redirecting energy to another person or object, and rationalization is a way of explaining something in a good, although not true, way.
DIF: Cognitive Level: Application REF: p. 42 | Table 5.1
OBJ: 2 TOP: Psychoanalytical Theories
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity a. Identification b. Symbolization c. Displacement d. Projection
15. A female client with low self-esteem tries to dress and act like the nurse who cares for her in an outpatient clinic setting. This behavior is an example of which defense mechanism?
ANS: A
Identification occurs when an individual takes on personal characteristics of someone she admires, especially when she has low self-esteem or poor self-concept. Symbolization involves the use of unrelated objects to represent a hidden idea. Displacement involves the redirecting of energies to another person or object; projection occurs when an individual projects onto another person his or her unacceptable thoughts or emotions.
DIF: Cognitive Level: Application REF: p. 42 | Table 5.1
OBJ: 2 TOP: Psychoanalytical Theories
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity a. Altruism b. Feedback c. Expressiveness d. Communion
16. During group therapy, certain group change mechanisms may be observed. When an individual engages in helping others, resulting in improvement in his or her own self-esteem, which group change mechanism has the individual experienced?
ANS: A
Altruism occurs when not only recipients benefit from assistance, but the individual who is giving assistance also benefits through improvement in his own self-esteem. Feedback refers to receipt of information about how one is perceived by others. Expressiveness is a group change mechanism in which group members share positive and negative emotions, and communion occurs in a group when members feel a sense of belonging.
DIF: Cognitive Level: Comprehension REF: p. 53 | Table 5.5
OBJ: 10 TOP: Group Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity a. psychoanalytic b. humanistic c. behavioral d. developmental
17. A client is granted permission to watch a favorite television show in the evening because she participated in an occupational therapy activity. Her therapist bases this on theory.
ANS: C
Behavioral theory believes behavior is a result of rewards to enforce desired behaviors. Psychoanalytic theory explores the unconscious, humanistic theory deals with the whole person, not just behavior, and developmental theory focuses more on life tasks at particular points.
DIF: Cognitive Level: Comprehension REF: p. 45 OBJ: 3
TOP: Behavioral Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
18. A client does not participate in group sessions due to feeling inferior to others in the group. Based on cognitive theory, he would be directed to: a. review his previous relationship with his parents. b. participate in group to receive extra privileges. c. suppress negative thoughts about the group. d. recognize and change his negative thoughts.
ANS: D
Cognitive theory and therapy stress self-regulation and control to change behavior. Reviewing relationships with parents is indicative of psychoanalysis. Behavior change for reward is based on behavioral theory, and suppression of thoughts is a negative means of coping.
DIF: Cognitive Level: Comprehension REF: p. 48 OBJ: 5
TOP: Cognitive Theories and Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Blood chemistry b. Physiologic needs c. Coping mechanisms d. Psychosocial level
19. Which of the following assessment parameters is a priority in a biobehavioral model of practice?
ANS: A
Biobehavioral theories follow the medical model, which states that illness is the result of abnormalities in the structure, function, or chemistry of the body. A history, physical examination, laboratory tests, imaging techniques, and electroencephalograms (EEGs; brain wave recordings) are used to assist in diagnosis. Blood chemistry is the only option providing for this structure, function, or chemical abnormality.
DIF: Cognitive Level: Comprehension REF: p. 49 OBJ: 8
TOP: Biobehavioral Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Orem b. Watson c. Peplau d. Roy
20. The nurse who feels the most beneficial part of the client’s inpatient stay is the establishment of an interpersonal relationship with the nurse is an example of which nursing theorist?
ANS: C
Peplau’s goal of nursing is to develop interpersonal interaction between the client and nurse. Orem’s goal is to help the client attain self-care, Watson’s goal is to promote and restore health, and Roy’s goal is to identify demands on clients and adaptation.
DIF: Cognitive Level: Comprehension REF: p. 52 | Table 5.4
OBJ: 9 TOP: Nursing Theories
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
Multiple Response
1. Freud’s psychoanalytical theory states that an adult is more likely to be mentally healthy if there is a balance between which parts of the mind? (Select all that apply.)
a. Id b. Ego c. Superego d. Conscience
ANS: A, B, C
Freud believed that if there was a dynamic balance between the id, the ego, and the superego, an adult’s personality would develop in a healthy manner. The conscience is part of the superego.
DIF: Cognitive Level: Knowledge REF: p. 41 OBJ: 1
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. Genetics b. Neurotransmitter activity c. Immune system dysfunction d. Social setting e. Unmet needs
2. Psychobiology theory considers the causes of mental illness to be which of the following? (Select all that apply.)
ANS: A, B, C
Psychobiological theories about the causes of mental illness relate to genetics, neurotransmitter activity, viruses, fetal development, and immune system dysfunction.
DIF: Cognitive Level: Knowledge
TOP: Psychobiological Theories
MSC: Client Needs: Psychosocial Integrity
REF: p. 49
OBJ: 8
KEY: Nursing Process Step: Assessment
Chapter 06: Complementary and Alternative Therapies
Morrison-Valfre: Foundations of Mental Health Care, 7th Edition
Multiple Choice
1. For a client with a sleep disorder, which CAM therapy could be used safely without interference with any allopathic methods of treatment?
a. Progressive relaxation b. Dietary supplements c. Herbal supplements d. Aromatherapy
ANS: A
Progressive relaxation is noninvasive in that it uses deep breathing and conscious muscle relaxation and therefore would not interfere with allopathic methods of treatment. Dietary and herbal supplements can interfere with other medications (allopathic therapy) that may be taken by this client. Aromatherapy could interfere with this client’s allopathic treatment if he is being treated for allergies.
DIF: Cognitive Level: Application REF: p. 63 OBJ: 8
TOP: CAM Approaches to Mental Health Care
KEY: Nursing Process Step: Intervention MSC: Client Needs: Physiological Integrity a. Aromatherapy b. Acupuncture c. Nicotine patches d. Group therapy
2. A female client would like to use biofield therapy for her addiction to nicotine. Which form of therapy would she most likely choose?
ANS: B
Acupuncture is a form of biofield therapy, which is a form of energy medicine. Aromatherapy is a CAM that is a biologically based practice. Nicotine patches would be considered allopathic, and group therapy is socioculturally based therapy.
DIF: Cognitive Level: Application REF: p. 61 OBJ: 7
TOP: Energy Medicine KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Physiological Integrity a. Music and sound therapy b. Relaxation and visualization c. Hypnosis therapy d. Spiritual healing
3. A male client experiences a phobia of enclosed spaces (claustrophobia) and is seeking an energy-based therapy that he can practice and initiate on his own when he experiences symptoms. Which therapy will the nurse recommend?
ANS: B
Although all of these therapies are considered energy-based, the one that would be best suited for these circumstances is relaxation and visualization. The other choices would be difficult to initiate in a claustrophobic situation.
DIF: Cognitive Level: Application REF: p. 61 OBJ: 6
TOP: Mind-Body Medicine KEY: Nursing Process Step: Planning
MSC: Client Needs: Psychosocial Integrity a. There is a harmony within the body, nature, and the world. b. The body has a natural ability to heal itself. c. There is a vital, life-force energy that flows through an individual’s body. d. The mind and spirit affect body functions and influence illness.
4. Which theory best describes energy medicine?
ANS: C
Energy medicine is best described as the belief that there is a vital energy that flows through an individual’s body. The theory that there is harmony within the body, nature, and the world describes holistic care. The theory that the body has a natural ability to heal itself describes body-based CAM therapies, and mind-body medicine followers believe that the mind and spirit affect body functions and influence illness.
DIF: Cognitive Level: Comprehension REF: p. 61 OBJ: 7
TOP: Energy Medicine KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
5. A female client is receiving therapy for severe depression that consists of repetitive transcranial magnetic stimulation. This form of therapy is considered to be: a. energy medicine. b. illegal according to FDA regulations. c. a form of expressive therapy. d. a biofield therapy.
ANS: A
Repetitive transcranial magnetic stimulation is a form of energy medicine in the category of electromagnetic field therapies. This therapy is not considered to be illegal. Expressive therapy is the use of creative activities such as dance and music to express emotions, and biofield therapy is another form of energy medicine.
DIF: Cognitive Level: Comprehension REF: p. 63 OBJ: 7
TOP: Energy Medicine KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity a. Allergic reactions b. Low potassium levels c. Elevated blood glucose levels d. Interactions with other medications
6. A 70-year-old male client tells the nurse that he is using chelation therapy to prevent Alzheimer’s disease. Which adverse effect is the client most likely to experience?
ANS: B
Although adverse effects of CAM therapy cannot be predicted in any individual, the most likely adverse effect of chelation therapy is a low potassium level because EDTA binds with heavy metals, causing potassium depletion. This therapy is controversial, and its effectiveness has not been proved scientifically.
DIF: Cognitive Level: Comprehension REF: p. 64 OBJ: 10
TOP: Adverse Effects KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Physiological Integrity a. Traditional Chinese medicine b. Homeopathy c. Ayurveda d. Reiki
7. A male client of Indian origin practices meditation and yoga, uses herbs and follows specific diet practices, and practices controlled breathing and exposure to sunlight. Which type of CAM therapy is this individual practicing?
ANS: C
Ayurveda is a body-based CAM therapy that often is practiced by Indian cultures with a central focus on being knowledgeable of how to live. Homeopathy uses natural substances to heal, and traditional Chinese medicine deals with a balance between yin and yang, “laying on of hands” to promote relaxation and healing.
DIF: Cognitive Level: Application REF: p. 57 OBJ: 4
TOP: Whole Medical Systems KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity a. To seek scientific validation of and be a resource for the public for CAM therapies b. To investigate and develop new CAM therapies c. To produce a monthly newsletter on new CAM therapies d. To monitor the production of dietary and herbal supplements used in CAM therapies
8. What is the main function of the National Center for Complementary and Alternative Medicine (NCCAM)?
ANS: A
The function of the NCCAM is to seek scientific validation of and be a resource for the public for CAM therapies. The other options are not representative of the functions of NCCAM.
DIF: Cognitive Level: Knowledge REF: p. 57 OBJ: 3
TOP: National Center for Complementary and Alternative Medicine
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance a. chiropractic treatment b. dietary supplements c. homeopathic treatments d. hypnotic therapy
9. The Food and Drug Administration (FDA) does not impose the same guidelines on as it does on prescription drugs.
ANS: B
The Dietary Supplement Health and Education Act of 1994 (DSHEA) addresses dietary supplements but does not include the same guidelines that govern prescription drugs. Guidelines are less stringent for dietary supplements; therefore, the safety of use of these products with prescription drugs is one of the concerns associated with such supplements. Dietary supplements include, but are not limited to, vitamins, minerals, and herbs. The FDA does not govern chiropractic treatment, homeopathic treatment, or hypnotic therapy.
DIF: Cognitive Level: Knowledge REF: p. 59 OBJ: 5
TOP: Biologically Based Practices KEY: Nursing Process Step: Assessment
MSC: Client Needs: Physiological Integrity
10. A 45-year-old male client uses a treatment method that focuses on the relationship between an individual’s body structure and its function. This mode of treatment is: a. naturopathic. b. homeopathic. c. chiropractic. d. acupuncture.
ANS: C
Chiropractors use manipulation therapy of the spine to improve the relationship of the body structure (spine) to its function, which is thought to aid the body in healing various conditions, such as migraine headache. Naturopathic therapy, homeopathic therapy, and acupuncture do not have this focus.
DIF: Cognitive Level: Comprehension REF: p. 59 OBJ: N/A
TOP: Body-Based Practices
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Intervention a. Schizophrenia b. Bipolar disorder c. PTSD and OCD d. Depression and anxiety
11. Massage therapy manipulates muscles and connective tissue and has been found to be very successful as a CAM method in the treatment of which disorder(s)?
ANS: D
Massage therapy has been frequently reported to assist in the relaxation of clients with a diagnosis of depression and anxiety disorder. No documentation of massage therapy for schizophrenia, bipolar disorder, or PTSD and OCD is available.
DIF: Cognitive Level: Knowledge REF: p. 60 OBJ: N/A
TOP: Body-Based Practices
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Implementation a. Mind-body medicine b. Chiropractic treatment c. Dietary supplements d. Herbal therapy
12. Which type of therapy has yielded positive results for psychological functioning and is considered one of the safest treatment modalities?
ANS: A
Mind-body medicine (music and dance therapy, expressive therapy, meditation) has been found effective in improving psychological functioning. It is considered safe because it is noninvasive. Chiropractic treatment, herbal therapy, and dietary supplements are more invasive and can interfere with medicines and cause alterations in body systems.
DIF: Cognitive Level: Knowledge REF: p. 60 OBJ: 6
TOP: Mind-Body Medicine
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Assessment
13. A therapy that once was denounced by the scientific community but now is being used to successfully treat victims of the events of 9/11, Hurricane Katrina, and the South Asian tsunami of 2004 and that helps the rational left side of the brain bond with a traumatic memory from the emotional right side of the brain is known as: a. hypnosis therapy. b. eye movement desensitization and reprocessing (EMDR). c. Shiatsu. d. doshas.
ANS: B
EMDR is thought to help clients who have experienced a horrific trauma to process the event so they can deal with their emotions. The other therapies are not being used widely for treatment following these events.
DIF: Cognitive Level: Knowledge REF: p. 60 OBJ: N/A
TOP: Body-Based Practices
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Intervention a. Yoga b. Meditation c. Therapeutic touch d. Acupuncture
14. is a form of therapy that has been used for over 2000 years to successfully treat clients with drug addiction; it is believed to restore the energy balance in the body and to stimulate the release of certain neurotransmitters and hormones.
ANS: D
Acupuncture is of oriental origin and has been used for over 2000 years. It has been found to be successful as adjunctive therapy for drug addiction. Yoga, meditation, and therapeutic touch are also forms of energy medicine, but they are more focused on relaxation and on understanding of the inner self.
DIF: Cognitive Level: Knowledge REF: p. 62 OBJ: 7
TOP: Energy Medicine
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Intervention
15. Color therapy has been found to be especially effective in the treatment of: a. seasonal affective disorder. b. bipolar disorder. c. drug addiction. d. generalized anxiety disorder.
ANS: A
Color therapy involves the use of high-intensity light therapy and is highly effective in improving the symptoms of seasonal affective disorder. Color therapy is not an effective therapy for bipolar disorder, drug addiction, or generalized anxiety disorder.
DIF: Cognitive Level: Knowledge REF: p. 62 OBJ: 7
TOP: Energy Medicine
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Intervention a. Chelation b. Phototherapy c. Therapeutic touch d. Magnetic therapy
16. A client experiencing symptoms of anxiety would benefit from which therapy?
ANS: C
Therapeutic touch is effective in stress-related conditions such as migraine headaches and anxiety. Chelation is effective against atherosclerosis, phototherapy is used in depression, and magnetic therapy is used primarily for pain.
DIF: Cognitive Level: Knowledge REF: p. 62 OBJ: 8
TOP: Energy Medicine: Stress reduction and relaxation
KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity a. Massage b. Biofeedback c. Aromatherapy d. Art therapy
17. A child who is the victim of domestic violence refuses to talk about the experience. He is doing poorly in school and having trouble sleeping. Which therapy would he benefit from?
ANS: D
Art, or expressive, therapy is indicated to release inner conflicts and repressed emotions. Massage uses manipulation to relax muscles, biofeedback monitors physical responses during relaxation, and aromatherapy uses scents to promote well-being. None of these provide for the expression of repressed emotions.
DIF: Cognitive Level: Knowledge REF: p. 61 OBJ: 6
TOP: Mind-Body Medicine: Expression Therapy
KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity a. Biologically based practices b. Body-based practices c. Mind-body practices d. Technology-based practices
18. Which CAM therapy would a nurse be most concerned about if used by a client being treated with antipsychotic medications?
ANS: A
Biologically based practices include dietary supplements and herbal therapies that may have adverse or unwanted effects in combination with pharmacotherapy. None of the other practices have the potential to interact with pharmacologic agents.
DIF: Cognitive Level: Comprehension REF: p. 59 OBJ: 10
TOP: Biologically Based Practices
MSC: Client Needs: Psychosocial Integrity
KEY: Nursing Process Step: Intervention a. Expressive therapy b. Acupuncture c. Antianxiety agents d. Dietary supplements
19. An allopathic mental health practitioner would most likely recommend which treatment for a client suffering from anxiety?
ANS: C
Allopathic practitioners use medical and surgical methods to treat disease and injury. The other therapies are CAM agents.
DIF: Cognitive Level: Comprehension REF: p. 56 OBJ: 10
TOP: Biologically Based Practices
MSC: Client Needs: Psychosocial Integrity
Multiple Response
KEY: Nursing Process Step: Intervention a. Dietary supplements b. Aromatherapy c. Herbal supplements d. EDTA
1. Which treatments are used in biologically based practice? (Select all that apply.)
ANS: A, B, C
Dietary supplements, aromatherapy, and herbal supplements fit the category of biologically based practice. EDTA is a body-based practice that involves moving the body into an improved state of function.
DIF: Cognitive Level: Knowledge REF: p. 59 OBJ: 5
TOP: Biologically Based Practices KEY: Nursing Process Step: Implementation
MSC: Client Needs: Physiological Integrity a. Groups are informal, nonprofit, and free of charge. b. Membership requires referral from a physician or counselor. c. Meetings are facilitated by trained counselors. d. Groups provide support, education, and encouragement to members. e. Groups benefit individuals who are dealing with life-altering events such as addiction.
2. Self-help groups provide support to individuals who are dealing with or who have had similar experiences. Which of the following are characteristics of self-help groups? (Select all that apply.)
ANS: A, D, E
Self-help groups are informal, nonprofit, and free of charge; provide support, education, and encouragement to members; and benefit individuals who are dealing with life-altering events. Membership is voluntary, and meetings usually are facilitated by a survivor or someone with experiences similar to those of the group.
DIF: Cognitive Level: Comprehension REF: p. 64 | Box 6.2
OBJ: 9 TOP: CAM Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
