Essentials of Mental Health Nursing 2nd Edition by Karen M. Wright, Mick McKeown All Chapters 1-45 T

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Chapter 1 The Context and Nature of Mental Health Care in the 21st Century 1. What does Eleanor Longden think is the best question a mental health professional can ask of a service user? a. What is wrong with you? b. What medication have you been prescribed? c. What has happened to you? d. What is your job?

Ans: C

2. What do the chapter authors favour for how to think better about changing services? a. Campaigns to persuade government of the need to change b. Lobbying of psychiatrists because they have most power in the team c. Revolutionary action

d. Build democratic dialogue between critical elements of the workforce and survivor groups Ans: D

3. Why might mental health services be called trauma-organized systems? a. They are designed to inflict trauma b. Too many staff are abusive of patients and colleagues c. Staff suffer high rates of sickness/absence d. Routine practices actually operate to re-traumatize individuals Ans: D

4. What is a key characteristic of the psy-complex? a. Governance and social control function b. A preponderance of psychological therapies c. Over-use of psychotropic medication d. A fictional representation of services Ans: A

5. Since 2010 levels of compulsion under the Mental Health Act have ______? a. Stayed constant b. Fallen c. Increased by around 5% per year d. Increased by around 10% per year

Ans: D

6. Neoliberalism is best described as ______? a. A political philosophy b. An economic system c. An economic philosophy favouring free-markets d. An economic philosophy promoting freedom and equality Ans: C

7. What has been the most important cause of a nursing legitimacy crisis? a. A number of significant service failings and scandals of abuse and neglect b. Nurses are essentially lacking in compassion c. Cuts in resources d. Dishonest media reporting Ans: A

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Chapter 2 Overview of Mental Health Nurse Education and Training 1. The current term to describe the sub-specialties of UK pre-registration nursing (adult, children’s, learning disability and mental health) is ______. a. Branch b. Domain c. Field d. Tree Ans: C

2. The highest level in Bloom’s taxonomy is ______. a. Creating b. Analysing c. Evaluating

d. Understanding Ans: A

3. Academic Level 5 (Level 8 in Scotland) is typically associated with what year of full-time study? a. Year 1 b. Year 2 c. Year 3 d. Year 4 Ans: B

4. AP(E)L stands for ______. a. Accreditation of Personal (Experiential) Learning b. Accreditation of Prior (Experiential) Learning c. Aspects of Personal (Experiential) Learning d. Assorted Personal Learning Experiences Ans: B

5. In what era was the ‘schizophrenogenic mothers’ theory dominant? a. 1700s b. 1880s c. 1910–1920s d. 1940s–1970s

Ans: D

6. Assessors of nursing students in practice settings are known as ______. a. Assessors b. Mentors c. Supervisors d. Mentalists Ans: B

7. In the ‘guided discovery’ instructional architecture, teachers tend to be ______. a. Coaches b. Lazy c. Directive d. Absent Ans: A

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Chapter 3 Working With Other Professionals 1. Which of the following is NOT a key component of interprofessional teamwork? a. Systematic relationships b. Regular interaction c. Combined knowledge d. Varied communication Ans: C

2. How does humour influence Community Mental Health Teams according to Griffiths (1998)? a. As a mechanism that helped team members support one another in their difficult work with patients who had serious mental health problems b. An important and central aspect of community mental health care provision c. A useful means of enhancing team bonding and throughout various levels of the health care team d. A communicative method which aids discussion between patients, family members and health care professionals Ans: A

3. Which of the following is at the CENTRE of the typology developed by Reeves et al. (2010)? a. Networking b. Teamwork c. Collaboration

d. Coordination Ans: B

4. Patient-centred care represents ______? a. A transition from a holistic economic model to a more individualized one b. The growing need to adapt intervention towards the needs of the patient, rather than focus specifically on the illness c. The prioritization of the patient above all else d. A removal of the need for distinction between acute and chronic assessment Ans: B

5. Which four main domains comprise Reeves et al.’s (2010) framework for interprofessional teamwork? a. Relational, combinational, processual, contextual b. Relational, processual, organizational, contextual c. Relational, internal, external, contextual d. Relational, interpersonal, processual, contextual Ans: B

6. Interprofessional collaboration is ______? a. A type of interprofessional work which involves different health and social care professions who regularly come together to solve problems or provide services b. Interaction between and amongst health care providers with the direct intention of improving practice

c. A system by which groups of professionals share and develop ideas surrounding improvement d. Discussion and communication between various professionals about their disciplinary identity Ans: A

7. Interprofessional education occurs when ______? a. Many professionals learn from each other in a focussed classroom setting b. Members (or students) of two or more health and/or social care professions engage in learning with, from and about each other to improve collaboration and the delivery of care c. A combination of healthcare professionals instruct colleagues about the value of collaborative working d. Members (or students) of similar health and/or social care professions engage in learning with, from and about each other to improve collaboration and the delivery of care Ans: B

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Chapter 4 Meaningful Service User Involvement 1. Service user involvement needs to be ______.

a. Meaningful b. Ethical c. Inclusive d. All of these Ans: D

2. It is a concern if service user involvement is ______. a. Empowering b. Person-centred c. Tokenistic d. Respectful Ans: C

3. People should be involved at ______. a. A few levels of service development and planning b. Some levels of service development and planning c. Most levels of service development and planning d. All levels of service development and planning Ans: D

4. Barriers to service user involvement may include ______. a. Finance, representation, bureaucracy and a lack of understanding about the purpose of involvement

b. Hospitality and refreshments c. Time and listening d. Respecting people’s choices Ans: A

5. Service user involvement in health professional education will ______. a. Confuse students who should only be taught by qualified people b. Benefit student learning and increase awareness of the user perspective c. Distract students from the business of providing best practice d. Be time-consuming and will not benefit patient care in the long term Ans: B

6. Sherry Arnstein’s ladder of involvement shows levels of ______. a. Ladder safety b. Citizen involvement in planning processes c. How local people should not get involved d. Bureaucracy that don’t help involvement Ans: B

7. Service users’ expectations will vary because ______. a. Historically people have thought professionals are the experts b. We are all individuals and have different expectations and experiences

c. Some staff are better at ensuring involvement than others d. All of these Ans: D

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Chapter 5 Working With Families and Carers 1. A planned intervention that looks at a care provision in a holistic way, whilst also providing information, support and coping strategies to carers and their loved ones is called ______. a. A formulation b. A carers assessment c. Psycho-education d. A multi-agency referral Ans: C

2. According to the Office for National Statistics, how many people provide unpaid care for a relative or friend with a mental health illness? a. Over 1.5 million

b. Up to 150,000 c. Approximately 15 million d. Over 15,000 Ans: A

3. Zubin and Spring (1977) introduced the concept of the ______. a. Care programme approach b. Stress vulnerability model c. Carers assessment d. High expressed emotion Ans: B

4. GHQ stands for ______. a. Global Health Questionnaire b. General Holistic Questionnaire c. General Health Questionnaire d. Global Holistic Health Ans: C

5. Who is the author who said that confidentiality is a widely established barrier when working with families and carers? a. Lowe b. Reece

c. Roper d. Rowe Ans: D

6. A study by Wilson et al. (2015) found that a number of informal carers have experienced difficulties obtaining information from mental health professions. How many was it? a. 43.6% b. 56.3% c. 13.5% d. 65.3% Ans: B

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Chapter 6 Championing Equalities and Addressing Vulnerability in Mental Health Care Quiz/MCQ: Exploring health inequality for Black and South-Asian migrant women who experience mental health problems due to no recourse to public fund

1. Which of the following best describes the term ‘no recourse to public funds’ (NRPF) is best represented by the following: a. A policy that restricts access to public welfare benefits for certain individuals b. A government initiative to provide financial support to migrant populations c. A programme that ensures equal access to public healthcare services for all residents d. A strategy aimed at reducing health disparities amongst marginalized communities Ans: A

2. How can ’no recourse to public funds’ policy impact on mental health outcomes for Black and South-Asian migrant women? a. It has no effect on mental health outcomes b. It increases the risk of mental health problems amongst this population c. It provides additional support and resources for mental health issues d. It ensures equitable access to mental health services for all migrants Ans: B

3. Which social determinant of health is primarily affected by the ‘no recourse to public funds’ policy? a. Employment status b. Income and wealth c. Education level d. Social support networks Ans: B

4. True or False: Black and South-Asian migrant women who have no recourse to public funds have equal access to mental health services as other residents.

Ans: False

5. Which of the following strategies could help address health inequality for Black and SouthAsian migrant women with no recourse to public funds? a. Increasing funding for mental health services b. Expanding eligibility criteria for public welfare benefits c. Enhancing cultural competency in mental healthcare d. All of the above Ans: D

6. Which additional factors could contribute to mental health problems among Black and SouthAsian migrant women with no recourse to public funds? a. Language barriers and difficulties to communicate b. Social isolation and lack of community support c. Discrimination and racism d. All of the above Ans: D

7. How does the intersectionality of race and immigration status further exacerbate mental health inequality? a. It has no impact on mental health inequality b. It creates additional barriers to accessing mental health services

c. It leads to better mental health outcomes for this population d. It ensures equitable distribution of mental health resources Ans: B

8. How can mental health nurses better support the mental health needs of Black migrant women with no recourse to public funds? a. Offering culturally sensitive mental health services b. Advocating for policy changes to remove barriers to access c. Providing language interpretation services d. All of the above Ans: D

MCQ: Exploring race and health inequality for Black and South-Asian migrant women who experience mental health problems due to gender-based violence 1. What is the term used to describe the unfair distribution of health outcomes among different racial or ethnic groups? a. Health disparity b. Health equity c. Health inequality d. Health discrimination Ans: A

2. Which of the following factors contribute to the mental health problems faced by Black and South-Asian migrant women experiencing Gender-Based Violence?

a. Social isolation and limited support networks b. Language barriers and cultural differences c. Systemic racism and discrimination d. All of the above Ans: D

3. Which of the following strategies could help address race and health inequality for Black and South-Asian migrant women experiencing Gender-Based Violence? a. Cultural competency training for healthcare providers b. Policy changes to ensure inclusive and accessible mental health services c. Community-based support programmes tailored to the needs of Black migrant women d. All of the above Ans: D

Quiz/MCQ: Exploring race and health inequality for Black young men who suffer mental health problems in criminal justice settings 1. What is the term used to describe the unfair treatment of individuals based on their race or ethnicity within the criminal justice system? a. Racial profiling b. Discrimination c. Disparity d. Prejudice Ans: B

2. True or False: Black young men are more likely to be arrested and imprisoned for the same crimes compared to their White counterparts. a. True b. False Ans: False

3. Which of the following factors contribute to the racial disparities in mental health outcomes amongst Black young men in criminal justice settings? a. Limited access to mental health services b. Higher rates of poverty and unemployment c. Historical trauma and systemic racism d. All of the above Ans: D

4. True or False: Black young men receive adequate mental health treatment whilst in the criminal justice system. a. True b. False Ans: A

5. What is the term used to describe the negative impact of discrimination and racism on the mental health of Black young men? a. Racial trauma b. Stereotype threat

c. Implicit bias d. Colourism Ans: A

6. Which of the following is a potential solution to address race and health inequality for Black young men with mental health problems in criminal justice settings? a. Increasing access to mental health services and treatment b. Implementing diversion programmes for Black young men with mental health issues c. Promoting cultural competency and sensitivity training for criminal justice professionals d. All of the above Ans: D

7. True or False: Black young men are more likely to be misdiagnosed with certain mental health conditions compared to other racial/ethnic groups. a. True b. False Ans: True

8. What is the term used to describe the cycle where individuals with mental health problems are released from prison only to return shortly afterward due to limited resources and support? a. Recidivism b. Stigma c. Re-entry d. Criminalization

Ans: A

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Chapter 7 Organizations and Settings for Mental Health Care 1. Evidence reported by experts by experience, evaluation and review by service users and case studies can help shape decisions on design and production as well as more formal research findings. They are examples of ______. a. Grey literature b. Hearsay c. Weak research d. Opinion polls Ans: A

2. How might the environment within a building make you feel personally? a. Cheered up by natural light and views onto gardens b. Frustrated by insufficient personal space or overcrowding

c. Distracted by noisy equipment and fittings d. All of these Ans: D

3. A protocol enabling patients to have safe access to the community outside a mental health unit is an example of ______ security. a. Perimeter b. Procedural c. Relational d. Additional Ans: B

4. In buildings for mental health care, the right to fresh air is best provided by ______. a. Free access to outdoor areas such as courtyards b. Air conditioning relayed to all rooms c. Natural colour schemes and uncluttered interior design d. Reducing the use of cleaning chemicals Ans: A

5. When a social worker, nurse, psychologist, etc. is a member of a First Tier Tribunal (Mental Health) they are known as the ______. a. Third Member b. Legal Member

c. Specialist Member d. Medical Member Ans: C

6. Which of the following has not been mental health charity MIND’s Champion of the Year? a. J K Rowling b. BBC Radio 4’s ‘The Archers’ c. Stephen Fry d. Frank Bruno Ans: A

7. What did future Prime Minister Tony Blair famously reply when Alastair Campbell disclosed his substance misuse and depression whilst being appointed to lead his campaign? a. ‘We’ll be taking a risk in appointing you’ b. ‘That means you’re not up to the job’ c. ‘You can’t reveal that in public’ d. ‘I’m not bothered if you’re not bothered’ Ans: D

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Chapter 9 Madness and the Law 1. Which is not claimed as a justification for compulsory treatment? a. People affected by mental illnesses may not know what is in their best interest b. Patients may decline treatments because they fail to understand their necessity c. Staff in mental health services prefer to have and use these powers d. When people are mentally ill, they may become a danger to themselves or others Ans: C

2. The United Nations Commission on Human Rights has referred to neuroleptic medication as ______. a. Efficacious b. Benign c. Legitimate d. Torture

Ans: D

3. Why does Szmukler refer to mental health legislation as essentially discriminatory? a. Mental health law enables disproportionate detention of ethnic minorities b. Compulsory treatment is warranted for other health conditions, but only legally mandated for mentally ill people c. Mental health law enables disproportionate detention of men rather than women d. Only targets people experiencing mental distress which excludes the majority of dangerous people Ans: D

4. Which section of the England and Wales Mental Health Act (1983, revised 2007) is forced treatment legally questionable following the recent European Court of Human Rights judgement (X v Finland 2012)? a. Section 2 b. Section 3 c. Sections 37/41 d. None of them Ans: A

5. What did the mental health alliance say about dangerousness? a. It is never associated with mental health b. It is unsurprisingly a political issue c. It is predictable

d. It should not be made a health issue for political or professional gain Ans: D

6. Which wasn’t drawn on to inform the open dialogue approach? a. Systemic family therapy b. Social constructionism c. Positive psychology d. Dialogical theory Ans: C

7. According to Unsworth which of these is not a main function of mental health legislation? a. Deciding who is sane or insane b. The regulation of mental health practices c. Inhibiting and restricting the power of psychiatry d. The division of labour in the mental health system Ans: A

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Chapter 10 Independent Advocacy in Mental Health Care 1.An advocate is someone who ______. a. Advises you and tells you what is best for you b. Helps you to get your point of view across c. Gives their viewpoint to help you make up your mind d. Acts on what they believe to be your best interests Ans: B

2. Which of these groups is most likely to access IMHA services? a. People in forensic mental health services b. People under a community treatment order c. People whose first language isn’t English d. Young people detained under the MH Act

Ans: A

3. Patients qualify for help from an IMHA if they are ______. a. A voluntary patient in a hospital in England b. A voluntary or involuntary patient in a hospital in Wales c. Wanting to make a complaint d. An adult over 21 years who is detained in hospital Ans: B

4. The role of the mental health nurse is to ______. a. Act in the person’s best interests b. Be the patient’s/service user’s advocate c. Represent the patient’s/service user’s views at Tribunals d. Stand up for the patients’ rights at manager’s hearings Ans: A

5. Family and friends who are carers can ______. a. Represent what the patient wants b. Present what they think is best for the patient c. Put forward an independent perspective d. Be totally objective about the person’s care and treatment Ans: B

6. Difficulties in the relationship between nurses and advocates can arise because ______. a. Nurses understand the role of independent advocacy b. Advocates are antagonistic to mental health professionals c. There is poor understanding of the role of independent advocacy d. The advocacy role is the responsibility of nurses Ans: C

7. Effective working relationships between mental health services and advocacy occur when a. Advocates are based in the hospital b. Advocates are considered as part of the team c. Advocates work in patients’ best interests d. There is a clear distinction between independent advocacy and clinical best interests Ans: D

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Chapter 11

The Ethical Mental Health Nurse 1. What are ‘values’? a. The worth of something b. What is important to you and how you see the world c. Morals d. Determined by your religious beliefs Ans: B

2. What are ‘group morals’? a. Clusters of moral statements b. Terms of reference c. The morals/ethics of a group of people d. Beliefs of a religious group Ans: C

3. Which document is a guide for nurses to enable them to make ethical decisions? a. NMC code of conduct b. The Bible c. Your university’s academic regulations d. Research Ethics Service Guidance Ans: A

4. Ethicists who believe in obligation-based (OB) theories hold that ______. a. Ethicists who believe in OB theories hold that living an ethical life is fundamentally concerned with abiding by a life of obligation b. Ethicists who believe in OB theories hold that living an ethical life is fundamentally concerned with abiding by a life of duty c. Living an ethical life is fundamentally concerned with abiding by a life of obligation and duty d. Ethicists who believe in OB theories hold that living an ethical life is fundamentally concerned with abiding by a life of submission to rules and obligations Ans: C

5. The word Deontology is derived from a Greek word meaning duty. It is ______. a. Deus b. Deity c. Deon d. Dettol Ans: C

6. Who said: ‘Educating the mind without educating the heart is no education at’ a. Aristotle b. Homer c. Benner d. Einstein Ans: A

7. To be an ethical nurse you need to ______. a. Refer to your own value base when making a decision b. Include the service user in all decisions c. Work according to the NMC code of practice d. Follow Kantian ethics Ans: C

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Chapter 12 Sociological Understandings of Mental Health 1. Social causation theories assume that ______. a. Mental disorder is socially constructed b. Psychiatrists are efficient at diagnosing mental disorder c. Mental disorder is real d. We always know what causes mental disorder Ans: C

2. For Goffman, people are turned into patients by ______. a. Degradation rituals b. Interaction with other patients c. The scrutiny of psychiatrists d. Over protective parents Ans: A

3. For social realists, what is it that is socially constructed? a. Everything b. Reality c. Psychological deviance d. Our understanding of reality Ans: D

4. For as long as there has been organized psychiatric institutions there has been ______. a. Consistent abuse of power b. Consistent provision of compassionate care c. Resistance to psychiatric power d. A natural emergence of occupational hierarchy Ans: C

5. Peter Sedgwick’s ideas are most accurately described as ______. a. Economic determinism b. Classical Marxism c. Anarchist d. Proto-critical realist Ans: D

6. New social movements are characterized by ______. a. Rigid hierarchies b. Bureaucratic systems c. Identity politics d. Class politics Ans: C

7. Judgements about health or illness are ultimately ______. a. Value judgements b. Independent of social norms c. Objective d. Best left to medical practitioners with relevant expertise Ans: A

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Chapter 13 Critical Psychological Ideas and Practices 1. Compared to psychiatric treatments, psychological interventions are ______. a. Always more benign? b. Never abusive c. Less physically invasive d. More effective Ans: C

2. Which is not associated with a categorical approach to classification? a. Clear dividing lines between different disorders b. Clear demarcation between states of health and illness c. Stigma attached to specific disorders d. A logical link with internal dysfunction Ans: D

3. Who was the first psychiatrist to refer to schizophrenia? a. Emile Kraepelin b. Eugene Bleuler c. Kurt Schneider d. Robert Spitzer Ans: B

4. What two conditions need to be met for a diagnostic system to be scientifically and clinically valid? a. Reliability and utility b. Predictive power and explanatory power c. Simplicity and reliability d. Reliability and flexibility Ans: A

5. The claims made for DSM reliability have been called ______. a. Exemplary medical science b. A complete nonsense c. A revolution in rhetoric and not reality d. Fake news Ans: C

6. High estimates of the heritability of mental disorders ______. a. Can be safely assumed to be accurate b. Can mask major environmental influences c. Justify eugenic practices d. Are uncontroversial Ans: B

7. Evidence for the impact of social factors in causing mental illness makes the case for which treatments? a. Medication b. ECT c. Counselling d. Trauma-focused psychological interventions Ans: D

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Chapter 14

Philosophical Understandings of Mental Health 1. Philosophical investigation investigates ______. a. Firmly held beliefs b. Common sense c. The laws of nature d. Concepts and meanings Ans: D

2. According to Thomas Szasz, mental illness is ______. a. A myth b. A luxury we cannot afford c. An excuse d. The result of poverty Ans: A

3. In his 2009 book Thomas Szasz called anti-psychiatry ______. a. Quackery squared b. Wisdom redoubled c. Foolishness quadrupled d. The only game in town Ans: A

4. If Simon has a mental illness then according to R.E. Kendell he must have ______. a. A lesion in the brain b. A statistical abnormality c. A risk of reduced fertility and increased mortality d. A biological dysfunction Ans: C

5. Boorse thinks that illness and disease ______. a. Are myths b. Are the same c. Are both value laden d. Are distinct with illness a subset of disease Ans: D

6. Fulford argues that Szasz and Kendell ______. a. Agree that all illness is value-laden b. Disagree about the status of physical illness c. Agree about the status of mental illness d. Agree about the value-free status of physical illness Ans: D

7. According to Fulford, mental and physical illness ______. a. Are both value-free b. Are both obviously value-laden c. Are both value-laden but mental illness is more obviously so d. Are both value-free but physical illness is more obviously so Ans: C

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Chapter 16 Psychiatric Understandings of Mental Health 1. What is the best way of referring to Peter Sedgwick’s conceptualizing of mental illness? a. A psychological concept b. A medical concept c. A unitary concept

d. A multi-factorial concept Ans: C

2. Which condition does have a pathological link between brain and disorder? a. Schizophrenia b. Depression c. Obsessive compulsion disorder d. Alzheimer’s disease Ans: D

3. Which is not a feature of patient centred psychiatric assessment? a. A focus on emotional needs b. A focus on patient’s concerns c. A focus on life issues d. A focus on brain abnormalities Ans: D

4. How has Diana Rose explained felt inadequacies in nursing communication? a. Nurses are ‘too busy’ to be helpful b. Nurses are terrible people c. Nurses are lazy d. Nurses are lacking in empathy

Ans: A

5. Which policy document led some psychiatrists to focus more narrowly on biological psychiatry at the exclusion of psychosocial approaches? a. The 5 Year Forward View b. No Health Without Mental Health c. The Griffiths Report d. New Ways of Working Ans: D

6. Mind–brain integration is best understood in terms of ______. a. Seeing the brain as the cause of mental illness b. Objectifying those identified as mentally ill by focusing on their brain abnormalities c. Seeing the brain as enabling the mind d. Reducing the mind to brain Ans: C

7. According to Eleanor Longden, what is the most important question in psychiatry? a. What happened to you? b. What symptoms do you have? c. What is wrong with you? d. What is the name of the Prime Minister?

Ans: A

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Chapter 17 Spiritual Care: Understanding Service Users, Understanding Ourselves 1. Which of the following is vital to service user recovery according to the service user author? a. Powerful medication b. A belief and reason for things to get better c. Psychological therapies d. Chaplains Ans: B

2. According to Forrest et al., what do service users consider a good nurse? a. Someone who is well-organised and efficient b. A person with a good sense of humour c. An expert in therapeutic techniques d. Someone with common sense, warmth, a ‘friend’

Ans: D

3. According to McSherry’s Royal College of Nursing survey, what proportion of nurses agreed or strongly agreed that spirituality and spiritual care are fundamental aspects of nursing? a. 83% b. 43% c. 38% d. 8% Ans: A

4. Co-production involves ______. a. Creating a top-quality nursing team b. Working with service users and carers, recognising everyone’s vital contribution c. Nurses working with occupational therapists and social workers d. Doing what service users want rather than doctors or nurses Ans: B

5. Spiritual care is primarily about ______. a. Getting a chaplain involved b. Recognising and affirming where spirituality provides resilience c. Providing religious objects when needed d. Complying with the Equality Act 2010 Ans: B

6. Keys’ mental health continuum proposes that ______. a. Some faith communities are more dodgy than others b. Service users can encourage each other towards better mental health c. Hospitals are among the safest institutions d. Everyone’s mental wellbeing fluctuates Ans: D

7. What factor does Swinton identify as the greatest challenge for people with chronic mental health problems? a. Social exclusion b. Poverty and debt c. Long waiting lists d. Fear of assault Ans: A

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Chapter 18 Public Mental Health: Prevention and Promotion 1. Van Os et al. (2009) conducted a systematic review and meta-analysis of the psychosis continuum. What was the median prevalence of people in the general population who experience psychotic symptoms? a. 1% b. 5% c. 23% d. 15% Ans: B

2. Who said that poverty ‘is the deprivation of opportunity’? a. Department for Health b. Corey Keyes c. Amartya Sen d. David Thoreau Ans: C

3. Which of these issues was raised in the 2009 and 2012 North West Mental Wellbeing Survey? a. Feeling unsafe outside your home b. Decreased sense of belonging to community

c. Living in a city d. All of the above Ans: D

4. Which specific diagnoses did Faris and Dunham (1939) find to be more prevalent in the densely populated, disorganized inner city regions of Chicago? a. Depression and anxiety b. Bipolar disorder and personality disorder c. Depression and drug addiction d. Schizophrenia and drug addiction Ans: D

5. Which type of locus of control is associated with depression, anxiety and paranoia? a. External locus of control b. Internal locus of control c. Both d. Neither Ans: A

6. What % below the median does your household income need to be in order for you to be deemed in poverty? a. 50% b. 60%

c. 70% d. 80% Ans: A

7. What is the term given to humans’ instinctual need to affiliate with nature? a. Urban penalty effect b. Gentrification c. Biophilia d. Botany Ans: C

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Chapter 19 Psychopharmacology for Mental Health Nurses 1. The amount of psychotropic medication prescribed has ______. a. Substantially decreased in the last decade

b. Stayed the same in the last decade c. Substantially increased in the last decade d. Increased in some years, decreased in others Ans: C

2. Antipyschotic medication was actually first used for ______. a. Analgesia b. Anti-inflammatory c. Mood stabilization d. Calming surgical patients Ans: D

3. What are extra-pyramidal effects? a. The most frequently experienced side effects of anti-psychotic drugs b. Stomach upset c. Sedative effects of medication d. A range of effects that mimic the symptoms of Parkinson’s disease Ans: D

4. Which neurotransmitter gave its name to a major hypothesis for the cause of psychotic symptoms? a. Dopamine b. Acetyl-choline

c. Serotonin d. Histamine Ans: A

5. What does Joanna Moncreiff say is a better way of understanding psychiatric medication? a. Pathological disturbance in brain chemistry is mediated by drugs b. Making a clear distinction between main effects and side effects c. Psychotropic substances cure psychiatric illnesses d. A drug-centred model of action Ans: D

6. Anti-psychotics are ______. a. Known for their efficacy b. A group of compounds with minimal side effects c. A heterogenous group of drugs d. Treatments with an unequivocally strong evidence base Ans: C

7. What is main difference between the first- and second-generation anti-psychotics? a. The side effect profile b. Superior efficacy for second generation anti-psychotics c. Differences in prescribing patterns

d. Differences in rates of concordance Ans: A

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Chapter 20 Wellbeing in Mental Health Care 1. What is wellbeing? a. Living without a mental illness b. Being happy at least 90% of the time c. Always being assertive d. Functioning effectively and with a sense of purpose much of the time Ans: D

2. Is it possible to have a diagnosed mental health problem and experience flourishing wellbeing? a. Absolutely, yes. b. No, people with a diagnosed mental health problem can’t also have good wellbeing

c. Very occasionally d. The two are exactly the same thing Ans: A

3. What does ‘dialectics’ mean? a. It is a way of understanding people as having a good side and an evil side b. It is a way of distinguishing between people who are well and people who are ill c. It’s a way of ensuring we’re always resilient enough for our work d. It’s a way of finding a new, deeper truth from apparent opposites Ans: D

4. It’s possible to reflect too much on ourselves and our wellbeing a. Never! b. It can be: it depends if we reflect kindly, non-judgementally and gently c. Yes. We should just act spontaneously and not think too much about ourselves d. Yes – because it can make us ill Ans: B

5. We should always be hopeful when working with people who have mental health problems a. Yes – a mental health nurse has an obligation to always be hopeful b. Yes– but whilst we need to approach things as much as we can with a sense of optimism, we need to allow ourselves to occasionally feel pessimistic and attempt to adopt a realistic approach to our own and others’ problems

c. Yes – otherwise we’d be letting ourselves down d. No – because life is terrible for most of us Ans: B

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 21 Recovery-Orientated Practice 1. Recovery includes values of ______. (Select three) a. Hope b. Independence c. Identity d. Cure Ans: A, B, C

2. Recovery is a process ______. (Select three) a. Of making sense of what happened b. Unique to each individual

c. Of growth d. Provided by services Ans: A, B, C

3. Common critiques of recovery include ______. (Select three) a. It has been hijacked by services b. It implies illness c. It focusses on the individual d. It ignores medication Ans: A, B, C

4. A Wellness plan typically includes ______. (Select two) a. A section on early warning signs b. A section on employment history c. A section on early childhood experiences d. A section on identifying triggers Ans: A, C

5. Which of these is not an approach to use for recovery-focussed working? a. Mutuality b. Strengths focus c. Directive support

d. Wellness planning Ans: C

6. Which of these is not part of an approach to implement recovery in forensic settings? a. Maintaining safety and security for everyone b. Participation of people in some aspects of their own care c. Open and transparent decision-making in partnership with people d. Informed choice Ans: B

7. Staff sometimes experience recovery focussed change as involving a loss of ______. (Select two) a. Status b. Friends c. Power d. Uniform Ans: A, C

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 22 Employment and Recovery in Mental Health Care 1. Vocational support can be strengthened if provided alongside ______. a. Physical exercise b. Developing a social life c. Achieving a qualification d. All of the above Ans: D

2. The main purpose of vocational support is to assist someone with ______. a. Finding a job that draws upon their service use experience b. Managing a structured daily routine of meaningful activity c. Claiming the welfare benefits they are entitled to d. Not taking on too much and becoming ill

Ans: B

3. If someone with a schizophrenia diagnosis is unemployed, those involved in their care should ______. a. Try to make sure they never have to work in a paid job again b. Help them to get into a paid job as soon as possible c. Stop them from applying for jobs until they are feeling better d. Positively support vocational goals, including employment Ans: D

4. Vocational issue ought to be identified ______. a. Right at the beginning of somebody’s inpatient care b. Within 6 weeks of admission c. After they have been formally assessed by a psychiatrist d. When they say they are ready to go back to work Ans: A

5. The main idea of ‘social inclusion’ is to make sure that ______. a. All people in society are valued and have rights b. Mental health inpatients can go on home visits c. Family, friends and neighbours are consulted about care decisions d. Service users know what services are available in their area Ans: A

6. The work that mental health service users should be expected to do ______. a. Depends upon their illness diagnosis b. Is nearly always voluntary or part-time c. Changes according to what is happening in wider society d. Ought to be in a sheltered workshop with other service users Ans: C

7. Vocational rehabilitation is a developmental learning process that should ______. a. Follow a standard timetable, so people get used to being disciplined b. Occur at the service user’s own pace c. Wait until somebody has been discharged from hospital d. None of the above Ans: B

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 23

Compassionate Communication in Mental Health Care Section A 1. What does CFT stand for?

Ans: Compassion Focused Therapy 2. What does SURETY stand for?

Ans: Sit at an angle, Uncross arms and legs, Relax, Eye contact, Touch, Your intuition 3. What does BOND stand for?

Ans: Being and becoming, Overcoming obstacles, Noticing, Doing 4. What does BOE stand for?

Ans: Brief, Ordinary, Effective

Section B 1. Is self-awareness an element of emotional intelligence according to Goleman? (Y/N) Ans: Yes 2. Is compassion one of Cummings’ six ‘C’s? (Y/N) Ans: Yes 3. Is relieving suffering an aim of compassion? (Y/N) Ans: Yes 4. Does the WHO core characteristics of person-centred communication in their global strategy state which behaviours should be ignored? (Y/N) Ans: No

Section C 1. Compassionate care is good at relieving mental distress but it is not helpful with physical pain. (T/F) Ans: False 2. Self-awareness is unnecessary to demonstrate compassionate communication. (T/F) Ans: False 3. Emotional intelligence consists of four interrelated skills: perceiving emotions, facilitating thought through emotions, understanding emotions, managing emotions. (T/F) Ans: True 4. Communication is about attending, listening and responding. (T/F) Ans: True

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 24 Meeting the Physical Health Needs of Mental Health Service Users 1. Which is not a factor in the reduced life expectancy for people with a range of mental illness diagnoses? a. Suicide b. Co-morbid physical illnesses c. Intelligence d. Accidents Ans: C

2. What is not associated with insomnia? a. Diabetes b. Cardiovascular disease c. Weakened immune system

d. Hearing loss Ans: D

3. Of what magnitude is the rate of smoking for people with serious mental health problems compared to the general population? a. The same b. Less c. Three times as much d. Twice as much Ans: D

4. What type of exercise may prevent weight gain and negative metabolic outcomes in the first few months of antipsychotic treatment? a. Intense structured exercise programme b. Regular walking c. Playing football for one hour a week d. Joining a walking group Ans: A

5. What is not a consequence of stigma and social exclusion? a. Unemployment b. Poverty c. Social isolation

d. Good quality housing Ans: D

6. Which of these statements is not the case about people with serious mental health problems attending primary care appointments? a. They have longer consultation times b. They attend more frequently than the general population c. They are reluctant to discuss physical health d. These represent about two thirds of all their health contacts Ans: C

7. What is a major barrier for mental health service users attempting to have their holistic needs met? a. Fragmentation of services b. Insufficient scholarly evidence of physical health issues c. Lack of relevant policy d. Insufficient knowledge in the system of what could help Ans: A

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 25 Therapeutic Engagement for Mental Health Care 1. What interpersonal skills are essential for a mental health nurse to possess to be able to build relationships with those in their care? (Tick all that apply) a. Being interested and curious in the life events that have bought the person to ask for help b. Being able to listen non-judgementally and to have well-developed self-awareness reflective skills c. Being open and transparent about the purpose/s of the proposed intervention d. Being flexible to the person’s needs regarding timing and venue for meetings Ans: A, B, C, D

2. How would you define the term ‘professional friend’ as a mental health nurse? a. A nurse who is always available to respond to requests for help and thinks of his/herself as ‘going the extra mile’ b. A nurse who always takes his/her service users out for coffee/tea

c. A nurse who is willing to offer practical support and help within the boundaries of his/her role d. A nurse who is willing to be flexible about how/when where appointments take place, but never shares any personal information with the people in his/her care Ans: C

3. When making contact with a person (who you know relies on public transport) for an initial assessment, which of the following statements encompasses best practice a. Send a letter offering an appointment at the team base during an assessment clinic b. Send a letter offering an appointment at their nearby GP surgery c. Sending a letter asking them to phone up your team administrator to book a convenient slot in the assessment clinic d. Phoning up the person to discuss how/where/when they would like to be seen for the assessment Ans: D

4. Whilst on placement as a second year student with a community mental health team, your mentor asks you to ‘chase up’ one of his service users (Betty) who he has heard has missed two appointments with the practice nurse for her annual physical health check. Your mentor advises you that Betty often misses appointments as she is regularly called on to help her look after her grandchildren. You have met her twice near the start of your placement, but aware you only have three weeks left before going back to university. Which of the following options might you choose as your engagement strategy with Betty? a. Phone Betty to ask if she would like you to accompany her to the surgery at a prearranged time over the next few weeks b. Phone the practice nurse to ask her to send out another appointment to Betty c. Send Betty a letter to say you will be visiting her to discuss not attending for her health checks

d. Send Betty a letter to offer an appointment to meet for a catch up to see how she is doing and if there might be anything you can help her with during the final few weeks’ of your placement Ans: D

5. Which of the following sentences best sums up your understanding of therapeutic engagement? a. Therapeutic engagement is the most important aspect of any of the work we do as mental health nurses b. Therapeutic engagement is the foundation for developing co-produced care c. Therapeutic engagement is just one aspect of working collaboratively with someone in our care d. Therapeutic engagement is not as important as doing what the person asks us to do Ans: A

6. Which of the following factors can affect people engaging with mental health services? a. Self and/or societal stigma; traumatic experiences of care b. Unstable housing and/or finances; poor transport links c. Appointments offered during working hours only d. All of the above Ans: D

7. As a mental health nurse, what policies and guidance support collaborative working with the people in our care? a. NMC Code of Conduct (2015)

b. Personal Recovery literature (e.g. Leamy et al., 2011; Shepherd et al., 2008) c. Department of Health Policies (e.g. 2008, 2012) d. All of the above Ans: D

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 26 Mental Health Assessment 1. Comprehensive and systematic assessment in mental health ______. a. Is determined by the plan of interventions b. Is completed upon first contact with a service user c. Underpins clinical decision-making and plans for interventions d. Is using the same approach with all service users Ans: C

2. The process of funnelling in assessment ______. a. Helps to disregard unnecessary information

b. Helps clarify needs and symptoms experienced c. Helps to highlight what the main problem is d. Requires assessment of all areas of a service user’s presentation Ans: B

3. The assessment process is ______. a. Completed at the start of the service user’s journey b. Completed by a designated person c. Can opportunity to get as much information as possible d. A dynamic process that is ongoing and helps to facilitate a greater understanding Ans: D

4. To complete assessments the nurse needs to be ______. a. Able to work efficiently and quickly b. Able to use any assessment tool c. Allocated the task d. Able to work collaboratively with a client and to make sense of their experiences Ans: D

5. Clarifying assessment tools ______. a. Need careful consideration and a clear rationale for undertaking them b. Can be used by anyone

c. Are only undertaken if the service user requests one d. Should be undertaken as routine practice Ans: A

6. Systematic assessment in mental health is ideally completed ______. a. As quickly as possible b. At the end of treatment c. By all practitioners involved in care d. In collaboration with a service user, their family and those working closely with them Ans: D

7. The nurse should avoid ______. a. Completing too few assessment tools b. Assessing needs c. Completing assessments without an understanding of how and why the information will be useful d. Involving the service user in the decision-making process Ans: C

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 27 Care Planning 1. When was Care Programme Approach (CPA) introduced in the United Kingdom a. 1900 b. 1990 c. 1991 d. 1988 Ans: B

2. Is care planning is a continuous process? a. True b. False Ans: A

3. Which of the following is NOT a level of analysis? a. False b. True Ans: B

4. Care planning can marginalize service users’ experiences a. False b. True Ans: B

5. Care plans must be ______ a. S-pecified ; M-onitored ; A-ttained ; R-elevant; T-imed b. S-pecific ; M-onitired ;A-ttained; R-ealistic; T-imely c. S-pecific; M-easurable; A-attained; R-elevant; Tmely d. S-pecific ; M-easureable ; A-chievable ; R:ealistic ; T:imely Ans: D

6. Holistic assessment identifies the biopsychosocial needs of service users and covers all potential needs an individual may have. a. True b. False Ans: A

7. Nurses play a central role in providing person-centred care. Who could be involved in the process of care planning? a. Priests b. Service users c. Carers d. All of these Ans: D

8. What is an IDEAL approach in care planning? a. I-ntensive; D-elibrate; E-quitable; A-ccurate; L-everage b. I-nclusion; D-iscussion; E-ducation; A-ssessment; L-istening c. I-nclusion; D-elibrate; E-ducation; A-dequate; L-istening d. I-nclusion; D-elibrate; E-qual; A-ssessment; L-istening Ans: B

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 28 Mental Health Care Coordination 1. Care co-ordination has been defined as ______. (Select all the correct answers) a. Getting a person clinically appropriate care in a timely manner without wasting resources b. A way of tailoring helps to meet individual needs through placing the responsibility for assessment and service coordination with one individual worker or team c. The integration of organizational structures d. An activity that is fundamentally about connections among interdependent actors Ans: D

2. A care co-ordinator is ______. a. A mental health nurse only b. Any suitably qualified person in England and Wales c. Any mental health worker in England but only specified professionals in Wales d. None of the above Ans: C

3. The need for care co-ordination resulted from ______. a. Large numbers of people wanting community care b. The introduction of new medications c. The deinstitutionalization programme d. A desire to control the work of community mental health nurses

Ans: C

4. A psychosocial assessment is primarily focused on ______. a. Checking what medication works for the person b. Ensuring the person has something to do during the day c. Examining the mental state of the person d. An evaluation of the person’s mental, physical, emotional and social circumstances Ans: D

5. A strengths focus helps with ______. a. Building muscle strength and fitness b. Focusing on the resources and relationships people have available to them c. Showing how good services are at helping with problems d. Building psychological resilience Ans: B

6. Care co-ordination can help people with recovery by ______. a. Facilitating control over aspects of one’s life and building social connectedness b. Doing everything possible for the person c. Ensuring people take their medication d. Helping people comply with their care plan Ans: A

7. A wicked problem is ______. a. One which is nasty and malignant b. A problem that defies definition c. Defined in relation to a possible solution and for which there is contested and often contrary evidence d. Something to do with witches Ans: C

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 29 Mental Health Risk Assessment: A Personalized Approach 1. Which of the following is least likely to be a consequence (or risk) of the lack of service user or family carer involvement in mental health risk assessment? a. Information about risk more likely to be misunderstood b. Care and safety plans being less well-informed c. Disagreement about risk, its seriousness and risk status being more likely

d. Opportunities for positive risk taking and accessing wider sources of support being more likely e. Overly restrictive/risk averse interventions being more likely Ans: D All of the options except for D are reported examples of consequences/risks associated with a lack of service-user/family carer involvement in mental health risk assessment. In fact, a lack of opportunities for positive risk taking and for accessing wider sources of support would be more likely in the event of limited service user/family carer involvement.

2. Which of the following is primarily an example of risk arising from stigma, social exclusion or vulnerability? a. Adverse effects of medication b. Suicide c. Violence d. Neglect of dependents e. Financial exploitation Ans: E Of these options, financial exploitation is the best example of a risk arising as a consequence of an individual’s vulnerability.

3. Which assessment tool is the odd one out? a. START b. WARNN c. FACE d. HCR-20

e. GRIST Ans: D The HCR-20 (Historical & Clinical Risk – 20 items) is the only specific risk assessment tool, focusing upon the risk of violence. All of the other tools focus upon assessing multiple risks.

4. Approximately how many people die by suicide in the UK each year? a. 1500 b. 3000 c. 6000 d. 9000 e. 12000 Ans: C Option C is the best response, as there ‘were 66,991 suicides in the general population in the UK between 2009 and 2019’, which is ‘an average of 6,090 deaths per year’ (NCISH, 2022, p.

5).

5. The following is a definition of which type of factor that should be considered when undertaking risk assessment: present for an uncertain length of time, tending to fluctuate in intensity & duration, and useful for informing the focus of timely, short-term intervention and care? a. Static b. Stable dynamic c. Acute dynamic d. Future e. Protective

Ans: C The provided definition best relates to acute dynamic risk factors, as this refers to changeable factors that tend to fluctuate in intensity and duration, and which are a good focus for short-term intervention and care.

6. Which of the following is an example of a static risk factor? a. Hopelessness b. Previous suicide attempts c. Access to means d. Suicidal ideation e. Psychosocial stress Ans: B. Of these options, previous suicide attempts is clearly a historical, unchangeable, static risk factor.

7. Which of the following is an example of a future risk factor? a. Gender: being male b. Having a plan for suicide c. History of childhood sexual abuse d. Impulsivity e. History of assaulting others Ans: B Of these options, having a plan for suicide is clearly a future risk factor.

8. Which of the following may be considered a protective or positive factor? a. Financial difficulties b. Hopelessness c. Disengagement d. Limited supports e. Commitment to work Ans: E Of these options, having a commitment to work is clearly a positive/protective factor.

9. Which of the following may be considered an example of a positive risk for someone experiencing suicidal and distressing thoughts? a. Self-administering medication b. Having contacts restricted c. Subject to 15-minute observations d. Being refused leave from the ward e. Being admitted to the ward Ans: A All except option A are examples of restrictive/supervisory interventions.

10. In the 5Ps model, which of the following is the best description of precipitating factors? a. Current symptoms and their immediate consequences b. Strengths or supports that may mitigate the impact of illness c. Significant events or situations leading to crisis

d. Factors that maintain current difficulties e. Historical and developmental factors contributing to risk Ans: C Precipitating factors refer to significant events or situations leading up to the crisis point.

11. Which of the following may best be considered examples of predisposing factors? a. Brain injury, family history, life-long personality traits b. Having a job, financial stability, having support from family and friends c. Sleep impairment, anxiety, low mood d. Loss of a loved one, heightened stress at work, being evicted e. Alcohol use, limited engagement, social isolation Ans: A Option A includes examples that may be considered predisposing factors.

12. Which of the following statements about mental health risk assessment is clearly false? a. Frequent review is required as risks change in response to changing circumstances b. Confidentiality is a personal right and must not be breached c. The identification of risk should always lead to a safety/risk management plan d. The information gathered and recorded in a risk assessment needs to be as comprehensive and accurate as possible e. The aim of risk assessment is to minimize rather than necessarily eliminate risk Ans: B

Of these options, option B is clearly false. Confidentiality may be breached in exceptional circumstances e.g. where the individual/others are deemed to be at serious risk of harm, and where the benefits clearly outweigh the risks of doing so.

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 30 Minimizing Violence and Related Harms 1. An example of an internal factor (Nijman et al. 1999; Duxbury 2002) of violence and aggression is ______ a. Lack of privacy b. Mental health issue c. Being denied access to certain items of one’s own property d. A ‘blanket rule’ of ‘lights-out’ at 22.30 Ans: B

2. An example of an external factor (Nijman et al. 1999; Duxbury 2002) example of violence and aggression is ______. a. Hearing voices b. Experience of trauma

c. Being denied access to one’s bedroom between 10.00 and 18.00 d. Age of patient Ans: C

3. What is an Advance Directive? a. A document detailing a patient’s preference for treatment and way of being nursed, in the event of a future incapacitating psychiatric crisis b. When a next of kin takes autonomy over a patient’s treatment c. A document detailing a psychiatrist’s recommendations of treatment, in the event of a future incapacitating psychiatric crisis of a patient d. A document patients are required to complete prior to discharge from an inpatient service Ans: A

4. Which of the following is not included as one of Huckshorn’s (2004) Six Core Strategies©? a. ‘Last Resort’ b. Use of data to inform practice c. Service user role in organization d. Leadership towards organizational change Ans: A

5. TIC (in the context of restrictive practice) stands for ______. a. Trauma in Care b. Treatment in Care

c. Treated Inpatient Community d. Trauma Informed Care Ans: D

6. REsTRAIN YOURSELF was the adaptation of Huckshorn’s (2004) Six Core Strategies©, in which country? a. USA b. UK c. UAE d. Sweden Ans: B

7. Which specific type of restraint have some groups contentiously called to ban? a. Supine b. Seated c. Prone d. Escort Ans: C

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 31 Cognitive Behavioural Therapies Multiple Choice Questions 1. The use of a reward chart where a child is given a sticker for demonstrating good behaviour is an example of ______. a. Positive reinforcement b. Classical conditioning c. Negative reinforcement d. Punishment Ans: A

2. Beck’s cognitive model of depression includes ______. a. Core beliefs b. Dysfunctional assumptions c. Negative automatic thoughts

d. All of the above Ans: D

3. Developing a shared understanding of clinical information using a cognitive model is called ______. a. Cognitive analysis b. Behavioural analysis c. Cognitive behavioural formulation d. Cognitive behavioural analysis Ans: C

4. Behavioural activation is best described as ______. a. A behavioural strategy that is easy to implement b. A behavioural strategy that reduces negative reinforcement and increases positive reinforcement c. A behavioural strategy that is only used for depression d. A behavioural strategy that is best used with energetic adults Ans: B

5. Which of the following negative automatic thoughts is an example of a catastrophic misinterpretation? a. ‘He’s upset: I must have said something wrong!’ b. ‘I’m no good: I’ll never get a job!’ c. ‘My heart’s beating fast: I’m having a heart attack!’

d. ‘I hate him: He’s an obnoxious man!’

Ans: C

6. Which of the following best describes the role of the therapeutic relationship in CBT? a. Necessary and sufficient to bring about therapeutic change b. Necessary but not sufficient to bring about therapeutic change c. Neither necessary nor sufficient to bring about therapeutic change. d. Irrelevant to the practice of CBT Ans: B

7. Graded exposure is best described as ______. a. Increasing exposure to a feared stimulus until habituation occurs b. Gradual exposure to a phobia c. Bringing on an anxiety response d. A treatment for anxiety Ans: A

Short Answer Questions 1. What is the type of conditioning developed by Pavlov?

Ans: Classical 2.’I feel guilty, so I must have done something wrong’ is an example of ______ reasoning.

Ans: Emotional

3. The process of catching and modifying negative automatic thoughts is called ______ restructuring.

Ans: Cognitive 4. A reduction in positive reinforcement is thought to play a role in the maintenance of depression. What is the other type of reinforcement that tends to increase when people are depressed?

Ans: Negative 5. The principles of effective graded exposure are that it should be graded, repeated, and ______ until habituation takes place.

Ans: Prolonged 6. Behavioural experiments are powerful interventions and promote both intellectual and ______ insight.

Ans: Emotional 7. At the end stage of CBT, the identification of helpful CBT strategies, early warning signs and helpful responses is referred to as a ______.

Ans: Therapy blue print

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 32 Psychosocial Interventions to Support Carers 1. What would NOT normally be part of a carer psychoeducation approach? a. Family therapy b. Medication management c. Family communication d. Crisis planning Ans: A

2. Which of the following is one of the 6 key standards of the Triangle of Care? a. Staff should be trained in carer engagement strategies b. Staff should contact carers on a regular basis c. Staff should call carers by their first name d. Staff should liaise with other members of the clinical team Ans: A

3. What is important to consider when arranging a family meeting? a. The availability of refreshments at the meeting b. Everyone attending the meeting already knows each other c. The location of the meeting d. The information to be presented at the meeting is available as a handout

Ans: C

4. Why do some people not like the term carer to be used to describe their role? a. They do not care for the person with mental health problems b. It does not differentiate between the role provided by family and friends and the role of health professionals c. They do not live with the person with mental health problems d. It assumes they have a formal caring qualification Ans: B

5. How many carers in the UK care for someone with a mental health problem? a. 0.5 million b. 1 million c. 1.5 million d. 2 million Ans: C

6. What makes a mental health nurse an ideal professional to liaise with carers? a. Mental health nurses are nice people b. Mental health nurses are trained to deal sensitively with carers c. Mental health nurses know more about the service user’s condition than other professionals d. Mental health nurses often have most professional contact with carers of users receiving inpatient care or community care

Ans: D

7. If the service user does not agree to information about their care being shared, carers do not have a right to receive information from the clinical team unless? a. They can prove they need to receive this information b. The information is not considered important c. They are the service user’s next of kin d. Withholding information might put the carer at risk Ans: D

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 33 Self-Help and Peer Support in Recovery 1. Self-help and peer support were first developed: a. In the National Health Service b. Informally among people with similar experiences c. In the Armed Forces

d. In Wales Ans: B People have long provided informal support to others sharing similar experiences.

2. Peer support can be provided in: a. In acute mental health wards b. In crisis services c. In community organizations d. In any of the above and other settings Ans: D Peer support can be provided in community settings and in a range of mental health services.

3. Peer support is available in: a. Many different countries b. Only in the USA c. Only in England and Wales d. Only in Australia and New Zealand Ans: A Peer support is now provided in many countries all over the world.

4. In England, peer support is included in which government health policy? a. The National Peer Support Policy

b. The England and Wales Peer Support Initiative c. The Community Mental Health Framework for Adults d. The Mental Health Act 1983 Ans: C Peer support is mentioned in numerous policy documents including the Community Mental Health Framework for Adults.

5. Which of the following was identified as most helpful for peer support workers in their role? a. A uniform b. A car c. Training d. A rule book Ans: C Training in peer support roles has been identified as important in many studies of peer support workers.

6. The research evidence suggests peer support has most impact on: a. Psychiatric symptoms b. Hospital admission rates c. Career development d. Self-reported recovery and empowerment Ans: D Research evidence is strongest for self-reported recovery and empowerment.

7. Which one of the following processes was not identified by Gillard et al. (2015) as helping in service users when they saw peer support workers? a. Building trusting relationships based on shared experiences b. Talking about how dreadful things are c. Role modelling recovery d. Engaging service users with services and community Ans: B Talking about how dreadful things are was not identified as supportive in peer support.

Acknowledging difficulties is acceptable, but emphasizing change, hope and recovery are more helpful.

8. To support peer support workers, mental health nurses should: a. Welcome, respect and value peer support workers b. Remind peer support workers who is in charge c. Let peer workers support the more challenging service users d. Just let them get on with it Ans: A Being warm and respectful towards peer support workers and recognizing their contributions towards people’s recovery is welcomed by peer workers.

9. Which of the following psychological theories may help explain the mechanisms that aid peer support? a. Lineker’s (2023) Levelling Up Theory.

b. Bandura’s (1977) Social Learning Theory. c. Rapp’s (1993) Strengths Case Management Model d. Marx’s theory of false consciousness.

Ans: B Bandura’s (1977) Social Learning Theory suggests that significant others provide compelling role models of how to think, feel and act, determining motivation, behaviour and change. Peer workers can role model recovery and living with mental illness.

10. A high-quality systematic review is described as: a. A method for listing all the RCTs completed on a topic b. A way of reviewing what people have said about their experiences of a topic c. An important statistical test d. A meticulous summary of all the available primary research in response to a research question Ans: D Systematic reviews are seen as a meticulous summary of all the available primary research in response to a research question and often the best guide to clinical practice. But systematic reviews can only provide summaries of the research that has been undertaken and there may be limited or poor quality studies of new developments such as peer support.

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 35 Dementia: Assessment and Care Approaches 1. Which of the following is not a clinical feature of dementia? a. Memory loss b. Language difficulties c. Manic episodes d. Physical decline Ans: C

2. The person-centred philosophy of care for people with dementia was set out by ______. a. Alois Alzheimer b. Tom Kitwood c. Carl Rogers d. Phil Barker

Ans: B

3. The key qualities needed by someone caring for a person with dementia are ______. a. Empathy, person-centred attitudes and a compassionate approach b. The ability to carry out control and restraint c. Getting physical care tasks done in the least possible time d. Prioritizing families’ needs over the person with dementia Ans: A

4. Diagnosis of dementia is usually carried out in a ______. a. Dementia clinic b. Memory assessment service c. Forgetfulness clinic d. Health visitor’s office Ans: B

5. Specialist nurses who work with people with dementia and their families are called ______. a. Macmillan nurses b. Commander nurses c. Dementia nurses d. Admiral nurses Ans: D

6. The proportion of people with dementia living in care homes is ______. a. 66% b. 33% c. 50% d. 25% Ans: B

7. The risk of contracting dementia may be reduced by ______. a. Continuing to be intellectually active as you grow older and eating more meat b. Eating a ‘Mediterranean’ diet and minimizing sources of stress c. Exercising and eating more meat d. Continuing to be intellectually active as you grow older, eating a ‘Mediterranean’ diet and exercising Ans: D

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 36 Care of People Experiencing Eating Disorders 1. How many people are thought to be suffering from an eating disorder in the UK? a. 500,00 b. 72,500 c. 1, 725,00 d. 725,00 Ans: D

2. The gender ratio for anorexia in the 13–18 age range is ______. a. Female to male = 4:1 b. Female to male = 9:1 c. Male to Female = 9:1 d. Male to Female = 1: 6 Ans: B

3. Anorexia nervosa is considered to be ______. a. A medical condition b. A psychological condition c. A social condition d. A combination of the above

Ans: D

4. Young people with anorexia are often found to have which one of the following traits? a. Obsessiveness b. Perfectionism c. Extroversion d. A tendency to openness Ans: B

5. Anorexia usually develops at what time of life? a. Middle age b. Old age c. Childhood d. Any age Ans: C

6. What is the name of the guidance from the RCP? a. Care and treatment of eating disorder b. MARSIPAN c. The Physicians guide to anorexia d. Beating eating disorders Ans: B

7. ‘Drop-out’ from eating disorder treatment is ______. a. Similar to other mental health conditions b. High c. Low d. Similar to long-term physical conditions Ans: B

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 37 Children and Young People’s Mental Health Care 1. How many 5–16 year olds had a mental health disorder in the UK in 2021? a. 1:3 b. 1:5 c. 1:9 d. 1:6

Ans: D In 2017 1:9, 5–16 year olds had a mental health disorder, this rose to 1:6 in 2021

2. Which of the below could be seen as a protective factor? a. Close friendships b. Secure parent-child relationship c. Access to healthcare d. All of the above Ans: D Protective factors are conditions or attributes of individuals, families, communities, and the larger society that mitigate risk and promote the healthy development and well-being of children, youth and families.

3. What best describes person-centred Care in nursing. Is it where: a. Each person is respectfully as an individual human being, and not just as a condition to be treated b. The patient is given a copy of their core care plans c. The patient can give informed consent to treatment d. The nurse can look at the patient’s history prior to assessment Ans: A Working in a person-centred way means working in partnership with the individual to plan for their care and support. The individual is at the centre of the care planning process and is in control of all choices and decisions made about their lives.

4. An example of an adverse childhood experience is: a. Having a parent with a mental health illness b. Physical abuse c. Neglect d. All of the above Ans: D ACEs are traumatic events that occur before a child reaches the age of 18. ACEs include all types of abuse and neglect, such as parental substance use, incarceration and domestic violence.

5. What are the four groupings identified in the Thrive Model (Wolpert et al. 2014) a. Coping, asking for help, getting some support, discharge b. Coping, asking for help, person centred care, getting more help c. Coping, getting help, getting risk support, getting more support d. Coping, being supported, surviving, thriving Ans: C The THRIVE model conceptualises four clusters (or groupings) for young people with mental health issues and their families, as part of the wider group of young people who are supported to thrive by a variety of prevention and promotion initiatives in the community. The groupings are coping, getting help, getting risk support, getting more help.

6. Children may not be able to give informed consent due to their age and/or maturity, but they can express a willingness to receive an intervention. What is the correct term for this? a. Agreement b. Dissent

c. Approve d. Assent Ans: D Assent is a term used for children to express a willingness to participate in a healthcare procedure or intervention. The child is usually too young to give informed consent but old enough to understand the proposed intervention, its expected risks and possible benefits, and the activities expected of them as patients. Assent by itself is not sufficient, if assent is given, informed consent must still be obtained from the child’s parents or carer.

7. There are some known warning signs which may indicate mental health problems in CYP. Which one is not a warning sign? a. Lack of motivation and interest in activities they used to enjoy b. Preferring to spend time with friends rather than family c. Increasing focus on calorie intake and excessive exercise d. Engaging in self injury Ans: B Playing and spending time with friends is a crucial part of all children’s development, no matter how old they are. By spending time with friends, they are learning about and establishing relationships which is important for social development.

8. In England and Wales, the Mental Health Act MHA (1983) covers the assessment, treatment and rights of people with mental health conditions. The Act is applicable to: a. People of all ages b. People 12 years and older c. People 16 years and older

d. People 18 years and older Ans: A The MHA (1983) applies to all children and young people under the age of 18. The Act allows for people to be detained in hospital if they need treatment for a mental health condition.

9. According to a report by the Royal College of Paediatrics and Child Health (2020) what percentage of mental health problems start before the age of 14? a. 34% b. 48% c. 50% d. 71% Ans: C Half of mental health conditions in adults start before the age of 14 and 75% before the age of 24. The prevalence of all types of mental health conditions is increasing in England.

10. What is the most common reported reason for young people not approaching their GP for support for their mental health? a. Fear of their parents being informed b. Not wanting to appear different from their peers c. Not feeling that their problem is bad enough d. Feeling that there is no point due to lengthy waiting lists for support Ans: C Many young people perceive their mental health as not being bad enough to seek support from their GP. The second most reported theme was perceived social stigma and embarrassment.

The third theme was the young person’s concern over perceived confidentiality and the ability to

trust an unknown person/professional. The fourth theme related to financial costs, logistical barriers and the availability of professional help.

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 38 Non-Medical Alternatives for Crisis Care 1. Which is not necessarily a characteristic of most non-medical care alternatives? a. Attempts to understand the unintelligible b. An emphasis on relational care c. Prescribed medication d. Central role for dialogue Ans: C

2. Which is a characteristic of non-medical alternatives for crisis care? a. Insistence on taking medication b. Compulsory admission c. High levels of physical security

d. Working within the person’s own preferred framework of understanding Ans: D

3. What is not a feature of a therapeutic community? a. Viewing all behaviour as meaningful b. Valuing positive relationships c. Clarity regarding decision-making d. Requires a residential setting Ans: D

4. Which town has attempted to develop a therapeutic community-inspired whole social system approach? a. Slough b. Hebden Bridge c. Canterbury d. Rochdale Ans: A

5. Who developed the Soteria model? a. Ronnie Laing b. David Cooper c. Rex Haigh d. Loren Mosher

Ans: D

6. Which is not the site of an open dialogue initiative? a. North East London b. Western Lapland c. Liverpool d. New York Ans: C

7. What is a feature of the open dialogue approach? a. Tolerance of uncertainty b. Exclusion of extended family members c. Prescribed medication d. Inpatient admissions Ans: A

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 39 Primary Mental Health Care 1. In primary care which of the following practitioners are likely to deliver low-intensity interventions? (Select 2) a. GP b. Mental health nurse c. Psychological wellbeing practitioner d. Practice nurse Ans: B, C

2. Which of the following would NOT be considered a low-intensity intervention? a. Relaxation b. Sleep hygiene c. Psychoeducation d. Challenge core beliefs Ans: D

3. Which of the following services would NOT be considered part of primary care? a. NHS direct b. IAPT practitioners c. Opticians d. 24-hour crisis intervention service

Ans: D

4. Which mental health condition is most commonly seen in primary care? a. Psychosis b. Anxiety and depression c. Personality disorder d. Drug dependency Ans: B

5. Which of the statements below is one of the key objectives of No Health Without Mental Health (DH, 2011)? a. No one will more than 4 weeks for an initial assessment b. No one will have to travel more than 10 miles to receive primary mental health care support c. Fewer people will experience stigma and discrimination d. Less emphasis will be placed on physical health needs in mental health services Ans: C

6. On which step might those suffering with chronic and severe problems, be treated in a stepped care model? a. Step 1 b. Step 2 c. Step 4 d. Chronic and severe problems would not be treated using the stepped care model

Ans: C

7. Which of the following practitioners might expect to see patients who have a mental health problem? a. Dietician b. Physiotherapist c. Diabetics nurse d. All of the above Ans: D

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 40 Palliative and End-of-Life Care in Mental Health Care 1. Which of the following are common problems experienced by people with dementia at the end of their lives: a. Pain b. Pressure sores

c. Immobility d. Feeding problems Ans: A, B, C, D

2. Optimism for the future can be enhanced by: a. Having more active control over one’s life b. Being told what is going to happen to you c. When staff use humour d. Antidepressant therapy Ans: A

3. Huntington’s disease is: a. An untreatable virus b. A side effect of neuroleptic medication c. An hereditary disorder of the central nervous system d. Only experienced by women Ans: C

4. One of the following is NOT a signs of dementia a. Disorientation b. Forgetfulness c. Lack of concentration

d. Weight loss Ans: D

5. When should ‘end of life care’ commence? a. When death is imminent b. when you need it to c. When the family can’t cope any more d. When you go to a hospice Ans: B

6. Which of the following provide palliative care? (tick all that apply) a. GP’s b. Mental health nurses c. Admiral nurses d. Pharmacist Ans: A, B, C

7. According to Lawrence et al. (2011), at least how many people die each year with dementia a. 100,000 b. 10,000 c. 1000,00 d. 1000,000

Ans: A

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 42 Democratic Leadership for Mental Health Care 1. Who called for the ‘developing and strengthening of leadership at all levels’? a. The NHS National Improvement and Leadership Board b. The Kings Fund c. The Department of Health d. The NMC Ans: B

2. Horvath and Greenberg’s (1989) Working Alliance Inventory (WAI) assesses the three essential components of the working alliance. There are ______. a. The goal, the bond and the task b. The goal, the agreement and the bond

c. The goal the bond and the environment d. The time-frame, the goal and the bond Ans: A

3. Collective leadership has been referred by the NHS Improvement and Leadership Development Board (2016) as ______. a. Collaborative leadership b. Consolidatory leadership c. Leadership of all, by all and for all d. Executive leadership Ans: C

4. Which one of the following is NOT a recommended kind of nurse leadership? a. Democratic b. Collective c. Autocratic d. Transformational Ans: C

5. Who is often credited as being a founder of the discipline of human geography? a. Eysenk b. Kropotkin c. Hare

Ans: B

6. What is the name for the process of collectively modelling the change you would like to see in the course of trying to achieve it? a. Democratic leadership b. Prefiguration c. Role modelling d. Activism Ans: B

7. The term used to describe the phenomenon where the focus is upon transparent communication with people and their family networks is ______. a. Open dialogue b. Family therapy c. The Maudsley approach d. Care in the community Ans: A

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 43 Clinical Supervision in Mental Health Nursing 1. Which of the following are ‘models’ for clinical supervision? a. Gibbs b. Peplau c. Procter d. Barker Ans: C

2. Ideally clinical supervision should be ______. a. Once a month b. Once a week c. Whenever you have a problem d. Every quarter

Ans: A

3. Edwards et al. (2006) suggested that effective CS lowers levels of ______. a. Tiredness b. Sickness c. Anxiety d. Burn-out Ans: D

4. Which report concentrated attention on the issue of safe and accountable practice in nursing in the wake of the Beverley Allitt case? a. The Willis Report b. The Clothier Report c. The Fallon Inquiry d. The Cavendish Report Ans: B

5. Peer supervision is ______. a. Where two practitioners take turns to be the supervisor b. Where two or more peers can supervise and learn from each other c. When your supervisor is the same grade as you d. When supervision is done in groups Ans: B

6. The restorative function of clinical supervision is when ______. a. The aim is to develop skills and knowledge b. Clinical supervision provides peer support and stress relief for nurses c. The supervisor promotes professional accountability d. The supervision reminds the supervisee of their roles and responsibilities Ans: B

7. Managerial supervision is ______. a. When your manager supervises you b. When your supervision focuses on your caseload and your management of your workload c. Supervision for managers d. Implemented when you are subject to a complaint Ans: B

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 44

Transferable Skills and Transition: Becoming a Mental Health Nurse and Beyond 1. The initial transition period for the newly qualified nurse is described as ______. a. A period of stress b. A period of time during which change takes place within the individual and the environment variance c. A time of significant change d. Role overload Ans: B

2. Continuing professional development (CPD) encompasses ______. a. Experiences, activities and practices that contribute towards the development of a nurse as a health care professional b. Activities necessary for revalidation c. Formal education programmes d. Sourcing information and self-directed learning Ans: A

3. In the UK preceptorship is described as the process of ______. a. Professional development b. Reflecting on their practice and experience

c. Supporting newly qualified nurses over the transition period from student to registered nurse (RN) d. Gaining feedback on their performance Ans: C

4. NMC Revalidation (2016) requires nurses to renew their registration every ______. a. Year b. Two years c. Three years d. Four years Ans: C

5. Resilience is influenced by ______. a. Wellbeing and job satisfaction b. Well-developed communication and conflict resolution skills c. Adapting positively to stressful working conditions d. The interaction between individual and environmental factors Ans: D

6. As a registrant, self-development strategies that can help build personal resilience to workplace adversity include ______. a. Listening attentively at all times, reflect in and on your actions ensuring that, you communicate effectively b. Building positive nurturing professional relationships and networks

c. Developing a sense of personhood that demonstrates respect for the person’s diversity, culture, norms, values and beliefs d. Developing effective communication and conflict resolution skills Ans: B

7. Reflection is a way of developing ______. a. Personal and professional ethics and values b. Personal resilience in order to survive and prosper c. Insights and understandings into experiences, and of developing knowledge that can be used in subsequent situations d. Appropriate standards of proficiency Ans: C

Testbank for Wright & McKeown: Essentials of Mental Health Nursing, 2e

Chapter 45 Commissioning for Mental Health Services 1. What is the commissioning cycle? a. A low temperature programme on a washing machine

b. The process of making new buildings serviceable c. A four-step method of contracting health services d. A four-step process for planning and contracting health services Ans: D

2. When was the purchaser/provider split established in the NHS? a. 1991 b. 2001 c. 2011 d. 1997 Ans: A

3. What were the expected advantages of this market-based approach? a. Drive down costs and raise quality b. Drive down quality c. Drive up costs and reduce quality d. Reduce waste Ans: A

4. How best can commissioners ensure that service users are actively involved in the commissioning process? a. By involving service users in identifying need and gaps in services b. By circulating leaflets telling service users what will be commissioned

c. By providing forums where service users can read about planned developments d. By providing multiple means of involvement at every stage of the process Ans: D

5. How best can commissioners ensure direct care staff/organizations are actively involved in the commissioning process? a. By ensuring that all stages of the process include meeting and listening to staff b. By providing opportunities to engage and involve staff in all steps of the process c. By asking for data and information on a regular basis d. Through circulating emails that keep everyone informed Ans: B

6. What key quality would a mental health case manager need to demonstrate? a. A specialist knowledge and understanding of patient pathways b. The ability to monitor the quality of service delivery and know what ‘good’ looks like c. To be able to place service users at the centre of decision-making d. To be efficient in keeping records up to date Ans: C

7. What is the key factor that commissioners need to prioritize in planning services? a. The collaboration of all stakeholders most notably service users and clinical staff b. The demands of the population concerned c. A contractual framework which incentivises innovation

d. The needs of the population concerned Ans: A