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Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank Chapter 5
Question 1
Type: MCSA
Which statement indicates the psychiatric–mental health nurse understands the basic principles of symbolic interactionism in working with clients?
1. “Clients with mental disorders are unlikely to understand the personal meaning of their experiences.”
2. “I try to avoid interventions that ignore the personal meaning of experiences to my clients.”
3. “Clients with altered brain chemistry need frequent reassurance that they should not worry about their condition.”
4. “After my first year of working in mental health, I was able to develop standardized interventions for clients with the same diagnoses.”
Correct Answer: 2
Rationale 1: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.
Rationale 2: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.
Rationale 3: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.
Rationale 4: Because all behavior has meaning, the nurse must develop interventions that recognize personal meanings and are person-specific. Grouping clients by diagnosis and using standardized approaches ignores this premise. In voicing generalized reassurance, the nurse invalidates the principle that people interpret the world in their own way. Interactionism stresses that all human beings have purpose and control over their lives, and have personal understandings of their life experience even if they have altered brain structure and chemistry and stressful environments.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: Discuss the major ideas of interactionism.
Question 2
Type: MCSA
Concepts of interactionism are evidenced in which of the following statements the nurse makes to the parent of an adolescent hospitalized for an overdose of cocaine and Valium?
1. “Peer pressure is usually responsible for these accidental overdoses.”
2. “All behavior has meaning, so we will focus on trying to understand the meaning of the drug use as well as the occurrence of overdose.”
3. “Use of Valium probably means your child accidentally overdosed by trying to treat the effects of cocaine.”
4. “Adolescence is such a painful time. Rehabilitation programs give kids a chance to get away from their everyday pressures.”
Correct Answer: 2
Rationale 1: To understand clients’ actions, the psychiatric–mental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatric–mental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurse’s personal point of view.
Rationale 2: To understand clients’ actions, the psychiatric–mental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatric–mental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurse’s personal point of view.
Rationale 3: To understand clients’ actions, the psychiatric–mental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatric–mental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurse’s personal point of view.
Rationale 4: To understand clients’ actions, the psychiatric–mental health nurse must identify the meanings those actions have for them. Assumptions about peer pressure, painful experiences, and the need to retreat from life stressors indicate the nurse discounts the meaning of the experiences to the client. It is essential that psychiatric–mental health nurses take into account the social and cultural environment of each client and not make generalizations about cause or meanings of experiences. It is inappropriate for nurses to provide information that is unsubstantiated or reflects the nurse’s personal point of view.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: Discuss the major ideas of interactionism.
Question 3
Type: MCSA
A grieving widow tells a psychiatric–mental health nurse, “I feel so tired and alone.” The nurse who incorporates an understanding of symbolic interactionism in practice would not suggest which of the following to the client?
1. “You had a terrible loss. Feeling tired and alone must be very difficult for you.”
2. “I would like to hear more about how you are feeling now.”
3. “Try to get plenty of rest. Most people who suffer losses like yours need more sleep than usual to cope effectively.”
4. “You seem sad. Can I sit with you for a while?”
Correct Answer: 3
Rationale 1: Giving advice and suggesting that the meaning of the widow’s loss is typical invalidates the person’s unique experience, a basic premise of symbolic interactionism—that people interpret the world in their own way. Other responses indicate an understanding that a client’s actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.
Rationale 2: Giving advice and suggesting that the meaning of the widow’s loss is typical invalidates the person’s unique experience, a basic premise of symbolic interactionism—that people interpret the world in their own way. Other responses indicate an understanding that a client’s actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.
Rationale 3: Giving advice and suggesting that the meaning of the widow’s loss is typical invalidates the person’s unique experience, a basic premise of symbolic interactionism—that people interpret the world in their own way. Other responses indicate an understanding that a client’s actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.
Rationale 4: Giving advice and suggesting that the meaning of the widow’s loss is typical invalidates the person’s unique experience, a basic premise of symbolic interactionism—that people interpret the world in their own way. Other responses indicate an understanding that a client’s actions and feelings are important and unique, and set the stage to help the person begin to exert control over feelings and life.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: Discuss the major ideas of interactionism.
Question 4
Type: MCSA
The nurse received the change-of-shift report on a 74-year-old woman admitted for depression. She has aphasia from a recent stroke and communicates minimally by using pencil and paper. Her college-age grandson moved in with her to help with meals and household chores and a home health aide provides daily assistance with ADLs and medications. For the past week, she has refused to bathe, eats poorly, and has stopped writing. Which of the following statements best demonstrates that the nurse has the ability to plan holistic care for this client?
1. The client’s psychobiologic health, rehabilitation, self-care potential, and discharge arrangements are interrelated.
2. Reliance on the grandson and home health aide have decreased her feelings of self-worth and caused this episode of depression.
3. The client’s quality of life and prognosis are primarily related to her aphasia and inability to communicate.
4. Sudden life changes, such as a stroke, usually lead to depression in older clients.
Correct Answer: 1
Rationale 1: A holistic assessment of a client accounts for the interrelated effects of the client’s social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the client’s quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.
Rationale 2: A holistic assessment of a client accounts for the interrelated effects of the client’s social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the client’s quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.
Rationale 3: A holistic assessment of a client accounts for the interrelated effects of the client’s social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the client’s quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.
Rationale 4: A holistic assessment of a client accounts for the interrelated effects of the client’s social and cultural environment as well as psychobiological health. Nurses must not assume they understand the meaning that symptoms have to the client’s quality of life, capacity to improve, or need for independence. While life changes at any age may lead to altered emotional responses, the nurse must seek to identify the meanings of events in order to plan effectively.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: Discuss the major ideas of interactionism.
Question 5
Type: MCSA
Which statement best describes a holistic-interactional approach to nursing care for clients with mental disorders?
1. “Clients with psychotic symptoms rarely indicate an interest in creative activities.”
2. “Medication is the only treatment required to manage affective symptoms for clients with mood disorders.”
3. “Developing comfortable relationships with clinicians is the major factor in maintaining mental health.”
4. “I always try to understand the complex relationship between a client’s psychobiologic health and expressions of self-esteem.”
Correct Answer: 4
Rationale 1: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.
Rationale 2: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.
Rationale 3: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.
Rationale 4: Healing and caring must be approached in a holistic manner. With all disorders, the holistic-interactional approach to nursing must include an understanding of both biological and psychological interventions. Psychosis does not negate the creative attributes of individuals, and they are appropriately included as part of a holistic approach to nursing care. Comfort is not the primary goal of therapeutic clinical relationships. Therapeutic relationships do not replace familial and social relationships in a holistic-interactional approach.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: Discuss the major ideas of interactionism.
Question 6
Type: MCSA
When planning care for clients on the mental health unit, the nurse using principles of humanism would consider which of the following?
1. Clinical interventions are most effective when they focus on the current actions, feelings, and concerns of clients.
2. Clients rely on providers to develop solutions for their problems.
3. Emotional stress has a relationship to physical symptoms.
4. The mind–body relationship focuses on biological explanations of illness.
Correct Answer: 3
Rationale 1: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.
Rationale 2: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.
Rationale 3: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.
Rationale 4: A humanistic-interactional view indicates physical and mental factors are interrelated and that a change in one may result in a change in another. Principles of humanism stress that people have the power or potential to solve their own problems and are not passive recipients of care given by psychiatric professionals. People are influenced by their past and the full range of life experiences, not simply by the present situation. Humanistic-interactional principles include, but are not limited to, biological explanations of mental disorders.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: Discuss the major principles of humanism.
Question 7
Type: MCSA
The psychiatric–mental health nurse understands that the philosophy underlying humanistic practice means which of the following?
1. Nurses must develop interests related to human beings, wherever they live and whatever their status or culture, in order to work for change within social and political systems.