Mental Health & Culture
A nurse is assessing a client’s overall mental wellness. Which statement made by the client best reflects positive mental health?
A. “I try to avoid stress because I can’t handle it well.”
B. “I set goals for myself and adjust them when needed.”
C. “I often feel overwhelmed and unable to complete daily tasks.”
D. “I rarely talk about my feelings because it makes me uncomfortable.”
B. “I set goals for myself and adjust them when needed.”
Mental health is defined as a state of well‑being in which a person reaches their potential, copes with normal stressors, works productively, and contributes to the community.
Setting realistic goals and adapting to challenges reflects traits of a mentally healthy individual, including rational thinking, resilience, emotional growth, and healthy self‑esteem.
A nurse is reviewing Freud’s psychoanalytic theory with a client in therapy. Which statement best describes the function of the ego?
A. “The ego operates on the pleasure principle and seeks immediate gratification.”
B. “The ego represents internalized morals, values, and societal rules.”
C. “The ego mediates between impulses, reality, and moral standards to make realistic decisions.”
D. “The ego is the source of instinctual drives present at birth.”
C. “The ego mediates between impulses, reality, and moral standards to make realistic decisions.”
According to Freud, the ego operates on the reality principle, mediating between the impulsive id (pleasure principle) and the moral superego. It helps the individual make realistic, socially acceptable decisions.
The id seeks immediate gratification
The superego represents internalized moral standards.
When a PMHRN has difficulty setting limits on a pts behavior bc of an emotional response to a pt, this is an example of?
A. Transference
B. Countertransference
C. Magnification
D. Codependency
B. Countertransference
A nurse is teaching a client about the diathesis–stress model of mental illness. Which statement by the client shows correct understanding?
A. “Mental illness only develops when someone experiences extreme stress.”
B. “If I have a genetic vulnerability, stress can increase my risk of developing a mental illness.”
C. “Stress alone is enough to cause a mental illness in anyone.”
D. “If mental illness runs in my family, stress won’t affect me.”
B. “If I have a genetic vulnerability, stress can increase my risk of developing a mental illness.”
The diathesis–stress model explains that mental illness results from the interaction between a biological predisposition (diathesis) and environmental stress.
True or false?
Many medical illnesses can mimic mental illness
True
NEED TO RULE OUT MEDICAL ILLNESS FIRST
A nurse is educating a group of students about mental illness. Which statement indicates a correct understanding?
A. “Mental illness only occurs when someone experiences severe stress.”
B. “A mental illness involves significant dysfunction in thinking, emotions, or behavior that interferes with daily functioning.”
C. “Mental illness is diagnosed based solely on the client’s self‑report of symptoms.”
D. “Mental illness is always caused by a biological disorder.”
B. “A mental illness involves significant dysfunction in thinking, emotions, or behavior that interferes with daily functioning.”
Mental illness is defined as significant dysfunction in mental functioning, affecting thoughts, emotions, behaviors, and the ability to perform daily activities. It may arise from developmental, biological, or physiological factors, often triggered by stress, and requires meeting DSM‑5 diagnostic criteria. The diathesis‑stress model explains that both predisposition and environmental stress contribute.
During which stage of the therapeutic relationship does the nurse examine personal feelings about working with a pt?
A. Pre-interaction
B. Orientation
C. Working
D. Termination
A. Pre-interaction
Which statement best reflects the epidemiology of anxiety disorders in the United States?
A. Anxiety disorders are the leading cause of disability in the United States.
B. Anxiety disorders are less common than depressive disorders.
C. Anxiety disorders are the most prevalent and frequently diagnosed mental health disorders
D. Anxiety disorders have minimal economic impact compared to other psychiatric conditions.
C. Anxiety disorders are the most prevalent and frequently diagnosed mental health disorders
Anxiety disorders are the most common psychiatric disorders in the United States and frequently co-occur with major depressive disorder or substance use.
treamtment:
Antidepressants such as Selective serotonin reuptake inhibitors (SSRIs) are considered a first line of defense in most anxiety-related disorders. They include paroxetine (Paxil), fluoxetine (Prozac), escitalopram (Lexapro), and sertraline (Zoloft). Some exert more of an activating effect than others and may actually increase anxiety initially
Therapy: Two important forms of therapy for anxiety disorders are behavioral therapy and cognitive-behavioral therapy.
A nurse is meeting a client for the first time in an outpatient mental health clinic. Which action by the nurse is most appropriate during the orientation phase of the therapeutic relationship?
A. Assisting the client in developing new coping strategies for anxiety.
B. Reviewing the goals of the relationship and discussing when the relationship will end.
C. Encouraging the client to explore past trauma in depth.
D. Evaluating the client’s progress toward previously established goals.
B. Reviewing the goals of the relationship and discussing when the relationship will end.
During the orientation phase, the nurse and client:
Establish rapport
Clarify the parameters of the relationship
Create a formal or informal contract
Discuss the terms of termination from the beginning
Options A and C occur later in the working phase. Option D occurs in the termination phase.
A nurse is reviewing neurotransmitter function with a group of nursing students. Which statement made by a student indicates a need for further teaching?
A. “Low serotonin levels are associated with depression and can affect mood and appetite.”
B. “High dopamine levels are linked to symptoms of schizophrenia such as hallucinations.”
C. “Low GABA levels can contribute to increased anxiety and sleep disturbances.”
D. “High norepinephrine levels are responsible for depression and low energy.”
D is incorrect teaching. Depression is associated with low norepinephrine, not high. Norepinephrine regulates mood, alertness, concentration, and energy.
A is correct: Serotonin regulates mood, anxiety, and appetite, and low levels are seen in depression, bipolar disorder, and schizophrenia.
B is correct: Excess dopamine is linked to schizophrenia and affects motivation, reward, attention, and mood.
C is correct: Low GABA contributes to anxiety and affects sleep regulation.
The cultural group in the US that is most likely to attribute a psychiatric disease to a medical illness rather than a mental illness is?
A. African Americans
B. Native Americans
C. Asian Americans
D. Latinos
D. Latinos
A patient’s unresolved feelings related to loss would be most likely observed during which phase of the therapeutic nurse-patient relationship?
A. Pre-Orientation
B. Working
C. Orientation
D. Termination
D. Termination
In the termination phase, the relationship comes to a close. Ending treatment sometimes may be traumatic for patients who have come to value the relationship and the help. Because loss is an issue, any unresolved feelings related to loss may resurface during this phase.
A pt has undergone Electroconvulsive therapy (ECT) and is awakening from anesthesia. The initial pt response that is most expected is?
A. Sedation
B. Memory impairment
C. Agitation
D. Anger
B. Memory impairment
ECT works by triggering a controlled seizure.
Most people experience:
Trouble remembering conversations from the past few days
Forgetting what happened earlier the same day
Difficulty learning new information right after a session
These issues usually improve over days to weeks.
A nurse is caring for four clients. According to Maslow’s hierarchy of needs, which client should the nurse assess first?
A. A client who reports feeling lonely and states, “I don’t think anyone cares about me.”
B. A client who is anxious about starting a new job next week.
C. A client who has not voided in 12 hours and reports lower abdominal discomfort.
D. A client who says, “I don’t feel respected by my family anymore.”
C reflects a physiological need (urinary elimination), which must be addressed before safety, love/belonging, esteem, or self‑actualization.
Maslow’s hierarchy prioritizes physiological needs first, because they are essential for survival.
A reflects love/belonging needs.
B reflects safety or psychological security needs.
D reflects esteem needs.
Lower‑level needs must be met before higher‑level needs can be addressed.
True or False?
Cognitive behavioral therapy (CBT) is one of the most widely used and empirically supported psychotherapeutic approaches, focusing on identifying and changing distorted patterns of thinking.
Answer: True
Rationale: CBT is highly accepted and well‑validated in research. It works by helping individuals recognize, understand, and modify distorted thoughts that influence emotions and behaviors.
An Asian American adolescent is to be discharged from a psychiatric unit after a psychotic episode, but the parents who are immigrants from China are adamant that the pt cannot receive any out pt tx or follow up care, stating that his illness was caused by an infection. The probable reason for this is?
A. They are unfamiliar with Western tx for mental illness
B. They have poor language skills and misunderstand the dx
C. They have low health literacy
D. They are ashamed their child has a psychiatric condition
D. They are ashamed their child has a psychiatric condition
(Asian cultures believe that psychiatric illness is caused by poor behavior and it brings shame on the pt and family)
True of False?
Cognitive behavioral therapy is the most commonly used, accepted, and empirically validated psychotherapeutic approach. It focuses on identifying, understanding, and changing distorted thought patterns.
True
Aaron Beck's Cognitive theory is based on the belief that thoughts come before feelings and actions. Thoughts may not be a clear representation of reality and may be distorted.
The technique used is Evaluating & modifying dysfunctional thoughts and behaviors
Commonly used to treat: Depression,Anxiety/panic & Eating disorders
A nurse is educating a family about Assisted Outpatient Treatment (AOT). Which statement best describes AOT?
A. “AOT is a voluntary outpatient program for individuals seeking additional support.”
B. “AOT is a court‑ordered outpatient treatment plan for individuals with serious mental illness who have a history of treatment non‑adherence.”
C. “AOT is an inpatient commitment used when a patient poses an immediate danger to self or others.”
D. “AOT is a short‑term emergency hold used to stabilize acute psychiatric symptoms.”
B. “AOT is a court‑ordered outpatient treatment plan for individuals with serious mental illness who have a history of treatment non‑adherence.”
(AOT) is a court‑ordered outpatient treatment plan designed for individuals with serious mental illness who have demonstrated difficulty engaging in treatment voluntarily. It aims to reduce relapse, hospitalization, and safety risks while allowing the individual to remain in the community.
Which statement best reflects the core principle of Cognitive Behavioral Therapy (CBT)?
A. Behavior is shaped primarily by unconscious conflicts.
B. Feelings and behaviors are determined by how a person thinks about events.
C. Mental illness results from unresolved childhood experiences.
D. Personality is fixed and cannot be changed.
Correct Answer: B
Rationale: Beck’s CBT is based on the idea that feelings and behaviors are largely determined by cognitions—how people interpret the world and their place in it. Options A and C reflect psychoanalytic concepts, not CBT. Option D is incorrect because CBT assumes thoughts and behaviors can be modified.
A client with major depressive disorder has been prescribed fluoxetine. Which statement by the client indicates a need for further teaching?
A. “I know this medication may take several weeks before I start feeling better.”
B. “If I suddenly feel a big burst of energy or happiness, I should let my provider know.”
C. “It’s important that I take this medication every day, even if I start to feel better.”
D. “This medication will improve my depression within the next 24 to 48 hours.”
D is incorrect teaching. SSRIs take 4–6 weeks to reach full therapeutic effect. Early in treatment, clients are at increased suicide risk because energy may improve before mood does.
A is correct: SSRIs require several weeks to work.
B is correct: A sudden lifting of anhedonia or unexpected happiness can signal increased suicide risk and must be reported.
C is correct: Medication adherence is essential for therapeutic effect and relapse prevention.
The RN has accepted a position in an area with a large Native American population. The RN expects that native Americans are?
A. Comfortable being touched by healthcare providers
B. Comfortable with small personal space
C. Comfortable with direct eye contact
D. Comfortable with silence during conversation
D. Comfortable with silence during conversation
A pt has a severe phobia about heights and is unwilling to fly in an airplane or to ascend beyond the ground floor or a building. The most effective treatment approach is likely?
A. Aversion Therapy
B. Mindfulness meditation
C. Exposure therapy
D. Operant Conditioning
C. Exposure Therapy
(form of systemic desensitization, reduces fear by gradually exposing pt to the feared situation which decreases emotional response over time)
Which intervention is MOST consistent with Beck’s CBT?
A. Encouraging the client to reinterpret automatic negative thoughts
B. Exploring early childhood trauma
C. Using dream analysis to uncover hidden conflicts
D. Focusing solely on behavioral reinforcement
A. Encouraging the client to reinterpret automatic negative thoughts
CBT emphasizes identifying and reframing automatic negative thoughts to change emotional and behavioral responses.
Cognitive-behavioral therapy includes cognitive restructuring, psychoeducation, breath restraining and muscle relaxation, teaching of self-monitoring for panic and other symptoms, and in vivo (real-life) exposure to feared objects or situations.
A client says, “If I’m not perfect, I’m a complete failure.” This statement is an example of which concept in Beck’s cognitive theory?
A. Schema
B. Automatic thought
C. Behavioral conditioning
D. Reality testing
Correct Answer: B
Rationale: This is a rapid, rigid, self‑critical thought that reflects a cognitive distortion—an automatic thought. A schema (A) is a deeper, underlying belief or assumption (e.g., “I am incompetent”). Behavioral conditioning (C) relates to learning theory, not specifically Beck’s model. Reality testing (D) involves evaluating whether thoughts match reality.
A client prescribed phenelzine for major depressive disorder is reviewing dietary instructions. Which statement by the client indicates a need for further teaching?
A. “I will avoid foods like aged cheese and cured meats while taking this medication.”
B. “Drinking beer or red wine could be dangerous for me now.”
C. “I can still eat chocolate as long as I only have a small amount.”
D. “If I eat foods high in tyramine, I could have a severe increase in blood pressure.”
C is incorrect teaching. Clients taking MAOIs must avoid all tyramine‑containing foods, including chocolate, because they can trigger a hypertensive crisis, which can be fatal.
A is correct: Aged cheese and cured meats contain tyramine.
B is correct: Beer and chianti/red wine are high in tyramine.
D is correct: Tyramine + MAOIs = hypertensive crisis, a medical emergency.