Psychiatric-Mental Health Nursing 8th edition by Videbeck Test Bank

Document Content and Description Below

Psychiatric-Mental Health Nursing 8th edition by Videbeck Test Bank Chapter 1 1. The nurse is assessing the factors contributing to the well-being of a newly admitted client. Which of the followin... g would the nurse identify as having a positive impact onthe individual's mental health? A) Not needing others for companionship B) The ability to effectively manage stress C) A family history of mental illness D) Striving for total selfrelianceAns: B Feedback: Individual factors influencing mental health include biologic makeup, autonomy, independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities. Interpersonal factors such as intimacy and a balance of separateness and connectedness are both needed for good mental health, and therefore a healthy person would need others for companionship. A family history of mental illnesscould relate to the biologic makeup of an individual, which may have a negative impacton an individual's mental health, as well as a negative impact on an individual's interpersonal and socialñcultural factors of health. Total self-reliance is not possible, and a positive social/cultural factor is access to adequate resources. 2. Which of the following statements about mental illness are true? Select all that apply. A) Mental illness can cause significant distress, impaired functioning, or both. B) Mental illness is only due to social/cultural factors. C) Social/cultural factors that relate to mental illness include excessive dependencyon or withdrawal from relationships. D) Individuals suffering from mental illness are usually able to cope effectively withdaily life. E) Individuals suffering from mental illness may experience dissatisfaction withrelationships and self. Ans: A, D, E Feedback: Mental illness can cause significant distress, impaired functioning, or both. Mental illness may be related to individual, interpersonal, or social/cultural factors. Excessive dependency on or withdrawal from relationships are interpersonal factors that relate to mental illness. Individuals suffering from mental illness can feel overwhelmed with daily life. Individuals suffering from mental illness may experience Page 2 dissatisfaction withrelationships and self. Page 3 3. Which of the following are true regarding mental health and mental illness? A) Behavior that may be viewed as acceptable in one culture is always unacceptablein other cultures. B) It is easy to determine if a person is mentally healthy or mentally ill. C) In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behaviorand coping, positive self-concept, and emotional stability. D) Persons who engage in fantasies are mentally ill.Ans: C Feedback: What one society may view as acceptable and appropriate behavior, another society maysee that as maladaptive, and inappropriate. Mental health and mental illness are difficult to define precisely. In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability. Persons who engagein fantasies may be mentally healthy, but the inability to distinguish reality from fantasyis an individual factor that may contribute to mental illness. 4. A client grieving the recent loss of her husband asks if she is becoming mentally illbecause she is so sad. The nurse's best response would be, A) ìYou may have a temporary mental illness because you are experiencing so muchpain.î B) ìYou are not mentally ill. This is an expected reaction to the loss you haveexperienced.î C) ìWere you generally dissatisfied with your relationship before your husband'sdeath?î D) ìTry not to worry about that right now. You never know what the future brings.îAns: B Feedback: Mental illness includes general dissatisfaction with self, ineffective relationships, ineffective coping, and lack of personal growth. Additionally the behavior must not be culturally expected. Acute grief reactions are expected and therefore not considered mental illness. False reassurance or overanalysis does not accurately address the client'sconcerns. Page 4 5. The nurse consults the DSM for which of the following purposes? A) To devise a plan of care for a newly admitted client B) To predict the client's prognosis of treatment outcomes C) To document the appropriate diagnostic code in the client's medical record D) To serve as a guide for client assessmentAns: D Feedback: The DSM provides standard nomenclature, presents defining characteristics, and identifies underlying causes of mental disorders. It does not provide care plans or prognostic outcomes of treatment. Diagnosis of mental illness is not within the generalist RN's scope of practice, so documenting the code in the medical record wouldbe inappropriate. 6. Which would be a reason for a student nurse to use the DSM? A) Identifying the medical diagnosis B) Treat clients C) Evaluate treatments D) Understand the reason for the admission and the nature of psychiatric illnesses.Ans: D Feedback: Although student nurses do not use the DSM to diagnose clients, they will find it a helpful resource to understand the reason for the admission and to begin building knowledge about the nature of psychiatric illnesses. Identifying the medical diagnosis,treating, and evaluating treatments are not a part of the nursing process. 7. The legislation enacted in 1963 was largely responsible for which of the following shiftsin care for the mentally ill? A) The widespread use of community-based services B) The advancement in pharmacotherapies C) Increased access to hospitalization D) Improved rights for clients in long-term institutional careAns: A Feedback: The Community Mental Health Centers Construction Act of 1963 accomplished therelease of individuals from long-term stays in state institutions, the decrease in admissions to hospitals, and the development of community-based services as an alternative to hospital care. Page 5 8. Which one of the following is a result of federal legislation? A) Making it easier to commit people for mental health treatment against their will. B) Making it more difficult to commit people for mental health treatment againsttheir will. C) State mental institutions being the primary source of care for mentally ill persons. D) Improved care for mentally ill persons.Ans: B Feedback: Commitment laws changed in the early 1970s, making it more difficult to commit people for mental health treatment against their will. Deinstitutionalization accomplished the release of individuals from long-term stays in state institutions. Deinstitutionalization also had negative effects in that some mentally ill persons aresubjected to the revolving door effect, which may limit care for mentally ill persons. 9. The goal of the 1963 Community Mental Health Centers Act was to A) ensure patients' rights for the mentally ill. B) deinstitutionalize state hospitals. C) provide funds to build hospitals with psychiatric units. D) treat people with mental illness in a humane fashion.Ans: B Feedback: The 1963 Community Mental Health Centers Act intimated the movement toward treating those with mental illness in a less restrictive environment. This legislation resulted in the shift of clients with mental illness from large state institutions to carebased in the community. Answer choices A, C, and D were not purposes of the 1963Community Mental Health Centers Act. 10. The creation of asylums during the 1800s was meant to A) improve treatment of mental disorders. B) provide food and shelter for the mentally ill. C) punish people with mental illness who were believed to be possessed. D) remove dangerous people with mental illness from the community.Ans: B Feedback: The asylum was meant to be a safe haven with food, shelter, and humane treatment forthe mentally ill. Asylums were not used to improve treatment of mental disorders or topunish mentally ill people who were believed to Page 6 be possessed. The asylum was not created to remove the dangerously mentally ill from the community. Page 7 11. The major problems with large state institutions are: Select all that apply. A) attendants were accused of abusing the residents. B) stigma associated with residence in an insane asylum. C) clients were geographically isolated from family and community. D) increasing financial costs to individual residents.Ans: A, C Feedback: Clients were often far removed from the local community, family, and friends becausestate institutions were usually in rural or remote settings. Choices B and D were not major problems associated with large state instructions. 12. A significant change in the treatment of people with mental illness occurred in the 1950swhen A) community support services were established. B) legislation dramatically changed civil commitment procedures. C) the Patient's Bill of Rights was enacted. D) psychotropic drugs became available for use.Ans: D Feedback: The development of psychotropic drugs, or drugs used to treat mental illness, began inthe 1950s. Answer choices A, B, and C did not occur in the 1950s. 13. Before the period of the enlightenment, treatment of the mentally ill included A) creating large institutions to provide custodial care. B) focusing on religious education to improve their souls. C) placing the mentally ill on display for the public's amusement. D) providing a safe refuge or haven offering protection.Ans: C Feedback: In 1775, visitors at St. Mary's of Bethlehem were charged a fee for viewing and ridiculing the mentally ill, who were seen as animals, less than human. Custodial care was not often provided as persons who were considered harmless were allowed to wander in the countryside or live in rural communities, and more dangerous lunatics were imprisoned, chained, and starved. In early Christian times, primitive beliefs and superstitions were strong. The mentally ill were viewed as evil or possessed. Priests performed exorcisms to rid evil spirits, and in the colonies, witch hunts were conductedwith offenders burned at the stake. It was not until the period of enlightenment when persons who were mentally ill were offered Page 8 asylum as a safe refuge or haven offering protection at institutions. Page 9 14. The first training of nurses to work with persons with mental illness was in 1882 inwhich state? A) California B) Illinois C) Massachusetts D) New YorkAns: C Feedback: The first training for nurses to work with persons with mental illness was in 1882 atMcLean Hospital in Belmont, Massachusetts. 15. What is meant by the term ìrevolving door effectî in mental health care? A) An overall reduction in incidence of severe mental illness B) Shorter and more frequent hospital stays for persons with severe and persistentmental illness C) Flexible treatment settings for mentally ill D) Most effective and least expensive treatment settingsAns: B Feedback: The revolving door effect refers to shorter, but more frequent, hospital stays. Clients arequickly discharged into the community where services are not adequate; without adequate community services, clients become acutely ill and require rehospitalization. The revolving door effect does not refer to flexible treatment settings for mentally ill. Even though hospitalization is more expensive than outpatient treatment, if utilized appropriately could result in stabilization and less need for emergency department visitsand/or rehospitalization. The revolving door effect does not relate to the incidence of severe mental illness. Page 10 16. Which of the following statements is true of treatment of people with mental illness inthe United States today? A) Substance abuse is effectively treated with brief hospitalization. B) Financial resources are reallocated from state hospitals to community programsand support. C) Only 25% of people needing mental health services are receiving those services. D) Emergency department visits by persons who are acutely disturbed are declining.Ans: C Feedback: Only one in four (25%) adults needing mental health care receives the needed services. Substance abuse issues cannot be dealt with in the 3 to 5 days typical for admissions in the current managed care environment. Money saved by states when state hospitals wereclosed has not been transferred to community programs and support. Although people with severe and persistent mental illness have shorter hospital stays, they are admitted tohospitals more frequently. In some cities, emergency department visits for acutely disturbed persons have increased by 400% to 500%. 17. Which of the following is the priority of the Healthy People 2020 objectives for mentalhealth? A) Improved inpatient care B) Primary prevention of emotional problems C) Stress reduction and management D) Treatment of mental illnessAns: D Feedback: The objectives are to increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives. The objectives also strive to decrease rates ofsuicide and homelessness, to increase employment among those with serious mental illness, and to provide more services both for juveniles and for adults who are incarcerated and have mental health problems. Answer choices A, B, and C are not priorities of Healthy People 2020. Page 11 18. Which is a positive aspect of treating clients with mental illness in a community-basedcare? A) ìYou will not be allowed to go out with your friends while in the program.î B) ìYou will have to have supervision when you want to go anywhere else in thecommunity.î C) ìYou will be able to live in your own home while you still see a therapistregularly.î D) ìYou will have someone in your home at all times to ask questions if you have anyconcerns.î Ans: C Feedback: Clients can remain in their communities, maintain contact with family and friends, andenjoy personal freedom that is not possible in an institution. Full-time home care is notincluded in community-based programs. 19. One of the unforeseen effects of the movement toward community mental healthservices is A) fewer clients suffering from persistent mental illnesses. B) an increased number of hospital beds available for clients seeking treatment. C) an increased number of admissions to available hospital services. D) Longer hospital stays for people needing mental health services.Ans: C Feedback: Although people with severe and persistent mental illness have shorter hospital stays, they are admitted to hospitals more frequently. Although deinstitutionalization reducedthe number of public hospital beds by 80%, the number of admissions to those beds correspondingly increased by 90%. The number of individuals with mental illness did not change. 20. Which is included in Healthy People 2020 objectives? A) To decrease the incidence of mental illness B) To increase the number of people who are identified, diagnosed, treated, andhelped to live healthier lives C) To provide mental health services only in the community D) To decrease the numbers of people who are being treated for mental illnessAns: B Feedback: One of the Healthy People 2020 objectives is to increase the number of people who are identified, diagnosed, treated, and helped to live healthier Page 12 lives. It may not be possible todecrease the incidence of mental illness. At this time, the focus is on ensuring that persons with mental illness are receiving needed treatment. It may not be possible or desirable to provide mental health services only in the community. Page 13 21. A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided at the center includes A) medical management of symptoms. B) daily psychotherapy. C) constant staff supervision. D) psychological stabilization.Ans: A Feedback: Community mental health centers focus on rehabilitation, vocational needs, education,and socialization, as well as on management of symptoms and medication. Daily therapies, constant supervision, and stabilization require a more acute care inpatient setting. 22. Which of the following is defined as an advanced-level function in the practice area ofpsychiatric mental health nursing? A) Case management B) Counseling C) Evaluation D) Health teachingAns: C Feedback: Advanced-level functions are psychotherapy, prescriptive authority, consultation andliaison, evaluation, and program development and management. Case management, counseling, and health teaching are basic-level functions in the practice area of psychiatric mental health nursing. 23. Psychiatric nursing became a requirement in nursing education in which year?A) 1930 B) 1940 C) 1950 D) 1960 Ans: C Feedback: It was not until 1950 that the National League for Nursing, which accredits nursingprograms, required schools to include an experience in psychiatric nursing. Page 14 24. A new graduate nurse has accepted a staff position at an inpatient mental health facility.The graduate nurse can expect to be responsible for basiclevel functions, including A) providing clinical supervision. B) using effective communication skills. C) adjusting client medications. D) directing program development.Ans: B Feedback: Basic-level functions include counseling, milieu therapy, self-care activities, psychobiologic interventions, health teaching, case management, and health promotionand maintenance. Advanced-level functions include psychotherapy, prescriptive authority for drugs, consultation and liaison, evaluation, program development and management, and clinical supervision. 25. Which one of the following is one of the American Nurses Association standards ofpractice for psychiatricñmental health nursing? A) Prescriptive authority is granted to psychiatricñmental health registered nurses. B) All aspects of Standard 5: Implementation may be carried out bypsychiatricñmental health registered nurses. C) Some aspects of Standard 5: Implementation may only be carried out bypsychiatricñmental health advanced practice nurses. D) Psychiatricñmental health advanced practice nurses are the only ones who mayprovide milieu therapy. Ans: C Feedback: Prescriptive authority is used by psychiatricñmental health advanced practice registerednurses in accordance with state and federal laws and regulations. Standards 5DñG are advanced practice interventions and may be performed only by the psychiatricñmental health advanced practice registered nurse. Psychiatricñmental health registered nurses may provide milieu therapy according to Standard 5C. This is not restricted to psychiatricñmental health advanced practice nurses. [Show More]

Last updated: 1 year ago

Preview 1 out of 432 pages