Deck 36: Community Mental Health Nursing

Question 1

A newly admitted homeless client diagnosed with Schizophrenia states,"I have been living in a cardboard box for 2 weeks.Why did the government let me down?" Which is an appropriate nursing reply?

A)"Your discharge from the state hospital was done prematurely.Had you remained in the state hospital longer,you would not be homeless."
B)"Your premature discharge from the state hospital was not intended for patients diagnosed with Chronic Schizophrenia."
C)"Your discharge from the state hospital was based on firm principles;however,the resources were not available to make the transition a success."
D)"Your discharge from the state hospital was based on presumed family support,and this was not forthcoming."

Answer 1

"Your discharge from the state hospital was based on firm principles;however,the resources were not available to make the transition a success."

Question 2

Which nursing statement best describes the current nature of mental health care in the community?

A)"All homeless people have a history of institutionalization and are frequently admitted to acute care settings."
B)"In the United States,the rate of serious mental illness in the prison population is the same as the general population."
C)"The deinstitutionalization movement in the United States was successful in transitioning clients into the community."
D)"Today,the majority of clients admitted to psychiatric hospitals are in a crisis stage,and the treatment goal is stabilization."

Answer 2

"Today,the majority of clients admitted to psychiatric hospitals are in a crisis stage,and the treatment goal is stabilization."

Question 3

Providing nursing education on drug abuse to a high-school class is an example of which level of preventive care?

A)Primary prevention
B)Secondary prevention
C)Tertiary prevention
D)Primary intervention

Answer 3

Primary prevention

Question 4

When a nurse attempts to provide health-care services to the homeless,what should be a realistic concern?

A)Most homeless individuals reject help.
B)Most homeless individuals are suspicious of anyone who offers help.
C)Most homeless individuals are proud and will often refuse charity.
D)Most homeless individuals relocate frequently.

Question 5

A client diagnosed with Schizophrenia is hospitalized because of an exacerbation of psychosis related to antipsychotic medication nonadherence.Which level of care does the client's hospitalization reflect?

A)Primary prevention level of care
B)Secondary prevention level of care
C)Tertiary prevention level of care
D)Case management level of care

Question 6

A community health nurse is teaching a class to expectant parents.All participants lack infant care knowledge.A student nurse asks,"If you had to assign a nursing diagnosis to this group,what would it be?" What is the best nursing reply?

A)"I would assign the nursing diagnosis of cognitive deficit."
B)"I would assign the nursing diagnosis of knowledge deficit."
C)"I would assign the nursing diagnosis of altered family processes."
D)"I would assign the nursing diagnosis of risk for caregiver role strain."

Question 7

A client with schizophrenia is readmitted to the psychiatric unit 1 month after discharge from the previous hospitalization.The psychiatric nurse is concerned that the client has had six readmissions over the past year.The nurse informs the charge nurse that the client has been readmitted due to which of the following?

A)Poor living conditions
B)Uncontrolled chronic health problems
C)Lack of community resources
D)Adherence to medication regimen

Question 8

The mental health nurse is developing a teaching plan for a community presentation on mental illness.Which should the nurse include in the teaching plan?

A)Homelessness is a primary cause of mental illness.
B)Access to mental health services is widely available.
C)Public attitudes and stigma are barriers to treatment.
D)Clients with mental illness are likely to harm others.

Question 9

A nurse is implementing care within the parameters of tertiary prevention.Which nursing action is an example of this type of care?

A)Teaching an adolescent about pregnancy prevention
B)Teaching an elderly client the reportable side effects of a newly prescribed neuroleptic medication
C)Teaching a client with schizophrenia to cook meals,make a grocery list,and establish a budget
D)Teaching a client about his or her new diagnosis of bipolar disorder

Question 10

A nursing instructor is teaching students about the Community Health Centers Act of 1963.What was a deterring factor to the proper implementation of this act?

A)Many prospective clients did not meet criteria for mental illness diagnostic-related groups.
B)Zoning laws discouraged the development of community mental health centers.
C)States could not match federal funds to establish community mental health centers.
D)There was not a sufficient employment pool to staff community mental health centers.

Question 11

When intervening with a married couple experiencing relationship discord,which reflects a nursing intervention at the secondary level of prevention?

A)Assessing how the children are coping with the parents' relationship issues
B)Supplying the couple with guidelines related to marital seminar leadership
C)Teaching the couple about various methods of birth control
D)Counseling the couple in relation to open and honest communication skills

Question 12

The school nurse is assessing a 12-year-old student who fell during recess.The nurse notices bruises on the student's upper arms.When the nurse asks about the bruises,the student looks down and states,"My mom was yelling at me because I hit my brother." Which intervention is the most appropriate secondary level of prevention?

A)Contact the Department of Child Protective Services.
B)Teach the mother methods to reinforce acceptable behavior.
C)Conduct a workshop on effective discipline techniques.
D)Ask the mother to complete the Beck Depression Inventory.

Question 13

A nursing instructor is teaching students about the differences between partial and inpatient hospitalization.In what way does partial hospitalization differ from traditional inpatient hospitalization?

A)Partial hospitalization does not provide medication administration and monitoring.
B)Partial hospitalization does not use an interdisciplinary team.
C)Partial hospitalization does not offer a comprehensive treatment plan.
D)Partial hospitalization does not provide supervision 24 hours a day.

Question 14

A homeless client comes to an emergency department reporting cough,night sweats,weight loss,and blood-tinged sputum.What disease that has recently become more prevalent among the homeless community should a nurse suspect?

A)Meningitis
B)Tuberculosis
C)Encephalopathy
D)Mononucleosis

Question 15

A 27-year-old client was diagnosed 5 years ago with Schizophrenia.What course of treatment should the nurse expect to be implemented?

A)Eventual admission for long-term care in a psychiatric facility
B)Community-based care with numerous brief hospitalizations
C)Case management in the community with few relapses
D)Occasional contact with outpatient counselors and psychiatrists

Question 16

A client diagnosed with Schizophrenia was released from a state mental hospital after 20 years of institutionalization.A nurse should recognize which characteristic that is likely to be exhibited by this client?

A)The client is likely to be compliant with treatment because of institutional dependency.
B)The client is likely to find a variety of community support services to aid in the transition.
C)The client is likely to adjust to the community environment if given sufficient support.
D)The client is likely to be admitted at some time to an acute care unit for psychiatric treatment.

Question 17

A client in the inpatient unit tells a student nurse,"My life has no purpose.I can't think about living another day,but please don't tell anyone about the way I feel.I know you are obligated to protect my confidentiality." Which is the most appropriate reply by the student nurse?

A)"The treatment team is composed of many specialists who are working to improve your ability to function.Sharing this information with the team is critical to your care."
B)"Let's discuss steps that will resolve negative lifestyle choices that may increase your suicidal risk."
C)"You seem to be preoccupied with self.You should concentrate on hope for the future."
D)"This information is secure with me because of client confidentiality."

Question 18

Which intervention should the nurse consider as primary prevention for an individual who is on the verge of being homeless because of a job layoff?

A)Referral to primary care provider to improve general health status
B)Encouraging client to recognize reasons for job layoff
C)Job training to increase employment options
D)Encouraging the use of prn medications to control symptoms

Question 19

A nursing instructor is teaching about case management.What student statement indicates that learning has occurred?

A)"Case management is a method used to achieve independent client care."
B)"Case management provides coordination of services required to meet client needs."
C)"Case management exists to facilitate client admission to needed inpatient services."
D)"Case management is a method to facilitate physician reimbursement."

Question 20

When a home health nurse administers an outpatient's injection of haloperidol decanoate (Haldol decanoate),which level of care is the nurse providing?

A)Primary prevention level of care
B)Secondary prevention level of care
C)Tertiary prevention level of care
D)Case management level of care

Question 21

The mental health nurse practitioner is preparing to see clients at the community street clinic.Which does the nurse practitioner recognize about the homeless population? Select all that apply.

A)Domestic violence is the primary cause among women.
B)Gonorrhea is the most prevalent sexually transmitted infection (STI).
C)The majority of the homeless are children and adolescents.
D)There is an increased risk of acquiring tuberculosis.
E)Children have higher rates of asthma and ear infections.

Question 22

The psychiatric nurse is planning home visits for the day.Which conditions are the clients most likely diagnosed with? Select all that apply.

A)Posttraumatic stress disorder
B)Major depressive disorder
C)Alzheimer's disease
D)Dysthymia
E)Schizophrenia

Question 23

Which of the following clients should a nurse recommend for a structured day program? Select all that apply.

A)An acutely suicidal teenager who has had three previous suicide attempts
B)A chronically mentally ill woman who has a history of medication noncompliance
C)An elderly individual with end-stage Alzheimer's disease
D)A depressed individual who is able to participate in a safety plan