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?

Accepted Answer

Option C acknowledges the client's statement and explains that the discharge was done based on principles but the resources were not available for a successful transition. This response validates the client's feelings and offers an explanation for the situation. Option A and B place blame on the system, which may not be helpful in the therapeutic relationship. Option D assumes that the client has family support, which may not be the case.

Question 2

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

Accepted Answer

The statement "Today, the majority of clients admitted to psychiatric hospitals are in a crisis stage, and the treatment goal is stabilization" best describes the current nature of mental health care in the community. This reflects a shift towards providing acute care and crisis intervention, as well as a preference for community-based care over institutionalization. Option A is not necessarily true for all homeless people, and option B is incorrect as the rate of serious mental illness is higher in the prison population. Option C is not entirely accurate as the success of deinstitutionalization is still a topic of debate.

Question 3

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

Accepted Answer

Providing nursing education on drug abuse to a high-school class is an example of primary prevention, which focuses on preventing the onset of health problems by promoting healthy behaviors and lifestyles.

Question 4

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

Accepted Answer

Most homeless individuals relocate frequently, which can make it challenging to provide consistent healthcare services. This mobility can be due to various reasons, including searching for resources, avoiding law enforcement, or personal safety concerns.

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?

Accepted Answer

The client's hospitalization reflects the secondary prevention level of care, which aims to identify and treat illnesses in their early stages to prevent further complications. In this case, the exacerbation of psychosis due to non-adherence to medication is detected early, and hospitalization is used to stabilize the client's condition and prevent further complications.

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?

Accepted Answer

The best nursing diagnosis to assign to a group that lacks knowledge on a particular topic is "knowledge deficit." This diagnosis acknowledges that while the participants may have some understanding of infant care, there is much that they do not know and need to learn. The other options (cognitive deficit, altered family processes, risk for caregiver role strain) do not accurately reflect the situation of the group.

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?

Accepted Answer

Poor adherence to medication regimen is a common reason for readmission in clients with schizophrenia. It could result in increased symptoms and relapse, thus requiring hospitalization. Adherence to medication is important in preventing recurrence of symptoms and promoting recovery. Poor living conditions, uncontrolled chronic health problems, and lack of community resources could be contributing factors, but medication non-compliance is more likely to be the primary cause of readmission.

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?

Accepted Answer

Public attitudes and stigma towards mental illness can prevent individuals from seeking and receiving treatment. This is an important issue to address in a community presentation in order to promote mental health awareness and reduce stigma. Choices A, B, and D are not accurate or helpful information to include in the teaching plan. Homelessness is not necessarily a primary cause of mental illness, access to mental health services is not always widely available, and the majority of individuals with mental illness do not pose a threat of harm to 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?

Accepted Answer

Tertiary prevention involves interventions that focus on preventing complications or further deterioration of a disease or condition. Teaching a client with schizophrenia to cook meals, make a grocery list, and establish a budget is an example of tertiary prevention, as it helps prevent further decline in their ability to function independently. Teaching an adolescent about pregnancy prevention is an example of primary prevention, as it aims to prevent the occurrence of a health problem. Teaching an elderly client the reportable side effects of a newly prescribed medication is an example of secondary prevention, as it aims to detect and treat potential complications of a health problem. Teaching a client about a new diagnosis of bipolar disorder could be considered both primary and secondary prevention, as it aims to prevent the occurrence of complications and detect and treat existing ones.

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?

Accepted Answer

The Community Health Centers Act of 1963 provided federal funding for the establishment of community mental health centers. However, states were required to match some of the federal funds to establish and maintain these centers. This was a deterrence to proper implementation, as many states were not able to match the required funds, leading to inadequate funding for 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?

Accepted Answer

Counseling the couple in relation to open and honest communication skills is a secondary level of prevention because it is aimed at addressing the existing problem in the relationship and preventing it from worsening. This intervention focuses on improving communication skills, which can promote a healthier relationship between the couple. The other options do not address the existing relationship issue and are not specifically aimed at preventing further problems. Assessing how the children are coping may be important, but it is not an intervention aimed at prevention. Providing guidelines related to marital seminar leadership and teaching about methods of birth control are both tertiary prevention interventions aimed at preventing future problems.

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?

Accepted Answer

The answer of The school nurse is assessing a 12-year-old...

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?

Accepted Answer

Partial hospitalization does not provide supervision 24 hours a day, whereas inpatient hospitalization does provide continuous supervision. However, partial hospitalization still offers medication administration, monitoring, an interdisciplinary team, and a comprehensive treatment plan.

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?

Accepted Answer

The symptoms described are characteristic of tuberculosis, which has become more prevalent among the homeless community due to overcrowding and lack of access to healthcare. Meningitis may present with some similar symptoms, but the blood-tinged sputum is not typically associated with this condition. Encephalopathy and mononucleosis are not likely candidates based on the symptoms described.

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?

Accepted Answer

Community-based care with numerous brief hospitalizations is a common approach for managing schizophrenia, allowing for treatment in the least restrictive environment while still providing access to acute care during exacerbations of symptoms.

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?

Accepted Answer

Clients who have been institutionalized for an extended period of time may have difficulty adjusting to life outside the hospital due to institutionalization syndrome. This may lead to symptoms that require acute care, such as hallucinations or delusions. It is important for the nurse to closely monitor the client for signs of relapse and ensure appropriate interventions are in place. While compliance and community support are important, they may not fully address the challenges faced by clients with institutionalization syndrome.

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?

Accepted Answer

The student nurse must prioritize the client's safety over confidentiality in cases of harm to self or others. Sharing the client's suicidal thoughts with the treatment team is essential for providing appropriate care and interventions.

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?

Accepted Answer

Primary prevention focuses on preventing a problem from occurring. In this case, job training to increase employment options could prevent the individual from becoming homeless by helping them find a new job or career path. Referral to a primary care provider, encouraging the individual to recognize reasons for job layoff, and encouraging the use of prn medications would not directly address the issue of impending homelessness.

Question 19

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

Accepted Answer

Choice B accurately defines case management as providing coordination of services to meet client needs. Choices A, C, and D do not fully and accurately define case management.

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?

Accepted Answer

The nurse administering an injection of Haloperidol decanoate to an outpatient is providing tertiary prevention level of care, which focuses on preventing further complications or deterioration of an existing health condition. In this case, the outpatient most likely has a chronic mental health condition, and the injection is meant to control and manage symptoms to prevent relapse or further deterioration of their mental health. Primary prevention focuses on preventing the development of a disease, while secondary prevention focuses on early detection and treatment of a disease. Case management involves coordinating care and resources for patients with complex needs, which is not necessarily the primary focus of the nurse administering the injection in this case.

Quiz 36: Community Mental Health Nursing