Question 1

Which individual should the nurse assess as having the highest risk for homelessness?

Accepted Answer

Individuals with serious mental illness are at higher risk for homelessness due to limited access to resources, lack of support systems, and difficulty managing their condition. The absence of family further increases the risk. Age, marital status, and medical conditions such as dementia or alcoholism do not necessarily predict homelessness. An eating disorder may pose significant health risks, but this alone does not increase the risk for homelessness.

Question 2

A nurse, preparing a community presentation, should include what information concerning the most accurate characterization of treatment of the mentally ill prior to the Period of Enlightenment?

Accepted Answer

Prior to the Period of Enlightenment, treatment of the mentally ill was often cruel and included putting patients on display for public amusement, such as in Bedlam in England. There was little focus on compassion or meeting patients' basic needs, and large public asylums provided custodial care without much emphasis on improving mental health.

Question 3

Which skill is most important to a nurse working as a member of a community mental health team that strives to use a seamless continuum of care?

Accepted Answer

Case management is the most important skill for a nurse working in a community mental health team that strives to use a seamless continuum of care. This involves organizing, coordinating, and facilitating services for patients with mental health disorders, ensuring that they receive appropriate care and services that are tailored to their individual needs. Effective case management also involves working closely with healthcare providers and other community resources to ensure that patients receive comprehensive and coordinated care. Diagnostic ability, physical assessment skills, and patients' rights advocacy are also important skills for nurses, but they are not as essential to ensuring a seamless continuum of care.

Question 4

Which nursing intervention is associated with a shift in the psychiatric nursing focus during the community mental health period of the 1960s?

Accepted Answer

The answer of Which nursing intervention is associated with a...

Question 5

A person says, "What mental health issues are a major concern for the general population." The nurse's reply should be based on what confirmed fact concerning mental health issues?

Accepted Answer

Major depression is a very prevalent mental health issue among the adult population, with an estimated lifetime prevalence of 16.2%. It is one of the leading causes of disability worldwide. Bipolar disorder and schizophrenia are less common, affecting approximately 1-2% of the population each. Alcohol-related issues are also widespread, with harmful alcohol use causing approximately 3 million deaths worldwide each year.

Question 6

Which of these services is most appropriate for an older client requiring minimal mental health interventions?

Accepted Answer

Scheduled visits at a community mental health center are most appropriate for an older client requiring minimal mental health interventions because it allows for targeted, professional mental health support without the intensity of day treatment or hospitalization, and with more specialized care than a senior center might provide.

Question 7

A nurse is preparing to present a discussion to a group of nursing students on meeting the needs of the mentally ill.What concerns should be identified as the focus of society's concerns during both the Period of Enlightenment and the Period of Community Mental Health?

Accepted Answer

During the Period of Enlightenment, there was a focus on treating individuals with mental illness with more humane and compassionate care, meeting their basic needs, and treating them with dignity. Similarly, during the Period of Community Mental Health, there was a focus on community-based care and meeting the basic needs of individuals with mental illness to help them live more normal and fulfilling lives. The other choices may also be important considerations but may not be the primary concerns of society during these time periods.

Question 8

An adult diagnosed with schizophrenia is being discharged from a state mental hospital after 20 years of institutionalization.What intervention should the nurse include in discharge planning to best manage the relapse of symptoms?

Accepted Answer

The answer of An adult diagnosed with schizophrenia is being...

Question 9

A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patient's insurance form.Which resource should the nurse use to discern the criteria used to establish this diagnosis?

Accepted Answer

The DSM is the primary resource used for diagnosing mental disorders, and it provides specific criteria for each diagnosis. The nursing diagnosis manual and psychiatric nursing textbook may be helpful in developing a care plan or understanding nursing interventions, but they do not provide specific diagnostic criteria. A behavioral health reference manual may provide general information about mental health disorders, but it is not as specific or comprehensive as the DSM.

Question 10

Which statement made by a nurse demonstrates an understanding of the issue affecting the delivery of care to the mentally ill that motivated passage of the Community Mental Health Centers Act in 1963?

Accepted Answer

The Community Mental Health Centers Act aimed to address the issue of mentally ill patients being isolated from their communities and families. Statement B demonstrates an understanding of this issue and suggests efforts to address it. Statements A, C, and D are not directly related to the issue motivating the passage of the act.

Question 11

The greatest impact in the care of the mentally ill over the past 50 years is represented in which nursing statement to a newly admitted patient?

Accepted Answer

The introduction and use of psychotropic drugs have significantly transformed the care of the mentally ill, allowing for more effective management of symptoms and enabling many patients to live more independently.

Question 12

An adult with serious mental illness is being admitted to a community behavioral health inpatient unit.Recognizing current trends in hospitalization, the nurse can reasonable assume the need to prioritize which intervention?

Accepted Answer

The current trend in hospitalization for individuals with serious mental illness is shorter length of stay and more acute symptoms, which may result in an increased risk for aggressive behavior. Therefore, implementing safety precautions to address aggressive behavior is a priority intervention to ensure the safety of the client and other patients on the unit. While medication adherence and education about the illness are important interventions, they may not be the immediate priority for this admission. Counseling about the risks involved in demanding discharge against medical advice may also be important, but not as critical as addressing safety concerns.

Question 13

The broadened scope of psychiatric nursing practice is attributable primarily to what factor?

Accepted Answer

The opening of community mental health centers allowed psychiatric nurses to practice in various settings, such as outpatient clinics, group homes, and residential treatment facilities, thereby broadening their scope of practice. The other options may have contributed to the increased demand for psychiatric nursing services, but they did not necessarily expand the scope of practice.

Question 14

A newcomer to a community support meeting asks a nurse, "Why aren't people with mental illnesses treated at state institutions anymore?" What would be the nurse's accurate responses? (Select all that apply.)

Accepted Answer

There has been a shift in focus towards community treatment due to funding, there are less restrictive settings available now, and better drugs make it possible for many with mental illness to live in the community. The closure of state institutions is not due to negative press, and it cannot be said that there are fewer people with mental illness, only that they are being treated differently.

Question 15

Which changes in psychiatric nursing practice are directly attributable to events occurring during the Decade of the Brain? (Select all that apply.)

Accepted Answer

The Decade of the Brain (1990-2000) brought about increased knowledge and understanding of brain functions and disorders. As a result, psychiatric nursing practice underwent significant changes, including an upgraded knowledge of psychopharmacology (B) to effectively manage symptoms related to brain irregularities (D), and the provision of psychoeducation to patients and families (C) to enhance understanding of mental illness and its treatment. However, the Decade of the Brain did not directly result in homeless shelters becoming practice sites (A) or nurses being more likely to advocate for patients' rights related to involuntary commitment (E).

Question 16

A nurse begins working in a clinic housed in a homeless shelter.The nurse asks the clinic director, "What topic should I review to improve my effectiveness as I begin my new job?" Which topic should the clinic director suggest?

Accepted Answer

The answer of A nurse begins working in a clinic...

Question 17

A patient diagnosed with an acute was hospitalized for a week and is now being discharged to a halfway house, where care is managed by a community mental health nurse.Which inference applies to this community?

Accepted Answer

The fact that there is a halfway house and community mental health nurse available for the patient shows that there is a continuum of care in place to serve persons with severe mental illness. It indicates that there is a transition from hospitalization to community care, which is an essential part of a comprehensive mental health service. This suggests that the community has a system in place that offers some level of support and care for persons with severe mental illness.

Question 18

When a nurse working in a well-child clinic asks a parent's address, the parent responds, "My children and I are homeless." What assumption should the nurse make of this response?

Accepted Answer

The nurse should make the assumption that homelessness is a common occurrence as 1 out of 50 children are homeless. This response provides important information for the nurse to provide appropriate resources to the family. It is not appropriate to assume mental illness, child abuse/neglect or substance abuse based on this response alone without further investigation.

Question 19

Which of Freud's contribution to psychiatry most affects current psychiatric nursing?

Accepted Answer

Freud's contribution that most affects current psychiatric nursing is the challenge to look at humans objectively, as it laid the foundation for understanding human behavior and mental processes in a scientific and systematic way, which is crucial in psychiatric nursing.

Quiz 2: Historical Issues