Question 1

What is the best rationale for including the client's family in therapy within the inpatient milieu?&#10;A)To structure a program of social and work-related activities&#10;B)To facilitate discharge from the hospital&#10;C)To provide a concrete demonstration of caring&#10;D)To encourage the family to model positive behaviors

Accepted Answer

Including the client's family in therapy within the inpatient milieu can facilitate discharge from the hospital by preparing the family for the client's return home, helping them understand the client's needs, and providing support for ongoing treatment. Research has shown that involving families in therapy can improve treatment outcomes and reduce the risk of relapse. While the other options may also be important considerations in the inpatient milieu, facilitating discharge is the best rationale for including the client's family in therapy.

Question 2

When Jonathan was admitted to an inpatient psychiatric unit,the nurse explained all patients are expected to attend various groups throughout the day.Which is a main goal of therapeutic groups?&#10;A)Establish trust.&#10;B)Provide structure.&#10;C)Facilitate behavior change.&#10;D)Increase self-esteem.

Accepted Answer

The main goal of therapeutic groups is to facilitate behavior change by providing opportunities for patients to learn and practice new skills and behaviors. While establishing trust, providing structure, and increasing self-esteem may be beneficial outcomes of therapeutic groups, they are not the primary goal.

Question 3

A client on an inpatient unit angrily states to a nurse,&#34;Peter is not cleaning up after himself in the community bathroom.You need to address this problem.&#34; Which is the appropriate nursing response?&#10;A)&#34;I'll talk to Peter and present your concerns.&#34;&#10;B)&#34;Why are you overreacting to this issue?&#34;&#10;C)&#34;You should bring this to the attention of your treatment team.&#34;&#10;D)&#34;I can see that you are angry.Let's discuss ways to approach Peter with your concerns.&#34;

Accepted Answer

This response acknowledges the client's emotional state and offers support in finding a solution to the problem. It also demonstrates the nurse's willingness to address the issue without deflecting blame or dismissing the client's concern. Option A could be a good choice as well, but it doesn't involve addressing the client's emotional state. Option B is inappropriate because it invalidates the client's emotions, while option C places responsibility on the client instead of the nurse.

Question 4

In the role of milieu manager,which activity should the nurse prioritize?&#10;A)Setting the schedule for the daily unit activities&#10;B)Evaluating clients for medication effectiveness&#10;C)Conducting therapeutic group sessions&#10;D)Searching newly admitted clients for hazardous objects

Accepted Answer

As the milieu manager, it is the nurse's responsibility to ensure the safety of clients and the environment. Searching newly admitted clients for hazardous objects is a critical activity in ensuring the safety of the unit. While setting the schedule for the daily unit activities, evaluating clients for medication effectiveness, and conducting therapeutic group sessions are important, they are not as urgent as ensuring the immediate safety of clients.

Question 5

To promote self-reliance,how should a psychiatric nurse best conduct medication administration?&#10;A)Encourage clients to request their medications at the appropriate times.&#10;B)Refuse to administer medications unless clients request them at the appropriate times.&#10;C)Allow the clients to determine appropriate medication times.&#10;D)Take medications to the clients' bedside at the appropriate times.

Accepted Answer

Encouraging clients to request their medications at the appropriate times promotes self-reliance by involving them in their own care process, while still ensuring they receive their medication appropriately.

Question 6

Which are the psychiatric nurse's responsibilities on the interdisciplinary treatment team? Select all that apply.&#10;A)Present educational programs for nursing staff.&#10;B)Perform in-depth psychosocial history.&#10;C)Develop one-to-one relationships with clients.&#10;D)Manage the therapeutic milieu on a 24-hour basis.&#10;E)Provide input in development of treatment plan.

Accepted Answer

The answer of Which are the psychiatric nurse's responsibilities on...

Question 7

A client diagnosed with Schizophrenia functions well and is bright,spontaneous,and interactive during hospitalization but then decompensates after discharge.What does the milieu provide that may be missing in the home environment?

A)Peer pressure
B)Structured programming
C)Visitor restrictions
D)Mandated activities

Accepted Answer

The milieu provides a structured programming that may be missing in the home environment. The structure and consistency of a therapeutic milieu can help stabilize a client with schizophrenia by providing a predictable routine and a supportive environment. Without this structure in the home environment, a client may struggle to maintain stability and may decompensate. Peer pressure, visitor restrictions, and mandated activities may also be present in a therapeutic milieu, but they are not the primary factors that contribute to a client's stability and functioning after discharge.

Question 8

How does a democratic form of self-government in the milieu contribute to client therapy?&#10;A)By setting punishments for clients who violate the community rules&#10;B)By dealing with inappropriate behaviors as they occur&#10;C)By setting community expectations wherein all clients are treated on an equal basis&#10;D)By interacting with professional staff members to learn about therapeutic interventions

Accepted Answer

A democratic form of self-government in the milieu can contribute to client therapy by setting community expectations wherein all clients are treated equally. This can create a sense of fairness and reduce feelings of isolation or discrimination, which can, in turn, foster a sense of trust and safety within the therapeutic environment. It can also encourage clients to take responsibility for their actions and work collaboratively with others to create a positive and supportive community. Punishments for clients who violate community rules are often discouraged in therapeutic settings as they can create a punitive and hostile environment that undermines the therapeutic relationships and goals. Inappropriate behaviors are typically addressed through therapeutic interventions, such as individual or group counseling sessions. Interacting with professional staff members to learn about therapeutic interventions can be helpful but is not directly related to the benefits of a democratic self-government model in the milieu.

Question 9

A newly admitted client asks,&#34;Why do we need a unit schedule? I'm not going to these groups.I'm here to get some rest.&#34; Which is the most appropriate nursing reply?&#10;A)&#34;Group therapy provides the opportunity to learn and practice new coping skills.&#34;&#10;B)&#34;Group therapy is mandatory.All clients must attend.&#34;&#10;C)&#34;Group therapy is optional.You can go if you find the topic helpful and interesting.&#34;&#10;D)&#34;Group therapy is an economical way of providing therapy to many clients concurrently.&#34;

Accepted Answer

Explaining the benefits of group therapy can help the client understand why it is important and may increase their motivation to attend.

Question 10

A client tells the nurse she is anxious and loudly demands the nurse give her Ativan right now.The nurse replies,"I understand you are having anxiety;however,demanding medication in a loud voice is unacceptable behavior." Which type of intervention is the nurse implementing?

A)Establishing trust
B)Limit setting
C)Validating feelings
D)Patient teaching

Accepted Answer

The nurse is implementing limit setting by acknowledging and validating the client's feelings while also setting a boundary around acceptable behavior.

Question 11

The psychiatric-mental health nurse understands the goal of milieu therapy is which of the following?&#10;A)To structure the environment to ensure a therapeutic experience&#10;B)To encourage clients to be active participants in their therapy&#10;C)To provide spontaneous opportunities for therapeutic interactions&#10;D)To design a homelike atmosphere that encourages communication

Accepted Answer

The answer of The psychiatric-mental health nurse understands the goal...

Question 12

Therapeutic community is based on which of Skinner's assumptions? Select all that apply.&#10;A)Every interaction is an opportunity for therapeutic intervention.&#10;B)Social interactions and group activities foster behavior change.&#10;C)Peer pressure is a useful and powerful tool.&#10;D)Inappropriate behaviors are dealt with as they occur.&#10;E)Physical facilities enhance adaptive coping skills.

Accepted Answer

The answer of Therapeutic community is based on which of...

Question 13

Which of the following are accurate descriptors of a therapeutic community? Select all that apply.&#10;A)The unit schedule includes unlimited free time for personal reflection.&#10;B)Unit responsibilities are assigned according to client capabilities.&#10;C)A flexible schedule is determined by client needs.&#10;D)The individual is the sole focus of therapy.&#10;E)A democratic form of government exists.

Accepted Answer

The answer of Which of the following are accurate descriptors...

Question 14

A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group.What should the nurse identify as an appropriate group topic?&#10;A)Dream analysis&#10;B)Creative cooking&#10;C)Paint by number&#10;D)Stress management

Accepted Answer

The answer of A nurse working on an inpatient psychiatric...

Question 15

A nurse attends an interdisciplinary team meeting on an inpatient unit.Which of the following individuals are typically included as members of the interdisciplinary treatment team in psychiatry? Select all that apply.

A)Respiratory therapist
B)Occupational therapist
C)Recreational therapist
D)Social worker
E)Mental health technician

Accepted Answer

The answer of A nurse attends an interdisciplinary team meeting...

Question 16

A client has undergone psychological testing.With which member of the interdisciplinary team should a nurse collaborate to review these results?&#10;A)Psychiatrist&#10;B)Psychiatric social worker&#10;C)Clinical psychologist&#10;D)Clinical nurse specialist

Accepted Answer

The answer of A client has undergone psychological testing.With which...

Question 17

An angry client on an inpatient unit approaches a nurse,stating,"Someone took my lunch! People need to respect others,and you need to do something about this now!" The nurse's response should be guided by which basic assumption of milieu therapy?

A)Conflict should be avoided at all costs on inpatient psychiatric units.
B)Conflict should be resolved by the nursing staff.
C)Every interaction is an opportunity for therapeutic intervention.
D)Conflict resolution should be addressed only during group therapy.

Accepted Answer

The answer of An angry client on an inpatient unit...

Deck 12: Milieu Therapythe Therapeutic Community