Question 1

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

Accepted Answer

The opening of community mental health centers in the 1960s and 1970s was a major factor in broadening the scope of psychiatric nursing practice. These centers shifted the focus of mental health care from inpatient treatment to community-based care, creating new opportunities for psychiatric nurses to provide services in a variety of settings. This allowed for expanded roles and responsibilities for psychiatric nurses, including case management, crisis intervention, and patient education. While the other options may have contributed to changes in psychiatric nursing practice, they are not the primary factor.

Question 2

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

C

Question 3

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, the mentally ill were often displayed in public for amusement. They were considered to be freaks or objects of curiosity and were often kept in chains, cages, or other inhumane conditions. Treatment was not compassionate and focused more on punishment or containment than on addressing underlying issues. Large public asylums were not common until later in history. The focus was not on reducing stress or meeting basic needs, but rather on controlling the behavior of the mentally ill.

Question 4

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

The focus has shifted towards community treatment, which is less restrictive and ensures better quality of life for individuals with mental illness. More options for treatment, including better drugs, make it possible for individuals to live in less restrictive settings. The reduction in the use of state institutions is not due to a decrease in the number of people with mental illness, but rather a shift in how they are treated. Negative stories in the press may have contributed to the change, but this is not the primary reason for the shift towards community treatment.

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 major concern for the general population, as it is one of the most prevalent mental health issues among adults. Bipolar disorder and schizophrenia are less common, and alcohol-related issues may vary depending on the demographic.

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

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

As part of a community mental health team, it is essential for a nurse to have strong case management skills. This involves coordinating care and services for patients across different settings and providers, ensuring that their needs are met as they move through the continuum of care. Diagnostic ability, physical assessment skills, and patients' rights advocacy are also important, but case management is the most critical skill for ensuring seamless care.

Question 8

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 the patient is being discharged to a halfway house where care is managed by a community mental health nurse suggests that there is a seamless continuum of services in place to serve persons with severe mental illness. This also implies that the community has a strong mental health system that provides both acute and long-term care.

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 standard reference manual for psychiatric diagnoses and criteria used by mental health professionals in the United States.

Question 10

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

Accepted Answer

The answer of Which of Freud's contribution to psychiatry most...

Question 11

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

Accepted Answer

A person with serious mental illness and no family has a higher risk for homelessness as they may struggle with managing their illness and have limited support systems. The other individuals listed may have other challenges or risk factors, but they are not necessarily at the highest risk for homelessness.

Question 12

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 was passed in response to the issue of mentally ill individuals being isolated from their families and communities. Option A refers to involuntary hospitalization based on violent behavior, which is not directly related to the issue addressed by the act. Option C refers to the issue of voluntarily admitted clients leaving before receiving adequate treatment, but this is not the main focus of the act. Option D refers to the issue of informed consent in pharmacologic research, which is not directly related to the act.

Question 13

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 14

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

Accepted Answer

During the Decade of the Brain, advances in neuroscience led to increased understanding of the biological underpinnings of psychiatric disorders. As a result, psychiatric nursing practice shifted to view symptoms as resulting from brain irregularities, and nurses upgraded their knowledge of psychopharmacology to assist with medication management. Nurses also played a key role in providing psychoeducation to patients and families about the biological basis of their condition. However, there is no direct relationship between the Decade of the Brain and the practice of nursing in homeless shelters or advocating for patients' rights related to involuntary commitment.

Question 15

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 16

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, the focus was on treating mental illness with humane treatment and meeting basic human needs, rather than just confining patients to asylums. During the Period of Community Mental Health, the focus was on deinstitutionalization and providing community-based care that addressed the basic needs of individuals with mental illness. Therefore, meeting basic human needs humanely is the concern identified during both periods.

Question 17

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 18

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 19

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

Current trends in hospitalization have shown an increase in patients with serious mental illness who exhibit aggressive behavior, which can be a safety concern for themselves and others. Therefore, implementing safety precautions should be a priority to ensure a therapeutic environment for all patients and staff. Although medication adherence and education on the illness are important interventions, they may not be the priority in this case. Counselling the client regarding the risks of demanding discharge against medical advice may be appropriate, but it is not as urgent as implementing safety precautions.

Quiz 2: Historical Issues