Question 1

An example of the primary responsibility of a nurse case manager for psychiatric patients in a residential home is to:

Accepted Answer

Case management involves linking the service system to the consumer and coordinating the service components so that he or she can achieve successful community living.

Question 2

The primary nursing responsibility of a community psychiatric nurse managing caring for patients diagnosed with serious and persistent mental illnesses residing in a group home is to conduct an ongoing:

Accepted Answer

A systems model of community mental health operates on the philosophy that all aspects of a person's life need care-basic human needs,physical health needs,and needs for psychiatric treatment and rehabilitation-if a person is to live successfully in the community.The initial step is to assess the individual patient's needs.

Question 3

A community mental health nurse is often a member of a multidisciplinary Assertive Community Treatment (ACT) team.An example of a nursing intervention that focuses on the primary concentration of care for such a team is:

Accepted Answer

One of the primary concerns of the Assertive Community Treatment team is relapse prevention.All the other answers are true if needed by the individual patient,but a primary concern is to keep the individual healthy and out of an inpatient setting such as a support group.

Question 4

Which intervention demonstrates effective management of two contradictory goals of case management?

Accepted Answer

With the advent of managed care,case management has come to reflect two basic but seemingly contradictory goals,increasing access to services and limiting costs.The correct option demonstrates an effective intervention that addresses these goals.

Question 5

Which patient would benefit from in-home psychiatric nursing services?

Accepted Answer

Patients with repeated inpatient or crisis-unit admissions are identified among patients who can benefit from in-home psychiatric nursing services.

Question 6

Which situation would be considered discrimination under the Americans with Disabilities Act?

Accepted Answer

Institutionalizing an individual by assuming activities of daily living that they are capable of performing would be considered a denial of their ability to be independent.The remaining options do not appear to violate any patient right.

Question 7

Which health care setting is most likely to meet the mental health care needs of an urban community?

Accepted Answer

According to the report from the New Freedom Commission on Mental Health,Achieving the Promise: Transforming Mental Health Care in America (NFCMH,2003),evidence shows that offering a full range of community-based alternatives is more effective than physician- or hospital-based or emergency-room treatment.

Question 8

Rural suicide rates:

Accepted Answer

Rural residents face greater social stigma in regard to seeking mental health care,and basic community services such as transportation,electricity,water,and telephones that are important to providing health care may not be available.Rural suicide rates have surpassed urban suicide rates over the past 20 years.

Question 9

A psychiatric home care nurse's greatest patient care challenge is:

Accepted Answer

Documentation is one of the most challenging requirements of psychiatric home care.If the nurse's documentation does not reflect the skilled service given,the payment for that service can be denied by Medicare or other payers.Few guidelines are available for documentation of psychiatric home care,but standardized coding and classification systems are preferred.The psychiatric home care nurse must be very organized and detail-oriented to successfully manage the extensive and detailed paperwork.

Question 10

Individuals may seek treatment for mental health disorders from their primary care provider.Which assessment questions are directed towards identifying the most common of these conditions? (Select all that apply.)

Accepted Answer

The three most common problems seen in primary care are depression,anxiety,and substance abuse.

Question 11

The National Alliance on Mental Illness (NAMI) believes that which program offers the most comprehensive treatment for severely mentally ill individuals living in the community?

Accepted Answer

The Program of Assertive Community Treatment (PACT) is recognized by the National Alliance on Mental Illness (NAMI) as the most effective service-delivery model for community treatment of severe mental illness.

Question 12

A psychiatric nurse is focusing on the fifth area of service,based on the Community Mental Health Centers Act of 1963,when:

Accepted Answer

The goal of the fifth service of the Community Mental Health Centers Act of 1963 is consultation and education.One focus for education is primary prevention.

Question 13

Which statement made by a psychiatric community nurse reflects a need for further education regarding Medicare criteria for home health reimbursement for mental health services?

Accepted Answer

Although a patient must be diagnosed with a psychiatric disorder,it need not be considered chronic for home care services to be reimbursable.

Question 14

A key component of focused treatment directed toward the homeless population that has been shown to be most successful is the facilitation of:

Accepted Answer

Mental health professionals have begun to explore the use of new approaches to providing treatment,rehabilitation services,and housing to homeless people with mental illness,a population that often avoids contact with traditional mental health programs.Key components of this focused treatment approach include frequent and consistent staff contact through assertive outreach.

Question 15

A community mental health nurse is conducting a home visit when the patient states,"I never want to go back to that hospital again." Which response has the greatest therapeutic value in terms of appropriate assurance for the patient's concerns?

Accepted Answer

Psychiatric home care is available to a broad segment of the population.Factors contributing to the development of the treatment setting include the following: continued trend of deinstitutionalization; growth of managed care,which focuses on cost,outcomes,and earlier hospital discharges; and advocacy by consumer groups to find less restrictive and more humane ways of delivering care to people with mental illness.Although the nurse cannot promise that the patient will not require future hospitalizations,reassurance that community-based care is available should provide appropriate emotional support.

Question 16

When considering mental health issues,deinstitutionalization is best demonstrated when a:

Accepted Answer

Deinstitutionalization refers to the transfer of a patient hospitalized for extended periods of time to a community setting.At the mental health care system level,it refers to a shift in the focus of care from long-term institution to the community,accompanied by discharging long-term patients and avoiding unnecessary admissions.

Question 17

Forensic nursing has two very different and sometimes conflicting goals.These goals are:

Accepted Answer

The conflicting goals of forensic nursing occur as the nurse attempts to provide the patient with the most appropriate,effective mental health care while preserving the community's safety.

Question 18

A community mental health center is adjusting to severe budget cuts.Which service is most likely to be considered for elimination?

Accepted Answer

Major amendments to the Community Mental Health Centers Act in 1975 required that community mental health centers continue to offer five areas of service.Because of the funding cuts,the services that most community mental health centers reluctantly reduce are their preventive efforts directed toward mental health education,focusing resources on the care of people with diagnosed mental illness.

Question 19

The outcome that resulted from the fundamental flaw with the deinstitutionalization of mental health patients was that: (Select all that apply.)

Accepted Answer

Soon after deinstitutionalization began,it became clear that policymakers had seriously miscalculated both the service needs of this population and the ability of communities to accommodate the large numbers of people with mental illness who had been discharged from the state.Often these former patients had to be readmitted to state hospitals.

Question 20

When assessing a new prison inmate the correctional nurse conducts a particularly thorough mental illness screening because:

Accepted Answer

The rate of serious mental illness in the incarcerated population is about three to four times that of the general U.S.population.

Quiz 34: Community-Based Psychiatric Nursing Care