Ch 1 - Mental health & Mental illness
What client assessment data demonstrates parity related to mental health care? Advance practice nurse can be certified as psychiatric nurse specialist. The client is admitted for a 72-hour mental hygiene evaluation. A client who has attempted suicide is hospitalized for a mental health evaluation. A client's mental health coverage is equal to his/her medical/surgical coverage.
A client's mental health coverage is equal to his/her medical/surgical coverage. Parity refers to equivalence that requires insurers who provide mental health coverage to offer annual and lifetime benefits at the same level provided for medical/surgical coverage. None of the other options are associated with mental health insurance coverage.
A registered nurse has accepted a position as staff nurse on a psychiatric unit. Which statement made by the nurse requires additional instructions regarding the therapies provided on the unit? "You will attend a psychotherapy group that I lead that will help you care for yourself." "You will be given a schedule daily of the groups we would like you to attend." "You will see your provider daily in a one-to-one session." "You will participate in unit activities and groups daily."
"You will attend a psychotherapy group that I lead that will help you care for yourself." Basic level RNs cannot perform psychotherapy. The other options are all appropriate expectations of a client's schedule on a psychiatric unit.
An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports what conclusion about this client? The client is not conforming with social norms. The client is engaging in egocentric behaviors. The client is demonstrating symptoms of bipolar disorder. The client is demonstrating socially deviant behavior.
The client is not conforming with social norms. Behavior that deviates from socially accepted norms does not indicate a mental illness unless there is significant disturbance in mental functioning.
The mental health status of a particular client can best be assessed by considering which factor? The degree to which an individual is logical and rational Rate of demonstrated intellectual and emotional growth Position placement on a continuum from health to illness The degree of conformity of the individual to society's norms
Position placement on a continuum from health to illness Many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Therefore, these disorders can be regarded as "diseases." Visualizing these disorders along the mental health continuum is helpful.
According to current information what factor is associated with the most disabling mental disorders? Biological influences Learned ways of behaving Faulty patterns of early nurturance Psychological trauma
Psychological trauma Biological and genetic factors influence mental health. The biologically influenced illnesses include schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress disorder, and autism. Therefore many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Psychological trauma, learned behaviors, and faulty patterns of nurturance may contribute to some forms of mental illness, but they are not major factors in most disabling mental disorders.
A client tells the mental health nurse "I am terribly frightened! I hear whispering in my head that someone is going to kill me." Which criteria of mental health can the nurse assess as lacking? Positive self-concept Rational thinking Learning and productivity Self-control
Rational thinking The ability to think rationally is lacking for this client. The client does not have an accurate picture of what is happening that is based on reliable cognitive thinking. The statement fails to meet the criteria for any of the other options.
Which nursing statement illustrates the concept of client advocacy? "I'd like you tell me more about your depression and your suicide attempt?" "Dr. Raye, during the admissions interview the client stated that there is a family history of three other suicide attempts in the past." "Dr. Raye, during the admission interview, the client stated they will refuse fluoxetine because of adverse effects they experienced previously." "I will take you on a tour of the unit and orient you to the rules so you can get adjusted here."
"Dr. Raye, during the admission interview, the client stated they will refuse fluoxetine because of adverse effects they experienced previously." By letting the provider know that the client does not want the treatment the provider is prescribing, you have advocated for the client and her right to make decisions regarding her treatment. The other selections do not describe client advocacy since they do not represent actions by the nurse that the client is incapable of on their own.
The nurse being aware that certain mental illnesses have a prevalence among a specific gender, will suspect which statement was made by a female client? (Select all that apply.) "I'm so anxious, about everything." "There is no way I could make a presentation to a group of people." "I freeze in panic when I see a spider." "I've been depressed most of my adult life." "I've been arrested 6 times in the last 15 years."
"I've been depressed most of my adult life." Antisocial personality disorder, characterized by repeated illegal behavior, is more commonly diagnosed in men while major depressive disorder, characterized by chronic feelings of sadness negatively impacts life, is more common among women. "I've been arrested 6 times in the last 15 years." Antisocial personality disorder, characterized by repeated illegal behavior, is more commonly diagnosed in men while major depressive disorder, characterized by chronic feelings of sadness negatively impacts life, is more common among women.
Which client statement demonstrates the mental health concept of resilience? "My kids, happiness is worth any sacrifice I have to make." "My mother made decisions about my husband's funeral when I just couldn't do that." "Losing my job was hard but my skills will help me get another one." "In spite of all the treatment, I know I'll never be really healthy."
"Losing my job was hard but my skills will help me get another one." Resilience is a characteristic that helps individuals cope with loss and trauma that may occur in life. Dependence is described as relying on others for decision making and care. Pessimism is a life philosophy that things are more likely to go wrong than right. Altruism is described as putting others before yourself.
A nursing diagnosis for a client with a psychiatric disorder serves what purpose with considering the plan of care? Justifying the use of certain psychotropic medication. Providing data essential for insurance reimbursement. Establishing a framework for selecting appropriate interventions. Completing the medical diagnostic statement.
"We have the specialized skills needed to care for those with mental illnesses." A psychiatric mental health nurse has specialized nursing skills and implements the nursing process to manage and deliver nursing care to the mentally ill. The remaining options either do not effectively answer the client's question or assume that the question is the result of the client's paranoia.
A nurse, active in local consumer mental health groups and in local and state mental health associations, keeps aware of state and national legislation affecting mental illness treatment. How can this nurse positively affect the climate for effective, mental health treatment? By educating the public on the effects that stigmatizing has on mental health clients. By becoming active in politics leading to a potential political career. Advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions. Advocating for laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons.
By educating the public on the effects that stigmatizing has on mental health clients. Nurses who are aware of legislative concerns and who are active in organizations that promote mental health awareness and appropriate and equal treatment for mental illness help achieve the goal of parity, or equality of treatment for mentally ill individuals. Becoming active in politics may be a personal goal but does not directly or necessarily reduce stigma or encourage treatment equality. The other options are undesirable outcomes.
Which branch of epidemiology is the nurse involved in when seeking outcomes for clients whose depression was treated with electroconvulsive therapy (ECT)? Descriptive Analytic Clinical Experimental
Clinical Clinical epidemiology represents a broad field that addresses what happens to people with illnesses who are seen by providers of clinical care. Studies use traditional epidemiological methods and are conducted in groups that are usually defined by illness or symptoms or by diagnostic procedures or treatments given for the illness or symptoms. None of the other options accurately identify the field that is associated with clinical practice.
The nurse planning care for a mentally ill client bases interventions on which concept? There are universal fears that are shared by all mentally healthy individuals. Every client comes with experiences that contribute to their problem. It is a client right to be treated respectfully. Every client has a certain degree of resilience.
Every client has a certain degree of resilience. Nurses are expected to evaluate clients with mental health issues for their strengths and their areas of high functioning. You will find many attributes of mental health in some of your clients with mental health issues. These strengths should be built upon and encouraged. Resilience is the ability and capacity for people to secure the resources they need to support their well-being. None of the remaining options describe concepts that are the foundation for the actual creation of individualized care plans.
How can a nurse best differentiate whether an Asian client is demonstrating a mental illness after having attempted suicide? Explain that suicide is often regarded as a desperate act. Assess the client for other examples of depressive behaviors. Identify the client's culture's view regarding suicide. Ask the client whether he views himself as being depressed.
Identify the client's culture's view regarding suicide. One approach to differentiating mental health from mental illness is to consider what a particular culture regards as acceptable or unacceptable. In this view, the mentally ill are those who violate social norms and thus threaten (or make anxious) those observing them. For example, traditional Japanese may consider suicide to be an act of honor, and Middle Eastern "suicide bombers" are considered holy warriors or martyrs. Contrast these viewpoints with Western culture, where people who attempt or complete suicides are nearly always considered mentally ill. While the remaining options are appropriate interventions, they fail to address the possible cultural component of the client's behavior.
Which statement best describes the Diagnostic and Statistical Manual, fifth edition (DSM-5) DSM-5? It suggests common interventions for mental disorders. It is a compendium of treatment modalities. It is a medical psychiatric assessment system. It offers a complete list of nursing diagnoses.
It is a medical psychiatric assessment system. The DSM-5 is a classification of mental disorders that includes descriptions and criteria of diagnoses. None of the other options are accurate descriptions.
Which severe mental illness has a prevalence of over 6% among the populace of the United States? (Select all that apply.) Major depressive disorder A personality disorder Generalized anxiety disorder Bipolar disorder Social phobia Alzheimer's Disease
Major depressive disorder and Bipolar disorder Data suggests that prevalence among the US populace is: Alzheimer's disease 10% (65 years and older), any personality disorder 9.1%, Social phobia 6.8%, Major depressive disorder 6.7% . The prevalence of Bipolar disorder is 2.6% while Generalized anxiety disorder is 3.1
What term is used to identify the quantitative study of the distribution of mental disorders in human populations? prevalence clinical epidemiology mortality epidemiology
epidemiology Epidemiology is the quantitative study of the distribution of mental disorders in human populations. Mortality refers to deaths. Prevalence refers to the proportion of a population with a mental disorder at a given time. Clinical epidemiology deals with what happens to people with illnesses who are seen by providers of care.