Chapter 7 - Recovery Framework for Psychiatric-Mental Health Nursing

The charge nurse is talking with another nurse who states, "I feel like my client has no interest in his or her care and does not care that I am trying to help." Which response should the charge nurse make? A. "A lot of clients behave that way, but you cannot take it personally." B. "Do you want me to assign another nurse to the client?" C. "Have you tried to establish a therapeutic relationship with the client?" D. "Clients often behave that way when they are in pain."

"Have you tried to establish a therapeutic relationship with the client?"

The nurse is caring for a group of clients at a substance use disorder treatment facility. Which statement would indicate a client is experiencing self-stigma? A. "Everytime I am outside getting fresh air I can feel people who are walking by just staring at me. I almost did not come back in." B. "I cannot wait to prove to my family that I am not using drugs anymore, but I know they are just going to see me as an addict forever." C. "I understand that I need to find a new group of friends, because my friends will keep offerring me drugs instead of helping me stay off of them." D. "How do I get my coworkers to understand that I have a disease and it is not a choice? Their whispers make me want to leave work and find drugs."

"How do I get my coworkers to understand that I have a disease and it is not a choice? Their whispers make me want to leave work and find drugs."

The nurse is caring for a client who is receiving the five-stage process for homeless rehabilitation. Which statement by the client would indicate the client is in the transition to the intensive care stage? A. "I am learning to redirect my anger, so I can prevent overreacting when I am upset." B. "I am ready to stop using drugs, but I need help with getting into a rehabilitation facility." C. "I have adjusted to living in the half-way house and sharing responsibilities." D. "I will always be seen as a failure to my siblings."

"I am ready to stop using drugs, but I need help with getting into a rehabilitation facility."

The nurse is caring for a client who was admitted with severe depression and the client's sibling states, "Can you just stop being so dramatic and snap out of this." Which response by the nurse would be most appropriate? A. "Would you be willing to understand how depression works in the brain?" B. "You should probably leave the room for awhile." C. "People cannot just snap in and out of feeling sad." D. "Do you understand that depression is a disease?"

"Would you be willing to understand how depression works in the brain?"

The nurse is explaining the concept of the shared decision-making model to the spouse of a client who was involuntarily admitted for a substance use disorder. The spouse states, "Is it really a good idea to let my spouse help make decisions since this is involuntary and the decisions my spouse made to begin with is why we are here?" Which response would be most appropriate by the nurse? A. "Your spouse still has rights, and this model can help improve the success of recovery." B. "You can make decisions for your spouse, if you become the conservator." C. "Do you think your spouse will try to make bad choices for treatment options, because your spouse has an addiction problem?" D. "The health care provider has the final say in the treatment, so your spouse will get the care needed."

"Your spouse still has rights, and this model can help improve the success of recovery."

The nurse is developing the plan of care for a client with suicidal ideations using person-centered care. Which action should the nurse take? A. Ask if the client would feel more safe having inpatient care or making a 24-hour safe contract. B. Ask if the client understands what the Baker Act is. C. Teach the client about the benefits of a newly prescribed antidepressant medication. D. Teach the client about the need for one-to-one care.

Ask if the client would feel more safe having inpatient care or making a 24-hour safe contract.

The nurse is talking with a client at a follow-up visit. The client has been recovering from a substance use disorder for more than 1 year. The client asks, "How do I become a peer support specialist, so I can help others recover?" Which response(s) should the nurse make? Select all that apply. A. "You must become certified in specific competencies." B. "Peer support specialists must have recovered from at least one relapse." C. "Peer support specialists are volunteers." D. "You would need to be comfortable with managing crisis." E. "You must be willing to share your own stories and experiences with others."

A. "You must become certified in specific competencies." C. "Peer support specialists are volunteers." D. "You would need to be comfortable with managing crisis." E. "You must be willing to share your own stories and experiences with others."

The nurse is planning care for a group of clients using the recovery model. Which client(s) would be appropriate for the nurse to include? Select all that apply. A. A client with a history of personality disorder. B. A client recovering from an opioid overdose. C. A client diagnosed with Alzheimer disease D. A client with an eating disorder. E. A client with erectile disfunction.

A. A client with a history of personality disorder. B. A client recovering from an opioid overdose. D. A client with an eating disorder

The nurse is discussing empowerment with a group of people at a community health fair. Which idea(s) should the nurse include in the discussion? Select all that apply. A. A needle exchange program for individuals with substance use disorder. B. Building a basketball court near the park. C. Developing a support group at a church for clients with addiction. D. Lobbying for building a movie theater in town. E. Providing a free education program for families of clients with mental health disorders.

A. A needle exchange program for individuals with substance use disorder. B. Building a basketball court near the park. C. Developing a support group at a church for clients with addiction. E. Providing a free education program for families of clients with mental health disorders.

The nurse is developing the care plan for a client with a substance use disorder using person-centered care. Which intervention(s) should the nurse include in the client's plan of care? Select all that apply. A. Refer the client for inpatient therapy. B. Determine if the client would prefer to have family members involved in the plan. C. Assess the client's willingness to participate in recovering. D. Provide the client with a list of support groups available in the community. E. Educate the client about how addiction works in the body.

B. Determine if the client would prefer to have family members involved in the plan. C. Assess the client's willingness to participate in recovering. D. Provide the client with a list of support groups available in the community.

The nurse is assessing a client in the emergency department who appears disheveled and anorexic and is malodorous. The client states, "I do not need your help, I am doing just fine on my own with all my stuff. Besides nobody wants to give a crazy person a job or apartment." Which action(s) should the nurse take? Select all that apply. A. Discuss implementing a paternalistic model of care with the health care provider. B. Focus on implementing person-centered care. C. Assist the client with receiving "Housing First" benefits. D. Establish a therapeutic nurse-client relationship. E. Document self-stigma as a barrier to the client's recovery.

B. Focus on implementing person-centered care. C. Assist the client with receiving "Housing First" benefits. D. Establish a therapeutic nurse-client relationship. E. Document self-stigma as a barrier to the client's recovery.

The nurse is leading a support group on the mental health unit. Which action should the nurse take first? A. Empower each client to share as much or as little as desired within the group. B. Promote comfort by allowing each client to find a place to sit that makes the client comfortable with in the room. C. Establish a connection by greeting each client by name and thanking each for joining the group. D. Encourage each client to invite a peer support person to come with him or her to the group sessions.

Establish a connection by greeting each client by name and thanking each for joining the group.

The nurse is discharging a client from inpatient mental health treatment to a halfway house and has referred a peer support specialist to assist the client. Which has the nurse demonstrated? A. Stigma resilience B. Shared decision-making model C. Stage 4 of the five-stage process in homeless rehabilitation D. Stage 3 of the five-stage process in homeless rehabilitation

Stage 4 of the five-stage process in homeless rehabilitation

The nurse is screening clients for risk factors associated with limited or no access to health care. Which client should the nurse identify as having the highest risk? A. The 5-year-old child who lives in the city and requires treatment for leukemia. B. The 10-year-old child who lives on a farm and requires treatment for depression. C. The 23-year-old client who is a veteran and requires treatment for post- traumatic stress disorder (PTSD). D. The 20-year-old client who is homeless and requires treatment for diabetes mellitus.

The 10-year-old child who lives on a farm and requires treatment for depression.

The nurse at a local clinic is caring for the following clients. Which client should the nurse recognize as being homeless and unsheltered? A. The client who sleeps in a friend's car at night. B. The client sleeping in a sleeping bag under a tree in the park. C. The client who looks for coins at the beach all day and sleeps on a bench in the pavillion. D. The client who sleeps in a tent during the day and at night digs through trash cans for food.

The client sleeping in a sleeping bag under a tree in the park.

The nurse is caring for a client with depression who was admitted for a substance use disorder. The nurse is using recovery oriented nursing care. Which goal would be the most appropriate for the client's care? A. To prevent re-admission B. To have the client achieve stigma resilience C. To empower the client to maintain recovery D. To provide person-centered care

To empower the client to maintain recovery

The nurse is caring for a client who was homeless and is being treated for mental illness. The nurse has requested a referral for a social worker to assist in establishing housing for the client after discharge. The nurse understands that housing is essential for which goal? A. To teach the client to maintain independence B. To reduce the client's risk of committing crimes C. To prevent the client from future re-admissions D. To establish the first level of Maslow's hierarchy of needs

To establish the first level of Maslow's hierarchy of needs

The nurse is caring for a client who wants to actively participate in the plan of care. Which action should the nurse take? A. Discuss the informed choice model with the client. B. Include the concept of empowerment when planning the client's care. C. Use the shared decision-making model when planning the client's care. D. Discuss the paternalistic model with the client.

Use the shared decision-making model when planning the client's care.

The nurse is caring for a client who has a history of several re-admissions for nonadherence to medications. Which action by the nurse would best help the client with medication adherence? A. Using a person-centered approach. B. Gaining the client's trust before informing the client about the plan of care. C. Asking why the client failed to adhere to the medication regimen. D. Including a support person from home in the client's plan of care.

Using a person-centered approach.

The nurse is planning short-term goals for a client to improve the client's self-esteem and treatment compliance. Which action by the nurse would assist the client to achieve these goals? A. Using shared decision-making model to plan the client's care. B. Using the informed choice model to plan the client's care. C. Referring the client for peer support after discharge. D. Assisting the client in finding employment after discharge.

Using shared decision-making model to plan the client's care.