Evolve ?s Ch 1 Mental Health and Mental Illness

A nurse's identification badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "What does that title mean?" The nurse responds best by answering:

a. "Don't be afraid; it means I'm here to help, not hurt, you." b. "Psychiatric mental health nurses care for people with mental illnesses." c. "We have the specialized skills needed to care for those with mental illnesses." d. "The nurses who work in mental health facilities have that title." C. 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.

You are caring for Kiley, a 29-year-old female patient who is being admitted following a suicide attempt. Which of the following illustrates the concept of patient advocacy?

A. "Dr. Raye, I notice you ordered Prozac for Kiley. She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed." B. "Dr. Raye, during her admissions interview Kiley stated that she has had three other suicide attempts in the past." C. "Kiley, can you tell me more about your depression and your suicide attempt?" D. "Kiley, I will take you on a tour of the unit and orient you to the rules." A. By letting the provider know that the patient does not want the treatment the provider is prescribing, you have advocated for the patient and her right to make decisions regarding her treatment. The other selections do not describe patient advocacy.

You have graduated with your BSN degree and have taken your first job on a psychiatric unit after becoming a licensed Registered Nurse. You are providing teaching to Mason, a newly admitted patient on the psychiatric unit, regarding his daily schedule. Which of the following would not be an appropriate teaching statement?

A. "You will participate in unit activities and groups daily." B. "You will be given a schedule daily of the groups we would like you to attend." C. "You will attend a psychotherapy group that I lead." D. "You will see your provider daily in a one-to-one session." C. Basic level RNs cannot perform psychotherapy. The other options are all appropriate expectations of a patient's schedule on a psychiatric unit.

A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking?

A. Control over behavior B. Appraisal of reality C. Effectiveness in work D. Healthy self-concept B. The appraisal of reality is lacking for this client. The client does not have a picture of what is happening around himself or herself.

Which of the following best demonstrates parity related to mental health care?

A. The client is admitted for a 72-hour mental hygiene evaluation. B. Advance practice nurse can be certified as psychiatric nurse specialist. C. A client's mental health coverage is equal to his medical/surgical coverage. D. A client who has attempted sucide is hospitalized for a mental health evaluation. C. 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.

In order to best differentiate whether an Asian client is demonstrating a mental illness when attempting suicide is to

A. ask the client whether he views himself as being depressed. B. identify his culture's view regarding suicide. C. explain to him that suicide is often regarded as a desperate act. D. assess the client for other examples of depressive behaviors. B. 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.

A nurse who is active in local consumer mental health groups and in local and state mental health associations and who keeps aware of state and national legislation affecting mental illness treatment may positively affect the climate for treatment by:

A. becoming active in politics leading to a potential political career. B. reducing the stigma of mental illness and advocating for equality in treatment. C. encouraging laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons. D. advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions. B. 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.

According to the DSM-5, there is evidence that symptoms and causes of mental illness are influenced by:

A. cultural and ethnic factors. B. occupation and status. C. birth order. D. sexual preference. A. The DSM-5 states there is evidence to suggest that mental illness is influenced by cultural and ethnic factors. The DSM-5 does not state that there is evidence that occupation, birth order, or sexual preference affect mental illness.

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 that he is

A. demonstrating symptoms of bipolar disorder. B. socially deviant. C. egocentric. D. not demonstrating any definitive signs of mental illness. D. One myth about mental illness is that to be mentally ill is to be different and odd. Another misconception is that to be healthy, a person must be logical and rational. Everyone dreams "irrational" dreams at night, and "irrational" emotions are universal human experiences and are essential to a fulfilling life. Some people who show extremely abnormal behavior and are characterized as mentally ill are far more like the rest of us than different from us. No obvious and consistent line between mental illness and mental health exists.

One characteristic of mental health that allows people to adapt to tragedies, trauma, and loss is:

A. dependence. B. resilience. C. pessimism. D. altruism. B. Resilience is a characteristic that helps individuals cope with loss and trauma that may occur in life. Dependence is described as being dependent 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.

The nurse planning care for a mentally ill client bases interventions on the concept that the client

A. has areas of strength on which to build. B. has right that must be respected. C. comes with experiences that contribute to their problem. D. share fears that are similar to those of all mentally healthy individuals. A. 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.

A 14-year-old belongs to a neighborhood gang, engages in sexually promiscuous behavior, and has a history of school truancy but reports that her parents are just old- fashioned and don't understand her. The assessment data supports that the client

A. is displaying deviant behavior. B. cannot accurately appraise reality. C. is seriously and persistently mentally ill. D. should be considered for group home placement. A. This client is demonstrating deviant behavior. This client demonstrates undersocialized, aggressive behavior such as a repetitive and persistent pattern of aggressive conduct in which the basic rights of others are violated.

A nursing diagnosis for a client with a psychiatric disorder serves the purpose of

A. justifying the use of certain psychotropic medication. B. providing data essential for insurance reimbursement. C. providing a framework for selecting appropriate interventions. D. completing the medical diagnostic statement. C. Nursing diagnoses provide the framework for identifying appropriate nursing interventions for dealing with the phenomena a client with a mental health disorder is experiencing.

The mental health status of a particular client can best be assessed by considering

A. the degree of conformity of the individual to society's norms. B. the degree to which an individual is logical and rational. C. placement on a continuum from health to illness. D. the rate of intellectual and emotional growth. C. 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.

Which statement best describes the DSM-5?

a. It is a medical psychiatric assessment system. b. It is a compendium of treatment modalities. c. It offers a complete list of nursing diagnoses. d. It suggests common interventions for mental disorders. A. The DSM-5 is a classification of mental disorders that includes descriptions and criteria of diagnoses.

Which statement about diagnosis of a mental disorder is true?

a. The symptoms of each disorder are common among all cultures. b. Culture may cause variations in symptoms for each clinical disorder. c. All mental disorders listed in the DSM-5 are seen in all other cultures. d. Psychiatric diagnoses are listed in separately from other physical disorders in a five axes system. B. Every society has its own view of health and illness and the types of behavior categorized as mental illness. Culture also influences the symptoms of a particular disorder. For example, individuals of certain cultures are more likely to express depression through somatic symptoms than through affect and feeling tone. The five axes system was abandoned in this edition of the DSM-5.

These severe mental illnesses are recognized across cultures:

a. antisocial and borderline personality disorders. b. schizophrenia and bipolar disorder. c. bulimia and anorexia nervosa. d. amok and social phobia. B. Worldwide studies indicate that both schizophrenia and bipolar disorder are recognized cross-culturally.

Current information suggests that the most disabling mental disorders are the result of

a. biological influences. b. psychological trauma. c. learned ways of behaving. d. faulty patterns of early nurturance. A. 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.

Which branch of epidemiology is the nurse involved in when seeking outcomes for patients whose depression was treated with electroconvulsive therapy (ECT)?

a. experimental b. descriptive c. clinical d. analytic C. 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.

The prevalence rate over a 12-month period for major depressive disorder is

a. lower than the prevalence rate for panic disorders. b. greater than the prevalence rate for psychotic disorders. c. equal to the prevalence rate for psychotic disorders. d. greater than the prevalence rate for generalized anxiety. D. Statistics show that the prevalence rate over a 12-month period for major depressive disorder is 6.7%, and the lifetime prevalence rate for generalized anxiety is 3.1%.

The quantitative study of the distribution of mental disorders in human populations is called

a. mortality. b. prevalence. c. epidemiology. d. clinical epidemiology. C. 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.