Milieu Therapy/ Treatment Modalities: Mental Health Nursing (Exam#1)

What does milieu therapy emphasize? a. Social skills b. Living conditions c. Physiological needs d. Medication adherence

a. Social skills ~ Milieu therapy maintains the client's environment in order to produce a behavioral change. This is done with the help of interpersonal interactions. Therefore, the emphasis is on social skills.

While performing a milieu therapy, the nurse provides a structured schedule of activities to a client with complicated grieving. Which outcome in the client indicates the effectiveness of the therapy? a. The client will develop social skills. b. The client will redirect his or her thinking about the loss. c. The client will analyze his or her own work to recognize and resolve underlying conflict. d. The client will demonstrate problem-solving ability

a. The client will develop social skills.

How should the nurse promote a client's connection with community life during milieu therapy? Select all that apply. a. Encouraging the client to share meals with family members b. Allowing the client to attend movies with peer groups c. Encouraging the client to visit a nearby zoo d. Allowing the client to participate in shopping activities e. Involving the client in the decision-making and problem-solving process

b. Allowing the client to attend movies with peer groups c. Encouraging the client to visit a nearby zoo d. Allowing the client to participate in shopping activities

The nursing instructor is explaining the responsibilities of a psychiatric clinical nurse specialist to the student nurse. Which statement made by the student nurse needs correction? a. "A psychiatric clinical nurse specialist is concerned with the client's social needs." b. "A psychiatric clinical nurse specialist presents educational programs for the nursing staff." c. "A psychiatric clinical nurse specialist conducts individual, group, and family therapy." d. "A psychiatric clinical nurse specialist provides consultation services to nurses who require assistance."

a. "A psychiatric clinical nurse specialist is concerned with the client's social needs." ~ The psychiatric social worker is concerned with the client's social needs, not the psychiatric clinical nurse specialist. This statement by the student nurse requires correction.

Question 3. The nursing instructor is teaching a group of nursing students about the program of the therapeutic community. Which statements made by the nursing students requires correction? Select all that apply. a. "Only two or three members of the interdisciplinary treatment (IDT) should sign the treatment plan." b. "The clinical psychologist should perform the initial assessment to establish the priority of care." c. "All team members of the therapeutic community should meet regularly to update the plan as needed." d. "The nurse should assume the responsibility for the management of the therapeutic milieu." e. "The information from the initial nursing assessment should be used to create the IDT plan."

a. "Only two or three members of the interdisciplinary treatment (IDT) should sign the treatment plan." b. "The clinical psychologist should perform the initial assessment to establish the priority of care."

What are the roles and responsibilities of a staff psychiatric nurse? Select all that apply. a. Assisting the client in daily activities b. Developing a relationship with the client c. Administering medications to the client d. Conducting group therapy e. Diagnosing the medical condition of the client

a. Assisting the client in daily activities b. Developing a relationship with the client c. Administering medications to the client

A nurse is planning care for the termination phase of a nurse-client relationship. Which of the following actions should the nurse include in the plan of care? a. Discussing ways to use new behaviors b. Practicing new problem-solving skills c. Developing goals d. Establishing boundaries

a. Discussing ways to use new behaviors

What aspects should the nurse include in the teaching plan for a client with a personality disorder in a therapeutic milieu? Select all that apply. a. Information on medical diagnoses b. Stress management techniques c. Mechanism of action for prescribed medications d. Importance of taking medications as prescribed e. Importance of cultural and spiritual beliefs

a. Information on medical diagnoses b. Stress management techniques d. Importance of taking medications as prescribed

What is the responsibility of the psychiatric nurse in a therapeutic community? a. Performing ongoing assessment of client's condition b. Interpreting psychological tests c. Conducting in-depth psychosocial history d. Working with the client to assist in activities of daily living

a. Performing ongoing assessment of client's condition

Which information should the nurse include about medications while teaching a client with behavioral disorder when working in the therapeutic milieu? Select all that apply. a. Reason for taking medications b. Improper use of higher doses of medications c. Harmless side effects of medications d. Side effects of medications that should be reported to the physician e. Drug label information

a. Reason for taking medications c. Harmless side effects of medications d. Side effects of medications that should be reported to the physician

What should be the minimal educational credentials required for an interdisciplinary treatment team member who administers medication to psychiatric clients? a. Registered nurse with a hospital diploma b. Graduate degree in psychology and social work c. College degree with advanced education in theology d. Master's degree in social work

a. Registered nurse with a hospital diploma

What should be the immediate nursing intervention if the client shows regression in the treatment regimen? a.Encourage the client to participate in the decision-making process. b. Assign a responsibility according to his or her level of ability. c. Emphasize interpersonal interaction and communication with other clients. d. Instruct the client to discuss the regressive behavior at a community meeting.

b. Assign a responsibility according to his or her level of ability.

What conditions are required to be met when preparing a separate nursing care plan in addition to the interdisciplinary treatment plan? Select all that apply. a. It should omit information from the initial nursing assessment. b. It should reflect the diagnoses that are specific to nursing. c. It should be done in all the treatment facilities. d. It should include interventions specifically assigned to nursing. e. It should omit the problems from the interdisciplinary treatment plan.

b. It should reflect the diagnoses that are specific to nursing. d. It should include interventions specifically assigned to nursing.

Which health-care professionals are parts of the interdisciplinary team that conducts the initial assessment of a client with a psychiatric disorder? Select all that apply. a. Artist b. Nurse c. Musician d. Dramatist e. Psychiatrist

b. Nurse e. Psychiatrist

Which interdisciplinary treatment team member focuses on one-to-one relationship development with the client? a. Psychodramatist b. Psychiatric nurse c. Recreational therapist d. Psychiatric clinical nurse specialist

b. Psychiatric nurse

Which member of the psychiatric care unit assists the clients in all therapeutic activities as required? a. Chaplain b. Psychiatric nurse c. Mental health technician d. Psychiatric clinical nurse specialist

b. Psychiatric nurse

Which member of the psychiatric team is responsible for managing therapeutic milieu on a 24-hour basis? a. Chaplain b. Psychiatric nurse c. Occupational therapist d. Psychiatric clinical nurse specialist

b. Psychiatric nurse

A nurse is in the working phase of the therapeutic relationship with a client who has methamphetamine use disorder. Which of the following actions indicates transference behavior? a. The client asks the nurse whether she will go out to dinner with him b. The client accuses the nurse of telling him what to do, just like his ex-girlfriend c. The client reminds the nurse of a friend who died of a substance overdose d. The client becomes angry and threatens to harm himself

b. The client accuses the nurse of telling him what to do, just like his ex-girlfriend

A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements should the nurse make? a. "I feel very sorry for the loneliness you must be experiencing" b."Suicide is not the appropriate way to cope with loss" c. "Losing someone so close to you must be very upsetting" d. "I know how difficult it is to lose a loved one"

c. "Losing someone so close to you must be very upsetting"

The nursing instructor is discussing Skinner's assumptions about how a therapeutic community is based. Which statement made by the student nurse indicates the need for correction? a. "Every client owns his or her environment." b. "Clients should be encouraged to improve their health." c. "Peer pressure hinders the client's development." d. "An opportunity for therapeutic intervention may be found in every interaction."

c. "Peer pressure hinders the client's development." ~ Peer pressure is an influence on the client to bring out a change in attitude, behavior, and thoughts. Therefore, this statement made by the student nurse indicates the need for correction.

A nurse is orientating a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements should the nurse make? a. "You and a group of the other clients will meet to discuss your treatment plans" b. Community meetings have a specific agenda that is established by staff" c. " You and other clients meet with staff to discuss common problems" d. "Community meetings are an excellent opportunity to explore your personal mental health issues"

c. "You and other clients meet with staff to discuss common problems"

What information is required to prepare an interdisciplinary treatment (IDT) plan for a client with a psychotic disorder in therapeutic milieu? a. Information about the medical diagnosis b. Information about cultural and spiritual needs c. Information from the initial nursing assessment d. Information from community and family resources Rationales

c. Information from the initial nursing assessment

A charge nurse is discussing the characteristics of a nurse-client relationship with a new nurse. Which of the following characteristics should the nurse include in the discussion? a. The needs of both participants are met b. An emotional commitment exists between participants c. It is goal-directed d. Behavioral change is encouraged e. A termination date has been established

c. It is goal-directed d. Behavioral change is encouraged e. A termination date has been established

Which health-care professional is responsible in an interdisciplinary team to ascertain that the client's physiological needs are met? a. Psychiatrist b. Psychodramatist c. Psychiatric nurse d. Clinical psychologist

c. Psychiatric nurse

Which therapy would best help in redirecting the client's destructive energy? . a. Use of art therapy b. Use of music therapy c. Use of recreational therapy d. Use of occupational therapy

c. Use of recreational therapy

Which statement made by the nurse while interacting with a client helps to develop a trusting relationship? a. "I will put up signs and orientation boards to assist you." b. "I will help you to take your medicines on time." c. "I will teach you about your medical condition." d. "I will listen to you if you want to discuss your feelings."

d. "I will listen to you if you want to discuss your feelings."

Which statement made by the student nurse indicates effective learning about fluid group work? a. "It is a multitude of complex interactions that occur only between staff members and visitors." b. "It is a multitude of complex interactions that occur only between clients and staff members." c. "It is a multitude of complex interactions that occur only between clients and visitors." d. "It is a multitude of complex interactions that occur between clients, staff members, and visitors."

d. "It is a multitude of complex interactions that occur between clients, staff members, and visitors."

A client in the milieu unit tells the nurse, "I think it's stupid to close the front gate at 10 pm. We should be allowed to be out until midnight." How should the nurse respond to this client? a. "Some people go to bed early. You will be disturbing them when you come in late making noise." b. "You must discuss this in the community meeting." c. "You should know the rules of the community." d. "You are not the only person in the unit. Decisions are made as a group."

d. "You are not the only person in the unit. Decisions are made as a group."