Chapter 4: Treatment Settings and Therapeutic Programs

Which areas of discharge planning are important to ensuring client safety? Select all that apply. Medication education Social status Special diet instructions Food-drug interactions Payment of care

Medication education Food-drug interactions Special diet instructions Medication education, food-drug interactions, drug-drug interactions, and special diet instructions (if applicable) are extremely important in ensuring client safety. Ability to pay for care and social status are not directly related to patient safety.

The nurse provides care to a client who requires crisis stabilization in a short-term inpatient setting. Which is the priority focus of care for this client? psychoeducation symptom management group psychotherapy seclusion

symptom management Explanation: When the immediate crisis does not resolve quickly, crisis stabilization is the next step. This type of care usually lasts fewer than 7 days and has a symptom-based indication for hospital admission. The primary purpose of stabilization is control of precipitating symptoms through medications, behavioral interventions, and coordination with other agencies for appropriate aftercare. The major focus of nursing care in a short-term inpatient setting is symptom management. Seclusion and the use of restraints should never be the focus of care; however, these interventions may be required for aggressive or violent clients. Psychoeducation and group psychotherapy may be included with crisis stabilization; however, these are not the priority focus of care

Which client is suitable for psychiatric transitional care services? An individual being discharged from hospital with residual symptoms of mania Schizophrenic woman found living under the freeway Adolescent with conduct disorder who took an overdose of alprazolam Paralyzed Vietnam veteran who is experiencing increasing respiratory difficulties and chronic infections

An individual being discharged from hospital with residual symptoms of mania A homebound individual with bipolar illness who is having subacute symptoms would be the perfect candidate for home care services. The paralyzed veteran, the adolescent who took an overdose, and the schizophrenic woman under the freeway should receive home care due to the acuity of their situations.

Which program provides comprehensive, highly individualized consumer services to those with severe and persistent mental illness? Clubhouse treatment Assertive community treatment Fairweather treatment Community living treatment

Assertive community treatment Assertive community treatment (ACT) is a service delivery model that provides comprehensive, locally based treatment to people with serious and persistent mental illness. Unlike other community-based programs, ACT is not a linkage or brokerage case-management program, but it is a direct provider of highly individualized consumer services.

The most diverse role for the nurse within community based psychiatric mental health care would most probably be what

Case Manager

Coordination of care uses services that enable individualized care. Which type of service is also known as the "broker" model? Respite residential care Crisis intervention Case management Partial hospitalization

Case management Coordinated care is often accomplished through a case management service model in which a case manager locates services, links the patient with them, and then monitors the patient's receipt of these services. This type of case management is referred to as the "broker" model. Crisis intervention, partial hospitalization, and respite residential care are not known as the "broker" model.

Which client may be the most appropriate candidate for telepsychiatry? An inpatient who is on visual checks every 15 minutes as a suicide precaution A client who has been brought to the emergency department because of acute psychosis A client with bipolar disorder who has been admitted to the hospital during a manic episode A client whose depression does not warrant inpatient or outpatient care but who is motivated to maintain the client's health

A client whose depression does not warrant inpatient or outpatient care but who is motivated to maintain the client's health Cybertherapy may be most appropriate for persons who do not qualify for therapeutic intervention but who are motivated for treatment. Acute illnesses are not likely to be effectively treated by this method.

A forensic nurse working in a prison must view all clients as people who deserve respect and professionalism. What should the nurse do to enforce this viewpoint? Conduct thorough physical assessments of clients. Conduct ongoing self-reflection and self-awareness. Apply religious beliefs to patient care. Apply the nurse's morals and values to everyone. /fờ rén sik/ phap y

Conduct ongoing self-reflection and self-awareness. Nurses who are successful in forensic nursing view clients as people who deserve respect and professionalism. Being able to adopt a therapeutic role requires ongoing self-reflection and self-awareness.

Which is an example of secondary prevention in the forensic setting? Advocacy Case management Rehabilitation Crisis intervention

Crisis intervention Crisis intervention is considered secondary prevention. Rehabilitation and case management are tertiary preventions. Advocacy is a primary prevention.

The introduction of psychotropic medications occurred in which decade? 1940s 1970s 1950s 1960s

1950s The introduction of psychotropic medication occurred in the 1950s.

How does the rate of suicide among active and veteran military personnel compare to that of the civilian population? 2% lower 2 times higher Equal 3 times lower

2 times higher The prevalence of disorders such as posttraumatic stress disorder and major depression among active duty military service members is greater than their civilian counterparts. There is also an increased rate of suicide— twice that of civilians—homicide, injury, and physical illness.

Which best defines a community support system in relation to mental illness? An organized system of group housing arrangements designed to support the deinstitutionalization of the mentally ill A network of 12-step programs and support groups A system of interventions designed to affect macrosystem variables that discriminate against people with mental illness A network that helps to meet the needs of people with mental illness and to realize their potential without unnecessary isolation

A network that helps to meet the needs of people with mental illness and to realize their potential without unnecessary isolation A community support system is a network of people committed to helping a vulnerable population meet its needs and reach its potentials without unnecessary isolation or exclusion.

Which best describes the scope of what community support services provide? Crisis intervention assistance and referral Help with instrumental activities of daily living, such as money management, transportation, and employment opportunities A wide range of services, from health care and education to housing arrangements, employment counseling, and rehabilitation Mental health counseling and medication management

A wide range of services, from health care and education to housing arrangements, employment counseling, and rehabilitation A community support system creates and delivers community-based care to a specific population that traditionally required long-term hospitalization. It includes a range of services: health care, mental health care, rehabilitation, social networks, housing arrangements, and educational and employment opportunities.

A nursing student is preparing for a debate with another student about e-mental health. Which would the nurse include to support its use? Ability to provide services in a variety of locations Improvement in therapeutic relationship Ensured quality of care Ability to provide high-intensive services for many mental illnesses

Ability to provide services in a variety of locations E-mental health services can be delivered in a variety of locations, such as schools, places of employment, and clinics. Although the use of e-mental health applications is increasing, concerns have been expressed about using the Internet for the delivery of mental health care. Difficulties may occur in developing a therapeutic client-provider relationship via the Internet. There are concerns about the ability to ensure the quality of online mental health interventions. Client privacy and confidentiality may be compromised in a web-based, e-mental health application. In addition, the Internet is often not available to subpopulations of clients with chronic and severe mental illnesses who require high-intensity services, such as those diagnosed with schizophrenia.

A nursing student is preparing for a debate with another student about e-mental health. Which would the nurse include to support its use? Ability to provide services in a variety of locations Improvement in therapeutic relationship Ability to provide high-intensive services for many mental illnesses Ensured quality of care

Ability to provide services in a variety of locations Explanation: E-mental health services can be delivered in a variety of locations, such as schools, places of employment, and clinics. Although the use of e-mental health applications is increasing, concerns have been expressed about using the Internet for the delivery of mental health care. Difficulties may occur in developing a therapeutic client-provider relationship via the Internet. There are concerns about the ability to ensure the quality of online mental health interventions. Client privacy and confidentiality may be compromised in a web-based, e-mental health application. In addition, the Internet is often not available to subpopulations of clients with chronic and severe mental illnesses who require high-intensity services, such as those diagnosed with schizophrenia.

Which is the most restrictive setting in the continuum? Acute inpatient hospitalization Crisis intervention Residential care Partial hospitalization

Acute inpatient hospitalization Of the settings listed, acute inpatient hospitalization involves the most intensive treatment and is considered the most restrictive setting in the continuum. Inpatient treatment is reserved for acutely ill clients who, because of a mental illness, meet one or more of three criteria: (1) high risk for harming themselves, (2) high risk for harming others, or (3) unable to care for their basic needs.

Which is the most restrictive setting in the continuum? Crisis intervention Residential care Partial hospitalization Acute inpatient hospitalization

Acute inpatient hospitalization Explanation: Of the settings listed, acute inpatient hospitalization involves the most intensive treatment and is considered the most restrictive setting in the continuum. Inpatient treatment is reserved for acutely ill clients who, because of a mental illness, meet one or more of three criteria: (1) high risk for harming them

A nurse has transferred recently to a forensic practice setting from an acute care medical setting. During the orientation period, the nurse's mentor helps the nurse learn the culture of a forensic setting. The nurse learns to be alert to one of the most dominant barriers to building a therapeutic relationship with forensic clients. What is this barrier? Nurses often transgress professional boundaries with the clients. The lifestyle of the incarcerated client is solitary. Clients commonly struggle with trusting others. Clients are transferred frequently to other forensic institutions.

Clients commonly struggle with trusting others. Recurring themes of power and control, negotiation, and trust building dominate therapeutic interventions in this setting; clients have, in varying degrees, learned to adapt to an environment that rewards distrust, manipulation, and deceit. The criminal history, frequent diagnoses of antisocial and borderline personality disorder, and aggressive interpersonal style of many forensic clients can evoke strong emotional responses, and countertransference and splitting reactions are common.

A nurse has transferred recently to a forensic practice setting from an acute care medical setting. During the orientation period, the nurse's mentor helps the nurse learn the culture of a forensic setting. The nurse learns to be alert to one of the most dominant barriers to building a therapeutic relationship with forensic clients. What is this barrier? The lifestyle of the incarcerated client is solitary. Clients commonly struggle with trusting others. Nurses often transgress professional boundaries with the clients. Clients are transferred frequently to other forensic institutions.

Clients commonly struggle with trusting others. Explanation: Recurring themes of power and control, negotiation, and trust building dominate therapeutic interventions in this setting; clients have, in varying degrees, learned to adapt to an environment that rewards distrust, manipulation, and deceit. The criminal history, frequent diagnoses of antisocial and borderline personality disorder, and aggressive interpersonal style of many forensic clients can evoke strong emotional responses, and countertransference and splitting reactions are common.

A nursing instructor informs a class that the trend in the United States today is to receive treatment without institutional-based intervention. What else is true concerning mental health care today? Insurance and Medicaid/Medicare are lenient in regards to payment for this care. Treatment settings for patients with mental illnesses have remained constant the last century. Criteria for admission to inpatient care have become legally regulated. Changes in health care reimbursement have had no effects on outcomes.

Criteria for admission to inpatient care have become legally regulated. Treatment settings for patients with mental illnesses have undergone a paradigm shift in recent years. Changes in health care reimbursement have greatly affected the U.S. behavioral health care system. Insurances and Medicaid/Medicare have affected the level of care given to patients. Criteria for admission to inpatient care have thus become very regulated, which has led to fewer services offered.

A client with psychiatric illness is referred to the day treatment program. Which services should the nurse include while teaching the client about the program? Select all that apply. Training to perform activities of daily living. Periodic prognostic tests. Treatment for comorbid conditions. Development of social skills. Stabilization of symptoms.

Development of social skills. Stabilization of symptoms. Training to perform activities of daily living. Day treatment program (partial hospitalization) provides services for mentally ill clients such as developing social skills, stabilizing psychiatric symptoms, and improving the skills required for activities of daily living. These programs do not perform prognostic testing for mentally ill clients. Services for treating comorbid medical illnesses are not provided in this program.

The nurse is reviewing a client's history, which reveals that the client is participating in a psychiatric rehabilitation program. The nurse understands that which is the goal of this program? Carefully detox from alcohol and substance abuse Promote the ability of clients with serious mental illness to live within the community Provide self-help groups and training in daily living Empower clients to achieve the highest level of functioning possible

Empower clients to achieve the highest level of functioning possible Psychiatric rehabilitation programs, also termed psychosocial rehabilitation, focus on the reintegration of people with psychiatric disabilities into the community through work, education, and social avenues while addressing their medical and residential needs. The goal is to empower clients to achieve the highest level of functioning possible. In-home detoxification promotes careful detoxification from alcohol and sbstances. The Assertive Community Treatment (ACT) model helps individuals with serious mental illness live in the community. Recovery centers assist in the mental health consumer's journey toward recovery by offering self-help groups and training in daily living. In addition, recovery centers offer illness self-management interventions.

The nurse is caring for a group of clients in a residential treatment facility. While the intensive outpatient programs promote education in the areas of stress management and relapse prevention, the residential treatment facility emphasizes what? Ensuring a sustainable living situation Nutritional therapies Drug abuse prevention Spiritual aspects of care

Ensuring a sustainable living situation A client's living environment affects his or her level of functioning, rate of reinstitutionalization, and duration of the remaining time in the community setting. Finding a quality living situation requires ensuring sustainability of the placement as this minimizes the possibility of future hospitalization due to decompensation of mental status.

Which areas of discharge planning are important to ensuring client safety? Select all that apply. Social status Medication education Food-drug interactions Special diet instructions Payment of care

Food-drug interactions Medication education Special diet instructions Medication education, food-drug interactions, drug-drug interactions, and special diet instructions (if applicable) are extremely important in ensuring client safety. Ability to pay for care and social status are not directly related to patient safety. Reference:

The greatest impact case management has had on mental health care is that it has caused what? Has increased client access to appropriate mental health care Has affected public awareness of mental health care needs Has stimulated an interest in professional mental health careers A focus on an illness, not a health paradigm

Has increased client access to appropriate mental health care Case management has increased client access to appropriate mental health services and offers availability of a choice of providers based on the type of care required.

A psychiatric client's nurse case manager best explains to the family that case management will facilitate the client's transition back into the community by providing which services? Identifying and meeting the client's health and human service needs Facilitating reimbursement and coverage by the client's private and public insurances Contacting and maintaining relationships with the client's various service providers Prescribing nursing care directed toward managing the client's acute and chronic health problems

Identifying and meeting the client's health and human service needs Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual client's health and human service needs.

A nurse is developing a community education program for a local women's club on the topic of managed care in mental health. Which topic would the nurse include as the main focus? Individualized care for additional inpatient stays Improved access to less costly services Cost savings Consistent third-party reimbursement

Improved access to less costly services Managed care aims to increase access to care and provide the most appropriate level of services in the least restrictive environment. Efforts focus on providing more outpatient and alternative treatment programs and avoiding costly inpatient hospitalizations. When properly conducted and administered, managed care allows clients better access to quality services while using health care dollars wisely.

Assertive Community Treatment (ACT) reduces the use of which type of service? Detoxification In-patient Hospital Community based Crisis intervention

In-patient Hospital ACT, a community based service, reduces the use of hospital and emergency room services, which in turn reduces the cost of mental health treatment for clients with serious mental illnesses. ACT does not reduce the use of crisis intervention, or detoxification.

A psychiatric-mental health nurse is working as a case manager. The nurse understands that the quality of case management is measured by outcomes that result from what? Level of functioning Improved financial status Provision of the most restrictive environment Emphasis on wellness

Level of functioning Quality is assessed by measuring client outcomes that result from the services, such as level of functioning, community integration, and client satisfaction with the services provided. In the community, the case manager works with clients on a broad range of issues from accessing needed medical and psychiatric services to carrying out activities of daily living. Quality of case management is not measured by improved financial status or provision of the most restrictive environment. Continuum of care spans from illness to wellness states

Which areas of discharge planning are important to ensuring client safety? Select all that apply. Payment of care Social status Special diet instructions Food-drug interactions Medication education

Medication education Food-drug interactions Special diet instructions Medication education, food-drug interactions, drug-drug interactions, and special diet instructions (if applicable) are extremely important in ensuring client safety. Ability to pay for care and social status are not directly related to patient safety.

The Fountain House in New York developed the clubhouse model in the 1940s. Which is an important characteristic of a clubhouse? Members receive mental health treatment from providers in the community. The clubhouse is run by staff members. Membership is time limited. Members live at the clubhouse.

Members receive mental health treatment from providers in the community. Members are encouraged and assisted to use psychiatric services, which are usually local clinics or private practitioners. Membership is not time limited. The clubhouse is run entirely by patients with psychiatric illnesses with minimal assistance from mental health professionals. Generally, members do not live in the clubhouse.

When clients are admitted to inpatient psychiatric settings, which member of the health care team is often the first whom they meet? Psychiatrist Case manager Social worker Nurse

Nurse Explanation: When clients are admitted to inpatient psychiatric settings, nurses often are the first health care providers they meet. Beginning with admission, nurses begin to form rapport with clients and initiate the assessment phase of care.

Which statement regarding those with serious and persistent mental illness (SPMI) is correct? Reinstitutionalization has resulted in many individuals being committed to mental hospitals and asylums. Supplemental Security Income provides enough money for those with mental illness to pay for a home, food, and medication. Opportunities to improve finances are limited or nonexistent because these people lack funds for education, clothing, and transportation. Medicaid funding for those with mental illness has optimized patient care for poor individuals.

Opportunities to improve finances are limited or nonexistent because these people lack funds for education, clothing, and transportation. Reliance on Supplemental Security Income as the major source of financial support allows little opportunity for choices. The average monthly stipend barely meets their rent payments. Unlike the early institutions that housed those with mental illness in hospitals and asylums, the current reinstitutionalization is in both hospitals and jails. Medicaid funding, although limited in noninstitutional settings, remains the primary source for poor people, including most people with SPMI. The result has been inappropriate admissions to nursing facilities and other institutions so that clients can receive appropriate care. Opportunities to improve finances are limited or nonexistent because these people lack funds for education, clothing, and transportation.

Which service aims to achieve client stabilization without hospitalization or a reduced length of inpatient care? Respite residential care 23-hour observation Partial hospitalization Residential services

Partial hospitalization Partial hospitalization programs were developed to complement inpatient mental health care and outpatient services and to provide treatment to clients with acute psychiatric symptoms who are experiencing a decline in social or occupational functioning. A short-term treatment that serves the client in an immediate but short-term crisis is 23-hour observation. This treatment is used for acute trauma, such as rape and alcohol/narcotic detoxification, and for individuals with Axis II personality disorders who present with self-injurious behaviors. Residential services provide a place for people to reside during a 24-hour period, or any portion of the day on an ongoing basis. Sometimes families of a person with mental illness who lives at home may be unable to provide care continuously. Respite residential care can provide short-term necessary housing for the client and periodic relief for the caregivers

Which mental health treatment setting is not a residential treatment setting? Adult foster care Respite Partial hospitalization programs Group homes

Partial hospitalization programs Partial hospitalization programs are designed to help the client make a gradual transition from being inpatients to having independence and to prevent repeat admissions. The remaining options are all settings that are associated with long-term living arrangements.

The goal of respite services as a prevention strategy includes what? Promoting a service to assist individuals with mental illness to achieve independent living Targeting the chronic population of individuals requiring daily monitoring of their behavior and medication adherence Preventing unnecessary long-term hospitalizations due to burnout of informal caregivers Identifying clients who are unable to continue living in their present circumstances

Preventing unnecessary long-term hospitalizations due to burnout of informal caregivers

One goal of transitional care in mental health care is what? Provide intensive monitoring of the client at home Provide crisis intervention services when needed Encourage the parents to participate in the client's care Provide an alternative for inpatient admission

Provide an alternative for inpatient admission The two goals of transitional mental health care are to increase the functionality of the client within the home and to provide an alternative for inpatient admission.

Which are functions of assertive community treatment? Select all that apply. Promotes continuity of outpatient care Reduces inpatient service use Increases the likelihood of relapse Increases the stability of people with serious mental illnesses Decreases availability of services

Reduces inpatient service use Promotes continuity of outpatient care Increases the stability of people with serious mental illnesses Assertive community treatment reduces inpatient service use, promotes continuity of outpatient care, and increases the stability of people with serious mental illness. Assertive community treatment does not increase the likelihood of relapse or decrease the availability of services.

The parents of a young adult diagnosed with schizophrenia are providing care for the client in their home. During a home visit, the parents state, "It's been so difficult taking care of our child. We need a break. But our child needs constant supervision." Which would be appropriate for the nurse to suggest? Respite residential care Partial hospitalization Intensive outpatient program Acute inpatient care

Respite residential care Sometimes families of a person with mental illness who lives at home may be unable to provide care continuously. In such cases, respite residential care can provide short-term, necessary housing for the client and provide periodic relief for the caregivers. This would be the most appropriate suggestion in this case and would provide the client with the least restrictive environment. Partial hospitalization programs provide treatment to clients with acute psychiatric symptoms who are experiencing a decline in social or occupational functioning, who cannot function autonomously on a daily basis, or who do not pose imminent danger to themselves or others. This would be appropriate if the client was experiencing any of these, but the major concern here is giving the parents some relief. Acute inpatient care is the most restrictive and is reserved for acutely ill clients. Intensive outpatient programs focus on stabilization and relapse prevention for highly vulnerable individuals who function autonomously on a daily basis. This client requires constant supervision.

The parents of a client with a mental illness being cared for at home tell the nurse that they have been feeling overwhelmed lately. They say, "We need to get away for a few days to recharge ourselves." Which care setting should the nurse recommend? Recovery center Psychosocial rehabilitation Respite residential care Assertive community treatment (ACT)

Respite residential care Sometimes the family of a person with mental illness who lives at home may be unable to provide care continuously. In such cases, respite residential care can provide short-term, necessary housing for the client and provide periodic relief for the caregivers. The ACT model is a multidisciplinary clinical team approach providing 24-hour, intensive community-based services. The ACT model helps individuals with serious mental illness live in the community. Psychiatric rehabilitation programs, also termed psychosocial rehabilitation, focus on the reintegration of people with psychiatric disabilities into the community through work, education, and social avenues, all while addressing their medical and residential needs. Recovery centers assist in the mental health consumer's journey toward recovery by offering self-help groups and training in daily living. In addition, recovery centers offer illness self-management interventions, such as Wellness Recovery Action Planning (WRAP).

Which type of care provides periodic relief to caregivers of a mentally ill client? Acute inpatient care Respite residential care Crisis stabilization Partial hospitalization

Respite residential care Explanation: Sometimes family members of a person with mental illness who lives at home may be unable to provide care continuously. In such cases, respite residential care can provide short-term, necessary housing for the client and provide periodic relief for the caregivers.

One major reason that clients with mental disorders are rehospitalized is what? Need for close supervision by medical personnel Resurfacing of acute symptoms Diagnosis of comorbid diseases Severe side effects of antipsychotic agents

Resurfacing of acute symptoms One major reason that clients with mental disorders are rehospitalized is the relapse of mental illness and substance abuse.

One major reason that clients with mental disorders are rehospitalized is what? Need for close supervision by medical personnel Resurfacing of acute symptoms Severe side effects of antipsychotic agents Diagnosis of comorbid diseases

Resurfacing of acute symptoms One major reason that clients with mental disorders are rehospitalized is the relapse of mental illness and substance abuse.

The nurse is conducting an admission assessment on a client in a forensic setting. Which is a priority care issue? Conditional release plan Recovery oriented care Discussion of crimes Risk assessment

Risk assessment Explanation: Risk assessment is an important determination to maintain the safety of the client and others. The data obtained in the risk assessment, including the client's known history, habits, legal status, and triggers, are used to develop an individualized treatment plan. In some institutions, risk assessment determines the type of facility for the client. Discussion of crimes is not appropriate because it may block the development of an effective therapeutic relationship. Conditional release plans are reserved for those individuals who have been stabilized and are not considered a danger. Recovery oriented care is important, but begins after the development of an individualized treatment plan to help the individual maintain optimal mental health after discharge.

A client is referred to a psychosocial rehabilitation program. When explaining this type of care to the client, what would the nurse emphasize? Intensive treatment that prepares the client to live in the community Detoxification services for alcohol and drugs in an outpatient setting Services that promote the client's reintegration into the community Frequent monitoring within a therapeutic milieu for relapse prevention

Services that promote the client's reintegration into the community Psychosocial rehabilitation or psychiatric rehabilitation programs focus on reintegrating people with psychiatric disabilities into the community through work, education, and social avenues while also addressing their medical and residential needs. The goal is to empower clients to achieve the highest level of functioning possible. Intensive treatment that prepares the client to live in the community reflects the focus of assertive community treatment. Outpatient detoxification provides detoxification services for alcohol and drugs in an outpatient setting. Intensive outpatient programs provide frequent monitoring and social support within a therapeutic milieu to enable the client to remain connected to the community.

A client is to be admitted to an inpatient psychiatric unit on an involuntary basis because the client has threatened to kill the client's spouse. The nurse should explain to the client's family members that the primary focus of the client's hospitalization is what? Provide 24-hour supervision Provide long-term therapy Provide rehabilitative services Stabilize acute symptoms

Stabilize acute symptoms The focus of a crisis stabilization stay is to stabilize the client's acute symptoms through medications and behavioral interventions. This type of care usually lasts fewer than 7 days and has a symptom-based indication for hospital admission.

The nurse explains that the primary criterion for enrollment in a day treatment program for clients with eating disorders is what? Diagnosis interferes with employability Treatment plan can be completed in less than 3 months Family home can be returned to each evening Symptom acuity does not require psychiatric hospitalization

Symptom acuity does not require psychiatric hospitalization The nurse explains that the primary criterion for enrollment in a day treatment program for clients with eating disorders is that their symptomology does not require psychiatric hospitalization. The other options do not describe the primary criterion for enrollment in a day treatment program.

A client is receiving crisis stabilization in an inpatient facility. The nurse would focus care on what? Discharge planning Psychoeducation Symptom stabilization Recovery

Symptom stabilization When the immediate crisis does not resolve quickly, crisis stabilization is the next step. This type of care usually lasts fewer than 7 days and has a symptom-based indication for hospital admission. The primary purpose of stabilization is control of precipitating symptoms through medications, behavioral interventions, and coordination with other agencies for appropriate after-care. The major focus of nursing care in a short-term inpatient setting is symptom management.

A patient scheduled to be released from prison in 1 month has been assigned a case manager and has been meeting with her 3 times a week. This is an example of which level of prevention? Primary Secondary Tertiary Chronic

Tertiary Case management is an example of tertiary prevention in the forensic setting.

A 47-year-old client missed 1 week of work while hospitalized with bipolar disorder. The client was placed on medication and was able to return to work. When asked, the client informed coworkers that the absence was due to influenza. What is the most likely reason the client lied about the illness? The client feared rejection, isolation, and discrimination. The client did not wish to elicit sympathy among coworkers. The medication is not effectively treating the illness. The workplace policies encourage the firing of those with mental illnesses.

The client feared rejection, isolation, and discrimination. Strong stigma still attaches to people who suffer from mental illness, largely related to public misunderstandings, misconceptions, and associated fears. At a personal level, people with mental illness must deal with painful rejection, isolation, and discrimination that erodes self-assurance and can systematically undermine self-confidence. Stigma creates or reinforces interpersonal, financial, employment, and social barriers to accessing care.

Which goal for an individual client is consistent with the overall objectives of community support service programs? The client will move from a group housing arrangement to independent living. The client's functional ability will improve. The client will gain insight into the causes of the client's mental illness. The client will experience fewer symptoms.

The client's functional ability will improve. The goal of community support service programs is to enable those with

Individuals may need assistance with the coordination of care and community service programs related to what? The number of choices of available services for specific diagnostic categories The number of hospital-based services available to clients The complexity of access to the community service programs available Changes of service providers over time

The complexity of access to the community service programs available Due to the complexity of access to the community service programs that are available, individuals and families may require assistance with the coordination of their care, services, and supports. Reference:

The nurse is discussing deinstitutionalization of mentally ill persons at a community forum. What is a consequence of the trend towards deinstitutionalization? The number of persons with mental illness in prison has increased. Male offenders receive more treatment than do female offenders. One million people in correctional facilities have mental illness. The justice and correctional systems work together to improve care.

The number of persons with mental illness in prison has increased. Explanation: As the number of state hospitals was dramatically reduced beginning in the 1960s, the number of persons with mental illness incarcerated in jails and prisons increased. Based on the total number of inmates, this means that there are approximately 356,000 inmates with serious mental illness in jails and state prisons. A large number of persons with mental illness are confined to U.S. prisons and jails. Individuals with mental illnesses are at higher risk for arrest than the general population. They are more likely to have encounters with the criminal justice system and be convicted of a crime than those without a mental illness. After they enter the corrections system, female offenders are more likely than male offenders to receive mental health services, and black offenders receive significantly less mental health treatment than similar non-black Americans. Reference:

A client is in need of a family-like environment with a high level of support. Which would be most appropriate? Personal care home Board-and-care home Therapeutic foster care Supervised apartment

Therapeutic foster care Therapeutic foster care is indicated for clients in need of a family-like environment and a high level of support. Personal care homes operate within houses in the community. Usually, six to 10 people live in one house with a health care attendant providing 24-hour supervision to assist with medication monitoring or other minor activities, including transportation to appointments, meals, and self-care skills. Board-and-care homes house 50 to 150 people in one location and provide 24-hour supervision and assistance with medications, meals, and some self-care skills. Individualized attention to self-care skills and other activities of daily living generally is not available. In a supervised apartment setting, individuals live in their own apartments, usually alone or with one roommate, and are responsible for all household chores and self-care.

A client is in need of a family-like environment with a high level of support. Which would be most appropriate? Personal care home Board-and-care home Therapeutic foster care Supervised apartment

Therapeutic foster care Explanation: Therapeutic foster care is indicated for clients in need of a family-like environment and a high level of support. Personal care homes operate within houses in the community. Usually, six to 10 people live in one house with a health care attendant providing 24-hour supervision to assist with medication monitoring or other minor activities, including transportation to appointments, meals, and self-care skills. Board-and-care homes house 50 to 150 people in one location and provide 24-hour supervision and assistance with medications, meals, and some self-care skills. Individualized attention to self-care skills and other activities of daily living generally is not available. In a supervised apartment setting, individuals live in their own apartments, usually alone or with one roommate, and are responsible for all household chores and self-care.

A college's nursing program has added an elective in forensic nursing to the curriculum. Which phenomenon underlies the expectation of an expanded role for forensic nursing in the future? There are high rates of mental illness among incarcerated populations. People with mental illness are the most common victims of crime. Most crimes are committed by people who have mental illness. Many states now require incarcerated individuals to be frequently assessed by a mental health nurse.

There are high rates of mental illness among incarcerated populations. Forensic nursing is expected to become one of the fastest growing nursing specialties of the 21st century because recent studies have noted the high rates of mental illness among the incarcerated population. People with mental illness are not responsible for most crimes. They are vulnerable to crime, but this fact does not underlie the growth of forensic nursing.

A 54-year-old with severe and persistent mental illness and has been referred to a community support system. What is the basic philosophy behind community support systems? To increase the community's acceptance of individuals with mental illness To ensure that clients comply with their medication regimens to prevent relapse To address the needs of adults with mental illness and increase their ability to function To teach the community about mental illness in order to prevent stigma

To address the needs of adults with mental illness and increase their ability to function A community support system is a network of people committed to helping a vulnerable population meet its needs and reach its potentials without unnecessary isolation or exclusion. This basic philosophy of care is meant to address humanely the needs of adults with serious and persistent mental illness, which limits their ability to function in the primary areas of daily living.

A client will soon be completing a course of inpatient treatment for the treatment of schizophrenia. At what point should the care team review the client's eligibility for additional services, coverage, and programs in the community? When requested by the client's health maintenance organization (HMO) When the client and/or client's family advocates for such a review Upon admission to the inpatient setting Once the client experiences an exacerbation of symptoms

Upon admission to the inpatient setting Explanation: It is important that a client's mental health benefits be reviewed during the discharge planning process, which should always aim to begin at the client's admission to the inpatient unit.

Initiatives that strive to strengthen links between primary care and specialized mental health services refer to ... inpatient psychiatric units. psychosocial rehabilitation programs. partial hospitalization programs. collaborative mental health care.

collaborative mental health care. Collaborative mental health care refers to activities or initiatives that strive to strengthen links between primary care and specialized mental health services.

A young client with severe depression and signs of hopelessness is seen in the emergency department of a large community hospital. The physician determines the need for a psychiatric consult. After the consult, the care team determines that the client is in need of hospitalization. Where should the nurse expect this client to be admitted? General medical floor In-house psychiatric unit Outpatient psychiatric care Psychiatric specialty unit

in-house psychiatric

Which role is the psychiatric-mental health nurse case manager displaying when providing medication education to a client who is newly diagnosed with major depressive disorder? collaborator teacher researcher leader

teacher Psychiatric nurse case managers serve in various pivotal functions across the continuum of care. These functions can involve direct care and coordination of the care delivered by others. The repertoire of required skills includes collaboration with members of a multidisciplinary team, teaching, management, leadership, group, and research skills. When the nurse case manager is providing a client with medication education, the role that is being fulfilled is that of teacher. repertoire tiet muc / répờtoaơ/