mental ch 1 prepU quiz
In terms of causing disability among people aged 15 to 44 years of age in North America, where does mental illness rank? First Fourth Third Second
First Explanation: Compared with all other diseases, mental illness ranks first in terms of causing disability in the United States, Canada, and Western Europe. Reference: pg 4
The nurse educator is teaching a group of students about the early psychiatric nursing founders and their perspectives. Which statement(s) should the nurse include in the teaching? Select all that apply. "Florence Nightingale encouraged independence and self-care." "Linda Richards first introduced the psychiatric nursing model." "Effie Taylor developed the first specialized training program for psychiatric nurses." "Harriett Bailey recommended interactions be based on therapeutic communication." "Hildegard Peplau identified nursing as a separate model from medicine."
"Florence Nightingale encouraged independence and self-care." "Hildegard Peplau identified nursing as a separate model from medicine." Explanation: Florence Nightingale is recognized as the early leader for encouraging independence and self-care as an intervention for anxiety, among other things. Nightingale's holistic view of the nurse-client relationship translated to what is now known as therapeutic communication. Hildegard Peplau conceptualized nursing practice as separate from doctors. Peplau introduced the psychiatric nursing model, developing the first specialized training program for psychiatric nurses. Linda Richards was the first trained nurse in the United States and developed training programs at McLean Hospital. Effie Taylor integrated psychiatric nursing content into the curriculum at Johns Hopkins's Phipps Clinic, introducing the psychiatric nursing model. Harriett Bailey published the first psychiatric nursing textbook. Reference: pg 7-8
A nurse is providing community education about the prevention of mental illness. In response to the question, "What does it mean to be mentally healthy?" which is the nurse's best response? "Mental health is marked by productivity, fulfilling relationships, and adaptability." "Mental health is defined as behavior accepted as normal by the major cultural group." "Mental health is the absence of mental illness." "Mental health is difficult to define and depends on cultural norms."
"Mental health is marked by productivity, fulfilling relationships, and adaptability." Explanation: Mental health means the successful performance of mental function, resulting in productive activities, fulfilling relationships, and the ability to adapt to change and cope with adversity. Mental health provides the capacity for rational thinking, communication, learning, emotional growth, resilience, and self-esteem. Mental health is thus not merely the absence of mental illness, nor is it a behavior deemed acceptable by any given cultural group. While it is accurate to say that mental health is hard to define and the precise state depends on cultural norms, responding with this statement does not help the person who asked the question understand the parameters of mental health. page 2
What percentage of adults requiring mental health services get the care they need? 15% 5% 25% 35%
25% Explanation: Only about 25%, or 1 in 4, of adults requiring mental health services get the care that they need. Reference: pg 4
Which is a result of deinstitutionalization? An increase in available community resources A "revolving door" of repetitive hospital admissions The improvement of the ability of people diagnosed with mental illness to achieve independence An improvement in community-based programs' ability to get funding
A "revolving door" of repetitive hospital admissions Explanation: One result of deinstitutionalization is the "revolving door" of repetitive hospital admission without adequate community follow-up. There are decreased community resources, and the majority of those who are mentally ill are unable to achieve independence. Reference: pg 4
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? The 23-year-old client who is a veteran and requires treatment for post-traumatic stress disorder (PTSD) A 5-year-old child who lives in the city and requires treatment for leukemia A 10-year-old child who lives on a farm and requires treatment for depression The 20-year-old client who is homeless and requires treatment for diabetes mellitus
A 10-year-old child who lives on a farm and requires treatment for depression Explanation: The nurse should identify the child who lives on a farm and has depression as having the highest risk for limited or no access to health care. People who live in rural areas and especially children with mental health needs have higher risks of limited to no access for care. Even the client who is homeless would be able to access care for diabetes through many services that are offered. The veteran could receive government assisted care, and the child with leukemia could also receive free care through facilities like the Shriner's hospital. Reference:
In the 1970s, state mental hospitals came under increasing scrutiny and many were closed. What was the end result of this trend? A lack of suitable housing for persons with mental illness Increased numbers of training programs for the mentally ill Increased numbers of for-profit institutions for the mentally ill Higher employment rates among previously institutionalized people
A lack of suitable housing for persons with mental illness Explanation: In 1970, the deinstitutionalization of clients from state mental hospitals to community living was considered a positive move; however, insufficient federal funding resulted in an increase in the number of homeless, mentally ill people. page 5
Which individual has experienced the consequences of deinstitutionalization? A man who was denied inpatient psychiatric treatment by his health maintenance organization (HMO) A woman who has been the frequent object of stigma due to her history of psychiatric illness A man who has been unable to obtain health insurance but who receives Medicare benefits A woman who was transferred from a psychiatric hospital to the community because of the hospital's impending closure
A woman who was transferred from a psychiatric hospital to the community because of the hospital's impending closure Explanation: The process of deinstitutionalization involves moving chronically mentally ill clients from state psychiatric hospitals back to their homes or to community-supervised facilities. page 4
The nurse knows the written instructions for healthcare when a person is incapacitated is called Durable Power of Attorney Advance directive Living will Informed consent
Advance directive Explanation: Advance care directives are written instructions for health care when individuals are incapacitated. For people who are gravely disabled ; are found to be incompetent; cannot provide food, clothing, and shelter for themselves even when resources exist; and cannot act in their own best interests may require advance care directives and/or may require appointment of a conservator or legal guardian. Reference:
Chlorpromazine is a drug in which classification? Antianxiety Antimanic Antidepressant Antipsychotic
Antipsychotic Explanation: Thorazine is a first generation antipsychotic medication. page 23
When comparing the theories of mental illness popular in ancient Greece with those popular in the Middle Ages, which is more applicable to the Middle Ages? Emotional disorders were believed to be an organic dysfunction. Mental illness was considered a disturbance of the four body fluids, or "humors." Belief in demonic possession and exorcism was common. Treatment included sedation, good nutrition and hygiene, and music and recreation.
Belief in demonic possession and exorcism was common. Explanation: While some of these answers are true of both ancient Greece and the Middle Ages, belief in demonic possession and exorcism was more common in the Middle Ages. page 3
The major goal of the Community Mental Health Act of 1963 was what? Build mental health centers that would provide mental health care within the local community. Attract more health care providers into local psychiatric clinics. Facilitate the integration of biology with the psychosocial components of treatment. Develop centers in which biopsychiatric research could take place within the community.
Build mental health centers that would provide mental health care within the local community. Explanation: The 1963 Community Mental Health Act was designed to provide community-centered mental health care. page 4
The psychiatric mental health nurse is planning the care of a client. What action best addresses the client's needs in the social domain? Teaching the client skills for identifying behavioral triggers Dialoguing with a client about the client's feelings around a traumatic event Collaborating with the client's family to organize support Administering a scheduled dose of an atypical antipsychotic
Collaborating with the client's family to organize support Explanation: Family support exists within the social domain. Feelings and thoughts are within the psychological domain and medications have a biologic effect. Reference: pg 4
Which activity is a function solely of the advanced practice psychiatric-mental health nurse? Counseling and crisis management Conducting milieu therapy Intake screening and evaluation Conducting individual psychotherapy
Conducting individual psychotherapy Explanation: The advanced practice psychiatric-mental health nurse may provide psychotherapy (individual, group, family). Examples include all common forms of brief or long-term therapy. The therapist role that the APRN-PMH assumes is formal and structured and often involves contracts (verbal, written, or both) with clients. Reference: pg 9
In early Christian times, what was thought to cause mental illness? Contaminated environments Personal failure Sin Demonic control
Demonic control Explanation: During early Christian times (1-1000), primitive beliefs and superstitions were strong. All diseases were blamed on demons and the mentally ill were viewed as possessed, or under demonic control. Reference: pg 3
When describing the historical aspects of psychiatric-mental health care, the nurse addresses the changes in thought about the cause of mental illness from 0 to 1000 CE. Which cause would the nurse most likely identify as the belief during this period? Demonic control Physical illness Personal failure Contaminated environments
Demonic control Explanation: During early Christian times (1-1000), primitive beliefs and superstitions were strong. During this time, sin or demonic possession, not physical illness and personal failure, was thought to cause mental disorders. Contaminated environments were a common causative belief during the medieval era (1000-1300 AD). Reference: pg 3
The nurse has been unsuccessful in the psychiatric clinical placement and will be obliged to repeat it next semester. The criteria for passing or failing were based on the Psychiatric-Mental Health Nursing Scope and Standards of Practice, which are? Descriptions of the responsibilities for which nurses are accountable Explanations of the ideal character of the psychiatric or mental health nurse The legal documents that allow a nurse to practice Future goals for the nursing profession as a whole
Descriptions of the responsibilities for which nurses are accountable Explanation: Standards of practice are authoritative statements used by the nursing profession to describe the responsibilities for which nurses are accountable. They do not have the same standing as laws, and they are not future goals but are instead current standards. page 8
Who was responsible for much of the reform of the mental health care system in the 19th century? Dorothea Dix Hildegard Peplau Florence Nightingale Sigmund Freud
Dorothea Dix Explanation: Dorothea Dix, a vigorous crusader for the humane treatment of clients with mental illness, was responsible for much of the reform of the mental health care system in the 19th century. Reference: pg 3
Initially, the nurse should focus on successfully achieving which goal in order to effectively provide care for a client diagnosed with a mental illness? Offering sound advice concerning the client's primary problem Promoting friendship within the relationship Establishing trust and rapport with the client Setting reasonable limits early in the relationship
Establishing trust and rapport with the client Explanation: Establishing trust and rapport are the most important components when caring for a client with mental illness. Without this foundation, therapeutic nursing care is not possible. The nurse does not offer advice but rather works with the client to arrive at effective solutions to existing problems. Reasonable limits regarding the actual work that is accomplished is important but limits can't be set or enforced until there is a therapeutic relationship established. The nurse-client relationship is therapeutic in its nature; it does not involve a social friendship. Reference: pg 9
The nurse educator is teaching a group of students about Freud's contributions to psychiatric nursing. Which disadvantage of the psychoanalytic model will the nurse identify?
Few therapists were able to perform the technique. Explanation: Based on Freud's contributions, the psychoanalytic model in the early 1900s exerted influence on the mental health community and intensive psychoanalysis and was the Freudian treatment of choice for psychological injury and emotional trauma. However, a major disadvantage of the psychoanalytic model is that few people could perform the technique. It was not that people did not believe in the model, but rather that the model would treat only a select group of clients with known psychological trauma. Reference:
Which is a difference between counseling and psychotherapy? Counseling may be used in the care of acutely psychotic clients, but psychotherapy is contraindicated. Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role. Transference and countertransference are significant obstacles in psychotherapy that can be avoided in a counseling mode. Psychotherapy is reserved for clients who have a documented history of failing to respond to counseling.
Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role. Explanation: The psychiatric nurse uses counseling interventions, but psychotherapy requires advanced certification according to the American Nurses Association. Psychotherapy is not reserved solely for those who have not responded to counseling. Transference and countertransference are significant obstacles in both modes, and neither intervention is appropriate during acute psychotic episodes. page 9
When providing care to a client, the psychiatric-mental health nurse is implementing the therapeutic use of self. The nurse is applying concepts based on the work of which individual? Sigmund Freud Florence Nightingale Dorothea L. Dix Hildegard E. Peplau
Hildegard E. Peplau Explanation: Hildegard E. Peplau conceptualized nursing practice as independent of physicians and emphasized the use of self as a nursing tool. Florence Nightingale identified the need to view clients holistically, was sensitive to human emotions, and recommended interactions that today would be classified as therapeutic communication. Dorothea L. Dix crusaded for the humane treatment of clients with mental illness. Sigmund Freud developed a personal theory based on unconscious motivations for behavior. Reference: page 7
Who was the first to introduce the concept of interpersonal relations and the therapeutic relationship? Mary Nutting Hildegard Peplau Linda Richards Florence Nightingale
Hildegard Peplau Explanation: Hildegard Peplau wrote a publication introducing the concepts of interpersonal relations and the therapeutic relationship within psychiatric-mental health nursing practice. Reference: pg 7
Who was the first to introduce the concept of interpersonal relations and the therapeutic relationship? Hildegard Peplau Linda Richards Florence Nightingale Mary Nutting
Hildegard Peplau wrote a publication introducing the concepts of interpersonal relations and the therapeutic relationship within psychiatric-mental health nursing practice. page 7
Which provides the best definition for mental illness? Existence of cognitive dysfunction resulting in a lack of autonomy Result of genetic or environmental alterations resulting in mental dysfunction Inability to function in a manner that manages both external and internal stressors effectively Manifestation of altered sensory perceptions
Inability to function in a manner that manages both external and internal stressors effectively Explanation: While mental illness is difficult to define with precision, it is best described as a state of being characterized by impairment in functioning. Not all mental illnesses are characterized by cognitive impairment or altered sensory perceptions. Genetic and environmental factors are not the only known causes of mental illness. page 2
The psychiatric health nurse is working as a liaison with the maternity unit to improve outcomes of maternity clients. Which action will the nurse take that best supports the objectives of Healthy People 2030? Decrease the number of women getting screened for routine gestational diabetes. Increase the number of women getting screened for postpartum depression. Increase the number of the women breastfeeding their infant. Decrease the number of women undergoing cesarean section childbirth.
Increase the number of women getting screened for postpartum depression. Explanation: Increasing the number of women getting screened for postpartum depression is a main objective of the Healthy People 2030 campaign. Decreasing the number of women undergoing cesarean section childbirth, increasing the number of women breastfeeding, and decreasing the number of women getting screened for routine gestational diabetes are not aspects of the Healthy People 2030 campaign. Reference:
Which is the most influencing factor that complicates the treatment of people with mental illness in the Unites States? Lack of effective treatments Insurers' reimbursement decisions Overuse of the well-coordinated mental health care system Increased responsibility for care by state mental hospitals
Insurers' reimbursement decisions Explanation: A goal of behavioral health managed care has been to reduce hospital admissions, which are the most expensive part of psychiatric care. Unfortunately, some managed care "gatekeepers" have denied or restricted access to needed services and therefore have added to the discouragement, distress, and even despair of clients and their families. Reference: pg 4-5
Which is a true statement regarding Medicaid? It covers people with permanent kidney failure. It covers people with certain disabilities. It covers individuals and families with low incomes. It covers people 65 years of age and older.
It covers individuals and families with low incomes. Medicaid covers individuals and families with low incomes. Medicare covers people 65 years of age and older, those with permanent kidney failure, and those with certain disabilities. page 7
Which is an inaccurate depiction of self-awareness? The nurse gains recognition of his or her feelings and beliefs. It involves changing one's values or beliefs. There is an understanding that a nurse's belief may conflict with the client's. It involves self-reflection.
It involves changing one's values or beliefs. Explanation: The goal of self-awareness is to know oneself so that one's values, attitudes, and beliefs are not projected to the client, interfering with nursing care. Self-awareness does not mean having to change one's values or beliefs, unless one desires to do so. Therefore, this is the inaccurate depiction of self-awareness the question asks for. page 10
Which is an inaccurate depiction of self-awareness? It involves self-reflection. The nurse gains recognition of his or her feelings and beliefs. There is an understanding that a nurse's belief may conflict with the client's. It involves changing one's values or beliefs.
It involves changing one's values or beliefs. Explanation: The goal of self-awareness is to know oneself so that one's values, attitudes, and beliefs are not projected to the client, interfering with nursing care. Self-awareness does not mean having to change one's values or beliefs, unless one desires to do so. Therefore, this is the inaccurate depiction of self-awareness the question asks for. Reference: pg 10
Until the onset of the Renaissance, the general population held which belief regarding the presence of sickness? It was based on social class. It was a weakness in physical strength. It was a consequence of inadequate parenting. It was punishment for sins and wrongdoing.
It was punishment for sins and wrongdoing. Explanation: People of ancient times believed that sickness was a punishment for sins and wrongdoing. It was not a weakness of physical strength, based on social class, or due to inadequate parenting. Reference: pg 3
A nurse is reviewing the historical trends impacting the practice of psychiatric-mental health nursing practice. The nurse demonstrate understanding of the information by identifying which individual as being resonsible for opening the first training school for nurses in 1882? Hildegard Peplau Florence Nightingale Linda Richards Dorothea Dix
Linda Richards Explanation: Linda Richards, the first trained nurse in the United States, opened the Boston City Hospital Training School for Nurses in 1882 at McLean Hospital, a psychiatric facility. Reference: page 7
Maintaining a therapeutic environment and promoting growth through role modeling are components of which basic level function? Case management Milieu therapy Health teaching Counseling
Milieu therapy Explanation: A basic level function is milieu therapy, which is the maintenance of the therapeutic environment. Counseling involves interventions and communication. Health teaching is a basic level function, as is case management. Reference: pg 9
The application of psychiatric mental health nursing theory to promote holistic client care in the therapeutic relationship is grounded in the work of which historical figure? Peplau Benner Dix Freud
Peplau Explanation: In 1952, Peplau published the landmark work, Interpersonal Relations in Nursing. It introduced psychiatric and mental health nursing practice to the concepts of interpersonal relations and the importance of the therapeutic relationship. The nurse-client relationship supported a holistic perspective on client care. Reference: pg 7-8
Which sets professional standards of care? States Hospitals Provinces Professional nursing organizations
Professional nursing organizations Explanation: States and provinces grant the legal authority to practice nursing, but professional nursing organizations set standards of care and professional nursing activities. Reference: pg 8
Which intervention is appropriate for a psychiatric-mental health nurse at the basic level of practice? Promoting symptom management Interpreting laboratory tests Conducting family therapy Prescribing psychotropic medications
Promoting symptom management Explanation: Basic psychiatric-mental health nurses promote and encourage the maintenance of health and prevention of disorders, assess biopsychosocial functioning, serve as case managers, design therapeutic environments, and promote self-care activities, including medication and symptom management. At the advanced level, psychiatric-mental health nurses deliver comprehensive primary mental health services. Functions include delivering psychotherapy, prescribing medications (in many states), teaching and screening, performing preventive interventions, and evaluating and managing care for people with mental illness. page 8
During the mid-20th century, the focus of treatment centered on treating neurotransmitter dysfunction in the brain. As a result hospital stays were shortened due to the introduction of which? Hydrotherapy Psychopharmacology Psychosurgery Insulin shock therapy
Psychopharmacology Explanation: Support for the biologic approaches received an important boost as successful symptom management with psychopharmacologic agents became a more widespread possibility in the early 1950s. Psychopharmacology revolutionized the treatment of mental illness and led to an increased number of clients discharged into the community, and the eventual focus on the brain became a key to understanding psychiatric disorders. page 4
Which is a clinical activity of only the advanced practice registered nurse? Triage Milieu therapy Crisis intervention Psychotherapy
Psychotherapy Explanation: Clinical activities of the advanced practice registered nurse include psychotherapy, community interventions, and clinical supervision. Milieu therapy, crisis intervention, and triage are clinical activities of the psychiatric-mental health registered nurse. page 9
Which mental health service is an advanced-level function? Counseling Psychotherapy Milieu therapy Self-care activities
Psychotherapy Explanation: Psychotherapy is an advanced-level function. Milieu therapy, counseling, and self-care activities are basic level functions. Reference: pg 9
The following events are important in the development of psychiatric-mental health nursing practice. Which event occurred first? Establishment of the first graduate program in psychiatric nursing at Rutgers University Publication of Standards of Psychiatric-Mental Health Nursing by the ANA Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey Publication of Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice
Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey Explanation: In 1920, the first psychiatric nursing text was published. In 1954, the first graduate program in psychiatric nursing was established. In 1967, the ANA published the Standards of Psychiatric-Mental Health Nursing. In 1985, the Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice was published. Reference: pg 7
What nursing action demonstrates the intended impact of the American Nurses Association (ANA) standards of care on mental health nursing care? Using the standards as a guide to identify advanced level nursing functions. Using the standards to determine if a nurse's action is considered criminally negligent. Citing the standards as a guide for determining the delegation of care. Referring to the standards to determine if a particularly prescribed treatment falls within the scope of a nurse's practice.
Referring to the standards to determine if a particularly prescribed treatment falls within the scope of a nurse's practice. Explanation: The American Nurses Association (ANA) develops standards of care as authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable, thus identifying the nurse's scope of practice. They are not legally binding unless they are incorporated into the state nurse practice act or state board rules and regulations. When legal problems or lawsuits arise, these professional standards are used to determine safe and acceptable practice and to assess the quality of care in the court of law. Neither identifying advanced level functions or safety delegation principles are directly associated with the ANAs nursing standards. Reference: pg 8
A client demonstrates sexually inappropriate behavior toward a student nurse. What is an effective way for the student to respond while protecting and respecting the client? Ignore the behavior at the time it occurs but report it to staff before leaving clinicals for the day. Immediately inform the client that the behavior is unacceptable and will be reported to staff. React to the incident with a sense of humor at the time but minimize contact with the client in the future. Report the incident to staff and the clinical instructor so boundaries can be reenforced with the client.
Report the incident to staff and the clinical instructor so boundaries can be reenforced with the client. Explanation: Some clients have difficulty recognizing or maintaining interpersonal boundaries. When a client seeks contact of any type outside the nurse-client relationship, it is important for the student (with the assistance of the instructor or staff) to clarify the boundaries of the professional relationship. The behavior should not be ignored or minimized but rather addressed in a professional, matter-of-fact manner so that the client understands the limits being placed on such behaviors. A student may initially be unskilled at dealing with such behavior while at the same time protecting the client's privacy and dignity, so the student should enlist the assistance of the instructor and staff. Reference: pg 9
A psychiatric-mental health registered nurse is studying the impact of factors like safety, effectiveness, and cost on the practice and delivery of nursing services. What is this process called? Professional practice evaluation Resource utilization Quality of practice Leadership
Resource utilization Explanation: Consideration of factors related to safety, effectiveness, and cost, and their impact on practice in planning and delivering nursing services, is resource utilization. Leadership is directing others. Quality of practice is systematic enhancement of the effectiveness of nursing practice. Professional practice evaluation is the evaluation of nursing practice against professional standards. Reference: pg 9
Which is a criterion for mental health? Satisfaction with personal relationships and self No observable demonstration of deviant behavior Absence of mental health disorders Absence of sadness or anger
Satisfaction with personal relationships and self Explanation: People in a state of emotional, physical, and social well-being fulfill life responsibilities, function effectively in daily life, and are satisfied with their interpersonal relationships and themselves. None of the remaining options fully satisfy the criteria for a healthy mental status. Reference: pg 2
Dorothea Dix's solution to gain humane treatment for the mentally ill population included what? State hospitals Community centers Locked wards Asylums
State hospitals Explanation: Dorothea Dix, a vigorous crusader for the humane treatment of clients with mental illness, was responsible for much of the reform of the mental health care system in the 19th century. Her solution was state hospitals. page 3
Which is necessary as a defining feature in mental illness? The individual must acknowledge that he or she is having difficulties in functioning. The individual must have physiological symptoms that match with behaviors that are impaired. The individual must have difficulties in functioning that cause distress and/or impairment of some type. The individual must need medications in order for the diagnosis to be of psychiatric origin.
The individual must have difficulties in functioning that cause distress and/or impairment of some type. Explanation: Mental illness is considered a clinically significant behavioral or psychological syndrome experienced by a person and marked by distress, disability, or the risk of suffering, disability, or loss of freedom. The symptoms of the disorder must be above and beyond expected reactions to an everyday event and not merely a cultural expectation. An individual can be diagnosed with a mental illness and not need psychopharmacological intervention. The individual may or may not acknowledge that he or she is having impaired functioning. The experience and consequences of mental illness are much more complicated than a list of symptoms. page 2
Which is the greatest barrier to an individual's ability to obtain the most effective and safest psychiatric medication? The side effects of newer medications are often too severe for clients to consider taking them. These medications are often not covered by the managed care system because they are expensive. These medications are paid for by all insurance companies, but clients do not like to take psychotropics. These medications are not available because they are in such great demand.
These medications are often not covered by the managed care system because they are expensive. Explanation: Managed care provides for the least costly treatment available. If less costly medicines are effective, they will be the approved treatments. The newer drugs have demonstrated superior effectiveness and safety profiles (i.e., serious and less frequent side effects) and are now available page 8
The nurse attempts to speak to a client; however, the client shows no interest in talking. What should the nurse do in this situation? Understand the client may require the use of silence Probe the client further Request a change in client assignment Make no further efforts to talk to the client
Understand the client may require the use of silence Explanation: It can take time to build a nurse-client relationship, especially if the client is reluctant to communicate. If the client refuses to speak with the nurse, it's possible that the client requires silence, possibly due to the influence of acute psychiatric symptoms. Probing the client further indicates the nurse has limited understanding of the use of silence in the therapeutic relationship. Requesting a change in the client assignment communicates the nurse has given up on attempting to establish the therapeutic relationship. Making no further efforts to talk to the client risks preventing an effective assessment and therapeutic use of self from taking place. Reference: pg 9
During the moral treatment period, clients were routinely placed into which environment? community mental health centers group homes psychosocial rehabilitation centers asylums
asylums Explanation: In the moral treatment period (1790-1900), moral treatment and the use of kindness, compassion, and a pleasant environment was adopted. Clients were routinely removed from their communities and placed in asylums, which was thought to be best for their safety and comfort. Community mental health centers, by and large, ignored the legions of people with serious mental illnesses and instead focused on the treatment of those with alcoholism and drug addiction. Clients were not placed in psychosocial rehabilitation centers or group homes during the moral treatment period. Reference: pg 3
A nurse is reading a journal article about practices involved during the moral treatment movement in psychiatric-mental health care. Which practice would most likely be included as being used during this time? asylums blood letting incarceration exorcisms
asylums Explanation: In the moral treatment period (1790-1900), the use of kindness, compassion, and a pleasant environment was adopted. Individuals with mental disorders were routinely removed from their communities and placed in asylums, which was thought to be best for their safety and comfort. Blood letting, exorcisms and incarceration were not practices associated with the moral treatment period. Reference: pg 3
A psychiatric-mental health nurse is describing the various programs offered by the local community mental health center. When explaining how these programs work, the nurse would emphasize which concept? collaboration autocratic leadership complete autonomy paternalistic decision-making
collaboration Explanation: In today's environment, the traditional medical model, which is viewed as autocratic and paternalistic, is being replaced by a collaborative model whereby mental health professionals work in partnership with consumers to help rebuild their lives. Consumer advocacy efforts have led to the implementation of recovery philosophy and practices. page 7-8
A psychiatric-mental health nurse is describing the various programs offered by the local community mental health center. When explaining how these programs work, the nurse would emphasize which concept? autocratic leadership collaboration paternalistic decision-making complete autonomy
collaboration Explanation: In today's environment, the traditional medical model, which is viewed as autocratic and paternalistic, is being replaced by a collaborative model whereby mental health professionals work in partnership with consumers to help rebuild their lives. Consumer advocacy efforts have led to the implementation of recovery philosophy and practices. page 8
One of the primary reforms accomplished by Dorothea Lynde Dix was the ... establishment of "commitment" laws in state legislatures. establishment or enlargement of state hospitals. use of exercise therapy to treat mentally ill clients. use of music to treat mentally ill clients.
establishment or enlargement of state hospitals. Explanation: One of the primary reforms accomplished by Dorothea Lynde Dix was the establishment or enlargement of state hospitals to treat the mentally ill. She also was instrumental in the establishment of mental hospitals in England, Canada, and Europe in the 19th century. Reference: pg 3