NUR 317 week 3
overcoming stigma
-educate the public- speak up politely against stigmatizing media - assist consumers with self stigmatization
External Advocacy System
Organizations that operate independently of mental health agencies and serve as advocates for the treatment and rights of mental health patients.
holistic perspective
PMH intergration into medical care is important because PMH nursing sees psychiatric nursing practices in a
Levels of practice
PMH-RN PMH-APRN
Using a Logic Thought Process
The Capacity to reach a logical conclusion consistent with the starting premise.
Asian Americans may experience a culture-bound syndrome, such as
neurasthenia, which is characterized by fatigue, weakness, poor concentration, memory loss, irritability, aches and pains, and sleep disturbances
cultural identity
or set of cultural beliefs with which one looks for standards of behavior
A nurse is working as a part of a research team that is examining the proportion of individuals in a population who have bipolar disorder on a particular date. What would the team most likely be measuring? a. prevalence b. rate c. point prevalence d. incidence
point prevalence
Racially and ethnically diverse groups are less likely to receive mental health services and more likely to receive
poorer quality care.
Speaking the same language does not guarantee shared
meaning and understanding
Women within minority groups may experience more conflicting feelings and psychological stressors than do
men in trying to adjust to both their defined role in the minority culture and a different role in the larger predominant society
Both spirituality and religion are factors that may influence beliefs about
mental illness and impact treatment and recovery
In many of these cultures, it is an embarrassment to have a family member treated for
mental illness, which may explain the extremely low utilization of mental health services
Families living in poverty are under tremendous financial and emotional stress, which may trigger or exacerbate
mental problems
The number of Hispanic Americans living in the United States has been gradually increasing, and this group is now the largest
minority in the United States
Nursing process the PMH-RN
promotes and fosters health and safety assesses dysfunction and areas of strength, and assists individuals in achieving personal discovery goals
African Americans are disproportionately diagnosed as having
schizophrenia when compared to other groups
Tool of Psychiatric nursing practice
self Plan Clinical reasoning and reflection interdisciplinary care
nursing process
serves as the foundation for clinical decision making and provides a framework for nursing practice
religiousness
sharing the beliefs and participating in the practices of an organized religion
Knowledge
genetics research and it significance on disorders such Alzheimer, schizophrenia, and demntia -co morbidities -Psychoneuroimmunology
In many African American families, older members are treated with
great respect
Evidence suggests that the overdiagnosis in research studies may be related to whether the interviewer perceived that the patient was
honest in reporting symptoms
Outcomes Identification
identifies expected outcomes and the health care consumers goals for a plan individualized to the health care consumer or to the situation.
implemtation
implements the specified plan
Understanding the impact of literacy levels is
integral to providing culturally competent care
Reflection
involves continual self evaluation through observing, monitoring, and judging nursing behaviors with the goal of providing ideal interventions
Cultural competence
is a set of academic and interpersonal skills that are respectful of and responsive to the health beliefs, health care practices, and cultural and linguistic needs of diverse patients to bring about positive health care outcomes
Fidelity
is faithfulness to obligations and duties. Important for establishing trusting relationships
Culture
is not only a way of life for people who identify or associate with one another on the basis of some common purpose, need, or similarity of background but also the totality of learned, socially transmitted beliefs, values, and behaviors that emerge from its members' interpersonal transactions
Paternalism
is the belief that knowledge and education authorize professionals to make decisions for the good of the patient.
Nonmaleficence
is the duty to cause no harm, both for the individual and for all
justice
is the duty to treat all fairly, distributing the risks and benefits equally. Justice becomes an issue in mental health when a segment of a population does not have access to health care
Breach of Confidentiality
The release of patient information without the patient's consent in the absence of legal compulsion or authorization.
Assault
The threat of unlawful force to inflict bodily injury upon another (threatening to cause harm).
Associated with the Korean culture, hwabyung,
"suppressed anger syndrome," is characterized by subjective and expressed anger, sensations of heat, and feelings of hate
Rate of disease
% of population affected
Challenges of psychiatric nursing
- keeping up with new knowledge -overcoming stigma -Integrating PMH into medical care -healthcare delivery systems -technology and electronic medical records
A psych-mental health nurse is conducting a seminar for a group of colleagues about client rights and mental health care treatment. the nurse determines that the seminar was successful when the group describes competency as being valid for: a. a specified time b. 30 days c. the duration of care d. 24 hours
A
What is accurate regarding documenting in the client record? a. courts consider acts not recorded as acts not done b. documentation can include staff bias c. documentation can be done in pencil in case of mistakes d. stereotypical entries may be used
A
When assessing a person with a mental disorder, which would be most important for a nurse to consider for recovery? a. degree of disability or impairment b. culture c. actual diagnosis of disorder d. language spoken
A
A psych-mental health nurse is providing a outpatient care to a patient with a history of anxiety. Which behavior would the nurse interpret as reflecting self-determinism? a. client seeks second opinion b. client asks nurse to decide which plan to follow c. client chooses a treatment to please the nursing staff d. client relies on client staff for direction and guidance
A
In 2015, the estimated population of African Americans was
46.3 million, or 13% of the US population
When describing the effects of stigma by society on individuals with mental illness, which would a nurse most likely include? a. the stigma tends to increase the more the person's behavior differs from the norm b. the stigma is the same for any person with mental illness c. the person being stigmatized is often considered part of the group d. the person being stigmatized typically has a moderately high self-esteem
A
Which court decision states that psychotherapists have a duty ot exercise reasonable care in protecting the foreseeable victims of their clients' violent actions? a. tarasoff v. Regents of the U of C
A
Negligence
A breach of duty of reasonable care for a patient for whom a nurse is responsible that results in personal injuries.
What is a stigma?
A mark of shame, disgrace, or disapproval that results in a person being shunned or rejected by others
Confucianism
A philosophy or a system of ethics for living rather than a religion that teaches how people should act toward one another. People are born "good." Moral character is stressed through sincerity in personal and public behavior. Respect is shown for parents and figures of authority. Improvement is gained through self-responsibility, introspection, and compassion for others.
What is mental health?
A state of well being in which the individual realizes his or her own abilities, can cope with life's normal stresses, can work productively and fruitfully, and can make a contribution to society. A person cannot be healthy without being mentally healthy.
What is a mental illness or disorder?
A syndrome-->a set of symptoms that cluster together that may have multiple causes and may represent several different disease states that have not yet been identified
8. A nurse is working on developing ways to meet the challenge of knowledge development. Which of the following would be most appropriate? A) Access new information through continuing education programs. B) Improve access to community psychiatric care for all populations. C) Reduce the burden of mental illness by fighting stigma. D) Provide culturally competent, high-quality nursing care.
A) Access new information through continuing education programs.
1. When applying the biopsychosocial model to client care, the nurse integrates the psychological domain when involved with which of the following? A) Behavior therapy B) Family support C) Nutritional therapy D) Sleep hygiene measures
A) Behavior therapy
7. A nursing instructor has prepared a lecture about the scope and standards of practice of psychiatric nurses. The instructor determines that the teaching was effective when the students identify which of the following as common to both basic and advanced level practice? A) Case management B) Program development C) Clinical supervision D) Community interventions
A) Case management
14. During assessment, a patient tells the nurse that he follows Buddhist beliefs. The nurse would integrate understanding of which of the following when developing the patient's plan of care? A) Desire is the cause of all human suffering and misery. B) Self-indulgence is necessary to reach nirvana. C) Present behavior is based on current unhappiness. D) Salvation is achieved through faith and humility.
A) Desire is the cause of all human suffering and misery.
12. A nursing instructor is preparing a class about rural cultures and the influence on mental health problems. Which of the following would the instructor include as impacting the use of mental health services for this group? Select all that apply. A) Limited access to care B) Lack of available resources C) Geographical similarities D) Diverse cultural groups E) Consistency in treatment approaches
A) Limited access to care B) Lack of available resources D) Diverse cultural groups
2. A nursing instructor is describing the impact of technology and electronic health records on psychiatric mental health care. Which of the following would the instructor identify as a major challenge associated with it? A) Maintaining confidentiality B) Establishing educational models C) Decreasing fragmented care D) Defining professional standards more clearly
A) Maintaining confidentiality
5. A psychiatric mental health nurse working in a Veteran's Administration Medical Center is meeting with a military wife who is an Asian American. The woman is to be joining a support group for wives of veterans who have posttraumatic stress syndrome. When asking her to describe her husband's mental health problems, which response would the nurse most likely expect? A) Oh, he may seem depressed, but it is just a vitamin deficiency. It runs in his family. B) I know the war messed his mind up. He'll never be the same. C) Sometimes he hallucinates that he is back in Vietnam. D) He just stays to himself; he never talks to me about what is bothering him.
A) Oh, he may seem depressed, but it is just a vitamin deficiency. It runs in his family.
What is the diagnostic and statistical manual of mental disorders-5?
DSM-5 is a manual that specifies criteria for diagnosing mental disorders. However, there are no absolute boundaries separating one disorder from another.
When describing an external advocacy system, which agency would the nurse most likely include? (SATA) a. American Public Health Association B. American Hospital Association C. American Healthcare Association d. The Joint Commission e. Centers for Medicare and Medicaid Services
A, B, C
which are examples of public stigma? (SATA) a. mental health clinicians are described as being arrogant and manipulative during an interview b. a film depicting an individual with mental illness as being possessed by the devil d. an individual with a mental illness refuses to seek treatment because of what others might think e. an individual with mental illness believes that he is unpredictable just like everyone else believes
A, B, C
A latin american client witnessed a traumatic event and is suspected of experiencing the cultural syndrome of susto. Which would the nurse most likely assess? (SATA) a. insomnia b. confusion c. mania d. psychomotor agitation e. constipation
A, B, D
A psych-mental health nurse is conducting a review class about legal liability and psych-mental health nursing. Which element would the nurse most likely include as being required to prove negligence on the part of a health care professional? (SATA) a. cause in fact b. damages c. financial obligation d. cause in proximity e. duty f. occurrence of a simple mistake
A, B, D, E
A psych-mental health nurse conducting a class for community group about the rights of individuals with mental health problems. As part of the program, the nurse is describig the concept of self-determinism. The nurse determines that the program was successful when the group identified which idea as exemplifying self-determination? (SATA) a. right to refuse treatment b. right to obtain other options c. right to refuse treatment during an emergency situation d. right to participate in experimentation w/o informed consent e. right to choose other forms of treatment
A, B, E
What can help prevent negative outcomes of malpractice litigations in psychiatric mental health care? (SATA) a. involve family w important decisions b. do not document decisions that might prove problematic c. evaluate risks d. adhere to policy and procedure e. seek consultation and record input
A, C, D, E
Several studies show that diagnoses and treatment for
African Americans often are racially biased
Tribal beliefs
All living things are related. Respect for powers of nature and pleasing the spirits are fundamental beliefs to meet the basic and practical needs for food, fertility, health, and interpersonal relationships and individual development. Harmonious living is comprehension and respect of natural forces.
Hinduism
All people are assigned to castes (permanent hereditary orders, each having different privileges in society; each was created from different parts of Brahma): Brahmans: includes priests and intellectuals Kshatriyas: includes rulers and soldiers Vaisya: includes farmers, skilled workers, and merchants Sudras: includes those who serve the other three castes (servants, laborers, peasants) Untouchables: the outcasts; those not included in the other castes
PMH Nursing organizations
American Nurse Association (ANA) American Psychiatric Nurses Association (APNA) International Society of Psychiatric Nursing (ISPN) IntNSA
Confidentiality
An ethical duty of nondisclosure.
Durable Power of Attorney
Appoints a proxy, usually a relative or trusted friend, to make health care decisions on an individual's behalf if that person is incapacitated.
Six standards of practice
Assessment Diagnosis Outcomes identification Planning Implementation Evaluation
What is label avoidance?
Avoiding tx or care in order to not be labeled as mentally ill
A nurse is teaching a client newly diagnosed with a mental disorder and their family. Which is an important aspect of a psychiatric advance directive? a. a physician cannot override the declaration b. during periods of competency, PADs can be revoked c. it must be signed by case manager and two witnesses d. it allows family members to make the choice of treatment for incompetent individuals
B
A psych-mental health nurse is reviewing information about the patient self-determination act. The nurse understands that this law addresses which element? a. protection from abuse b. client rights when receiving mental health care c. job discrimination b. advance care
B
A psych-mental health nurse is reviewing the medical record of a client who was involuntarily committed to the mental health unit of the hospital. The nurse determines that the client was mot likely involuntarily committed for which reason? a. refused to take medication at the clinic this morning b. ranting and waving a loaded gun in a crowded mall c. recently lost a sibling and had a crying outburst at work d. missed an appointment with the mental health counselor.
B
A psych-mental helath nurse is providing care to a male client who came in to the substance abuse rehab on his own asking for assistance with cocaine dependency. The nurse anticipates that the client would legally be required to stay at the facility for which duration? a. a minimum of 24 hours b. as long as needed or desired c. no longer than 96 hours d. a max of 60 days
B
Client with schizophrenia has a PAS which rules out the use of antipsychotics. The care team would be justified in disregarding the provisions of the PAD in which circumstance? A. the PAD contradicts the client's best interests b. the PAD is verbal, not written c. the client requires inpatient treatment d. the client is 20 years old
B
5. In a postclinical conference, a group of students are engaged in a discussion with their instructor. The instructor repeatedly has the students analyze and evaluate the nursing interventions implemented throughout the clinical experience. The students are engaged in which of the following? A) Therapeutic use of self B) Critical thinking C) Interdisciplinary care D) Planning care
B) Critical thinking
9. During an assessment, the patient states, We rely on our large extensive family for moral support and help and we treat our elders with a great deal of respect. If someone gets sick, the family takes care of him. The nurse interprets this as indicating which of the following? A) Acculturation B) Cultural identity C) Cultural competence D) Linguistic competence
B) Cultural identity
15. When applying the biopsychosocial model for a patient with a mental health problem, the nurse addresses the psychological domain when assessing which of the following? A) Sleep patterns B) Feelings C) Family functioning D) Cultural groups
B) Feelings
18. The nurse is assessing an Asian American patient. During the interview, the nurse determines that the patient likely follows Taoism based on which statement? A) Purity and balance guide all of my actions. B) I strive to be in happy harmony with nature. C) Nature's powers must be respected in life. D) God is worshipped out of love, not fear.
B) I strive to be in happy harmony with nature.
11. A psychiatric mental health nurse is adhering to the standards of practice. When engaging in clinical decision making, the nurse is integrating which of the following as the foundation? A) Developmental issues B) Nursing process C) Commitment D) Accountability
B) Nursing process
15. After teaching a group of students about the beliefs associated with the major religions, the instructor determines that additional teaching is needed when the students identify which belief as associated with Confucianism? A) People are born good. B) People are assigned to castes. C) Authority figures are respected. D) Self-responsibility leads to improvement.
B) People are assigned to castes.
18. A nurse is engaged in exercises to develop self-awareness. The nurse is using which tool? A) Interdisciplinary care B) Reflection C) Plan of care D) Clinical reasoning
B) Reflection
Which is an accurate statement regarding an advance care directive? a. it needs to be signed by an attorney b. it must be witness by two people and notarized c. it needs to be written by an attorney d. it applies to those who can make their own decisions
BWh
Buddhism
Buddhism attempts to deal with problems of human existence such as suffering and death. Life is misery, unhappiness, and suffering with no ultimate reality in the world or behind it. The cause of all human suffering and misery is desire. The "middle path" of life avoids the personal extremes of self-denial and self-indulgence. Visions can be gained through personal meditation and contemplation; good deeds and compassion also facilitate the process toward nirvana, the ultimate mode of existence. The end of suffering is the extinction of desire and emotion and ultimately the unreal self. Present behavior is a result of past deed.
A client diagnosed with depression tells the psych-mental health nurse that the client wants to use an herbal supplement to treat the symptoms rather than an antidepressant. The nurse interprets this information as demonstrating which concept? a. competency b. informed consent c. self-determinism d. confidentiality
C
16. During an interview, a patient states, God does not exist for me. The nurse interprets this statement as reflecting which of the following? A) Animism B) Agnosticism C) Atheism D) Polytheism
C) Atheism
17. After reviewing the major beliefs of Hinduism, a nursing student identifies the following castes. The student demonstrates understanding by identifying which of the following as the highest caste? A) Kshatriyas B) Vaisyas C) Brahmans D) Untouchables
C) Brahmans
10. Within the context of the culture of poverty, which of the following most clearly describes why individuals who are part of this culture become trapped in a downward economic spiral? A) Unemployment causes poverty; a lack of willpower and motivation can, in turn, cause unemployment in people who do not have a strong work ethic. B) Individuals lack the finances to pay rent, so they eventually do not have an address to use in filling out job applications. C) Characteristics of poverty (joblessness and lack of financial independence) can, in turn, contribute to attributes (feelings of powerlessness and low self-esteem) that sustain poverty. D) Poverty is passed on from generation to generation; individuals learn at an early age that there is no way to escape living in poverty.
C) Characteristics of poverty (joblessness and lack of financial independence) can, in turn, contribute to attributes (feelings of powerlessness and low self-esteem) that sustain poverty.
4. A nursing student is initiating a relationship with an assigned patient. After meeting and spending approximately 20 minutes talking with the patient, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of patients to play volleyball. The student starts to go with them but then remembers the promise to meet with the patient. The student decides to stay behind and talk to with her patient. The student's decision reflects which ethical principle? A) Autonomy B) Beneficence C) Fidelity D) Veracity
C) Fidelity
6. A psychiatric mental health nurse is working with a patient who is being treated for depression. Which patient statement would indicate that her spirituality is intact? A) My church friends came to visit me this past Sunday afternoon. B) Nothing will ever be the same again; my life is not worth living. C) I know I am as well off as I can be under the circumstances. D) I know God must be punishing me for all my sins.
C) I know I am as well off as I can be under the circumstances.
16. A nurse had developed a plan of care for a patient with depression. Which nursing diagnosis would reflect the social domain? A) Imbalanced Nutrition, Less Than Body Requirements related to lack of appetite. B) Powerlessness related to feelings of lack of control over the situation. C) Ineffective Role Performance related to inability to participate as family provider D) Risk for Suicide related to depressed mood and feelings of oneself as a failure
C) Ineffective Role Performance related to inability to participate as family provider
17. The plan of care for a patient with schizophrenia identifies the following outcomes. Which of the following would the nurse identify as addressing the biologic domain? Select all that apply. A) Improving problem-solving skills B) Promoting economic stability C) Minimizing adverse effects of drug therapy D) Improving nutritional status E) Providing family education
C) Minimizing adverse effects of drug therapy D) Improving nutritional status
6. A group of students is reviewing the functions of psychiatric nurses. The students demonstrate understanding of the information when they identify which of the following as an advanced practice level function? A) Milieu therapy B) Promotion of self-care C) Psychopharmacology interventions D) Health promotion activities
C) Psychopharmacology interventions
13. A psychiatric mental health nurse is providing care to patients with a mental illness and is investigating factors related to the patient safety, delivery of care services, and cost effectiveness. The nurse is involved with which area of professional performance? A) Education B) Quality of practice C) Resource utilization D) Collaboration
C) Resource utilization
4. A psychiatric mental health nurse is providing care to a patient who has recently emigrated to the United States from Eastern Europe. Which of the following would be least effective in providing culturally competent care? A) Demonstrating a genuine interest in the patient B) Avoiding assumptions about the patient's culture C) Speaking to the patient in his native language. D) Acquiring information about the patient's country.
C) Speaking to the patient in his native language.
3. The nurse is doing an assessment interview of a patient. During the interview, the patient comments, Our people are connected with nature. Our world, our seasons, and our weather they all have many lessons to teach us. The nurse interprets the patient's statement as an expression of which of the following? A) Religiousness B) Tribal law C) Spirituality D) Ecological values
C) Spirituality
10. A nurse is faced with an ethical dilemma involving a patient. Which question would be most important for the nurse to ask first when engaging in the process of ethical decision making? A) What are my own feelings about the situation? B) What assumptions am I making that need more data? C) What do I know about the situation? D) What do I know about the patient's values?
C) What do I know about the situation?
Understand Relevant Information
Capacity to comprehend the meaning of the information given about treatment.
interdisciplinary care
Collaboration with other healthcare professionals outside of mental health nursing
Biologic domain
Consist of biological theories related to mental disorders and problems as well as all of the biologic activity related to other health problems Relate to functional health patterns such as exercise, sleep, and adequate nutrition.
A nurse understands the importance of protecting clients' rights of self-determinism. Self-determinism is similar to which ethical principle? a. beneficence b. veracity c. justice d. autonomy
D
A physician who fails to obtain informed consent before performing a procedure is subject to liability for: a. false imprisonment b. battery c. assault d. medical battery
D
9. A 22-year-old patient with schizophrenia is refusing his antipsychotic medication. He states, I don't like the dopey way it makes me feel. I feel like I'm walking under water when I take it. The nurse explains to him, Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better. This conversation reflects a conflict between which two types of ethical principles? A) Autonomy and justice B) Paternalism and veracity C) Justice and nonmaleficence D) Autonomy and beneficence
D) Autonomy and beneficence
12. A group of nursing students are reviewing the standards of professional performance. The students demonstrate understanding when they identify which as a standard of professional performance? A) Prescriptive authority B) Consultation C) Planning D) Collegiality
D) Collegiality
11. A group of nursing students are reviewing information about spirituality and religiousness. The group demonstrates understanding of these concepts when they identify religiousness as which of the following? A) Feeling of connectedness B) Way of interpreting life events C) Relationship with a unifying force D) Community participation in common worship
D) Community participation in common worship
13. A psychiatric mental health nurse is working on developing cultural competence. Which of the following would be most appropriate for the nurse to do? A) Research information about the cultures of the population being served after assessing the patients. B) Recognize that one's own culture is the predominant way of addressing a patient's health care needs. C) Assume that any individual of a racial or ethnic group is the same as another individual in that group. D) Demonstrate an appreciation of and a genuine interest in the individual and his or her cultural beliefs.
D) Demonstrate an appreciation of and a genuine interest in the individual and his or her cultural beliefs.
1. When reviewing several studies about Hispanic Americans and their use of mental health care facilities, the nurse notes that this cultural group tends to use all other resources before seeking help from mental health professionals. Which of the following would the nurse identify as a reason for this belief about many mental health facilities? A) Require periods of hospitalization B) Do not provide 24-hour emergency services C) Are not reimbursed by third party payers D) Do not accommodate their cultural needs
D) Do not accommodate their cultural needs
8. A psychiatric mental health nurse is teaching a class about social factors associated with mental illness at a community health center. When describing the influence of poverty and effects of the downward economic spiral on mental health, which population would the nurse identify as being the most at risk? A) Older adults B) Individuals with physical disabilities C) Single-parent families D) Homeless individuals
D) Homeless individuals
3. A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse's opinion most closely reflects which ethical principle? A) Nonmaleficence B) Paternalism C) Veracity D) Justice
D) Justice
14. An instructor is preparing a class for a group of students about professional organizations and the leadership provided. Which of the following would the instructor include as an important function of the International Society of Psychiatric-Mental Health Nurses? A) Advocating for mental health nursing practice through liaison activities B) Advancing psychiatric mental health nursing practice C) Improving mental health care for culturally diverse individuals D) Providing a strong voice for psychiatric mental health nurses
D) Providing a strong voice for psychiatric mental health nurses
2. A nurse is preparing a presentation about mental health problems associated with specific cultural groups. When describing mental health problems associated with Asian Americans, Polynesians, and Pacific Islanders, the nurse would address high rates of which of the following? A) Schizophrenia B) Manic disorders C) Dementia D) Suicide
D) Suicide
7. A patient is being treated for prostate cancer; his prognosis is very poor. The patient has a strong faith, and he has been active in his church for many years. He is concerned about his health and the challenges he faces as his cancer progresses. Which comment by the nurse reflects the most appropriate spiritual nursing intervention for the patient? A) I'll take you to visit my church if you can get a pass. B) You have to belong to the same church I do if you're going to go to heaven. C) Would you like me to bring you a guided imagery audiotape? D) We can pray together if you'd like.
D) We can pray together if you'd like.
PMH-RN
Demonstrates specialized competence and knowledge skills and abilities in caring for persons with mental health issues and problems and psychiatric disorders
MH nursing areas of concern
Emotional stress or crisis, self concept changes, developmental issues, physical symptoms that occur with psychological change, and symptom management of patients with MD
Islam
God is just and merciful; humans are limited and sinful. God rewards the good and punishes the sinful. Mohammed, through the Koran, guides people and teaches them truth. Peace is gained through submission to Allah. The sinless go to Paradise, and the evil go to Hell. A "good" Muslim obeys the Five Pillars of Islam
Christianity
God's love for all creatures is a basic belief. Salvation is gained by those who have faith and show humility toward God. Brotherly love is emphasized in acts of charity, kindness, and forgiveness.
Power of Attorney
Health proxies. Recognized under state laws and their courts. Ex. Living Wills and Advanced Directives
What are the four dimensions to support mental health recovery?
Health, home, purpose, and community
PMH-APRN
Highest level Two subcategories: Mental health clinical nurse specialist Psychiatric mental health nurse practitioner
Voluntary Commitment
If an individual admited themselves to a public facility.
Medical Battery
Intentional and unauthorized harmful or offensive contact. Occurs when a patient is treated without informed consent.
Judaism
Jews have a special relationship with God: obeying God's law through ethical behavior and ritual obedience earns the mercy and justice of God. God is worshiped through love, not out of fear.
Cultural Competence and Mental Health
Learn about the patient's country of origin before assessment. Conduct a thorough social and cultural assessment. Demonstrate genuine interest in and respect for the individual . Educate patients about mental health issues, including available treatments, benefits of obtaining services, and contributions and abilities of individuals with a mental illness. Do not assume that all individuals of a racial or ethnic group are the same. Being quiet and lack of eye contact may be culturally appropriate and may indicate shyness, not depression or another mental illness. Tailor interventions to the individual; one intervention does not work for everyone.
Internal Rights Protection System
Mechanisms to combat any violation of their patients' rights
What is a public stigma?
Occurs after individuals are publicly "marked" as being ill. Common stereotypes include being dangerous, unpredictable, or incapable of functioning independently.
What is self stigma?
Occurs when negative stereotypes are internalized by people with mental illness
APNA
Primary mission of advancing psychiatric mental health nursing improving mental health care for culturally diverse individuals, families, groups, and communites, and shaping health policy for the delivery of mental health services
Self-Determination
Promotes growth and well-being toward human potential through having basic psychological needs met including autonomy, competence, and relatedness.
social factors
Psychiatric disorders are not caused by _____, but their manifestations and treatment can be significantly affected by the society in which a patient lives
What is wellness?
Purposeful process of individual growth, integration of experience, and meaningful connection with others, reflecting personally valued goals and strengths and resulting in being well and living values.
Taoism
Quiet and happy harmony with nature is the key belief. Peace and contentment are found in the personal behaviors of optimism, passivity, humility, and internal calmness. Humility is an especially valued virtue. Conformity to the rhythm of nature and the universe leads to a simple, natural, and ideal life.
Shintoism
Reverence for ancestors and a traditional Japanese way of life are emphasized. Loyalty to places and locations where one lives or works and purity and balance in physical and mental life are major motivators of personal conduct.
Living Will
States what treatment should be omitted or refused in the event that a person in unable to make those decisions.
Communicate Choices
The ability to express choices.
Appreciate the Situation
The capacity to grasp what the information means specifically to the patient.
Competence
The degree to which the patient can understand and appreciate the information given during the consent process.
Plan of care
The emphasis is developing nursing care plans because they serve as a basis of practice and can be included in multidisciplinary or interdisciplinary individual treatment plan
Least Restrictive Environment
The idea that an individual cannot be restricted to an institution when he or she can be successfully treated in the community.
Privacy
The part of an individual's personal life that is not governed by society's laws and government intrusion.
scope standards of practice.
The practice of psychiatric nursing is regulated by law but guided by
Accreditation
The recognition or approval of an institution according to the accrediting body's criteria.
self
Through relationship building patients learn to trust the nurse who then guides, teaches, and advocates for quality treatment and care
Voluntary Admission
Treatment that occurs when the individual maintains all civil rights and is free to leave at any time even if it is against medical advice.
Incompetent
Unable to understand and appreciate the information given during the consent process.
Impact of Technology
With the use of electronic health records protection in patient confidentiality is more difficult in some ways Patients records now more readily available and accessed Electronic documentation enables nurses terminology to be standardized and readily available to nurses
Advanced Care Derectives
Written instructions for health care when individuals are incapacitated.
A nurse is preparing a presentation for a group of new nurses about mental illness and recovery. When describing the guiding principle that recovery is person-driven, what information would the nurse include? a. definition of personal life goals to develop a unique path b. role of mutual support and aid groups for sharing c. belief in the reality of recovery as motivation for a better future d. integration and coordination of services to address the individual's whole life
a
what statement is most accurate abut the DM-5? a. boundaries separating disorders are not absolute b. diagnoses avoid the inclusion of subtypes c. specifiers for classification are extremely rar d. the manifestations of disorders are consistent over time
a
Informed Consent
a legal procedure to ensure that a patient knows the benefits and costs of treatment.
the biopsychosocial framework
a well recognized holistic model for organizing patient health care issues. The model Delineates interactive domains of an individuals mental health and provides a framework for implementing the nursing process
When a person avoids mental health treatment for fear of being labeled mentally ill, which type of sigma is occurring? a. label avoidance b. public stigma c. discrimination d. self-stigma
a. label avoidance
In epidemiology, certain terms have specific meanings relative to what they measure. What represents the total number of people who have a disorder within a given population at a specific time, regardless of how long ago the disorder started? a. prevalence b. rate c. incidence d. point prevalence
a. prevalence
There are several definitions of cultural and linguistic competence, but there is a general consensus that cultural and linguistic competence involves an
adjustment or recognition of one's own culture in order to understand the culture of another person
point prevalence of disease
affected number of pop. at a specific time.
Studies indicate that Hispanic Americans tend to use
all other resources before seeking help from mental health professionals
Diagnosis
analyzes the assesment data determine diagnosis, problems, and areas of focus for care and treatment including level of risk
Although competency is a legal determination, it is not clearly defined across states. What is a true statement regarding competence? a. competent clients may not refuse all aspects of the treatment plan b. it is decision specific c. health care providers can overrule an irrational decision made by a competent person d. competency is the same as rationality
b
Which mental health client meets criteria to be involuntarily committed? A. a client diagnosed with mania who is pacing the hallways b. client diagnosed with borderline personality disorder who is threatening to self-harm c. diagnosis of anxiety who is fidgeting d. diagnosis of schizo who is singing in their room
b
When reviewing research related to the epidemiology of mental disorders, a nurse understands that this information reflects: a. causes of disorders b. associations among possible factors c. raw data about the population d. total population with the disorder
b.
Which statement would a nurse integrate into an education plan for a local community group about mental illness and mental disorders? a. often there is one primary cause that is responsible for the mental disorder b. clusters of behaviors, thoughts, and feelings define mental disorders c. diagnostic testing is often required to arrive at a diagnosis d. the current belief is that there is an underlying biologic pathology associated with a mental illness
b. clusters of behaviors, thoughts, and feelings define mental disorders
Which would be used to document a specific pattern of symptoms that occurs within a community? a. stigma b. cultural syndrome c. wellness d. stereotype
b. cultural sydrome
When reviewing epidemiological info about mental illness which term would nurse identify as being used to describe # of cases in population compared with the total population a. incidence b. rate c. point prevalence d. prevalence
b. rate
Communication may be adversely affected when patients are unable to fully
express themselves in English
What are barriers for treatment for the Hispanic population include
beliefs that mental health facilities do not accommodate their cultural needs (e.g., language, beliefs, and values), cost of care, and concerns regarding immigration status
A nurse is working with a patient diagnosed with a mental illness. Which is the most important goal for individuals with mental disorders? a social networking b self-direction c recovery d empowerment
c recovery
According to the WHO, by 2030 which mental illness is projected to be leading burden of disease worldwide? a. substance abuse b. schizophrenia c. depression d. anxiety
c. depression
Assesment
collects and synthesizes comprehensive health data that are parent to health care consumers or situation
intNSA
comitted to addition disorders
how is competent behavior is decided
communicate choices understanding of info appreciate the situation and consequences use a logical thought process
biopsychosocial domains
consists of three separate but interdependent domains: Biological, psychological, and social. Each domain has independent knowledge and treatment focus but interacts and is mutually interdependent with the other domains
A nurse who is culturally competent understands and appreciates
cultural differences in health care practices and similarities within, among, and between groups
There are linguistic variations within cultural groups as well as
cultural variations within a language group
Psychiatric-mental health nurses have an obligation to be
culturally and linguistically competent to provide quality care.
Many African Americans have
extensive family networks in which members can be relied on for moral support, help with child rearing, provide financial aid, and help in crises
After educating a group of nursing students about mental health and wellness, which statement by a group member indications the need for additional education? a. a person can't be healthy without being mentally healthy b. poverty and unemployment are common in mental health issues. c. person can be mentally healthy but still have a mental disorder d. mental health problems have minimal effect on the process of wellness
d
One of the major problems facing individuals with mental illness and their families is stigma. Which is inconsistent with stigmatization? a. discrimination b. prejudice c. misunderstanding d. approval
d. approval
Epidemiology addresses the distribution of mental illness and the determinants of health within a given population. Which term is defined as the rate of new cases within a defined time period? a. rate b. prevalence c. point prevalence d. incidence
d. incidence
A nurse is conducting education program in a community to have an outpatient mental health facility build. One of participants states "i don't want those people in this area. They are dangerous and unpredictable" This is what: a. cultural syndrome b. label avoidance c. self-stigma d. public stigma
d. public stigma
Asian cultures have a tradition of
denying or disguising the existence of mental illnesses
clinical reasoning
depends on critical thinking skills and reflection. Critical thinking skills such as problem solving and decision making nurses analyze, evaluate, explain, interfere, and interpret biopsychosocial data
planning
develops a plan the prescribes strategies and alternatives to assist the health care consumer in attainment of expected outcomes
Spirituality
develops over time and is a dynamic, conscious process characterized by two movements of transcendence (going beyond the limits of ordinary experiences): either deep within the self or beyond the self. Self-transcendence involves self-reflection and living according to one's values in establishing meaning to events and a purpose to life. Transcendence beyond self is characterized by a feeling of connection and mutuality to a higher power
Native American cultures emphasize respect and reverence for the
earth and nature, from which come survival and comprehension of life and one's relationships with a separate, higher spiritual being and with other human beings
Cultural competence is demonstrated in several ways. Valuing patients' culture beliefs and recognizing the need to bridge language barriers are
essential behaviors
standard of professional performance
ethics, education, EBP and research, quality of practice, Communication, Leadership, Collaboration, professional practice evaluation, resource utilization, and environmental health
evaluation
evaluates the progress toward attainment of expected outcomes
In certain Native American groups, people with mental illnesses are
stigmatized
In other groups, a particular event, such as suicide, is
stigmatized
African Americans with mental illness suffer from the
stress of double stigma—not only from their own cultural group but also from longtime racial discrimination To make matters worse, racial discrimination may come from within the health community itself
mental illness is viewed as a
supernatural possession, as being out of balance with nature in some native american culture
Epidemology
the branch of medicine that investigates the causes and conditions of epidemics
Linguistic competence
the capacity to communicate effectively and convey information that is easily understood by diverse audiences and address the health literacy needs of patients and their families, is an important part of cultural competence
Veracity
the duty to tell the truth
. Demonstrating an understanding that literacy levels contribute to
the interpretation of personal, psychological experiences is critical
Involuntary Commitment
the mandated treatment without the person's consent but with a court order.
incidence of disease
the rate of NEW diagnosed cases of a disease
Acculturation is the term used to describe
the socialization process by which minority groups learn and adopt selective aspects of the dominant culture. Their culture changes as a result of the influences of the new environment
PHM-RN is characterized by
the use of the nursing process to treat people with actual or potential mental health problems, psychiatric disorders and co occuring psychriatric and substance abuse disorder
Ethnic and racial minorities in the United States live in a social environment of inequality that increases their exposure to racism, discrimination, violence, and poverty, which contribute to the experience of
their illnesses
Psychological domain
theoretical basis fo the psychological processes - thought, feelings, and behavior that influence ones emotions, cognition, and behavior
Social Domain
theories that account for the influence of social forces encompassing the patient, family, and community within cultural settings.
prevalence of disease
total number of existing cases with respect to the entire population