Psych - Videbeck Ch 4

Which areas of discharge planning are important to ensuring client safety? Select all that apply.

Medication education Food-drug interactions Special diet instructions

The nurse works for a psychiatric-mental health facility that utilizes traditional milieu therapy. Which stage of milieu therapy allows for control and limitation of maladaptive behaviors including yelling and screaming?

Structure

Which client is suitable for psychiatric transitional care services?

An individual being discharged from hospital with residual symptoms of mania

Which program provides comprehensive, highly individualized consumer services to those with severe and persistent mental illness?

Assertive community treatment

Coordination of care uses services that enable individualized care. Which type of service is also known as the "broker" model?

Case management

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

Case manager

Which client may be the most appropriate candidate for telepsychiatry?

A client whose depression does not warrant inpatient or outpatient care but who is motivated to maintain the client's health

The nurse is caring for a group of individuals with mental health disorders in an outpatient clinic. Which client is most likely to be referred to transitional care mental health services?

A client with schizophrenia and diabetes

A client was diagnosed with bipolar I disorder several years ago. After occasional inpatient admissions surrounding manic episodes over the past few years, the client has been receiving outpatient psychiatric services for the past 12 months. The client's care providers, however, are concerned that these outpatient services are not meeting the client's needs. Which service would best fit this client's needs at this time?

A day-treatment program

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 ongoing self-reflection and self-awareness.

The same principles that define the nursing process are at work within the provision of community based mental health services through which interventions?

Coordination of care

Which is an example of secondary prevention in the forensic setting?

Crisis intervention

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?

Clients commonly struggle with trusting others.

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?

Criteria for admission to inpatient care have become legally regulated.

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

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?

Upon admission to the inpatient setting

The introduction of psychotropic medications occurred in which decade?

1950s

Which mental health clients is most likely to frequently present in the emergency department in hospital?

A 34-year-old person diagnosed with an amphetamine addiction who has overdosed

A nursing instructor is teaching a class about transitional psychiatric care. The instructor determines that additional education is needed when the class identifies which client as appropriate for this care?

A 42-year-old who would like to enter marriage counseling

Which community activity is an example of tertiary prevention in a community that experienced a massive fire?

A master plan was formulated for what to do in case of another fire.

Which best defines a community support system in relation to mental illness?

A network that helps to meet the needs of people with mental illness and to realize their potential without unnecessary isolation

Which best describes the scope of what community support services provide?

A wide range of services, from health care and education to housing arrangements, employment counseling, and rehabilitation

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

Which is the most restrictive setting in the continuum?

Acute inpatient hospitalization

Which would not be considered an impediment to successful discharge planning?

Compliance with the therapeutic regimen

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.

Development of social skills. Stabilization of symptoms. Training to perform activities of daily living.

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?

Empower clients to achieve the highest level of functioning possible

The approach of the services provided to facilitate recovery for individuals must be based on which aspect?

Empowerment

Clients admitted to a psychiatric unit may be frightened, angry, and paranoid; it may be difficult for a nurse to establish good rapport under these circumstances. Often they also fear being bullied or attacked. What is a nursing priority at this time?

Ensure safety.

The client is a 46-year-old who is being admitted to a psychiatric-mental health facility. The client is angry, defensive, and paranoid. Which is the nurse's priority?

Ensuring client and personal safety

Which areas of discharge planning are important to ensuring client safety? Select all that apply.

Food-drug interactions Special diet instructions Medication education

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

The nurse is planning care for clients in a forensic setting. Which supports a trusting nurse-client relationship?

Health teaching

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

A nurse is developing a community education program for a local women's club on the topic of managed care in mental health. Which would the nurse include as the main focus?

Improved access to less costly 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?

In-house psychiatric unit

Assertive Community Treatment (ACT) reduces the use of which type of service?

In-patient Hospital

Which statement is true concerning clients with dual diagnoses?

Integrated care is preferred over split care for the separate diagnoses

Which statement accurately describes the clubhouse model of community-based mental health rehabilitation?

It exists to promote rehabilitation alliance.

Which is accurate regarding assertive community treatment (ACT)?

It offers intensive community-based services.

The nurse working in a psychiatric institution is researching treatment systems that facilitate effective learning. The nurse believes that effective milieu therapy cannot be practiced in today's institutional settings. What disadvantage related to milieu therapy may have led the nurse to believe this?

It requires clients to have longer lengths of stay.

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

A nurse working in a psychiatric inpatient facility correctly identifies the term "milieu therapy" to mean what?

Maintenance of the therapeutic environment

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.

When clients are admitted to inpatient psychiatric settings, which member of the health care team is often the first whom they meet?

Nurse

Which type of setting is used for clients who continue to need supervision but not long-term admission?

Partial (day) hospitalization

The client is a 32-year-old diagnosed with bipolar disorder. The client attends group therapy for 6 hours a day and then returns home to the client's residence. In which setting would the client receive this type of care?

Partial hospitalization program

Which goal for an individual client is consistent with the overall objectives of community support service programs?

The client's functional ability will improve.

A nurse is reviewing information about the various types of outpatient mental health care programs. The nurse demonstrates understanding by identifying which type as providing the most intensive outpatient nursing care?

Partial hospitalization programs

Which mental health treatment setting is not a residential treatment setting?

Partial hospitalization programs

Which would be most important for the nurse to do in order to maximize client adherence with the discharge plan?

Partnering with the client from the beginning

Despite family members' concerns, a client has been discharged home after a recent suicide attempt and a diagnosis of major depression. Which phenomenon has been identified as contributing to reduced lengths of hospital stays in recent years?

Pressures to reduce health care costs associated with inpatient care

The goal of respite services as a prevention strategy includes what?

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

A case manager is working with a parent whose child has schizophrenia. The parent reports sadness, frequent crying, and fatigue. The case manager works with the parent to establish some scheduled rest, relaxation, and respite from caring for the child. At which level of prevention is the case manager working with the parent?

Primary

One goal of transitional care in mental health care is what?

Provide an alternative for inpatient admission

What are some of the goals of psychiatric rehabilitation? Select all that apply.

Recovery from mental illness Increased independence Increased involvement in treatment decisions

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?

Respite residential care

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

Which type of care provides periodic relief to caregivers of a mentally ill client?

Respite residential care

One major reason that clients with mental disorders are rehospitalized is what?

Resurfacing of acute symptoms

Which are core skill areas that must be implemented by any effective team member of an interdisciplinary team? Select all that apply.

Risk assessment and risk management skills Teamwork skills Communication skills Interpersonal skills

A client is referred to a psychosocial rehabilitation program. When explaining this type of care to the client, what would the nurse emphasize?

Services that promote the client's reintegration into 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?

Stabilize acute symptoms

The ultimate goal of the treatment plan in inpatient care settings is what?

Stabilize the client

During milieu therapy, nurses offer positive feedback and praise for appropriate behaviors. These actions are essential to which concept of milieu therapy?

Support

The nurse explains that the primary criterion for enrollment in a day treatment program for clients with eating disorders is what?

Symptom acuity does not require psychiatric hospitalization

A client is receiving crisis stabilization in an inpatient facility. The nurse would focus care on what?

Symptom stabilization

Which would be an appropriate intervention to help a client regain, maintain, or improve psychological well-being?

Teach problem solving, stress reduction, coping, and proper interpersonal communication skills.

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?

Tertiary

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.

A 22-year-old client with a history of a recent suicide attempt is being treated for depression. Prior to becoming depressed, the client self-describes as "very social and doing well in school." Which of the following long-term treatment goals is best suited for this client?

The client will resume previous level of functioning.

Individuals may need assistance with the coordination of care and community service programs related to what?

The complexity of access to the community service programs available

A college's nursing program has added an elective in forensic nursing to the curriculum. Which phenomenon underlies the expanded role for forensic nursing that is expected in the future?

The fact that there are high rates of mental illness among the populations of jails and prisons

A client is in need of a family-like environment with a high level of support. Which would be most appropriate?

Therapeutic foster care

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 address the needs of adults with mental illness and increase their ability to function

Initiatives that strive to strengthen links between primary care and specialized mental health services refer to ...

collaborative mental health care.