Chapter 1: PrepU
How should the nurse best explain the purpose of the DSM-5 to the client recently diagnosed with bipolar disorder? A- "It provides a standardized language that is understood by all mental health professionals." B- "It is used to assist in identifying the underlying causes of your disorder." C- "It helps identify possible medical conditions that are contributing to your signs/symptoms." D- "It contains information about all the major psychiatric disorders including bipolar disorder."
"It is used to assist in identifying the underlying causes of your disorder." While all the options present accurate information about the DSM-5, the client's interest in this mental health resource is one of a personal nature. Describing the purpose of the DSM-5 in relationship to the client's diagnosis would be the most appropriate answer.
What is considered 'mental health'?
"Mental health is marked by productivity, fulfilling relationships, and adaptability." 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.
What is deinstitutionalization?
(from Google): Deinstitutionalization is a government policy that moved mental health patients out of state-run "insane asylums" into federally funded community mental health centers. It began in the 1960s as a way to improve the treatment of the mentally ill while also cutting government budgets. (from CoursePoint): the process of deinstitutionalization involves moving chronically mentally ill clients from state psychiatric hospitals back to their homes or to community-supervised facilities.
What are some negative outcomes from deinstitutionalization?
-"revolving door" of repetitive hospital admission without adequate community follow-up -decreased community resources -the majority of those who are mentally ill are unable to achieve independence.
Which is an inaccurate depiction of self-awareness? -It involves changing one's values or beliefs. -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 self-reflection.
-It involves changing one's values or beliefs.
Skills and practices of the psychiatric-mental health registered nurse may include...
-assessing and recording behavior -administering and evaluating the effectiveness of medications -communicating with other team members -being in charge of the psychiatric milieu
Skills and practices of the advanced psychiatric-mental health nurse may include...
-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.
The Substance Abuse and Mental Health Services Administration (SAMSHA)estimates that more than what percentage of Americans aged 18 years and older has a diagnosable mental disorder?
18.6% It is estimated that more than 18.6% of Americans aged 18 years and older have a diagnosable mental disorder.
What percentage of adults requiring mental health services get the care they need?
25%
Approximately what percentage of homeless people suffer from a severe psychiatric illness of a chronic substance use disorder?
42% Approximately 257,300 of the homeless population (42%) have a severe mental illness of a chronic substance use disorder.
Deinstitutionalization has reduced the number of public hospital beds by what percentage?
80% Although deinstitutionalization has reduced the number of public hospital beds by 80%, the number of admissions to those beds correspondingly increased by 90%.
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
When discussing instutionalization, which issue would most likely be considered a major problem associated with large state institutions? Select all that apply. A- Attendants were accused of torturing female residents B- Sophisticated biologic treatments were unsuccessful C- Clients were isolated from family and community D- Financial costs increased to individual residents E- Clients were not given proper nutrition or clothed properly
A- Attendants were accused of torturing female residents C- Clients were isolated from family and community E- Clients were not given proper nutrition or clothed properly Explanation: Clients were socially isolated from their families and normal community life, often far removed from the local community, family, and friends because state institutions were usually in rural or remote settings. As well, there were serious deficits in the quality of care and instances of abuse have been documented. Women were psychologically degraded, used as servants, and physically tortured by male physicians and female attendants. Residents were not normally required to pay for their own care. Institutions had little more to offer than food, clothing, pleasant surroundings, and perhaps some means of employment and exercise.
What are the standards of professional performance that a nurse should implement when caring for a mentally ill client? Select all that apply. A- Collegial interaction B- Evaluation of client progress C- Integration of research D- Consultation with clients and their families E- Collaboration with clients and their families
A- Collegial interaction C- Integration of research E- Collaboration with clients and their families The standards of professional performance are integrating research findings into practice; collegiality, i.e., interaction with and contribution to the professional development of colleagues and peers; and collaboration with clients, the family, and others in nursing practice. Evaluation of a client's progress with treatment and consultation are standards of practice.
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? A- Demonic control B- Personal failure C- Physical illness D- Contaminated environments
A- Demonic control 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).
What is the primary benefit of the DSM-5 to the student nurse's practice with the mentally ill population? A- Encourages the building of a knowledge base about the nature of psychiatric illnesses. B- Facilitates communication with other mental health care providers through a standardized language C- Identifies medical conditions that could be contributing to decline of the client's mental health status D- Provides insight into the effects of environmental problems the client may be facing
A- Encourages the building of a knowledge base about the nature of psychiatric illnesses. While all the options are true statements, the greatest benefit the DSM-5 has for the nursing student is that is contributes to the student's knowledge about the nature of the major mental illness. Since the student nurse is not involved in the actual diagnosing of clients, the remaining options have limited value.
How can a nurse best assure the management of personal long-term self-reflection that is associated with professional interaction with clients? A- Engage in regular discussions with a formal clinical supervisor B-Keep a journal that focuses on personal feelings C- Communicate with peers working in similar client environments D- Regularly reflect from the client's point of view
A- Engage in regular discussions with a formal clinical supervisor While all the options present interventions to foster self-reflection, the nurse should engage in formal clinical supervision. Even experienced clinicians have a supervisor with whom they discuss personal feelings and challenging client situations to gain insight and new approaches. The other options are more focused on less formal, more self-directed reflection activities.
A psychiatric-mental health nurse is working a booth at a local community college job fair. One of the participants comes to the booth and asks the nurse about the different types of conditions for which psychiatric-mental health nurses provide care. Which condition would the nurse most likely include in the response? (Select all that apply.) A- Issues involving self-mutilation B- Self-esteem issues related to loss of a limb C- Problems associated with family or group isolation D- Substance use disorders E- High health literacy issues for adherence
A- Issues involving self-mutilation B- Self-esteem issues related to loss of a limb C- Problems associated with family or group isolation D- Substance use disorders Psychiatric nurses care for clients with a wide range of emotional problems and mental disorders. These nurses, specializing in mental health nursing, are not only experts in caring for persons with a primary diagnosis of a mental disorder but also for those with self-concept and body image issues, developmental crises, co-occurring disorders, end-of-life changes, and emotional stress related to illness, disability, or loss. It is a psychiatric nurse who is called when violence, suicide, or a disaster erupts. Issues involving non-adherence related to low health literacy would be a situation in which psychiatric-mental health nurses would be involved.
Who was the first trained nurse in the United States? A- Linda Richards B- Florence Nightingale C- Hildegard Peplau D- Effie Taylor
A- Linda Richards Linda Richards was the first trained nurse in the United States. She opened the Boston City Hospital training school for nurses in 1882 at McClean Hospital. The roots of contemporary psychiatric-mental health nursing can be traced to Florence Nightingale's holistic view of the client who lives within a family and community. Hildegard Peplau conceptualized nursing practice as independent of physicians. In 1913, Effie Taylor integrated psychiatric nursing content into the curriculum at John Hopkins' Phipps Clinic.
A psychiatric-mental health nurse is working on a committee that is developing programs that integrate the objectives for mental health and mental disorders, as identified in Healthy People 2020. Which type of program would be least appropriate? A- Single substance abuse treatment programs B- Depression-screening programs for primary care providers C- Mental health programs for the homeless population D- Employment programs for those with serious mental illness
A- Single substance abuse treatment programs The objectives of Healthy People 2020 identify the need to increase the proportion of persons with **co-occurring substance abuse and mental disorders** receiving treatment for both disorders. Thus, **single** substance abuse treatment programs would be least beneficial. The objectives call for an increase in depression screening by primary care providers, an increase in the proportion of homeless adults with mental health problems who receive mental health treatment, and an increase in the proportion of persons with serious mental illness who are employed.
The nurse knows the written instructions for healthcare when a person is incapacitated is called a- living will b- durable powerr of attorney c- advanced directive d- informed consent
Advanced 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.
Chlorpromazine is a drug in which classification?
Antipsychotic Chlorpromazine (Thorazine) is a first generation antipsychotic medication.
The nurse is planning care for a client who has been newly diagnosed with a mental illness. Which should be the nurse's first step in managing this client's nursing care?
Assessment (ADPIE)
During the moral treatment period, clients were routinely placed into which environment?
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 (safe places), which were thought to be best for their safety and comfort.
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 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.
A psychiatric-mental health nurse is preparing a presentation about the historical evolution of current psychiatric-mental health treatment. When describing the impact of Sigmund Freud's work on care, which information would the nurse most likely include? Select all that apply. A- Focus on the physiological aspects of mental illness B- A disturbance in personality development as an underlying issue C- Use of psychoanalysis to address the underlying injury D- Short-term use of medication therapy to correct the cause E- Application of conscious motivations for behavior
B- A disturbance in personality development as an underlying issue C-Use of psychoanalysis to address the underlying injury Sigmund Freud believed the primary causes of mental illnesses were psychological and a result of disturbed personality development and faulty parenting. He developed a personality theory based on unconscious motivations for behavior, or drives. Psychoanalysis, which was long-term and costly, focused on repairing the trauma of the original psychological injury. Medication therapy was not associated with Freud.
A nurse can accurately identify which personal characteristics that contribute to mental health? Select all that apply. A- Rarely recognizes stress B- Generally happy with life C- Personal self-awareness D- Sense of responsibility for one's own actions E- Relatively worry free
B- Generally happy with life C- Personal self-awareness D- Sense of responsibility for one's own actions E- Relatively worry free
A client refuses to interact with a student nurse during a clinical session. Which would be the most helpful in the immediate situation? Select all that apply. A- Ask to be assigned to another client B- Listen to the client C- Ask another student for support D- Show genuine interest in the client's situation E- Share something personal with the client
B- Listen to the client D- Show genuine interest in the client's situation
The nursing instructor asks the student to perform an assessment of a mentally ill client. What should the student do when executing this task? A- Diagnose the problem B- Identify the outcome C- Collect comprehensive data D- Plan alternative interventions to attain the outcome
C- Collect comprehensive data Assessment is the first standard of practice, during which the nurse collects comprehensive data from the client. Diagnosis is arrived at after analyzing the data obtained. Outcome identification is done after diagnosing the client's illness. Planning alternative interventions to attain an outcome is performed after identifying the outcome.
Which skill is in the psychiatric-mental health registered nurse's scope of practice? A- Prescribing psychiatric medications B- Conducting individual psychoanalysis C- Evaluating the effectiveness of psychiatric medications D- Diagnosing psychiatric-mental health conditions
C- Evaluating the effectiveness of psychiatric medications
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? A- Leadership B- Quality of practice C- Resource utilization D- Professional practice evaluation
C- Resource utilization 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.
A psychiatric-mental health nurse is asked to be a guest speaker at a community fund-raising event for mental health services. Which would the nurse emphasize as the primary focus of the current consumer movement and mental health services? A- Access to affordable mental health care B- Removal of exclusions because of preexisting conditions C-Recovery from mental illness as a realistic goal D- Effective treatment for mental health care needs
C-Recovery from mental illness as a realistic goal Although access to affordable mental health care, removal of exclusions for preexisting conditions, and effective treatment for mental health care needs are important, recovery from mental illness is a realistic and now a worldwide goal. To attain this goal, mental health professionals work in partnership with consumers to help rebuild their lives.
In the early Christian period, who treated clients thought to be possessed by demons causing their mental illness?
Clergymen
The psychiatric mental health nurse is planning the care of a client. What action best addresses the client's needs in the social domain?
Collaborating with the client's family to organize support Family support exists within the social domain
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
The following events are important in the development of psychiatric-mental health nursing practice. Which event occurred first? a- Publication of Standards of Psychiatric-Mental Health Nursing by the ANA b- Publication of Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice c- Establishment of the first graduate program in psychiatric nursing at Rutgers University d- Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey
D- Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey 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.
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? A- Emotional disorders were believed to be an organic dysfunction. B- Treatment included sedation, good nutrition and hygiene, and music and recreation. C- Mental illness was considered a disturbance of the four body fluids, or "humors." D- Belief in demonic possession and exorcism was common.
D- Belief in demonic possession and exorcism was common.
A client diagnosed with schizophrenia has recently become divorced and is living in public housing. How would the DSM-5 best help in planning this client's care? A- It is used by all mental health professionals to identify and treat the mentally ill client. B- It provides information on all major mental health disorders and their effect on existing health issues. C- It provides the mental health team with links to the latest clinical research on schizophrenia. D- It is used by the mental health team to identify the psychosocial and environmental factors currently affecting the client.
D- It is used by the mental health team to identify the psychosocial and environmental factors currently affecting the client. Explanation: While all the options are correct, the primary benefit the DSM-5 has for effective care planning for this client is that it assists in identifying psychosocial and environmental factors that may affect the client's treatment and prognosis. None of the other options has this direct connection to the client's specialized needs.
A client diagnosed with schizophrenia has recently become divorced and is living in public housing. How would the DSM-5 best help in planning this client's care? A- It is used by all mental health professionals to identify and treat the mentally ill client. B- It provides information on all major mental health disorders and their effect on existing health issues. C- It provides the mental health team with links to the latest clinical research on schizophrenia. D- It is used by the mental health team to identify the psychosocial and environmental factors currently affecting the client.
D- It is used by the mental health team to identify the psychosocial and environmental factors currently affecting the client. While all the options are correct, the primary benefit the DSM-5 has for effective care planning for this client is that it assists in identifying psychosocial and environmental factors that may affect the client's treatment and prognosis. None of the other options has this direct connection to the client's specialized needs.
In early Christian times, what was thought to cause mental illness?
Demonic control
The student nurse has been unsuccessful in the psychiatric clinical placement and will have 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
The nurse recognizes that public education is needed to erode stigma to prevent what?
Discrimination Discrimination against an individual is the greatest negative result of the public's stigma related to mental illness.
When reviewing the evolution of mental health care in the United States, a psychiatric-mental health nurse reads about the creation of state hospitals for mental health care. The nurse would attribute this concept of care as the idea supported by... Horace Mann. Clifford Beers. Dorothea Dix. Sigmund Freud.
Dorothea Dix. Dorothea Dix was a vigorous crusader for the humane treatment of clients with mental illness and was responsible for much of the reform of the mental health care system in the 19th century. Her solution was the creation of state hospitals. Horace Mann is credited with the mandate that states assume financial responsibility for the care of people with mental illnesses. Clifford Beers was an advocate for the human treatment of individuals with mental illness. Sigmund Freud developed a personality theory for mental illness based on unconscious motivations for behavior.
Who was responsible for much of the reform of the mental health care system in the 19th century?
Dorthea Dix
Freud's personality theory was based on what?
Drives Freud developed a personality theory based on unconscious motivations for behavior, or drives. --- Oral Anal Phallic Latent Genital
The advanced practice registered nurse is planning interventions for clients in a mental health practice. Which are considered basic level? Consulting Conducting psychotherapy Ensuring a therapeutic environment Improving client function and health Prescribing medications
Ensuring a therapeutic environment Improving client function and health Basic level nurses do not consult; prescribe meds; or conduct psychotherapy -- those can be performed by an advanced practice registered nurse.
Initially, the nurse should focus on successfully achieving which goal in order to effectively provide care for a client diagnosed with a mental illness?
Establishing trust and rapport with the client 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.
In terms of causing disability among people aged 15 to 44 years of age in North America, where does mental illness rank?
First Compared with all other diseases, mental illness ranks first in terms of causing disability in the United States, Canada, and Western Europe.
Which is a difference between counseling and psychotherapy?
Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role.
Who was the first to introduce the concept of interpersonal relations and the therapeutic relationship?
Hildegard Peplau In 1952, Hildegard 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.
When providing care to a client, the psychiatric-mental health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual?
Hildegard Peplau conceptualized nursing practice as independent of physicians and emphasized the use of self as a nursing tool.
A nurse is reading a journal article about the evolution of psychiatric-mental health nursing. Which individual would the nurse identify as being the first to address the education of psychiatric nursing? Effie Taylor Linda Richards Harriet Bailey Hildegarde Peplau
In 1913, Effie Taylor integrated psychiatric nursing content into the curriculum at Johns Hopkins' Phipps Clinic.
What is the best definition for mental illness?
Inability to function in a manner that manages both external and internal stressors effectively
Which is the most influencing factor that complicates the treatment of people with mental illness in the Unites States?
Insurers' reimbursement decisions 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.
Medical insurance coverage for medical illnesses is greater than for psychiatric illnesses. What term best describes this discrepancy?
Lack of parity Parity refers to the various inequities inherent in any health care system. Many health plans cover the costs of psychotropic drugs at far lower rates than they do for other medications. Health care inequities are largely a result of social values and perceived significance. A gap exists between the most effective treatments available and what people actually receive
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?
Linda Richards 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.
What is the difference between Medicaid and Medicare?
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.
Which federal law prevents insurance companies from enforcing annual or lifetime dollar amounts to be paid for mental health care?
Mental Health Parity Act In 1996, Congress passed the Mental Health Parity Act, which eliminated annual and lifetime dollar amounts for mental health care for companies with more than 50 employees. However, substance abuse was not covered by this law, and companies could still limit the number of days in the hospital or the number of clinic visits per year.
A nurse is conducting a review class for a group of psychiatric-mental health nurses about the changes in psychiatric care that have occurred through the years related to legislation and policy initiatives. The nurse determines that the teaching was successful when the group identifies that supporters of the Community Mental Health Centers Construction Act (1963) believed that institutionalization was contributing to what?
Mental Illness The supporters of the 1963 legislation believed the exact opposite of what Dorothea Dix believed during the previous century. That is, instead of viewing an institution as a peaceful asylum, institutionalization was viewed as contributing to illness. Financial problems declined with deinstitutionalization as federal legislation was passed to provide an income for disabled persons allowing people with severe and persistent mental illness to be more independent financially. Overpopulation was prevented by commitment laws in the early 1970s, making it more difficult to commit people which further decreased the state hospital populations. Medication abuse was not associated with institutionalization
Maintaining a therapeutic environment and promoting growth through role modeling are components of which basic level function?
Milieu therapy A basic level function is milieu therapy, which is the maintenance of the therapeutic environment. (from Google): milieu therapy is a form of psychotherapy in which the patient's social environment is controlled or manipulated with a view to preventing self-destructive behavior.
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 In 1952, Hildegard 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.
Which organization sets professional standards of nursing care?
Professional nursing organizations ...States and provinces grant the legal authority to practice nursing, but professional nursing organizations set standards of care and professional nursing activities.
Which intervention is appropriate for a psychiatric-mental health nurse at the basic level of practice? Promoting symptom management Managing psychotropic medications Conducting family therapy Interpreting laboratory tests
Promoting symptom management
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?
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.
Which mental health service is an advanced-level function?
Psychotherapy
Which is a clinical activity of only the advanced practice registered nurse?
Psychotherapy Also clinical supervision and community interventions.
What nursing action demonstrates the intended impact of the American Nurses Association (ANA) standards of care on mental health nursing care?
Referring to the standards to determine if a particularly prescribed treatment falls within the scope of a nurse's practice.
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?
Report the incident to staff and the clinical instructor so boundaries can be reinforced 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.
Which is a criterion for mental health?
Satisfaction with personal relationships and self. 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.
Dorothea Dix's solution to gain humane treatment for the mentally ill population included what?
State hospitals 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.
A client with mental illness has come to an outpatient mental health clinical for a counselling session with the community mental health nurse. Which areas should be the focus of counselling for this client? Select all that apply. Occupational skills Stress management Behavior modification Role modeling Communication skills
Stress management Behavior modification Communication skills Counseling is a process that brings about desired change in managing a client's stress and behavior as well as improvement in the client's communication. Teaching skills and promoting growth through role modeling are components of milieu therapy.
What was the major goal of the Community Mental Health Act of 1963?
The 1963 Community Mental Health Act was designed to build/provide community-based facilities that were centered around mental health.
One of the primary reforms accomplished by Dorothea Dix was...?
The establishment or enlargement of state hospitals. Dorothea Dix is well known for the establishment/ 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. Dorothea Dix crusaded for the humane treatment of clients with mental illness.
Which is necessary as a defining feature in mental illness?
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.
Which is the greatest barrier to an individual's ability to obtain the most effective and safest psychiatric medication?
The medications are often not covered by the managed care system because they are expensive.
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
What are the individual factors a nurse has to be aware of that may influence the mental health of a client with schizophrenia? Select all that apply: Intimacy Vitality Connectedness Self-esteem Biological makeup
Vitality Self-esteem Biological makeup The personal and individual factors that may influence the mental health of a client with schizophrenia are vitality, self-esteem, and biological makeup. Intimacy and connectedness are the interpersonal factors that influence mental health.
During the 1800s, Pinel believed that the cure for mental illness was:
moral treatment defined as kindness, compassion, and a pleasant environment. Philippe Pinel was one of the first physicians who began using moral treatment in France.
