Chapter 1: Psychiatric Mental Health Nursing and Evidence-Based Practice

The nurse is revising policies on the behavioral health unit to align with current standards of practice to ensure safe, quality care. Which regulations that guide the nursing profession will guide the nurse?

ANA (American Nurses Association)

A psychiatric-mental health clinical nurse specialist is conducting an in-service program for a group of psychiatric-mental nurses. The clinical nurse specialist is discussing the use of evidence-based practice, describing it as a:

problem-solving approach to clinical decision making.

If a client states, "I carry this lucky rabbit's foot for luck, my parent did too, and it really works," which statement by the nurse reflects respect for the client's belief?

"I can accept that you feel it is lucky, so let's get to our activities for the day."

Which client statement demonstrates the most positive aspect of treating clients with mental illness in community-based care?

"I can live in my own home and still see a therapist regularly."

The nurse is assessing a newly admitted client with cholecystitis. When performing the admission assessment, which statement by the client is an indicator of optimal mental health?

"I practice yoga regularly since it helps manage any stress I am feeling."

A client grieving the recent loss of a spouse, asks, "Am I becoming mentally ill? I feel so sad" Which is the nurse's best response?

"You are not mentally ill. This is an expected reaction to the loss you have experienced."

The nurse knows the written instructions for healthcare when a person is incapacitated is called

Advance directive

Why is the document Mental Health: A Report of the Surgeon General (1999) significant?

Because it states clearly that there are effective treatments for mental illness

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

The nurse is working as a case manager in an inpatient psychiatric unit and preparing discharge planning for a client that is homeless. Which will be the primary goal of the case manager when coordinating the discharge care of this client?

Coordinating all types of care so that the client does not receive fragmented care

The nurse identifies that mental health issues are constantly evolving. Which is a standard of professional performance to keep in current practice?

Education

Which skill is in the psychiatric-mental health registered nurse's scope of practice?

Evaluating the effectiveness of psychiatric medications

Which item is considered the standard of care in psychiatric nursing and mental health care?

Evidence-based practice

Who was the first to introduce the concept of interpersonal relations and the therapeutic relationship?

Hildegard Peplau

A psychiatric-mental health nurse practitioner is conducting an in-service program for a group of psychiatric-mental health nurses about the current state of psychiatric-mental health nursing practice. As part of the program, the nurse practitioner describes how psychiatric-mental health nursing has evolved. After describing this evolution, the nurse practitioner determines that the teaching was successful when the group identifies the therapeutic relationship as being emphasized by which individual?

Hildegarde Peplau

The first training of nurses to work with persons with mental illness was in 1882 in which state?

Massachusetts

The nurse is caring for a young adult client that is unable to work due to chronic schizophrenia and the inability to procure the required medications for treatment. Which referral to the case manager will the nurse make to assist the client in obtaining the needed medications?

Medicaid services

A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Which treatment will be most beneficial that the client will receive in this setting?

Medical management of symptoms

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

A client comes to the community mental health center for a visit. During the interview, the client tells the nurse that now he has health insurance that will allow him to get the treatment he needs. "I couldn't get it before because of my history of depression." The nurse understands that the client's ability to obtain health insurance is most likely a direct result of which legislation?

Patient Protection and Affordable Care Act

Which law prevents insurance companies from excluding people because of preexisting conditions?

Patient Protection and Affordable Care Act

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

Which sets professional standards of care?

Professional nursing organizations

Which is a clinical activity of only the advanced practice registered nurse?

Psychotherapy

In the 1800s, humane and supportive rehabilitative attitudes toward caring for the mentally ill in the United States were influenced by the

Quakers

The nurse educator is teaching a group of students about the history of psychiatric nursing. Who will the nurse identify as being responsible for stopping the practice of therapeutic bloodletting?

Quakers

Which religious group was instrumental in stopping the practice of bloodletting?

Quakers

A psychiatric-mental health nurse has identified the following clinical question: Is cognitive behavioral therapy effective in addressing depression in clients who have experienced a stroke? As the novice nurse begins the evidence-based process, which action would the nurse do first?

Seek out a mentor.

A psychiatric-mental health nurse is working as part of a team to develop programs to address the Healthy People 2020 goals. The team is tasked with addressing the conditions to improve mental health status. Which area would be a focus of program development for the group? Select all that apply.

Suicide Disordered eating behaviors Major depressive disorder

The psychiatric nurse is providing teaching on the ways in which the recovery philosophy and practices have changed over the years. Which concept will the nurse identify as the biggest reason for the change?

consumer advocacy

Which piece of legislation put consumers of mental health care back in charge of their care?

The Patient Protection and Affordable Care Act

The geriatric psychiatry nurse reviews the DSM-5-TR for the specific criteria associated with a client's diagnosis. Which purpose does the nurse identify will be obtained from reviewing this data? Select all that apply.

To provide a standardized nomenclature and language for all mental health professionals To present defining characteristics or symptoms that differentiate specific diagnoses To assist in identifying the underlying causes of disorders

The nurse is using the DSM-5-TR for a newly admitted client diagnosed with bipolar I disorder. Which information will the nurse obtain to assist with the use of this resource?

Use as a guide for client assessment

According to Freud, in which phase does the toddler develop a sense of autonomy through withholding?

anal

During the moral treatment period, clients were routinely placed into which environment?

asylums

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

A nurse is reviewing information about various pieces of legislation that have affected psychiatric-mental health care. When reading about the Hill-Burton Act, the nurse would most likely find information about which type of federal support for health care?

hospital construction

During an assessment, the nurse suspects that a client has a mental health condition. Which finding(s) indicates to the nurse that the client has interpersonal factors contributing to a mental health disorder? Select all that apply.

inadequate social support ineffective communication excessive dependency on others