Chapter 4: Treatment Settings and Therapeutic Programs - PrepU

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 nurse is planning care for a client in a forensic setting. Which are essential assessment considerations for this client? Select all that apply.

Assessment of risk Development of rapport Early recognition of aggression

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

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

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 client with mental illness is being discharged to a group home. The discharge planning nurse is helping the family to make the transition. The discharge planning nurse is least responsible for what related to the client's discharge?

Chart review for inadequacies

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

The rate of mental illness in the jailed population has been increasing faster than that of the general population. How many times higher is the rate of mental illness in the jailed population?

5

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 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

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

Initiatives that strive to strengthen the coordination of care involves cooperation and what?

Collaboration

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

Compliance with the therapeutic regimen

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.

Which type of residential setting may care for one to three clients in a family-like atmosphere, including meals and social activities with the family?

Foster homes

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

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.

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

Maintenance of the therapeutic environment

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

Nurse

Which statement regarding those with serious and persistent mental illness (SPMI) is correct?

Opportunities to improve finances are limited or nonexistent because these people lack funds for education, clothing, and transportation.

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

The client is a 54-year-old who is addicted to drugs and alcohol. Which setting would be best for an individual in need of support to minimize the risk of repeat hospitalizations?

Partial hospitalization program

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

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

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

The nurse is conducting an admission assessment on a client in a forensic setting. Which is a priority care issue?

Risk assessment

The case manager makes a home visit to the client's household and finds that the client has become psychotic in the prior 3 days and has bolted himself in the his room. The case manager works to encourage the client to come out and calls the ambulance to take the client to the emergency department. At what level of prevention is the case manager working?

Secondary

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

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

The nurse is advising the caregiver of a client to encourage the client to join an evolving consumer household. What may be the reason for the nurse to give this advice to the caregiver?

The client will be able function independently.

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

Therapeutic foster care

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

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

There are high rates of mental illness among incarcerated populations.

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.

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

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

collaborative mental health care.

A community mental health model program that incorporates membership responsibility in maintaining and advancing the program and social/recreational, vocational, residential, and educational services is called:

psychosocial rehabilitation model.

When comparing homeless people without mental illness to homeless people with mental illness, homeless people with mental illness:

spend more time in jail.