Introduction and Perceptions of Mental Health & Mental Illness/ Settings/Culture

NAMI presciption of medications

-Psychiatrists -Psychiatric Or Mental Health Nurse Practitioners -Primary care physicians -Family care nurse practitioners

NAMI Assessment and Therapy

-Psychologists: PHD, trained to evaluate a person's mental health using clinical interviews, psychological evaluations and testing. They can make diagnoses and provide individual and group therapy. -Counselors, Clincians, therapists: Masters, trained to evaluate a person's mental health and use therapeutic techniques based on specific training programs. Working with them can lead not only to symptom reduction, better ways of thinking, feeling and living. -Clinical Social Workers: rained to evaluate a person's mental health and use therapeutic techniques based on specific training programs. They are also trained in case management and advocacy services

NAMI types of psychosocial treatments

-Psychotherapy: Often called talk therapy -Psychoeducation: teaches people about their illness and how they'll receive treatment. -Self-Help And Support Groups: help address feelings of isolation and help people gain insight into their mental health condition. -Psychosocial rehabilitation: helps people develop the social, emotional and intellectual skills they need in order to live happily with the smallest amount of professional assistance they can manage. -Assertive community treatment: is a team-based treatment model that provides multidisciplinary, flexible treatment and support to people with mental illness 24/7.

Issues Facing Those with Severe Persistent Mental Illness?

-Residual symptoms -Medication side effects, particularly extra pyramidal symptoms (EPS) -Medications are expensive (>$20,000 annually) Possible relapse, chronicity, and loss -Co-occurring medical illnesses -Unemployment and poverty -Housing instability -Stigma exists. -Social isolation and loneliness are common. -Medication may reduce libido and the ability to have a relationship. -Treatments are inadequate. -Substance abuse has been estimated to co-occur in 50% of those with SPMI. -Victimization occurs more than twice as often among mentally ill people.

Satisfying/Unsatisfying relationships

-Satisfying: stable, strong, variety of support -Unsatisfying: unstable, intense, lack of support

The biologically influences illnesses are?

-Schizophrenia -Bipolar disorder -Major depression -OCD -OPD -PTSD -Autism -Anorexia -ADHD

The MH recovery model?

-Shifts the focus off the illness and disease and emphasizes the recovery process -Makes the health care family driven -Focuses care on coping with challenges and building resilience, not just managing the symptoms -Care plan is individualized and consumer centered

DSM-5

-The Diagnostic and Statistical Manual of Mental Disorders is the current official guidebook for categorizing and diagnosing psychiatric mental health disorders in the United States -Categorizes the mental illnesses via diagnosis and the information on how the clinician arrived at the diagnosis and codes them -Considered the universal bible to some because it is used internationally -Makes changes and allowances for different cultures -No nursing diagnosis in the book or care plans it just gives you the criteria

inpatient treatment environments

-24-hour nursing care -Locked units (for safety) -Crisis care -Residential treatment programs -State acute care systems -General hospital psychiatric units -Private psychiatric hospital acute care

Stigma

-A "collection" of: Negative attitudes, beliefs, thoughts, and behaviors that influence the individual and general public -Stereotyping, labeling, separating, and status loss or discrimination in a context of power imbalance, social isolation, and reduced opportunities

Areas that adults with SMI struggle with?

-ADLS -relationships -social interaction -task completion -communication -leisure -safe movement in the community -finances/budgeting -academic avitivity -coping with stressors -poverty -isolation -unemployment -poor health outcomes -stigma isolation -inadequate living arrangements -victimization

How to integrate EBP into clinical practice with the 5 A's?

-ASK a questions to identify problem -ACQUIRE literature to address the issue -APPRAISE the literature to evaluate the validity -APPLY the Evidence based on the pts values and needs -ASSESS the performance and evaluate the outcomes

What does an accurate/inaccurate appraisal of reality mean?

-Accurate: sees environment accurately understands consequences -Inaccurate: doesn't see environment accurately hallucinations/delusions

Which statement accurately describes the concept of parity in relation to coverage for mental health issues? A. Requires all mental illness and substance abuse treatment programs to be covered B. Reduces required copayments for mental illness and substance abuse services C. Allows receipt of mental illness and substance abuse services to be kept confidential from the insurance provider D. Requires benefits for mental health and substance abuse treatment to be equal to those for physical illness

D.

Which term refers to the inability of a client to recognize that he or she has an illness because of the illness itself, significantly contributing to nonadherence? A. Apathy B. Anergia C. Anhedonia D. Anosognosia

D.

Which term applies to planning and implementing effective care based on current valid research? A.Competence B. Holistic practice C. Advanced practice D. Evidence-based practice

D. EBP

Mental health nurses have to have what skills?

-Therapeutic communication -Ability to care for complex medical needs (not just mental illness) -Caring -Attending(presence) -Advocacy (ethical role, not legal)

What is mental illness, according to NAMI?

A condition that affects a person's thinking, feeling or mood. Such conditions may affect someone's ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis.

While assessing your patient, Simon, a 63-year-old man in the psychiatric unit with a diagnosis of generalized anxiety disorder, he asks you, "Can you tell me why my family thinks that I am just acting sick to get attention?" Drawing from your knowledge of the impact of mental illness on families, which of the following would you include in your discussion to help Simon see his illness as a real illness? A. Mental health is fundamental to health. B. Mental disorders are real health conditions that have an immense impact on individuals and families. C. The efficacy of mental health treatment is well documented. D. A range of treatments exists for most mental disorders

A, B, C, D

What is an example of client advocacy? Select all that apply. A. Being informed of best practices B. Providing informed consent C. Using the nurse's clinical knowledge D. Respecting client decisions E. Protecting against threats to well-being

A, B, D, E

A serious mental illness (SMI) client who has undergone a serious battering comes to the facility for nursing care. What makes people with SMI more vulnerable to being victimized? Select all that apply. A. They live in high-crime neighborhoods. B. They get punished for their violent behaviors. C. They fake injuries to gain some advantages. D. They lack self-esteem and are likely to be victimized. E. They have impaired judgment and interpersonal skills

A, D, E

Why is the treatment of clients with serious mental illness often discontinued? Select all that apply. A. Anosognosia B. Institutionalization C. Substance abuse D. Lack of insurance E. Residual symptoms

A, D, E

A popular misconception about seriously mentally ill people is that they are A. Violent and aggressive. B. Generally given the care they require. C. Likely to experience periods of remission. D. Usually abandoned by their families

A.

What information does the Diagnostic and Statistical Manual of Mental Disorders contain? A. Mental health coding system B. Research data C. Practice guidelines D. Clinical algorithms

A.

To which human characteristic is resilience most closely related? A. Adaptation B. Spirituality C. Self-confidence D. Self-actualization

A. Adaption (Resilience is associated closely with the process of adapting and helps people facing tragedies, loss, trauma, and severe stress. Resilience refers to an ability and capacity to secure resources needed to support one's well-being. Spirituality relates to one's search for the meaning of life, a relationship with a higher being, and adherence to transcendent values. Self-confidence is the result of intact self-image and self-esteem. Self-actualization is part of Maslow's hierarchy of needs)

Which factors contribute to an individual's culture? Select all that apply. A. Age B. Religion C. Sexual orientation D. Ignorance E. Traditions

A. B. C. E. (Culture includes socially acquired traditions of thought, behavior, and practices. The concept of culture is most often considered with racial or ethnic minority groups but also includes age groups, religion, sexual orientation, physical abilities or disabilities, gender, and socioeconomic status. Knowledge, not ignorance, contributes to an individual's culture.)

A nurse is told during shift change that a client is stuporous. What behavior should the nurse expect? A. The client arouses briefly in response to a sternal rub B. the client GCCS score is less than 7 C. the client exhibits decorticate rigidity D. the client is alert but disoriented to time and place

A. The client arouses briefly in response to a sternal rub

The decision to intervene as a client advocate is clearly identified by the American Nurses Association's (ANA) code of ethics as vital in which situation? A. A client's need for assistance while ambulating post-surgery B. A suspicion that a staff member is unqualified to provide client care C. Working with a client to identify triggers for aggressive behavior D. Providing emotional support to a client experiencing a loss of a parent

B.

Which concept is related to the art of psychiatric mental health nursing? A. Recovery model B. Advocacy C. Trauma-informed care D. Quality and Safety Education for Nurses (QSEN)

B.

What attribute of the art of nursing is defined as being there for and in tune with the client? A. Advocacy B. Attending C. Caring D. Honoring

B. (Being there for and in tune with the client is the nursing art of attending. Advocacy involves speaking up for the client's causes and rights. Caring involves expressing empathic understanding. Honoring is one of the Ten Caritas (loving principles) identified by Dr. Jean Watson.)

The nurse implementing treatments based on decisional points is using what type of clinical tool? A. Critical pathways B. Clinical algorithms C. Clinical practice guidelines D. Clinical proficiencies

B. (Clinical algorithms are step-by-step guidelines prepared in a flowchart or decision tree format. Alternative diagnostic and treatment approaches are described based on decisional points using a large database relevant for the symptoms, diagnosis, or treatment modalities. Critical pathways serve as a map for specified treatments and interventions to occur within specific time frames. Clinical practice guidelines are systematically developed statements based on literature review that appraise and summarize the best evidence to guide clinicians in making informed decisions. Clinical proficiencies are the skills the nurse is required to perform.)

What characteristic of mental health allows people to adapt to tragedies, trauma, and loss? A. Altruism B. Resilience C. Pessimism D. Dependence

B. Resilience (Resilience is a characteristic that helps individuals cope with loss and trauma that may occur in life. Dependence is described as being dependent on others for decision making and care. Pessimism is a life philosophy that things are more likely to go wrong than right. Altruism is described as putting others before oneself.)

A nurse is planning a peer group discussion about the DSM-5. Which of the following information is appropriate to include in the discussion? (select all that apply) A. the DSM-5 includes client education handouts for MH disorder. B. the DSM-5 establishes diagnostic criteria for individual MH disorders. C. the DSM-5 indicated recommended pharmaological treatment for MH disorders D. the DSM-5 assist nurses in planning care for clients who have MH disorders E. the DSM-5 indicates expected assessment finding of MH disorders

B. the DSM-5 establishes diagnostic criteria for individual MH disorders. D. the DSM-5 assist nurses in planning care for clients who have MH disorders E. the DSM-5 indicates expected assessment finding of MH disorders

A senior nurse is conducting an orientation program for junior nurses. The focus is on categorizing mental illnesses. What forms the basis of categorization of mental illnesses? A. Established insurance reimbursement standards B. Percentage of the population affected with the illness C. Level of impact of psychiatric disorder on client's life D. Physical strength of the population during the illness

C.

The mental health nurse who is performing within the scope and standards of practice is compliant with what resources? A. Critical pathways B. Clinical proficiencies C. Clinical practice guidelines D. Clinical algorithm

C.

About how many diagnoses does the current DSM-5 delineate? A. 100 B. 200 C. 300 D. 40

C. 300

Which mental health concept results in an imbalance of power due to negative attitudes and beliefs, stereotyping, and discrimination against the mentally ill? A. Culture B. Spirituality C. Stigma D. Stress

C. stigma (Stigma is defined as a collection of negative attitudes, beliefs, and thoughts that influence public perception of the mentally ill. Stigma contributes to fear, rejection, and discrimination against the mentally ill that taint and discount the individual. Stereotyping, labeling, and separating can occur on an individual or institutional level, resulting in an imbalance of power. Culture is the beliefs and customs of a particular society. Culture influences who becomes stigmatized. Spirituality is a sense of a higher power. Stress is mental strain due to challenging circumstances.)

A client says, "When I go to the mall, I steal things. I don't know why I do it because I take things I don't need." Which term applies to this behavior? A. Eustress B. Pyromania C. Dysthymia D. Kleptomania

D.

Who has mental health?

EVERYONE has mental health but not everyone has mental illess

What term is used to describe disorders that involve deviation from conventional, socially acceptable sexual behaviors?

Paraphilias

What is psychiatric mental health nursing defined as?

Specialized area in that focuses on the treatment of individuals with psychiatric and substance abuse disorders. Nurses are committed to promoting MH through the assessment, diagnosis, and treatment of human responses to MH problems and psychiatric disorders

According to the WHO, what is mental health?

State of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community

residual symptoms and relapse

a reoccuring or worsening of ones illess which occurs even when one adheres to their treatment

What are the attributes of mental health?

-Accurate appraisal of realty -The ability to love and experience joy -Capacity to deal with conflicting emotions -Ability to live without fear, guilt, or anxiety -Ability to take responsibility for actions -Ability to control behavior -Ability to think clearly -Ability to relate to others -Attain self-defined spiritualtiy -Negotiate each developmental task -Ability to work and be prodcuctive -Maintain a health self-concept and self-value -Ability to play and laugh -effective coping skills -happiness -satisfying relationships

LOC

-Alert: response is spontaneous -Lethargic: drowsy and falls asleep but able to open eyes -Stuporous: painful stimuli needed to -Comatose: unconcious/doesn't respond can have decorticate rigidity or decerebrate rigidity

NAMI other people you may encounter?

-Certified Peer Specialists: lived experience with a mental health condition or substance use disorder. They are often trained, certified and prepared to assist with recovery by helping a person set goals and develop strengths. They provide support, mentoring and guidance. -Social workers: provide case management, inpatient discharge planning services, placement services and other services to support healthy living. -Pastoral counselors: clergy members with training in clinical pastoral education. They are trained to diagnose and provide counseling

Psychiatry's definition of mental health changes and reflects what?

-Changes in cultural norms and society's expectations -Values and professional biases -Individual differences and political climate -Psychology of women -Does this because there is no definite line between mental health and mental illness

Control of behavior/Out of control behavior

-Control: Ability to recognize cues -Out of control: aggressive or violent behaviors

Decorticate rigidity and decerebrate rigidity

-Decorticate: flexion and internal rotation of upper-extremity joints and legs. -Decerebrate: Neck and elbow extension, wrist and finger flexion.

Evidence based practice?

-Evidence gleaned on review of literature -Clinical knowledge of the nurse from experience -The patients values and desire for care

Happy/Unhappy

-Happy: find life enjoyable, optimistic about needs being met -Unhappy: loss of interest or pleasure, discourage or hopeless mood

Health/Unhealthy self concept

-Healthy: self-confidence, resourcefulness -Unhealthy: lacks self confidence, inability to function independently

Interventions for the individual and society?

-Inpatient, outpatient, community mental health -Rehabilitation versus recovery model -Evidence-based treatment approaches and services -Programs of assertive community treatment (PACT, ACT) -Cognitive-behavioral therapy (CBT) -Promotion of family support and partnership National Alliance for the Mentally Ill (NAMI) -Social skills training -Supportive psychotherapy, focusing on supporting the individual here and now -Vocational rehabilitation

Issues Affecting Society and the Individual?

-Involuntary treatment is mandated by a court order. -Outpatient commitment is designed to provide mandatory treatment. -Criminal offenses and incarceration may be the result of desperation, impaired judgment, and impulsivity. -Some with SPMI may not accept treatment, and they may not meet the criteria for involuntary treatment. -Without treatment, those with SPMI can become public nuisances, committing nonviolent crimes (e.g., trespassing, petty theft).

Glasgow Coma Scale

-LOC -eye -verbal -motor response -Highest score=15 -Lowest score=7

Multidisciplinary Treatment Team

-Nurse in Outpatient and Inpatient care settings -Advanced-practice psychiatric nurse -Mental health technician -Occupational therapist -Recreational therapist -Psychiatrist -Psychologist

outpatient treatment enviornments

-Primary care providers (can prescribe anti-psychotic and anti-depressant medications) -Patient-centered medical homes -Primary care medical homes -Community mental health centers -Psychiatric home care -Intensive outpatient programs

NAMI treatment centers

-Private practice: Individual, family and group therapy sessions are held either in an office or home meeting weekly, bi-weekly or monthly with a care provider -Community or county mental health care center: provides public mental health care services when a referral to a private doctor or therapist is not possible. Services include outpatient services, medication management, case management services and intensive community treatment services.Often refer clients for employment, day program services, residential treatment services, therapeutic residential services and supportive residential services.Psychiatrists, psychologists, social workers, counselors and peer support specialists work at centers to provide the range of services clients need. Some centers use the Assertive Community Treatment (ACT) team-based care model to coordinate a client's care. Services may include psychiatry, case management services and help with employment and substance use issues. Mental health centers often have emergency walk-in services or a mobile crisis unit with clinical staff able make an on-site evaluation of a person's condition -Substance Abuse Treatment Centers Receives care for both a specific mental illness and substance abuse. Types of substances abuse centers include: -Detoxification facilities: withdrawl control -Acute Residential Treatment: help individuals solidify their recovery and sobriety. -Intensive Outpatient Programs: allows individuals to work, go to school and carry on their regular activities while also providing services and supports, such as a 12-step program to remain sober.

What is seeking treatment for mental health problems complicated by?

-The nature of mental illness is misunderstood. -Psychosis impedes a person's ability to recognize the need for care. -The Health care system is complicated to navigate. -Apathy is present; no motivation exists to seek care. -There may be no previous experience with mental illness

NAMI supported employment

-Vocational Rehabilitation (VR): career counseling and job search assistance -Individual Placement And Support (IPS) Supported Employment: helps locate a job and continuously helps them be successful in it -Clubhouses: help individual gain skills, locate a job, find housing, and pursue continuing education.

Factors affecting mental health?

-biological/hormones/genetics -spirituality/religion -culture/regional differences -family/friends/community -personality traits -health practices and beliefs -environmental experiences -negative influences -psycho social stressors -poverty -impaired parenting

What does the MMSE assess?

-clients cognitive status - orientation to time and place -attention span and ability to calculate by counting backwards -registration and recalling of objects -language, including naming of objects, following of commands, and ability to write.

effective/ineffective coping

-effective: ability to problem solve and cope in ways that aren't harmful -ineffective: poor coping that creates further dysfunction

effective/ineffective work

-effective: performs with abilities, recovers from minor failure -ineffective: de-orientation in work performance, inability to remain steady employment

Resouces for obtaining research findings?

-internet resources: CINAHL, PubMed, Cochrane reviews -clinical algorithms: step-by-step guidelines prepared in a flowchart or decision tree format. -clinical/critical pathways: serve as a map for specified treatments and interventions to occur within specific time frames. -Clinical practice guidelines: systematically developed statements based on literature review that appraise and summarize the EBP.

Stigma in mental health

-major barrier in MH treatment and recovery -these attitudes have harmful effects on the individual and family

Continuum of mental illness

-moves from well to unwell -WELL: occasional stress to mild stress with no impairment (talking to friends, exercising, eating well, setting goals) -Gets concerning when there is mild to moderate stress and a mild or temporary impairment -UNWELL: marked with a mental illness, distressed, moderate to severe/disabling/chronic impairment

Medication side effects

-sedation -sexual dysfuntion -metabolic syndromes (HLD, increased insulin -resistance increased abd fat deposits) -weight gain -cardiovascular disease -diabetes

A competent psych nurse does what?

-sees their patient (assesses) -Maintain safety of patient (#1 priority) -Maintain therapeutic milieu -Show care -Show empathy -Have clinical competence -Learn therapeutic communication skills -Become self-aware

The DSM-5 includes information specifically related to culture in what 3 areas?

1. Discusses cultural variations for each clinical disorder 2. Describes culture-bound syndromes 3. Outline assists clinicians in evaluating and reporting the impact of an individual's cultural context

Which guidelines should the nurse consider when conducing an assessment of a client diagnosed with a paraphilic disorder? Select all that apply. A. Assessing for suicidal risk B. Focusing on the presenting problem C. Assessing for acting on ritualistic behaviors D. Assessing for psychological disorders like depression E. Assessing the client's awareness about the disorder and its effects

A, B, D, E (The aim of the assessment should be to focus on the presenting problem, such as depression with suicidal tendency. Assessing the possibility of self-harm is important, because such clients can become hopeless and may attempt to harm themselves. It is important to know about the client's awareness of the disorder to plan for its management. Suicidal risk needs to be considered, because clients with paraphilic disorders have an increased risk of suicide. Depression is known to be associated with paraphilic disorders; thus, the nurse should consider this while assessing a client with paraphilic disorder. The nurse would assess the client for acting on ritualistic behaviors if the health care team suspected the client of having obsessive-compulsive disorder. )

Which are extensive databases that provide psychiatric and medical resources? Select all that apply. A. CINAHL B. WebMD C. PubMed D. Google E. Cochrane reviews

A, C, E

The nurse, striving to minimize the bias of a Western view on what is considered acceptable behavior, will consult which mental health-associated resource? A. Cultural Formulation Interview (CFI) B. Glossary of Cultural Concepts of Distress C. The client's past and present mental health assessment D. The Diagnostic and Statistical Manual of Mental Disorders

A. the CFI (The CFI assesses the client's cultural perception of distress, social supports such as family and religion, and relationship factors between the client and provider including language and discrimination experiences in the societal majority. While useful resources, none of the remaining options focus on these cultural perceptions.)

A charge nurse is discussing MSE with a new nurse. Which of the following statements by the new nurse indicates an understanding of the teaching? (select all that apply) A. to assess the cognitive ability, I should ask the patient to count backwards." B. "to asses affect, I should observe the client's facial expression." C. "to assess language ability, I should instruct the client to write a sentence." D. "to assess remote memory, I should have the client repeat a list of objects." E> "to assess the client's abstract thinking, I should ask the client to identify our most recent presidents."

A. to assess the cognitive ability, I should ask the patient to count backwards." B. "to asses affect, I should observe the client's facial expression." C. "to assess language ability, I should instruct the client to write a sentence."

A nurse in an outpatient MH clinic is prepping to conduct an initial interview. WHen conducting the interview, which of the following action should the nurse identify as the priority? A. coordinate holistic care with social services B. identify the client's perception of her MH status C. include the client's family in the interview D. teach the client about her current MH disorder

B. identify the client's perception of her MH status

Which resource for clinical practice identifies the best evidence about prevention, diagnosis, prognosis, therapy, harm, and cost effectiveness? A. Evidence-based practice B. Internet resources C. Clinical practice guidelines D. Hierarchical rating system

C. (Clinical practice guidelines identify the best evidence about prevention, diagnosis, prognosis, therapy, harm, and cost effectiveness. The internet is a source to access research. Evidence-based practice is a component of clinical practice guidelines. The hierarchical rating system is a method of evaluating evidence.)

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there is evidence that symptoms and causes of mental illness are influenced by which factor? A. Birth order B. Sexual preference C. Culture D. Occupation

C. Culture (The DSM-5 states there is evidence to suggest that mental illness is influenced by cultural and ethnic factors. The DSM-5 does not state that there is evidence that occupation, birth order, or sexual preference affect mental illness.)

Which statement best describes the Diagnostic and Statistical Manual of Mental Disorders V (DSM-5)? A. It is a compendium of treatment modalities. B. It offers a complete list of nursing diagnoses. C. It is a medical psychiatric assessment system. D. It suggests common interventions for mental disorders

C. It is a medical psychiatric assessment system (The DSM-5 is a classification of mental disorders that includes descriptions and criteria of diagnoses. It is not a compendium of treatment modalities, nor does it list nursing diagnoses, nor list of common interventions, so these responses are incorrect.)

Which severe mental illnesses are recognized across cultures? A. Amok and social phobia B. Bulimia and anorexia nervosa C. Schizophrenia and bipolar disorder D. Antisocial and borderline personality disorders

C. Schizophrenia and bipolar disorder (Worldwide studies indicate that both schizophrenia and bipolar disorder are recognized cross-culturally. Amok, social phobia, bulimia, anorexia nervosa, and antisocial or borderline personality disorders are not as widely recognized, so these responses are false.)

What would be the result of the exclusive use of Western psychological theories by nurses making client assessments? A. High level of care for all clients B. Standardization of nomenclature for psychiatric disorders C. Inadequate assessment of clients of diverse cultures D. Greater ease in selecting appropriate treatment interventions

C. inadequate assessment of clients of diverse cultures (Unless clients have faith in a particular healing modality, the treatment may not be effective. When nurses make assessments on the basis of Western theories, treatments consistent with those assessments follow. Clients of other cultures may find the treatment modalities unacceptable or not useful. Treatments consistent with the client's cultural beliefs are preferred. Exclusive use of Western theories would not provide a high level of care to all clients. Considering other cultures would not interfere with standard nomenclature of disorders or with selecting appropriate treatment interventions.)

A client with a serious mental illness gives an advance directive during a period of remission. What does this action indicate? A. The client is adamant about the way he or she wants to be treated. B. The client lacks faith in the treatment protocol and health care programs. C. The client allows the primary care provider to make all decisions about managing the therapy. D. The client directs the future management of therapy if client's judgment is impaired

D.

What is the most important basis for treatment approaches in evidence-based practice? A. Policy B. Tradition C. Trial and error D. Scientifically sound methods

D.

A hospitalized client is on a therapy plan, and the nurse must evaluate the current treatment. Which institution-specific clinical practice resource will the nurse use to integrate evidence-based practice (EBP) into the client's care? A. Researching current medication options using internet resources B. Reviewing decision points for therapy planning provided by clinical practice guidelines C. Using a clinical algorithm in the form of a decision tree to review treatment approaches D. Implementing a clinical pathway to provide expected outcomes using a measurable format

D. (Clinical pathways are the only resources specific to the institutions using them. However, clinical practice resources for implementation of EBP can include internet resources, clinical practice guidelines, and clinical algorithms.)

Social stigma related to mental illness refers to which one of the following statements? A. Mental illness is a disease process. B. Mental illness is inherited. C. Mental illness is a complex problem. D. Mental illness is due to wrong thinking

D. (Having a psychiatric illness is often stigmatized as being flawed in some way rather than being acknowledged as illness.)

What is the prevalence rate over a 12-month period for major depressive disorder? A. Lower than the prevalence rate for schizophrenia B. Lower than the prevalence rate for panic disorders C. Equal to the prevalence rate for schizophrenia disorders D. Greater than the prevalence rate for bipolar affective disorder

D. Greater than the prevalence rate for bipolar affective disorder (Statistics show that the prevalence rate over a 12-month period for major depressive disorder is 6.7%, and the lifetime prevalence rate for bipolar affective disorder is 2.6%, so this answer is correct. The prevalence rate for schizophrenia is lower than that of major depressive disorder so the responses indicating major depressive disorder is lower than or equal to the rate of schizophrenia are incorrect. The rate of major depressive disorder is higher than that of panic disorders, so the response indicating it is lower is incorrect.)

A nurse is planning care for a client who has a mental health disorder. Which of the following action should the nurse include as a psychobiological intervention? A. assist the client with systematic desensitization therapy B. teach the client appropriate coping mechanisms C. assess the client for comorbid health conditions D. monitor the client for adverse effects of medications

D. monitor the client for adverse effects of medications