Mental Health and Mental Illness
You have graduated with your BSN degree and have taken your first job on a psychiatric unit after becoming a licensed Registered Nurse. You are providing teaching to Mason, a newly admitted patient on the psychiatric unit, regarding his daily schedule. Which of the following would not be an appropriate teaching statement?
"You will attend a psychotherapy group that I lead." Basic level RNs cannot perform psychotherapy.
A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking?
The appraisal of reality is lacking for this client. The client does not have a picture of what is happening around himself or herself.
The mental health status of a particular client can best be assessed by considering:
placement on a continuum from health to illness. Many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Therefore, these disorders can be regarded as "diseases." Visualizing these disorders along the mental health continuum is helpful.
A nursing diagnosis for a client with a psychiatric disorder serves the purpose of:
providing a framework for selecting appropriate interventions. Nursing diagnoses provide the framework for identifying appropriate nursing interventions for dealing with the phenomena a client with a mental health disorder is experiencing.
A nurse who is active in local consumer mental health groups and in local and state mental health associations and who keeps aware of state and national legislation affecting mental illness treatment may positively affect the climate for treatment by:
reducing the stigma of mental illness and advocating for equality in treatment. Nurses who are aware of legislative concerns and who are active in organizations that promote mental health awareness and appropriate and equal treatment for mental illness help achieve the goal of parity, or equality of treatment for mentally ill individuals.
You are caring for Kiley, a 29-year-old female patient who is being admitted following a suicide attempt. Which of the following illustrates the concept of patient advocacy?
"Dr. Raye, I notice you ordered Prozac for Kiley. She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed." By letting the provider know that the patient does not want the treatment the provider is prescribing, you have advocated for the patient and her right to make decisions regarding her treatment.
Which of the following best demonstrates parity related to mental health care?
A client's mental health coverage is equal to his medical/surgical coverage. Parity refers to equivalence that requires insurers who provide mental health coverage to offer annual and lifetime benefits at the same level provided for medical/surgical coverage.
The most disabling mental disorders are the result of:
Biological influences. These include schizophrenia, bipolar disorder, major depression, obsessive compulsive and panic disorders, posttraumatic stress disorder and autism. Psychological trauma, learned behaviors and faulty patters of nurturance may contribute to some forms, but they are not major factors
Which branch of epidemiology is the nurse involved in when seeking outcomes for patients whose depression was treated with electroconvulsive therapy (ECT)?
Clinical epidemiology represents a broad field that addresses what happens to people with illnesses who are seen by providers of clinical care. Studies use traditional epidemiological methods and are conducted in groups that are usually defined by illness or symptoms or by diagnostic procedures or treatments given for the illness or symptoms.
Clinical epidemiology
Deals with what happens to people with illnesses who are seen by a provider of care
A psychiatric mental health nurse has specialized nursing skills & implements the nursing process to manage and deliver nursing care to the mentally ill.
Do not assume a paranoid client's questions are the result of the client's paranoia. For example, don't use "Don't be afraid; it means I'm here to help, not hurt, you." Use direct and honest answers.
The nurse planning care for a mentally ill client bases interventions on the concept that the client:
Has areas of strength on which to build. Nurses are expected to evaluate clients with mental health issues for their strengths and their areas of high functioning. You will find many attributes of mental health in some of your clients with mental health issues. These strengths should be built upon and encouraged.
The quantitative study of the distribution of mental disorders in human populations is:
Epidemiology
Culture may cause variation in symptoms for each clinical disorder.
Every society has its own view of health and illness and the types of behaviors categorized as mental illness. Culture also influences the symptoms of a particular disease. For example, individuals of certain cultures are more likely to express depression though somatic symptoms than through affect and feeling tone.
The prevalence rate over a 12-month period for major depressive disorder is:
Greater than the prevalence rate for generalized anxiety.
DSM-5
Is a classification of mental disorders that includes descriptions and criteria of diagnoses.
One characteristic of mental health that allows people to adapt to tragedies, trauma, and loss is:
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 yourself.
According to the DSM-5, there is evidence that symptoms and causes of mental illness are influenced by:
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.
A 14-year-old belongs to a neighborhood gang, engages in sexually promiscuous behavior, and has a history of school truancy but reports that her parents are just old- fashioned and don't understand her. The assessment data supports that the client:
This client is demonstrating deviant behavior. This client demonstrates undersocialized, aggressive behavior such as a repetitive and persistent pattern of aggressive conduct in which the basic rights of others are violated.
Which mental illnesses are recognized cross-culturally?
World wide studies indicate that both schizophrenia and bipolar disorder are recognized cross-culturally.
In order to best differentiate whether an Asian client is demonstrating a mental illness when attempting suicide is to:
identify his culture's view regarding suicide. One approach to differentiating mental health from mental illness is to consider what a particular culture regards as acceptable or unacceptable. In this view, the mentally ill are those who violate social norms and thus threaten (or make anxious) those observing them. For example, traditional Japanese may consider suicide to be an act of honor, and Middle Eastern "suicide bombers" are considered holy warriors or martyrs. Contrast these viewpoints with Western culture, where people who attempt or complete suicides are nearly always considered mentally ill.
An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports that he is:
not demonstrating any definitive signs of mental illness. One myth about mental illness is that to be mentally ill is to be different and odd. Another misconception is that to be healthy, a person must be logical and rational. Everyone dreams "irrational" dreams at night, and "irrational" emotions are universal human experiences and are essential to a fulfilling life. Some people who show extremely abnormal behavior and are characterized as mentally ill are far more like the rest of us than different from us. No obvious and consistent line between mental illness and mental health exists.
