Ch 2: Mental Health and Mental Disorders: Fighting Stigma and Promoting Recovery

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a) Approval Pg. 15-16 Stigma can be defined as a mark of shame, disgrace, or disapproval that results in an individual being shunned or rejected by others. Stigma leads to community misunderstanding, prejudice, and discrimination. Therefore, approval is inconsistent with stigmatization.

14. One of the major problems facing individuals with mental illness and their families is stigma. Which is inconsistent with stigmatization? a) Approval b) Misunderstanding c) Prejudice d) Discrimination

d) "I am of no use to society because of my mental illness" Pg. 16 Self-stigma occurs when negative stereotypes are internalized by people with mental illness. Clients are aware of the public's negative view of mental illness and agree with the public's perceptions. They begin to believe that they are unpredictable, cannot become productive members of society, or have caused their illness. The statement of being no use to society reflects self-stigma. The statements about being dangerous because of the diagnosis or treating the person as weak because of the illness reflect public stigma—that is, others' perceptions of persons with mental illness. Avoiding treatment because of a fear of being labeled reflects label avoidance.

1. A psychiatric-mental health nurse is interviewing a client diagnosed with depression. Which statement would lead the nurse to suspect that the client is experiencing self-stigma? a) "I didn't get treatment because I didn't want to be labeled as mentally ill" b) "Some say that people with mental illness are dangerous" c) "Others treat people with mental illness, like me, as being weak because of my illness" d) "I am of no use to society because of my mental illness"

c) Depression Pg. 14

10. According to the World Health Organization (WHO), by the year 2030, which of the following mental health disorders will be the leading burden worldwide? a) Anxiety disorder b) Bipolar disorder c) Depression d) Schizophrenia

b) Recovery Pg. 16 Recovery is the single most important goal for individuals with mental disorders. Mental health recovery is a journey of healing and transformation, enabling a person with mental health problems to live a meaningful life in a community of his or her choice, while striving to achieve his or her full potential. Self-direction and empowerment are the means to the recovery process.

11. Which of the following is the single most important goal for the person with a mental disorder? a) Empowerment b) Recovery c) Self-direction d) Respect

a) Client describes actions used to appropriately cope with life stresses b) Client verbalizes a realistic depiction of surroundings and events d) Client identifies strengths and weaknesses in abilities e) Client talks readily about doing things with friends and family Pg. 14 Mental health is conceptualized by the World Health Organization (WHO) as a state of well-being in which the individual realizes his or her own abilities, can cope with life's normal stresses, can work productively and fruitfully, and can make a contribution to society. Participation with friends and family, positive coping actions, realistic depiction of surroundings and events, ability to identify strengths and weaknesses, and a stable working environment (not employment difficulties) support the concept of mental health.

12. A nurse is assessing a client who has come to the clinic for an evaluation. The nurse determines that the client is mentally healthy based on which finding? Select all that apply. a) Client describes actions used to appropriately cope with life stresses b) Client verbalizes a realistic depiction of surroundings and events c) Client reports moving from job to job to job over the years d) Client identifies strengths and weaknesses in abilities e) Client talks readily about doing things with friends and family

b) The stigma tends to increase the more the person's behavior differs from the norm Pg. 15-16 When people with mental illnesses or emotional problems are stigmatized by society, they are often ostracized by the society in which they live. The stigma associated with all forms of mental illness is strong, but generally it increases the more an individual's behavior differs from the cultural norm. People who are stigmatized begin to believe in the negative view of themselves and subsequently have low self-esteem.

13. When describing the effects of stigma by society on individuals with mental illness, which would a nurse most likely include? a) The person being stigmatized typically has a moderately high self-esteem b) The stigma tends to increase the more the person's behavior differs from the norm c) The person being stigmatized is often considered part of the group d) The stigma is the same for any person with a mental illness

b) Depression Pg. 14 Epidemiological data suggests that depression is projected to be the leading burden of disease by the year 2030. Therefore, planning programs to address depression, not generalized anxiety disorder, post-traumatic stress syndrome or schizophrenia, would be important.

15. A psychiatric-mental health nurse working at a community mental health center is using epidemiological data to plan the development of programs for the population in the future. Based on the nurse's knowledge associated with disease projections and the leading burden of disease, the nurse would work on developing programs for which condition? a) Schizophrenia b) Depression c) Generalized anxiety disorder d) Post-traumatic stress syndrome

a) Client with major depression Pg. 16 Nonstigmatizing language refers to the client who has a disorder; for example, the client with major depression. Using language such as schizophrenic, bipolar client or hypochondriac are examples of stigmatizing.

16. A nursing instructor is teaching a class about stigma and using nonstigmatizing language. The instructor determines that the education was successful when the students state which of the following as an example? a) Client with major depression b) Schizophrenic c) Hypochondriac d) Bipolar client

d) Associations among possible factors Pg. 14 Epidemiologic research provides information on the patterns of disease distribution and the determinants of health within populations. These studies examine the associations among possible factors related to an area of investigation, but they do not determine the causes of illnesses. Epidemiologic data are expressed as the number of cases of a disorder (population rates), rather than raw numbers. The total population (cases and noncases) is used when determining the rate.

17. When reviewing research related to the epidemiology of mental disorders, a nurse understands that this information reflects: a) Causes of the disorders b) Raw data about the disorder c) Total population with the disorder d) Associations among possible factors

d) Health Pg. 16 Recovery-oriented treatment is based on the belief that mental illnesses and emotional disturbances are treatable and that recovery is an expectation. There are four dimensions that support recovery, including health (managing disease and living in a physically and emotionally healthy way), home (a safe and stable place to live), purpose (meaningful daily activities and independence, resources, and income), and community (relationships and social networks). The client's status reflects the dimension of health.

18. A client with depression participates in all areas of his treatment plan such that the client is managing the condition and living in a physically and emotionally healthy manner. The client's status reflects which dimension of recovery? a) Home b) Purpose c) Community d) Health

d) "Mental health recovery is a growth experience with setbacks" Pg. 17 Recovery is not a step-by-step process but is viewed as nonlinear, or a growth experience with setbacks. Instead of focusing on the illness, the recovery process is based on strengths.

19. A psychiatric-mental health nurse is conducting an in-service education program for a group of nurses about recovery from mental illness. The nurse determines that the teaching was successful based on which group statement? a) "Mental health recovery focuses primarily on the mental illness" b) "Mental health recovery occurs in a straight line from beginning to end" c) "Mental health recovery is a step-by-step process" d) "Mental health recovery is a growth experience with setbacks"

d) "There are additional characteristics that help classify the diagnosis" Pg. 15-16 Mental disorders are organized and diagnosed according to the criteria published in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). The current DSM-5 system contains subtypes and other specifiers that further classify disorders. Although the DSM-5 specifies criteria for diagnosing mental disorders, there are no absolute boundaries separating one disorder from another, and disorders often have different manifestations at different points in time.

2. A psychiatric-mental health nurse is conducting an information session for a group of family members of clients diagnosed with mental disorders. One of the participants asks, "I've heard that criteria are used to diagnose the condition, but what exactly does that mean?" Which response by the nurse would be most appropriate? a) "There are specific cut off points that separate one disorder from another" b) "A disorder is a stand-alone condition without any other different types" c) "The signs and symptoms are relatively constant throughout the disorder" d) "There are additional characteristics that help classify the diagnosis"

a) Mental health involves psychological well-being but not emotional well-being Pg. 13-14 According to various professional nursing associations, mental health is the emotional and psychological well-being of an individual who has the capacity to interact with others, deal with ordinary stress, and perceive one's surroundings realistically.

20. After teaching a class of nursing students about mental health and mental disorders, the instructor determines that additional education is needed when the class states which of the following as reflective of mental health? a) Mental health involves psychological well-being but not emotional well-being b) A mentally healthy individual is able to interact with others c) A person who is mentally healthy can deal with ordinary stressors d) Being able to perceive one's surroundings is a component of mental health

c) Prejudice Pg. 16 An example of prejudice occurs when a person has feelings of intolerance about those who are hospitalized in psychiatric-mental health facilities. This situation is not an example of cultural bias, self-awareness, or self-reflection.

21. While visiting a mental health clinic during an observational experience, the student nurse overhears a client's relative talking about the client in a very demeaning manner. The family member is most likely exhibiting which type of behavior? a) Self-reflection b) Cultural bias c) Prejudice d) Self-awareness

c) New cases of anorexia within a specified time period Pg. 15 Incidence refers to a rate that includes only new cases that have occurred within a clearly defined time period. Rate is the proportion of the cases in the population when compared with the total population. It is expressed as a fraction, in which the numerator is the number of cases and the denominator is the total number in the population, including the cases and noncases. Prevalence refers to the total number of people who have the disorder within a given population at a specified time regardless of how long ago the disorder started.

41. When reading a journal article about anorexia nervosa, the nurse finds that the incidence of anorexia has increased in a specific age group. The nurse interprets this incidence data as reflecting which information? a) Cases and noncases of anorexia b) Cases compared to total population c) New cases of anorexia within a specified time period d) Total number with anorexia for that age group

a) Mental illness can cause significant distress b) Individuals suffering from mental illness may experience dissatisfaction with relationships and self d) Mental illness can interfere with a person's ability to function Pg. 14 A mental illness or mental disorder is a syndrome, a set of symptoms that cluster together that may have multiple causes and may represent several different disease states that have not yet been defined. Unlike many medical diseases, mental disorders are defined by clusters of behaviors, thoughts, and feelings, not underlying biologic pathology. Laboratory tests are not generally used in diagnosing mental disorders. Mental disorders are clinically significant disturbances in cognition, emotion regulation, or behavior that reflect a dysfunction in the psychological, biological, or developmental processes underlying mental dysfunction. They are usually associated with distress or impaired functioning.

22. A family member of a client diagnosed with a mental illness asks the nurse, "What is mental illness, really?" Which information would the nurse most likely integrate into the response? Select all that apply. a) Mental illness can cause significant distress b) Individuals suffering from mental illness may experience dissatisfaction with relationships and self c) Individuals suffering from mental illness are usually able to cope effectively with daily life d) Mental illness can interfere with a person's ability to function e) Mental illness is primarily due to social/cultural factors

b) Community Pg. 16 There are four dimensions that support recovery, including health (managing disease and living in a physically and emotionally healthy way), home (a safe and stable place to live), purpose (meaningful daily activities and independence, resources, and income), and community (relationships and social networks). Strengthening social networks would address the community dimension.

23. A psychiatric-mental health nurse is developing a recovery-oriented plan of care for a client with obsessive-compulsive disorder. The nurse identifies interventions to strengthen the client's social networks. The nurse is addressing which dimension to support recovery? a) Home b) Community c) Health d) Purpose

b) Trauma c) Poverty e) Unemployment Pg. 16-17 Poverty, unemployment, underemployment, trauma, and lack of education, common in people who have mental health issues, often prevent the achievement of wellness. Active involvement in satisfying work and play are associated with wellness.

24. A nurse is conducting a research study about mental health issues and wellness. When conducting a literature review, which factor would the nurse most likely find as a factor impacting mental health? Select all that apply. a) Satisfaction in work b) Trauma c) Poverty d) Higher level of education e) Unemployment

a) "Most mentally ill people belong on the funny farm" c) "Mentally ill people are violent and just waiting to cause trouble" d) "Mentally ill people are too weak to deal with the world around them" e) "Mentally ill people are unpredictable and dangerous" Pg. 16 Negative stereotypes, such that mentally ill people are weak, unpredictable, dangerous, violent, waiting to cause trouble, or belong on the "funny farm" reinforce the stigma associated with mental illness. In addition, people with mental illness are sometimes treated as if they are responsible for their disabilities (i.e., that the mental illness is their fault) and are sometimes inaccurately accused of being weak or immoral.

25. A psychiatric-mental health nurse is preparing a presentation for a local community group about mental illness and the stereotypes often attributed to the persons with mental illness. Which example would the nurse most likely include? Select all that apply. a) "Most mentally ill people belong on the funny farm" b) "When a person has a mental illness, it's not the person's fault" c) "Mentally ill people are violent and just waiting to cause trouble" d) "Mentally ill people are too weak to deal with the world around them" e) "Mentally ill people are unpredictable and dangerous"

c) Home Pg. 16-17 Trying to find the client a safe and stable place to live addresses the dimension of home. Other dimensions include: health (managing disease and living in a physically and emotionally healthy way), purpose (meaningful daily activities and independence, resources, and income), and community (relationships and social networks).

26. A psychiatric-mental health nurse is providing care to a client with post-traumatic stress disorder who is homeless. The nurse is collaborating with the client to find a stable group home so that the client no longer lives on the street. The nurse is addressing which dimension of recovery? a) Purpose b) Home c) Health d) Community

a) Degree of disability or impairment Pg. 15 The amount of disability or impairment in functioning is an important consideration when assessing a person with a mental disorder. A person's ability to understand, communicate, and get along with others is important in the recovery process. If symptoms impair an individual's ability to independently perform self-care and daily activities, recovery will be more difficult. Although the actual diagnosis, culture, and language may influence care, the amount of disability or impairment in functioning is most important.

27. When assessing a person with a mental disorder, which would be most important for a nurse to consider for recovery? a) Degree of disability or impairment b) Language spoken c) Culture d) Actual diagnosis of the disorder

a) Inability to function in a manner that manages both external and internal stressors effectively Pg. 14 Mental illness is best defined as a syndrome characterized by symptoms and/or impairment in functioning. Not all mental illnesses are characterized by cognitive impairment or altered sensory perceptions. Genetic and environmental factors are not the only known causes of mental illness.

28. A nurse shows the best understanding of mental illness when defining it as the... a) Inability to function in a manner that manages both external and internal stressors effectively b) Result of genetic or environmental alterations resulting in mental dysfunction c) Existence of cognitive dysfunction resulting in a lack of autonomy d) Manifestation of altered sensory perceptions

b) Label avoidance Pg. 16 Label avoidance is the avoidance of treatment or care so as not to be labeled as mentally ill. This is one reason that so few people with mental problems actually receive help. Self-stigma occurs when negative stereotypes are internalized by people with mental illness. Public stigma occurs after individuals are publicly "marked" as being mentally ill. Although discrimination occurs as part of the stigma, it is not a type of stigma.

42. When a person avoids mental health treatment for fear of being labeled mentally ill, which type of stigma is occurring? a) Discrimination b) Label avoidance c) Self-stigma d) Public stigma

d) Public stigma Pg. 16 The media often perpetuates negative stereotypes of persons with mental health issues. The movie described perpetuates the myth that all people who leave psychiatric hospitals are violent and dangerous. This movie demonstrates public stigma, such that the person is publicly marked as being mentally ill. Self-stigma occurs when negative stereotypes are internalized by people with mental illness. Label avoidance, avoiding treatment or care in order not to be labeled as being mentally ill, is another type of stigma and one of the reasons that so few people with mental health problems actually receive help. By avoiding treatment, they avoid the stigma of mental illness. Prevalence refers to the total number of people who have a disorder within a given population at a specified, time regardless of how long ago the disorder started.

29. A nurse is watching a movie which tells the story of a person previously confined to a psychiatric hospital for several years. The movie shows the individual going on a violent murder spree after discharge. Which of the following is the movie depicting? a) Label avoidance b) Prevalence c) Self-stigma d) Public stigma

c) Mental health Pg. 15 A universal condition that shapes the way we think, feel and communicate refers to mental health.

3. A universal condition that shapes the way we think, feel and communicate refers to: a) Mental stability b) Mental wellness c) Mental health d) Mental illness

d) "I feel bad for the mentally ill, but I wish we didn't have to see them panhandling on every single corner" Pg. 16 Creating a division between "us" and "them" is a component of stigmatization. Being dissatisfied with treatment options for mental illness does not mean that the speaker is stigmatizing mental illness.

30. Which of the following statements is suggestive of the stigmatization of mental illness? a) "It's too bad that there aren't better medications to treat mental illness" b) "I think that we should look at people who are mentally ill much like we see people who are physically ill" c) "We're sure not putting enough money into public programs for people who are mentally ill" d) "I feel bad for the mentally ill, but I wish we didn't have to see them panhandling on every single corner"

c) Recovery is person-driven Pg. 17 Self-determination and self-direction are the foundations for recovery, as individuals define their own life goals and design their unique path(s). This reflects the principle of recovery being person-driven. The belief that recovery is real provides the essential and motivating message of a better future—that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. This concept is reflected in the principle of recovery emerging from hope. The principle of recovery being holistic is reflected by the concept that recovery encompasses an individual's whole life, including mind, body, spirit, and community, with the integration and coordination of the array of services and supports available. The principle of recovery being based on respect is reflected by the protection of rights and elimination of discrimination through community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems.

31. A psychiatric-mental health nurse is working with a client who has a mental health disorder on ways to develop self-determination and self-direction. The nurse is integrating which principle of recovery into the plan of care? a) Recovery emerges from hope b) Recovery is holistic c) Recovery is person-driven d) Recovery is based on respect

b) Recovery is person-driven Pg. 17 The statement about being drug-free and responsible reflects the person's focus on defining personal life goals, indicating self-determination and self-direction. This statement reflects that recovery is person-driven. Statements involving beliefs that recovery is real and that the person can and does overcome the challenges and barriers confronting them would support the principle that recovery emerges from hope. Statements related to integration and coordination of services and supports that encompass a person's whole life would support the principle that recovery is holistic. Statements involving the protection of rights and elimination of discrimination as well as acceptance by community, systems, and society would support the principle that recovery is based on respect.

32. A psychiatric-mental health nurse is collaborating with a client on ways to promote recovery. The client is diagnosed with a substance use problem. As part of the process, the person tells the nurse, "I want to be drug-free and show everyone that I can be a responsible person." The nurse interprets this statement as reflecting which principle of recovery? a) Recovery emerges from hope b) Recovery is person-driven c) Recovery is holistic d) Recovery is based on respect

d) Mental health problems have minimal effect on the process of wellness Pg. 13-14 Mental health problems significantly affect the process of wellness, such that many people with mental health problems die from preventable disease decades earlier than the general public. Mental health is conceptualized by the World Health Organization as a state of well-being, in which the individual realizes his or her own abilities, can cope with life's normal stresses, can work productively and fruitfully, and can make a contribution to society. A person cannot be healthy without being "mentally" healthy, but it is possible to be mentally healthy and have a mental or physical disorder. Poverty, unemployment, underemployment, trauma and lack of education, common among people who have mental health issues, often prevent the achievement of wellness.

33. After educating a group of nursing students about mental health and wellness, which statement by a group member indicates the need for additional education? a) Poverty and unemployment are common in individuals with mental health issues b) A person cannot be healthy without being mentally healthy c) A person can be mentally healthy but still have a mental disorder d) Mental health problems have minimal effect on the process of wellness

d) Population rates, not raw numbers, are used to describe the measurement Pg. 15 Epidemiology, the study of patterns of disease distribution and determinants of health within populations, contributes to the overall understanding of the mental health status of population groups, or aggregates, and associated factors. When expressing the number of cases of a disorder, population rates (rather than raw numbers) are used. Epidemiological studies examine associations among possible factors related to an area of investigation, but they do not determine causes of illnesses. The Centers for Disease Control and Prevention (CDC) tracks and reports mental health epidemiological data.

40. A nurse is reading an epidemiologic research study on depression. Which of the following would the nurse need to keep in mind? a) The study is designed to determine the cause of the illness b) Epidemiologic research examines primarily new occurrences of the disorder c) Data from epidemiologic research are tracked but not reported d) Population rates, not raw numbers, are used to describe the measurement

a) Encourage staff members to interact and have contact with individuals who have mental illness Pg. 16 An excellent way to counteract the negative effects of stigma is to have contact with the stigmatized group. Another way is to use non-stigmatizing language. A person with a mental disorder should never be referred to as an "anorexic" or "bulimic," but rather as a "person with anorexia" or a "person with bulimia." Using words such as "psycho," "nuts," "funny farm," and "maniac," or terms that trivialize the client's condition reinforces negative images of mental illness. Jokes that depict people with mental illness as stupid, dangerous, or incompetent perpetuate negative myths. Negative terms should never be used. If a person demonstrates a significant deviation in behavior from the norm, the stigma associated with the behavior often increases.

34. A psychiatric-mental health nurse is working with the staff of a local community mental health center on ways to reduce the stigma associated with mental illness. Which action would be most helpful for the nurse to suggest? a) Encourage staff members to interact and have contact with individuals who have mental illness b) Limit the use of negative terms to those individuals who demonstrate significant behavioral deviation from the norm c) Use terms, such as "anorexic" or "bulimic" when referring to clients with those disorders d) Urge staff members to use words that trivialize the person's condition in a joking manner

d) Recovery is based on respect Pg. 17 By addressing issues related to the protection of rights and eliminating discrimination, the group is applying the principle of recovery being based on respect. Addressing a person's culture, including values, traditions, and beliefs, and incorporating them into the client's journey to recovery, would reflect the principle of recovery being culturally based and influenced. Providing services and supports to foster safety and trust while also promoting choice, empowerment, and collaboration would reflect the principle of recovery being supported by addressing trauma. Integrating and coordinating mutual support and aid groups as well as social learning would reflect the principle of recovery being supported by peers and allies.

35. A psychiatric-mental health nurse is working as part of a group to develop programs for individuals with mental illness to promote recovery. The group is addressing issues to protect the rights of these individuals and reduce the stigma and discrimination associated with mental illness. The group would most likely integrate which principle of recovery as the foundation for these programs? a) Recovery is supported by peers and allies b) Recovery is supported by addressing trauma c) Recovery is culturally based and influenced d) Recovery is based on respect

b) Prevalence Pg. 15 The nurse would examine prevalence which refers to the total number of people who have the disorder within a given population at a specified time regardless of how long ago the disorder started. Rate is the proportion of the cases in the population when compared with the total population. It is expressed as a fraction, in which the numerator is the number of cases and the denominator is the total number in the population, including the cases and noncases. The term average rate is used for measures that involve rates over specified time periods. Incidence refers to a rate that includes only new cases that have occurred within a clearly defined time period.

36. A nurse is reviewing the literature in preparation for a research study about eating disorders. The nurse wants to find out information about the total number of people with eating disorders occurring within a population of girls between the ages of 12 to 18 years. The nurse is not concerned about when the disorder had its onset for this population. Which epidemiological data would the nurse identify? a) Rate b) Prevalence c) Incidence d) Average rate

a) Social isolation Pg. 14-15 Wellness involves having a purpose in life, being actively involved in satisfying work and play, having joyful relationships, having a healthy body and living environment, and being happy. Social isolation would be a factor that would interfere with achieving wellness, whereas employment, marriage and a focus on goals would support the concept of wellness.

37. A psychiatric-mental health nurse is assessing a client with a history of depression. Which finding would the nurse interpret as interfering with the client's wellness? a) Social isolation b) Employment as a bank teller c) Focus on goals d) Marriage of 15 years

d) People with mental illness are inherently violent Pg. 16-17 Although it is true that people with major mental illnesses who do not take prescribed medication are at increased risk for being violent, most people with mental illness do not represent a significant danger to others. Criminalization of mental illness refers to the practice of arresting and prosecuting mentally ill offenders, even for misdemeanors, at a rate four times that of the general population in an effort to contain them in some type of institution where they might receive needed treatment. People with a mental illness are more likely to be the victims of violence, both in prisons and in the community.

38. A nurse is orienting to a new position working the infirmary in the state penitentiary. When working with prisoners who are mentally ill, the nurse examines the nurse's own attitudes. Which beliefs should the nurse discuss with a supervisor before caring for incarcerated clients? a) Many mentally ill people would not be in prison if they were stabilized on medication b) The mentally ill can get better treatment in prison than in the community c) People with mental illness are more vulnerable to victimization when incarcerated d) People with mental illness are inherently violent

a) Proportion of individuals who have the disorder at a specified point in time Pg. 15 The point prevalence refers to the proportion of individuals who have the disorder at a specified point in time.

39. In epidemiological studies, the point prevalence refers to the... a) Proportion of individuals who have the disorder at a specified point in time b) Proportion of cases in a population compared to the total population c) Number of individuals in a population who have risk factors for mental illness d) Number of new cases within a defined period of time

d) Self-stigma Pg. 16 The client is verbalizing awareness of others' negative view of himself and agreeing with their view. Thus he has internalized the negative stereotype, believing that he cannot be productive. This is an example of self-stigma. Label avoidance is avoiding treatment or care in order not to be labeled as being mentally ill. Public stigma occurs after individuals are publicly "marked" as being mentally ill, leading to negative stereotypes.

4. A client with a mental illness tells the nurse, "I'm just like what others say I am. I can never be normal." The nurse interprets this statement as reflecting which of the following? a) Label avoidance b) Public stigma c) Manipulation d) Self-stigma

d) Recognize the impact of trauma on the client's entire community Pg. 17-18 Trauma is a universal experience for those with mental illness, and learning to address it is critical to compassionate, patient-centered nursing care. The trauma-informed care model is based on the concept of preventing re-traumatization of the client. A key concept to this model is recognizing the deep impact that trauma has on individuals, families, groups, organizations, and communities. The remaining answer choices are incorrect and lead to increased stigma for the individual with a mental illness.

43. The nurse manager is developing a recovery-oriented nursing care model for a new outpatient treatment facility. Which action or belief does the nurse take or assume when using the trauma-informed care model? a) Avoid therapeutic touch in order to prevent re-traumatization b) Recognize that those traumatized will always be unable to trust others c) Avoid policies and procedures that place the client in a decision-making position d) Recognize the impact of trauma on the client's entire community

c) Prevalence Pg. 15 Prevalence refers to the total number of people who have the disorder within a given population at a specified time, regardless of how long ago the disorder started.

44. In the United States, more than 57 million people have a diagnosable mental disorder in any given year. This statistic is an example of which of the following? a) Point prevalence b) Incidence c) Prevalence d) Rate

b) Self-care dependence Pg. 15 The amount of disability or impairment in functioning is an important consideration when assessing a person with a mental disorder. A person's ability to understand, communicate, and get along with others is important in the recovery process. If symptoms impair an individual's ability to independently perform self-care and daily activities, recovery will be more difficult. Compliance with medications, interest in social interaction and positive family support would be factors that promote recovery.

5. A psychiatric-mental health nurse is developing the plan of care for a client with a mental disorder. The nurse reviews the client's assessment data. Which finding would the nurse identify as contributing to a more difficult recovery? a) Medication compliance b) Self-care dependence c) Interest in social interaction d) Positive family support

c) Clusters of behaviors, thoughts, and feelings define mental disorders Pg. 14 A mental illness or mental disorder is a syndrome, a set of symptoms that cluster together, may have multiple causes, and may represent several different disease states that have not yet been defined. Unlike many medical diseases, mental disorders are defined by clusters of behaviors, thoughts, and feelings, not underlying biologic pathology. Laboratory tests are not generally used in diagnosing mental disorders.

6. Which statement would a nurse integrate into an education plan for a local community group about mental illness and mental disorders? a) Diagnostic testing is often required to arrive at a diagnosis b) Often there is one primary cause that is responsible for the mental disorder c) Clusters of behaviors, thoughts, and feelings define mental disorders d) The current belief is that there is an underlying biologic pathology associated with a mental illness

d) "Mental health is marked by productivity, fulfilling relationships, and adaptability" Pg. 13-14 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.

7. A nurse is giving a presentation about preventing mental illness to college freshmen. A student asks, "What does it mean to be mentally healthy?" Which of the following potential responses by the nurse is best? a) "Mental health is difficult to define and depends on cultural norms" b) "Mental health is the absence of mental illness" c) "Mental health is defined as behavior accepted as normal by the major cultural group" d) "Mental health is marked by productivity, fulfilling relationships, and adaptability"

d) Stigma Pg. 15-16 Many students new to psychiatric-mental health nursing are afraid, because they do not know what they will encounter, or because they have preconceived ideas about mental illness. Mental illnesses still carry stigma (widespread fear and misunderstanding of mental illness).

8. It is not uncommon for new psychiatric mental health students to be fearful of interacting with individuals suffering from mental illness. The fear and misunderstanding of those with mental illness is known as which of the following? a) Bias b) Discrimination c) Prejudice d) Stigma

d) Epidemiology Pg. 14 Epidemiology is the study of patterns of disease distribution and determinants of health within populations and contributes to the overall understanding of the mental health status of population groups, or aggregates, and associated factors. Epidemiological studies examine associations among possible factors related to an area of investigation, but they do not determine causes of illnesses. Diagnostic criteria identify specific characteristics used to diagnose mental illnesses. Stereotyping involves labeling an individual based on preconceived notions. Stigma refers to a mark of shame, disgrace or disapproval that results in an individual being shunned or directed by others.

9. A nurse is working as a part of a group studying the distribution patterns of depression and contributing factors within the older adult population of a geographic area. The nurse is working in which area? a) Diagnostic criteria determination b) Stigma identification c) Stereotyping d) Epidemiology


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