Chapter 4 Treatment Settings and Rehabilitation

A nurse is orienting to a new position working the infirmary in the state penitentiary. When working with prisoners who are also mentally ill, the nurse examines her own attitudes. Which of the following beliefs should the nurse discuss with her supervisor before caring for incarcerated patients? A) People with mental illness are inherently violent 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) Many mentally ill would not be in prison if they were stabilized on medication

A

A nurse is working with a group of clients in a partial hospitalization program. Which of the following is likely to require a referral for additional services not provided by the program? A) Diagnosis of illness B) Medication monitoring C) Social skills development D) Structuring leisure time

A

A patient with bipolar disorder has a long history of both hospitalizations and incarcerations. The patient has no permanent residence and has infrequent contact with his family. Upon admission to the inpatient psychiatric unit for stabilization, the nurse documents all of the following in the record. Which data most suggests a positive outcome for this patient? A) Reporting meeting with the same case manager monthly for the last 3 years B) History of residential stays at several local homeless shelters C) Last contact with siblings 4 years ago D) Income from day labor for 10 days last month

A

A patient with bipolar disorder taking lithium returns from a walk outside and reports feeling shaky and dizzy. The nurse suspects the patient is experiencing a toxic reaction to the lithium and immediately notifies the: A) Psychiatrist B) Psychologist C) Nurse manager D) Recreation therapist

A

Assertive Community Treatment (ACT) is an effective approach to community-based treatment for the mentally ill population. This type of treatment encompasses which of the following? A) 24-hour-a-day services B) Infrequent contact with clients C) High staff-to-client ratio D) Limited length of service

A

The largest factor influencing the current trend in treatment settings is the fact that in recent years: A) funding for community programs has been inadequate. B) laws have enabled more people to be committed to treatment. C) state hospitals have expanded to meet the demand. D) community programs have been fully developed to meet treatment needs.

A

A patient has just begun daily participation in a community-based partial hospitalization program. The patient can expect the staff to assist with which of the following treatment goals? (Select all that apply): A) Stabilizing psychiatric symptoms B) Improved vocational functioning C) Improving activities of daily living D) Learning to structure time E) Reintegrating into the community F) Developing social skills

A,C,D,F

A patient is encouraged to join in daily outdoor games with peers on the unit. The interdisciplinary team member who will monitor the patient's involvement will be: A) Occupational therapist B) Recreation therapist C) Vocational rehabilitation therapist D) Psychiatric nurse

B

A psychiatric nurse is planning an educational program addressing primary prevention strategies in the community. The nurse explores current research regarding which health care need? A) Influencing schizophrenic patients to adhere to medication regimens B) Assisting high school students to effectively manage stress C) Coaching patients with depression to obtain employment D) Teaching parents the early signs of attention deficit disorder in children

B

Case management is an important concept in both inpatient and community settings. Which of the following would not be a role of the case manager? A) Buying groceries B) Prescribing a psychotropic medication C) Accessing needed psychiatric services D) Managing money

B

The primary advantage of an evolving consumer household is that clients A) Are provided with adequate income to combat poverty B) Do not have to relocate as they become more independent C) Have on-site staff supervision 24 hours a day D) Receive on-site medical care

B

A patient has just been referred to a psychosocial rehabilitation program. The nurse explains that the benefits of being involved in such a program include: (Select all that apply): A) Continuous monitoring of symptoms B) Increased independence C) Increased involvement in treatment decisions D) Education on medication management E) Increased community integration F) greater opportunities for personal growth

B

A patient is being discharged to a residential treatment setting. The patient has no permanent home or family support. The case manager should consider which type of residential setting for this patient? A) Respite housing B) Group home C) Halfway house D) Supervised apartment

B

A nurse is meeting with the city council to advocate the need for a group home in an area where the plans have been strongly opposed by the neighbors. The nurse can effectively educate the public on the realities of group home by citing research that indicates: A) property values quickly rebound in neighborhoods that have group homes. B) police surveillance will be increased to avert any violence by residents. C) group homes pose no increased dangers to neighborhoods. D) neighborhoods that provide park areas provide children a centralized and safe place to play.

C

A patient has been started on antidepressants. The interdisciplinary team member most responsible for monitoring effectiveness of this new medication is: A) Pharmacist B) Psychiatrist C) Psychiatric nurse D) Psychologist

C

A patient is being transferred from a group home to an evolving consumer household. The goal of this transition is for the patient to eventually: A) meet with a therapist on a weekly basis. B) resolve crises within a shorter time period. C) fulfill daily responsibilities without supervision. D) use the increased emotional support of paid staff.

C

A patient who has continuously experienced severe symptoms of schizoaffective disorder for the past 17 years is experiencing an acute psychotic episode. Which level of care is most appropriate for this patient at this time? A) Partial hospitalization B) Residential treatment C) Inpatient hospital treatment D) Clubhouse

C

Discharge planning from inpatient care for people with severe mental illness needs to address which of the following to be effective? A) Locating an outpatient therapist B) Finding a job for the client C) Finding housing and transportation D) Improving family support

C

The major cause of relapse and repeated hospitalizations for clients with persistent and severe mental illness living in the community is A) Homelessness B) Lack of family support C) Medication noncompliance D) Suicide attempts

C

The primary goal of a psychiatric rehabilitation program is to promote A) Family involvement B) Medication compliance C) Recovery from mental illness D) Stabilization of symptoms

C

Which of the following is the highest priority for admission to inpatient care? A) Confusion or disorientation B) Need for medication changes C) Safety of self or others D) Withdrawal from alcohol or other drugs

C

A patient with depression is admitted to an inpatient hospital unit for treatment. The type of therapy most likely provided in this setting includes: A) leisure skills B) self monitoring of treatment C) skills for daily living D) talk therapy

D

A psychiatric nurse is planning activities aimed at secondary prevention of mental illness. Which activity would be most appropriate to develop? A) Self-esteem building with a local after-school program B) Social skills training for chronic schizophrenics C) Parenthood classes at a local community center D) Depression screening in an assisted living facility

D

Assertive community treatment (ACT) has been shown to be one of the most effective approaches to community-based treatment for people with mental illness. One of the features of ACT that contributes to this success is: A) ACT services allow for extended periods of unsupervised functioning. B) the ACT team makes a wide range of referrals. C) ACT services meet immediate short-term needs. D) services are provided directly by the ACT team.

D

Some residential treatment settings are transitional. This means that clients are eventually expected to A) Become self-sufficient B) Find employment C) No longer need medication D) Relocate to another setting

D

The nurse is part of a group setting up a mobile crisis service in conjunction with the local police department. Community education on which this team will focus includes: A) teaching police officers counseling skills. B) crisis counseling services to be provided in the prison system. C) educating about the dangers of the mentally ill in the community. D) assisting police officers to recognize mental illness.

D

The priority of inpatient care for people with severe mental illness is A) Family issues B) Insight into illness C) Social skills D) Symptom management

D