Mental Health - Chapter 1 - Mental Health and Mental Illness
The nurse understands which information can be obtained from the Diagnostic and Statistical Manual (DSM)? 1 Classification of mental health disorders 2 An explanation of the mental health continuum 3 Treatment intervention options for people with illnesses 4 Diagnoses for mental health disorders based on international models
1 Classification of mental health disorders The DSM is one of the two major classification systems used in the United States for mental health disorders. It identifies mental health disorders based on specific criteria. An explanation of the mental health continuum is not provided in the DSM. Treatment intervention options for people with illnesses comes from healthcare provider knowledge and other resources, not the DSM. Diagnoses for mental health disorders based on international models can be found in the International Classification of Diseases (ICD).
What achievements were made in the field of neuroscience and brain research during the "Decade of the Brain?" Select all that apply. 1 Identifying the roles of cytokines in brain disorders such as depression 2 Mapping of the genes involved in neurological illnesses like Alzheimer disease 3 Pharmacological treatment of mental illnesses like schizophrenia and Parkinson disease 4 Refinement of neuroimaging techniques, such as magnetic resonance imaging (MRI) scans 5 Discovery that the brain has a large number of neurotransmitters and a lower number of receptors
1 Identifying the roles of cytokines in brain disorders such as depression 2 Mapping of the genes involved in neurological illnesses like Alzheimer disease 4 Refinement of neuroimaging techniques, such as magnetic resonance imaging (MRI) scans There were many advances in brain research during the 1990s, which was referred to as the "Decade of the Brain." These included identifying the roles of cytokines in brain disorders like depression, mapping of the genes involved in neurological illnesses like Alzheimer disease, and refining neuroimaging techniques like MRI and CT. Pharmacological treatment of diseases like schizophrenia and Parkinson disease was developed relatively early (before 1900). During the Decade of the Brain, it was found that the brain had a lower number of neurotransmitters but a vast assortment of neurotransmitter receptors. This means that mental illnesses are multifactorial.
Which is the most significant dysfunction in a patient with Alzheimer disease? 1 Impaired cognitive abilities 2 Impaired emotional control 3 Impaired behavioral control 4 Impaired sensory perception
1 Impaired cognitive abilities In Alzheimer disease, the primary impairment is in cognition due to degenerative changes in the brain. Emotional control is more affected in conditions like depression due to changes in levels of neurotransmitters such as serotonin. Behavioral control is more impaired in conditions such as schizophrenia due to an impaired thought process. Impaired sensory perception is not associated with Alzheimer disease; it may appear in later stages.
A nurse works in a psychiatry clinic. In which age group is the nurse likely to find dementia and Alzheimer disease? 1 Old age 2 Childhood 3 Middle age 4 Adolescence
1 Old age Dementia and Alzheimer disease are commonly found in old age or aging populations. These disorders are caused by impairment in the brain and the nervous system, mostly due to degenerative changes. These diseases are not very common in childhood, adolescents, or middle-aged adults. Injuries and infections are common in childhood. Sports injuries, hormonal disorders, and disorders of growth and development are common in adolescence. Chronic diseases and lifestyle disorders are common in middle-aged adults.
The nurse is performing a follow-up assessment of a patient with bipolar mood disorder. The patient tells the nurse, "I feel so good and alive. There is so much I want to do now. I feel I am capable of doing anything I want and there is nothing that can stop me." What does the nurse interpret from this patient's behavior? 1 The patient is in the manic phase. 2 The patient is in the depressive phase. 3 The patient has optimal mental health. 4 The patient is recovering from the mental illness.
1 The patient is in the manic phase. The patient's statement indicates that the patient is extremely active, which indicates that the patient is in the manic phase of bipolar mood disorder. The patient's statement does not indicate that the patient is upset or depressed. A person in optimal mental health is aware of one's own abilities and has realistic expectations. This patient has high energy levels and may overestimate his or her capability. The patient's statement does not indicate that the patient is in the recovery phase of mental illness.
How can a nurse who is active in state and national legislation affect the climate for mental health treatment? 1 By becoming active in politics leading to a potential political career. 2 By reducing the stigma of mental illness and advocating for equality in treatment. 3 By advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions. 4 By encouraging laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons.
2 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. Becoming active in politics may be a personal goal but does not directly or necessarily reduce stigma or encourage treatment equality. Encouraging laws regarding the involuntary long-term commitment process and advocating for reduced mental health insurance benefits are undesirable outcomes.
A psychiatric mental health advanced practice registered nurse (PMH-APRN) works with patients in a community mental health center. Which actions differentiate this nurse's practice from the basic practice level? Select all that apply. 1 Preparing a nursing plan of care. 2 Conducting a family therapy session. 3 Leading an exercise group in an outpatient program. 4 Prescribing medication to manage a severe mental illness. 5 Conducting a psychoeducational session about medication side effects.
2 Conducting a family therapy session. 4 Prescribing medication to manage a severe mental illness. The PMH-APRN is licensed to practice autonomously depending on the state and is eligible for specialty privileges, which include psychotherapy, consultation, and prescription of pharmacological agents. Case management, basic health teaching, and milieu therapy are interventions within the scope of practice of a nurse at the basic practice level.
What characteristic of mental health allows people to adapt to tragedies, trauma, and loss? 1 Altruism 2 Resilience 3 Pessimism 4 Dependence
2 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.
The nurse is speaking to a Japanese patient who attempted suicide. On assessment the nurse finds that the patient does not show any signs of mental illness or depression. What does the nurse keep in mind about this patient? 1 The patient is trying to get attention 2 The patient may have an underlying health issue 3 Cultural factors affect how people view the act of suicide 4 The patient should be prescribed antidepressants to prevent suicide
3 Cultural factors affect how people view the act of suicide Some traditional Japanese consider suicide to be an act of honor, whereas suicide attempts are seen as a symptom of mental illness in Western cultures. The nurse can perform a general health assessment of the patient, but should not assume that this particular patient has an unrelated health issue. Similarly, the nurse should not assume that the patient is simply trying to get attention or needs to be put on antidepressants. Before making assumptions about a patient, the nurse should consider the larger cultural context.
A nurse wants to find a description of the diagnostic criteria for addictive disorders. Which resource would have the most complete information? 1 The Future of Nursing: Leading Change, Advancing Health 2 Nursing Diagnoses Definitions and Classifications 2015-2017 (10th edition) 3 Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) 4 International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)
3 Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) The DSM-5 is published by the American Psychiatric Association and serves as the official guideline for diagnosing psychiatric disorders. It is the dominant mode of understanding mental illness in the United States and the framework for describing psychiatric disorders. The Future of Nursing: Leading Change, Advancing Health is a publication of the Institute of Medicine (IOM). The IOM publishes reports regarding national health initiatives and solutions in the United States. Nursing Diagnoses Definitions and Classifications 2015-2017 details approved nursing diagnoses. The ICD-9-CM is an international standard for diagnostic classification for all diseases. The United States adapted this resource to its system with clinical modification.
According to earlier psychological theory, mental illness was caused by a faulty psychological process that could be corrected by increasing personal insight and understanding. What challenged this theory? 1 Invention of insulin shock therapy 2 Invention of psychosurgery techniques 3 Identifying the effects of chlorpromazine (Thorazine) 4 Identification of specific agents causing mental illness
3 Identifying the effects of chlorpromazine (Thorazine) Chlorpromazine (Thorazine) is known to have a calming effect on agitated patients. The finding indicates that psychiatric illness may respond to medications that alter the intercellular components. This implies that the mental illness is also caused by disruption of intercellular components. This theory rejected the earlier psychological theory which stated that mental illness is caused by a faulty psychological process that can be corrected by increasing personal insight and understanding. Insulin shock therapy and psychosurgery techniques (surgery on specific parts of the brain) are invasive techniques that were used to modify behavior. Germ theory stated that mental illness is caused by a specific agent that is identifiable and can be eliminated. This is an old theory of the cause of mental illness and was disproved, as a single agent causing mental illness was not identified.
During crisis management in an earthquake-hit area, a nurse comes across a woman who has lost her family in the earthquake. However, she is still helping the team to recover other dead bodies from the debris. What characteristic does the woman exhibit in this case? 1 Panic 2 Anxiety 3 Resilience 4 Depression
3 Resilience Resilience means an ability to recover from a difficult situation quickly. A resilient person is able to adapt to the loss and does not become a victim of negative emotions. Panic, anxiety, and depression take away the power to think and make a proper decision. These characteristics may interfere with coping and increase stress.
Which severe mental illnesses are recognized across cultures? 1 Amok and social phobia 2 Bulimia and anorexia nervosa 3 Schizophrenia and bipolar disorder 4 Antisocial and borderline personality disorders
3 Schizophrenia and bipolar disorder Worldwide studies indicate that both schizophrenia and bipolar disorder are recognized across cultures.
A nurse plans and implements effective care based on current valid research. Which term applies? 1 Competence 2 Holistic practice 3 Advanced practice 4 Evidence-based practice
4 Evidence-based practice Evidence-based practice refers to optimal nursing care resulting from integrating the best current evidence from valid research. Competence refers to overall ability and quality. Holistic practice refers to practice which considers biological, psychological, social, spiritual, and cultural issues. Advanced practice refers to autonomous practice with specialty privileges and is beyond the basic level.
A nurse is explaining to a group of nursing students about various factors that lead to a mental disease. Which mental disease was commonly found in the soldiers of Vietnam after the war? 1 Sleep disorder 2 Bipolar mood disorders 3 Obsessive-compulsive disorder (OCD) 4 Posttraumatic stress disorder (PTSD)
4 Posttraumatic stress disorder (PTSD) Posttraumatic stress disorder (PTSD) was found in soldiers after the war in about 30% of patients. This disorder can develop at any time after exposure to a traumatic event. Sleep disorder, bipolar mood disorders, and obsessive-compulsive disorder are not common after a traumatic event. Sleep disorder refers to a disturbance in the sleep-wake cycle and is multicausal. Bipolar disorder is characterized by alternate intervals of low and high mood. Obsessive-compulsive disorder is characterized by repetitive and intrusive thoughts or a strong urge to perform an act repetitively.
