psych CH 2
When immigrants arrive from another country to live in the U.S. they bring their own culture. When providing care the nurse should know that an individual's culture includes what items? Select all that apply: stressors feelings patterns of accepted behavior values beliefs
values beliefs patterns of accepted behavior Explanation: All cultural groups have sets of values, beliefs, and patterns of accepted behavior, and it is often difficult for those of one culture to understand those of another. An individual's culture does not include stressors or feelings.
The nurse manager of a psychiatric unit immediately asks to speak with a newly assigned nurse about client care when the nurse is overheard stating: "I believe everyone has some control over their behaviors." "Asking a sexually abused client questions is always difficult for me." "I'm never really sure how to handle a client who is getting angry." "I really need a day off so I think I'll call off sometime this week."
"I believe everyone has some control over their behaviors." Explanation: While all these statements require follow-up by the nurse manager, the nurse's expression of a prejudice or feelings of intolerance about clients requires immediate intervention since it has the greatest impact on client care.
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? "I of no use to society because of my mental illness." "I didn't get treatment because I didn't want to be labeled as mentally ill." "Others treat people with mental illness, like me, as being weak because of my illness." "People say that people with mental illness are dangerous."
"I of no use to society because of my mental illness." Explanation: 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.
A psychiatric-mental health nurse is providing recovery-oriented care for several clients with mental illness. When implementing this care, the nurse would assume which primary role? Leader Decision-maker Educator Partner
Partner Explanation: In recovery-oriented care, the person with a mental health problem develops a partnership with a clinician to manage the illness, strengthen coping abilities, and build resilience for life's challenges. The nurse would not be the decision-maker or leader. Although the nurse may assume the role of an educator throughout the process, this would not be the primary role.
Frequently, psychiatric clients are stereotyped by the public. Which is a common stereotype of this client population? Self-centered Calm Wealthy Violent
Violent Explanation: Psychiatric clients are often stereotyped or categorized by the public as being poor, violent, confused, or unable to care for themselves.
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. "Mentally ill people are unpredictable and dangerous." "Mentally ill people are too weak to deal with the world around them." "When a person has a mental illness, it's not the person's fault." "Mentally ill people are violent and just waiting to cause trouble." "Most mentally ill people belong on the funny farm."
"Mentally ill people are too weak to deal with the world around them." "Mentally ill people are unpredictable and dangerous." "Most mentally ill people belong on the funny farm." "Mentally ill people are violent and just waiting to cause trouble." Explanation: 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.
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? "The signs and symptoms are relatively constant throughout the disorder." "There are additional characteristics that help classify the diagnosis." "There are specific cut off points that separate one disorder from another." "A disorder is a stand-alone condition without any other different types."
"There are additional characteristics that help classify the diagnosis." Explanation: 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.
A nurse is conducting a presentation to a group of community leaders as part of an initiative to develop community mental health programs. When describing mental illness to the group, which information would the nurse most likely include? Select all that apply. Mental illness requires a biological causation. A cluster of symptoms usually defines the illness. A mental illness is a syndrome. A mental illness typically has a single cause. Mental illness rarely leads to disability.
A cluster of symptoms usually defines the illness. A mental illness is a syndrome. Explanation: 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. Mental disorders can disrupt mental health and result in one of the most common causes of disability.
Which are examples of public stigma? (Select all that apply.) A television show depicting an individual with mental illness as being possessed by the devil An individual with a mental illness refuses to seek treatment because of what others might think. A film depicting an individual with a mental illness as dangerous and out of control. An individual with mental illness believes that he is unpredictable just like everyone else believes. Mental health clinicians are described as being arrogant and manipulative during an interview.
A film depicting an individual with a mental illness as dangerous and out of control. Mental health clinicians are described as being arrogant and manipulative during an interview. A television show depicting an individual with mental illness as being possessed by the devil Explanation: Public stigma occurs after individuals are publicly "marked" as being mentally ill. When individuals with mental illness act or say things that are odd or unusual, or tell others that they have a mental illness, they are at risk of being publicly identified as having a mental illness, and may be subject to prejudice and discrimination. Common stereotypes include being dangerous, unpredictable, and incapable of functioning independently. Examples include portrayals of such behavior in the media, such as films and television shows. Mental health treatment and providers are also objects of public stigma, being portrayed as arrogant and ineffectual, cold-hearted and authoritarian, passive and apathetic, or shrewd and manipulative. Self-stigma is exemplified by an individual with mental illness who believes that he is unpredictable just like everyone else believes. Refusing to seek treatment because of what others might think is an example of label avoidance.
Culture-bound syndromes are behaviors limited to specific cultures that have meaning within that culture. Which culture-bound syndrome tends to occur in the Latino population? Brain fag Mal de ojo Falling out Ataque de nervios
Ataque de nervios Explanation: Ataque de nervios is an idiom of distress principally reported among Latinos from the Caribbean. Symptoms include uncontrollable shouting, attacks of crying, trembling, heat in the chest rising into the head, and verbal or physical aggression. A term originally used in West Africa, brain fog is a condition experienced by high school or university students in response to the challenges of schooling. Symptoms include difficulties in concentrating, remembering, and thinking. Falling out is an episode of sudden collapse that is sometimes preceded by feelings of dizziness. This occurs primarily in southern United States and Caribbean groups. Mal de ojo is known as the "evil eye" in Mediterranean cultures and elsewhere in the world. Symptoms include fitful sleep, crying without apparent cause, diarrhea, vomiting, and fever in a child or infant.
Which statement is most accurate about the Diagnostic and Statistical Manual of Mental Disorders-5? Specifiers for classification are extremely rare. The diagnoses avoid the inclusion of subtypes. The manifestations of disorders are consistent over time. Boundaries separating disorders are not absolute.
Boundaries separating disorders are not absolute. Explanation: Mental disorders are organized and diagnosed according to criteria published in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5; American Psychiatric Association, 2013). 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.
Which statement would a nurse integrate into an education plan for a local community group about mental illness and mental disorders? Often there is one primary cause that is responsible for the mental disorder. Diagnostic testing is often required to arrive at a diagnosis. The current belief is that there is an underlying biologic pathology associated with a mental illness. Clusters of behaviors, thoughts, and feelings define mental disorders.
Clusters of behaviors, thoughts, and feelings define mental disorders. Explanation: 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.
A nurse is preparing a presentation for a group of new nurses about mental illness and recovery. When describing the guiding principle that recovery is person-driven, what information would the nurse include? Definition of personal life goals to develop a unique path Role of mutual support and aid groups for sharing Integration and coordination of services to address the individual's whole life Belief in the reality of recovery as motivation for a better future
Definition of personal life goals to develop a unique path Explanation: The principle that recovery is person-driven involves self-determination and self-direction as the foundations for recovery, with individuals defining their own life goals and designing their unique path. The principle that recovery is holistic encompasses an individual's whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated. The principle that recovery emerges from hope involves the belief that recovery is real and 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. The principle that recovery is supported by peers and allies involves mutual support and mutual aid groups. This principle includes the sharing of experiential knowledge and skills, as well as social learning, and plays an invaluable role in recovery.
When assessing a person with a mental disorder, which would be most important for a nurse to consider for recovery? Culture Language spoken Degree of disability or impairment Actual diagnosis of the disorder
Degree of disability or impairment Explanation: 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.
According to the World Health Organization (WHO), by the year 2030, which of the following mental health disorders will be the leading burden worldwide? Bipolar disorder Depression Schizophrenia Anxiety disorder
Depression
Which of the following is the leading cause of disease in middle- and high-income countries? Lung cancer Cardiovascular disease Depression Diabetes
Depression Explanation: Depression is responsible for the leading burden of disease in middle- and high-income countries such as the United States-—more than cancer or cerebrovascular disease.
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? Post-traumatic stress syndrome Generalized anxiety disorder Depression Schizophrenia
Depression Explanation: 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.
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? Encourage staff members to interact and have contact with individuals who have mental illness. Urge staff members to use words that trivialize the person's condition in a joking manner. Limit the use of negative terms to those individuals who demonstrate significant behavioral deviation from the norm. Use terms, such as "anorexic" or "bulimic" when referring to clients with those disorders.
Encourage staff members to interact and have contact with individuals who have mental illness. Explanation: 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.
Which of the following is most accurate about the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)? It specifies criteria for diagnosing mental disorders. It categorizes disorders based on different axes. It provides specific boundaries to separate disorders. Subtypes have been eliminated from this manual.
It specifies criteria for diagnosing mental disorders. Explanation: Mental disorders are organized and diagnosed according to criteria published in the Diagnostic and Statistical Manual of Mental Disorders-5 (American Psychiatric Association, 2013). The current DSM-5 system contains subtypes and other specifiers that further classifies 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. The DSM-5 does not organize disorders using axes.
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? Purpose Health Home Community
Health Explanation: 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.
The National Consensus Statement on Mental Health Recovery stated that recovery is guided by ten fundamental components. Which component is the catalyst of the recovery process? Self-direction Hope Respect Empowerment
Hope Explanation: Hope, the catalyst of the recovery process, is one of the most important concepts. Through hope, clients and families can overcome the barriers and obstacles that they face.
A nurse shows the best understanding of mental illness when defining it as the ... Manifestation of altered sensory perceptions Result of genetic or environmental alterations resulting in mental dysfunction Inability to function in a manner that manages both external and internal stressors effectively Existence of cognitive dysfunction resulting in a lack of autonomy
Inability to function in a manner that manages both external and internal stressors effectively Explanation: 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.
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 mentally healthy individual is able to interact with others. Being able to perceive one's surroundings is a component of mental health. A person who is mentally healthy can deal with ordinary stressors. Mental health involves psychological well-being but not emotional well-being
Mental health involves psychological well-being but not emotional well-being Explanation: 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.
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. Mental illness can cause significant distress Mental illness is primarily due to social/cultural factors. Individuals suffering from mental illness may experience dissatisfaction with relationships and self. Individuals suffering from mental illness are usually able to cope effectively with daily life. Mental illness can interfere with a person's ability to function.
Mental illness can cause significant distress Mental illness can interfere with a person's ability to function. Individuals suffering from mental illness may experience dissatisfaction with relationships and self. Explanation: 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
The nurse educator is talking about beliefs of different cultures and asks the student nurse, "Which culture would the nurse expect to view mental illness as an imbalance between body, mind, and spirit?" Which culture does the student nurse choose? Asian African American Hispanic Native American
Native American Explanation: Traditional view about mental illnesses vary among the Native American tribes. In some, mental illness is viewed as a supernatural possession, as being out of balance with nature. In certain Native American groups, people with mental illnesses are stigmatized. Asian, African American, and Hispanics do not view mental illness as an imbalance between, mind, body, and spirit. African Americans, especially women, are more likely to experience and mention physical symptoms related to mental health problems. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD. Discussing mental health concerns is considered taboo, and as a result Asian Americans tend to dismiss, deny or neglect their symptoms. Many Latinos/Hispanics do not seek treatment for fear of being labeled as "locos" (crazy) or as having a mental health condition because this may cause shame.
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? The mentally ill can get better treatment in prison than in the community. People with mental illness are inherently violent. People with mental illness are more vulnerable to victimization when incarcerated. Many mentally ill people would not be in prison if they were stabilized on medication.
People with mental illness are inherently violent. Explanation: 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.
A nurse is reading an epidemiologic research study on depression. Which of the following would the nurse need to keep in mind? Population rates, not raw numbers, are used to describe the measurement. Epidemiologic research examines primarily new occurrences of the disorder. The study is designed to determine the cause of the illness. Data from epidemiologic research are tracked but not reported.
Population rates, not raw numbers, are used to describe the measurement. Explanation: 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.
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. Trauma Poverty Unemployment Satisfaction in work Higher level of education
Poverty Unemployment Trauma Explanation: 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.
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? Incidence Rate Prevalence Point prevalence
Prevalence Explanation: 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.
After teaching a group of nursing students about mental disorders, the instructor determines that the education was successful when the group identifies which of the following as the most important goal for individuals with mental disorders? Treatment Recovery Symptom resolution Stigma reduction
Recovery Explanation: Although stigma reduction, symptom resolution and treatment are important, recovery is the single most important goal for individuals with mental disorders
Which of the following is the single most important goal for the person with a mental disorder? Empowerment Self-direction Recovery Respect
Recovery Explanation: 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.
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? Recovery is person-driven. Recovery is based on respect. Recovery emerges from hope. Recovery is holistic.
Recovery is person-driven. Explanation: 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.
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? Recovery is holistic. Recovery is based on respect. Recovery emerges from hope. Recovery is person-driven.
Recovery is person-driven. Explanation: 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.
The greatest social obstacle to accessing mental health treatment is ... Society's belief that mental health treatment is ineffective The consistent lack of federal government funding for mental health services Insufficient numbers of health care providers interested in providing mental health treatment Society' inability to require mental health treatment for those needing it
Society's belief that mental health treatment is ineffective Explanation: Although seeking professional help for mental health problems is now more accepted by Americans, the public's belief in the effectiveness of mental health treatment has changed very little over the past ten years. Therefore, many individuals who would benefit from mental health services choose not to pursue them or fail to fully participate once treatment has begun. While funding may not be sufficient, it is not the primary obstacle to accessing mental health treatment. As with many areas of health care, more professionals are needed, but insufficient interest is not the primary obstacle to accessing mental health treatment. While the mentally ill individual has the right to refuse treatment, there are processes in place to require the individual who is a danger to himself or herself or to others receive mental health treatment.
A nurse is reading a journal article about cultural syndromes. Which of the following would the nurse identify as having been well documented? Falling out Brain fog Evil eye Susto
Susto Explanation: Cultural syndromes are specific disorders found within a particular locality or culture. There is little research on the syndromes, but there are two conditions, ataque de nervios and susto, that are well documented
A nurse is working as part of a research team that is examining the proportion of individuals in a population who have bipolar disorder on a particular date. What would the team most likely be measuring? prevalence rate point prevalence incidence
point prevalence Explanation: Point prevalence is a basic measure that refers to the proportion of individuals in a population who have a disorder at a specified point in time (t). This point can be a day on the calendar, such as April 1, 2020, or a point defined in relation to the study assessment, such as the day of the interview. Rate is a proportion of the cases in a 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. Incidence refers to a rate that includes only new cases that have occurred within a clearly defined time period. 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.
