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Chapter 35 Public Psychiatry | Kaplan and Sadock

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Chapter 35 Public Psychiatry

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Chapter 35: Public Psychiatry
MULTIPLE CHOICE

1. In addition to excellent assessment skills and keen insight into human behavior, what
additional ability is most critical to effective community mental health nursing?

a. Attention to economical nursing practice

b. Willingness to advocate for the patient

c. Familiarity with local patient-focused resources

d. Working relationship with community medical professionals


ANS: C

The role of the community mental health nurse is to help the patient to maintain his or her
highest level of functioning and independence within the community. It is critical for the nurse to
be familiar with the available community resources and community networks, so they can work
with the multidisciplinary treatment team to help patients and their families adjust to the
community. The remaining options are appropriate but are not unique to community mental
health nursing and its role in facilitating the patients ability to live and function as a member of a
community.

2. What factor had the greatest impact on the limited success of the deinstitutionalization of the
mentally ill population?

a. The initiative was never funded by the federal government.

b. The mentally ill population found it too difficult to function autonomously.

c. Community support systems were unprepared to provide the required services.

d. The communities were biased against having the mentally ill living among them.




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,ANS: A

During deinstitutionalization, federal dollars were designated for community mental health
facilities; however, the enacted legislation was never funded. The effects of the other options
would have been directly related to the lack of sufficient funding.

3. What is the primary event that results in many eccentric individuals being initially diagnosed
with a psychiatric disorder?

a. They commit a crime and are incarcerated.

b. They become both homeless and destitute.

c. They are unable to meet their own physical needs.

d. There is proof that they are a danger to themselves or others.


ANS: D

The family may describe the persons behavior as odd or eccentric without realizing or being
willing to admit that the family member has a psychiatric illness that needs professional help.
The family generally seeks treatment for the ill member when the behavior becomes irrational,
threatening, assaultive, or self-destructive. Although the remaining options are characteristic of
mental illness, they are generally not sufficient to warrant a mental illness diagnosis.

4. To best respect the mentally ill patients rights, no restricting intervention can be implemented
without:

a. First securing the patients informed consent

b. Proof that the patient is a danger to self or others

c. Initially attempting to secure the patients cooperation

d. Securing an order from the patients psychiatric care provider


ANS: B

Mentally ill persons who are disturbed or actively psychotic are not required to obtain psychiatric
treatment unless they are a threat to themselves or others. In cases where safety is a concern,




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, informed consent is not required and actions can be approved by the care provider
postintervention.

5. Which nursing intervention by a community mental health nurse demonstrates an
understanding of the potential health risks that psychotropic medications present?

a. Discussing the risk of food interactions when taking buspirone (BuSpar)

b. Monitoring the blood glucose levels of a patient prescribed risperidone
(Risperdal)
c. Stressing the importance of using alprazolam (Xanax) only as a short-term
therapy
d. Evaluating a patients understanding of the possible weight gain resulting from
escitalopram oxalate (Lexapro) therapy


ANS: B

The onset of type 2 diabetes is one of the less known side effects of commonly used
antipsychotic medications. Diabetes associated with psychotropic medications has been
demonstrated to be more frequent with risperidone (Risperdal).

Weight gain is a possible side effect of the antidepressant escitalopram oxalate (Lexapro). Drugs
used to treat anxiety, including buspirone (BuSpar), have known food interactions such as
grapefruit. Benzodiazepines, like alprazolam (Xanax), are prescribed for depression and anxiety
but should not be used on a long-term basis.

6. Which behavior engaged in by a patient diagnosed with both schizophrenia and hepatitis C
presents the community mental health nurse with the greatest need to share information
ordinarily protected by the patients right to confidentiality?

a. Engaging in unprotected sex

b. Wearing the uniform of a police officer

c. Expressing a real hatred for the government

d. Stealing clothing and food from stores in the neighborhood




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