NR 548 (NR548) Week 1 Exam (Latest Update) Questions and Verified Solutions (GRADED A)

NR 548 (NR548) week 1 Exam (Latest Update) Questions and Verified Solutions (GRADED A) What does the competency about "anticipatory guidance" mean? -Standard 5B: Health Teaching & Promotion -An educated professional nurse is aware of normal developmental and situational threats to wellness and can educate healthcare consumers to avoid them. Ex: Moving a toddler from a crib to a bed can prevent injury associated with climbing out of the crib at that developmental age What do the standards explain the art of nursing is based on? -Scope of Nursing Practice -Based on caring and respect for human dignity What is the fundamental principle of and attitude that the professional nurse must have as outlined in provision 1? -The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person How should the nurse respond to the discovery of human trafficking in his or her practice? -Code of Ethics: Provision 8-Nurses must "bring attention to human rights violations in all settings and context" What is the focus of Psychiatric-Mental Health Nursing? Promotes integrated and comprehensive health and wellness through prevention and education, as well as assessment, diagnosis, care, and treatment of a full range of PMH disorders, including Substance Use Disorders, across the life span. What is the role of PMHNPs and PMH clinical nurse specialists? Both PMHNPs and PMH clinical nurse specialists are considered PMH APRNs. Their roles are synonymous in purpose, functions, settings, and qualifications. They have essential roles in integrating physical and mental health needs, and they work in both inpatient and outpatient settings. What are some elements of the role of Psychiatric-Mental Health Nurses? Promotion of mental health in society and collaboration with and referral to other health professionals are key elements of the role. Key roles of PMHNP -Provision of psychotherapy -Provision of psychopharmacological interventions -Provision of clinical supervision Consensus Model for APRN Regulation -Provides recommendations for licensure, accreditation, certification, and education pertaining to all APRN practice -PMHNP certification exam criteria set by ANCCWhat are some consequences of mental illness according to ODPHP? Neuropsychiatric disorders are among the leading causes of disability, disease burden, premature mortality, and suicide worldwide. How do mental health disorders impact individuals, families, and society? Mental health disorders impose a significant burden on individuals, families, and society. What percentage of adults with mental illness receive treatment? Only 10.3% of adults with mental illness receive treatment. What is recognized as a need by mental health professionals for the mental health system? Mental health professionals recognize the need for a recovery-oriented mental health system. What role can PMHNPs play in advocating for change in mental health? PMHNPs may serve as leaders in their organization and community to advocate for change in mental health. Prevalence -1 in 5 US adults experience MI -17% of youth (6-17 years) experience MH disorder-1 in 20 US adults experience SMI Life expectancy -People with PMH conditions have higher rates of preventable chronic illness and decreased life expectancy (approximately 20-year shorter life span) -Decreased life expectancy impacted by increased risk for suicide & deaths r/t drug OD How does mental illness relate to substance use? People with mental illness use alcohol/drugs/tobacco at higher rates Who is at the highest risk for Substance Use Disorder (SUD) among adults? Adults with Serious Mental Illness (SMI) What is the Comprehensive Addiction and Recovery Act (CARA) of 2016 known for? Allows NPs to receive federal waiver to prescribe buprenorphine What is the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) of 2018 known for? Permanently allows NPs to prescribe buprenorphine What barriers do minority populations face in accessing healthcare for mental health treatment? Reduced utilization of necessary mental healthcare, decreased quality of care, and lack of adherence in treatment servicesWhich specific minority populations, especially those with severe mental illnesses like schizophrenia or bipolar disorder, face disparities in mental health treatment? Minority populations, especially minority patients with severe mental illnesses like schizophrenia or bipolar disorder What factors contribute to disparities in healthcare outcomes? - Minorities and ethnic groups have shown poorer outcomes due to delay or avoidance of care stemming from a mistrust of providers. Name some of the key factors influencing disparities in healthcare outcomes. - Race/ethnicity, socioeconomic status, age, gender, citizenship, disability status, geographic/environmental location, sexual orientation. What are some of the systemic and social factors that contribute to healthcare disparities? - Policies, level of service utilization, social exclusion, exposure to racism and discrimination-related stressors, quality of health care practice, challenges to accessing care, providers' behaviors and biases, stigma, linguistic and cultural barriers. Strategies to eliminate -Increase number of minority providers -Improve access to services via telehealth -Understand social determinants of health in underserved communities -Use cultural humility to enhance communication -Increase use of primary care behavioral health integrative clinics (medical and behavioral health in one location)Social Determinants of Health -The conditions in which people are born, grow, live, work, and age. These conditions are influenced by economics, political influence, and resources at the global, national, and local levels -Understanding these is foundational to overcoming the disparities in mental healthcare Provision 1: Respect for Others The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. -PMHNP instills hope, empowers, and affirms worth and dignity of pts with MI -Approaches professional relationships with compassion, caring, and respect -Advocate to overcome negative stigmas towards PMH dxs to ensure access to care Provision 2: Commitment to the patient The nurse's primary commitment is to the patient, whether an individual, family, group, community, or population. -PMHNP's commitment is to individual, family, group, or community -Recognizes and addresses personal attitudes and bxs that could interfere with meeting ethical guidelines for care -Maintains proper boundaries-Participates in self, peer, and supervisory oversight of clinical skills and practice -Recognizes those with brain-based MH disorders may have maladaptive coping bxs which impact individual, family, and society (bx may continue in spite of negative consequences and may involve setbacks) -Aware of need to balance human rights with safety, including coercive measures or forced tx when individuals are unable to maintain their safety. Provision 3: Advocacy for the patient The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. -PMHNP recognizes vulnerability, complexity, and legal considerations associated with providing care to those with MI Provision 4 Accountability and Responsibility for Practice The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care. -PMHNP is responsible for own practice -Must articulate competencies and be aware of scope of practice and professional standards guiding their practice -Must understand scopeProvision 5: Duty to self and duty to others The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth. -PMHNP owes same duties to self as to others -Accords moral worth and dignity to self and others -Practices self-care, managing stress, and maintaining supportive relationships to meet personal needs outside of therapeutic relationship Provision 6: Contribution to Healthcare Environments The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care. -Maintains and improves healthcare environment and conditions of employment -Recognizes s/sx of psych disorders in workplace -Reports peer observation or concerns to leadership -Helps address problems faced by colleagues that may impact pt safety or violate public trust, including SU Provision 7 Advancement of the Nursing ProfessionThe nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy. -PMHNP advances profession through practice, education, knowledge development, and participates in continuous quality improvement -Maintains knowledge of and applies EB practice guidelines (risk assessment and management) -Pursues CE Provision 8: The nurse collaborates with other health professionals The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs. (Health needs and concerns, Responsibilities to the public) -Promotes community, national, and international efforts to meet health needs through collab with other healthcare professionals -Engages in partnerships with other specialty nurses, govt agencies, professional nursing orgs, and MH orgs to promote prevention, tx, and recovery Provision 9: Promotion of the nursing profession The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy. -Advocates for environments that respect human rights, customs, and spiritual beliefs-Engages in interacts/collabs to articulate nursing values and maintain integrity -Participates in policy development and implementation that recognizes PMH disorders as treatable -Ensures nursing care is delivered with respect to human needs and values w/o prejudice Ethical Issues - Social media -Monitor and manage confidentiality, therapeutic self-disclosure and professional boundaries Person-Centered, Recovery-Oriented Model of Public Health -Working to improve access to and quality of care through prevention, screening, early intervention, integrated care, innovative use of HIT, and appropriate number and distribution of MH professionals Healthy people 2030 SDOH: -Education access and quality (language, literacy) -Health care access and quality -Economic stability (housing instability) -Neighborhood and built environment (crime and violence) -Social and community context (incarceration) What is health literacy? The degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others What is culturally sensitive care?Care that respects and is responsive to the cultural and linguistic needs of patients What does Relative Risk measure? Probability of an event occurring in an exposed group vs the probability of the event in a non-exposed group How many people in the US meet the diagnostic criteria for Substance Use Disorder (SUD)? Estimates indicate that 20.4 million people in the US meet the diagnostic criteria for SUD What are the consequences of individuals with Severe Mental Illness (SMI) having a fourfold higher incidence of SUD? Poor outcomes, increased disability rates, increased suicide rates, and lower life expectancy According to NAMI, what are the ripple effects of Mental Illness (MI)? MI has ripple effects on the person, family, community, and the world How does mental illness impact physical health? Reduced ability to maintain physical health What risks are associated with mental illness in terms of diseases? Increased risk of cardiovascular and metabolic diseasesWhat is a potential consequence of mental illness in terms of employment? Increased risk for unemployment How does mental illness affect life expectancy? Decreased life expectancy by 11-30 years How does mental illness affect life on the family Increased stress and caregiver fatigue What proportion of emergency department visits by adults in the US involve mental health and substance use disorders? 1/8 What is the most common cause of hospitalization for patients under 45 in the US? Mood disorders How much money is estimated to be lost in earnings due to mental illness? Over $190 billion What are individuals with mental illness at an increased risk for? Homelessness and incarcerationHow does mental illness affect the world ? -Depression and anxiety cost global economy $1 trillion in lost productivity/year -Depression is leading cause of disability worldwide PMHNP Scope of Practice - Education -PMH APRN practice requires master's, post-master's certificate, or doctoral degree PMHNP Scope of Practice - Practice Focuses -Application of competencies, knowledge, and experience to pts/groups with complex PMH problems, promoting MH in society, & collaboration with and referral to other health professionals PMHNP Functions -Prescribing or recommending meds -Providing integrative therapy interventions -Psychotherapy and community interventions -Case management -Consultation and liaison services -Clinical supervisionWhat are the components of acute inpatient care? Short-term treatment for acute ill patients at risk of harming self or others, occurs in intensive hospital or psychiatric facility setting What is the purpose of intermediate and long-term care in clinical practice settings? For patients at chronic risk to self or others or unable to function without supervision, includes direct admits or transfers from inpatient care Define PHP/IOP in clinical practice settings. Acute symptom management and intensive treatment for patients not requiring 24-hour medical care What is residential care in clinical practice settings? 24-hour care and housing for an extended period Explain the role of case management in clinical practice settings. Psychiatric Mental Health Nurse Practitioner (PMHNP) serves as the point of contact person, coordinating the treatment team which includes a social worker and psychologist or psychiatrist, involves oversight and coordination of care Where does community-based care take place in clinical practice settings? In clinics, homes, group homes, worksites, shelters, crisis centers, schools, etc. What is Assertive Community Treatment (ACT)? It is a team treatment approach for patients with severe mental illness that operates 24/7.What services does Assertive Community Treatment (ACT) provide? It offers comprehensive, community-based psychiatric treatment, rehabilitation, and support to patients with severe mental illness. What is the role of Primary Care in healthcare? Basic level healthcare What is the role of Psychotherapy? Using evidence-based methods like CBT, DBT, ACT, etc. What is involved in Psychopharmacological management? Prescribing medications, ordering baseline tests, and monitoring for adverse reactions What are the responsibilities of a Care Coordinator in mental health? Organizing patient care and sharing information with all involved, ensuring a coordinated approach to care What is the role of a Case Manager in mental health? Working 1:1 with patients to find providers/facilities, coordinating care and making related decisions What does Psychiatric Consultation-Liaison Nursing (PCLN) involve?Assessment, diagnosis, and treatment of behavioral, emotional, cognitive responses in patients with cooccurring physical illnesses What is Clinical Supervision in mental health? Assisting other clinicians in evaluating their practice, expanding skills, and meeting standards through growth and development What does Self-Employment in mental health entail? Working in a solo or group private practice setting What is involved in Program, System, and Policy Development Management in mental health? Designing, implementing, and managing programs, systems, and policies to address mental health needs through prevention, health promotion, and early intervention What are some examples of integrative programs in mental health care? Integrated primary and behavioral health care; PMHNP functions as part of interdisciplinary team to provide treatment for patients with mental illness What is telehealth in mental health care? It involves communication through phone, video, and e-mail; issues related to confidentiality and regulation may arise What is forensic mental health nursing? It is the intersection of psychiatric nursing and the criminal justice system, involving work in jails, prisons, communities, and state psychiatric hospitalsWhat is disaster psychiatric assessment for PMHNPs? It involves first responders providing psychological first aid and mental health services in response to environmental or man-made disasters What are some roles in mental health care related to administration, education, and research? Overseeing business operations of hospitals/health care systems Nursing workforce development and leadership succession What does a comprehensive psychiatric assessment involve? Performing a person-centered diagnostic evaluation using relevant tests and procedures. How do evidence-based Clinical Practice Guidelines (CPGs) influence assessments? They inform screening and diagnostic activities. What may be included in a psychiatric assessment? Multigenerational family assessment and examining interactions between the patient, family, community, and social systems as they relate to mental health. How is a psychiatric diagnosis developed? Using data obtained during interview, exam, and diagnostic testsWhat factors are evaluated in relation to psychiatric diagnoses? Effects on recovery, quality of life, and functional status What is the role of a mental health professional in assessing stressors and trauma? Examining their impact in the context of the family cycle How can mental health professionals support colleagues in the diagnostic process? By assisting them in developing competence What is the role of Outcomes Identification in nursing? Assist PMH-RN to identify expected outcomes based on scientific evidence What factors are considered in Outcomes Identification? Costs, clinical effectiveness, satisfaction, consistency, and continuity among providers How can clinical guidelines be utilized in Outcomes Identification? Develop and apply clinical guidelines associated with positive clinical outcomes What factors are considered when planning a patient's care? Application of current evidence, expert clinical knowledge, patient's beliefs/values, and various treatment modalitiesWhat treatment modalities can be included in an individualized care plan? Psychopharmacology, psychodynamic therapy, cognitive-behavioral therapy (CBT), and interpersonal therapies What are the key functions of a PMHNP in implementation? Facilitate use of system and community resources to implement plan of care What is the role of a PMHNP in accountability? PMHNP functions as single point of accountability for all medical and psychiatric services What is the role of a healthcare provider in coordination of care? Coordinate implementation of care and help patients identify options for care, advocate for delivery of care, and document coordination of care How does a healthcare provider promote health literacy and health promotion? Provide teaching to promote stabilization of symptoms and recovery, teach at an appropriate level to promote health literacy, and use evidence-based practices to enhance care What is the purpose of consultation in healthcare? Provide consultation to maximize outcomes from the care plan, collaborate with clinicians to provide services, and contribute to system change How does a healthcare provider incorporate pharmacological and biological therapies?Incorporate pharmacological and biological interventions to restore health and prevent disability, and use prescriptive authority according to laws and regulations What are some examples of complementary and integrative therapies used in healthcare? Incorporate integrative therapies such as yoga, meditation, acupuncture, Reiki, nutrition, exercise, dietary supplements, art, and music to restore health and prevent disability What is the goal of milieu therapy in healthcare? Provide a safe, therapeutic, recovery-oriented physical environment, and ensure patients are in the least restrictive environment necessary for safety How does a healthcare provider build a therapeutic relationship with patients? Use therapeutic communication and interpersonal skills to support the relationship, maintain boundaries, use a patient-centered approach, and be culturally sensitive What is the role of counseling and psychotherapy in healthcare? Use therapeutic communication and counseling to promote recovery through individual, couples, group, and family therapy What aspects are considered in the evaluation process? Accuracy of diagnosis, effectiveness of interventions, impact on patient and others, potential recommendations for changes What are the potential outcomes of evaluations? Recommendations for process, protocol, or policy changesWhat does the ANA Code of Ethics with interpretive statements guide in practice? Informing patients of risks, benefits, and outcomes associated with care How does the ANA Code of Ethics promote ethical care? By creating environments that support ethical care In what way does the ANA Code of Ethics encourage advocacy? By using ethical principles to advocate for people with mental health problems, psychiatric disorders, and addiction services What is cultural humility? Engaging in self-reflection to assess personal biases when working with culturally diverse people, groups, and communities How can healthcare professionals cultivate curiosity about patients' experiences and treatment desires? By being curious about the experience and treatment desires of patients from diverse backgrounds What is one way to promote an inclusive work environment? Promoting an inclusive work environment What is the importance of lifelong learning for healthcare professionals?To develop and reinforce working effectively and inclusively with diverse populations What are the key aspects of assessing communication preferences in healthcare? Assess communication preferences of healthcare consumers, families, and colleagues How can personal communication skills be improved in healthcare? Assess and improve personal communication skills, accurately conveying info, and thoroughly documenting care Why is maintaining communication important in an interprofessional healthcare team? Maintain communication with other members of interprofessional teams and contribute professional perspective What are some activities involved in professional collaboration? Consultation, education, research, and technological development How can professionals collaborate to improve care? By partnering with other disciplines, modeling expert practice, mentoring colleagues, and facilitating interprofessional practices Leadership in influencing health policy Providing leadership by influencing decision-making bodies and health policy to promote personcentered, recovery-oriented mental health services.Leadership in team direction Providing direction to interprofessional teams. Leadership in practice innovation Designing innovations to improve practice and health outcomes. Leadership in modeling expert practice Modeling expert practice and mentoring colleagues. Why is seeking current evidence important in education? To expand clinical knowledge, improve role performance, and increase understanding of professional issues What are some roles involved in interprofessional education? Modeling expert practice, mentoring RNs and other colleagues, and participating in teams that promote interprofessional education, role development, advanced nursing practice, and healthcare What is the role of evidence-based practice in nursing? Contribute to nursing knowledge by conducting, appraising, or synthesizing research to improve healthcare practice How does evidence-based practice promote research and clinical inquiry?Promote research and clinical inquiry, including dissemination of research findings and integration of current evidence into practice How can one improve the quality of practice? Obtain and maintain professional certification at advanced level What is one way to evaluate the practice environment? Evaluate practice environment in relation to existing evidence What is another way to improve the quality of practice? Design quality improvement initiatives How can one identify opportunities for research use? Identify opportunities for generation or use of research What does professional practice evaluation involve? Formally seeking feedback regarding practice from healthcare consumers, colleagues, peers, and others Why is reflection important in professional practice evaluation? To reflect on and evaluate practice and role performance to model self-improvement How can organizational and community resources be utilized in healthcare?To create innovative, interprofessional plans of care that address healthcare consumers' concerns. What do evaluation strategies in healthcare resource utilization demonstrate? Quality, cost-effectiveness, cost-benefit, and efficiency. Why is it important to build collaborative relationships in healthcare resource utilization? To identify and meet resource needs effectively. What does environmental health involve? Analyzing the impact of social, political, and economic influences on environment and human health exposures How can partnerships promote sustainable environmental health policies? By creating partnerships that promote sustainable environmental health policies