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1. The nurse is assessing the factors contributing to the well-
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being of a newly admitted client. Which of the following would the nurse identify as
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having a positive impact on the individual's mental health?
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A) Not needing others for companionship LL LL LL LL
B) The ability to effectively manage stress LL LL LL LL LL
C) A family history of mental illness LL LL LL LL LL
D) Striving for total self- LL LL LL
reliance Ans: B LL L L
Feedback:
Individual factors influencing mental health include biologic makeup, autonomy, inde
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pendence, self- LL
esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilien
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ce or hardiness, sense of belonging, reality orientation, and coping or stress managem
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ent abilities. Interpersonal factors such as intimacy and a balance of separateness and
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connectedness are both needed for good mental health, and therefore a healthy person
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would need others for companionship. A family history of mental illness could relate t
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o the biologic makeup of an individual, which may have a negative impact on an indi
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vidual's mental health, as well as a negative impact on an individual's interpersonal an
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d socialñcultural factors of health. Total self-
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reliance is not possible, and a positive social/cultural factor is access to adequate reso
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urces.
2. Which of the following statements about mental illness are true? Select all that apply.
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A) Mental illness can cause significant distress, impaired functioning, or both.
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B) Mental illness is only due to social/cultural factors. LL LL LL LL LL LL LL
C) Social/cultural factors that relate to mental illness include excessive dependenc LL LL LL LL LL LL LL LL LL
y on or withdrawal from relationships.
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D) Individuals suffering from mental illness are usually able to cope effectively wit LL LL LL LL LL LL LL LL LL LL LL
h daily life. LL LL
E) Individuals suffering from mental illness may experience dissatisfaction wit LL LL LL LL LL LL LL LL
h relationships and self. LL LL LL
Ans: A, D, E L L LL LL
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental illn
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ess may be related to individual, interpersonal, or social/cultural factors. Excessive de
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pendency on or withdrawal from relationships are interpersonal factors that relate to m
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ental illness. Individuals suffering from mental illness can feel overwhelmed with dail
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y life. Individuals suffering from mental illness may experience dissatisfaction with rel
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ationships and self. LL LL
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,3. Which of the following are true regarding mental health and mental illness?
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A) Behavior that may be viewed as acceptable in one culture is always unacceptabl
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e in other cultures.LL LL LL
B) It is easy to determine if a person is mentally healthy or mentally ill.
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C) In most cases, mental health is a state of emotional, psychological, and social
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wellness evidenced by satisfying interpersonal relationships, effective behavio
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r and coping, positive self-concept, and emotional stability.
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D) Persons who engage in fantasies are mentally ill LL LL LL LL LL LL LL
. Ans: C
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Feedback:
What one society may view as acceptable and appropriate behavior, another society ma
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y see that as maladaptive, and inappropriate. Mental health and mental illness are diffi
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cult to define precisely. In most cases, mental health is a state of emotional, psycholog
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ical, and social wellness evidenced by satisfying interpersonal relationships, effective b
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ehavior and coping, positive self-
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concept, and emotional stability. Persons who engage in fantasies may be mentally hea
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lthy, but the inability to distinguish reality from fantasy is an individual factor that ma
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y contribute to mental illness.
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4. A client grieving the recent loss of her husband asks if she is becoming mentally i
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ll because she is so sad. The nurse's best response would be,
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A) ìYou may have a temporary mental illness because you are experiencing so muc
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h pain.î LL
B) ìYou are not mentally ill. This is an expected reaction to the loss you hav
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e experienced.î LL
C) ìWere you generally dissatisfied with your relationship before your husband'
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s death?î LL
D) ìTry not to worry about that right now. You never know what the future brings
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.î Ans: B
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Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships, ineff
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ective coping, and lack of personal growth. Additionally the behavior must not be cult
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urally expected. Acute grief reactions are expected and therefore not considered ment
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al illness. False reassurance or overanalysis does not accurately address the client's con
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cerns.
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,5. The nurse consults the DSM for which of the following purposes?
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A) To devise a plan of care for a newly admitted client
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B) To predict the client's prognosis of treatment outcomes
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C) To document the appropriate diagnostic code in the client's medical record
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D) To serve as a guide for client assessmen
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t Ans: D
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Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and ident
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ifies underlying causes of mental disorders. It does not provide care plans or prognost
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ic outcomes of treatment. Diagnosis of mental illness is not within the generalist RN's
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scope of practice, so documenting the code in the medical record would be inappropri
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ate.
6. Which would be a reason for a student nurse to use the DSM?
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A) Identifying the medical diagnosis LL LL LL
B) Treat clients LL
C) Evaluate treatments LL
D) Understand the reason for the admission and the nature of psychiatric illnesses LL LL LL LL LL LL LL LL LL LL LL
. Ans: D
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Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a he
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lpful resource to understand the reason for the admission and to begin building knowl
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edge about the nature of psychiatric illnesses. Identifying the medical diagnosis, treatin
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g, and evaluating treatments are not a part of the nursing process.
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7. The legislation enacted in 1963 was largely responsible for which of the following shift
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s in care for the mentally ill?
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A) The widespread use of community-based services
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B) The advancement in pharmacotherapies LL LL LL
C) Increased access to hospitalization LL LL LL
D) Improved rights for clients in long- LL LL LL LL LL
term institutional care Ans: A
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Feedback:
The Community Mental Health Centers Construction Act of 1963 accomplished the rel
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ease of individuals from long-
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term stays in state institutions, the decrease in admissions to hospitals, and the develo
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pment of community-based services as an alternative to hospital care.
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, 8. Which one of the following is a result of federal legislation?
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A) Making it easier to commit people for mental health treatment against their will.
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B) Making it more difficult to commit people for mental health treatment agains
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t their will. LL LL
C) State mental institutions being the primary source of care for mentally ill persons.
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D) Improved care for mentally ill persons. LL LL LL LL LL
Ans: B
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Feedback:
Commitment laws changed in the early 1970s, making it more difficult to commit
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people for mental health treatment against their will. Deinstitutionalization accom
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plished the release of individuals from long-
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term stays in state institutions. Deinstitutionalization also had negative effects in t
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hat some mentally ill persons are subjected to the revolving door effect, which ma
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y limit care for mentally ill persons.
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9. The goal of the 1963 Community Mental Health Centers Act was to
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A) ensure patients' rights for the mentally ill. LL LL LL LL LL LL
B) deinstitutionalize state hospitals. LL LL
C) provide funds to build hospitals with psychiatric units. LL LL LL LL LL LL LL
D) treat people with mental illness in a humane fashion
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. Ans: B
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Feedback:
The 1963 Community Mental Health Centers Act intimated the movement toward trea
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ting those with mental illness in a less restrictive environment. This legislation resulte
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d in the shift of clients with mental illness from large state institutions to care based i
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n the community. Answer choices A, C, and D were not purposes of the 1963 Commu
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nity Mental Health Centers Act.
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10. The creation of asylums during the 1800s was meant to
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A) improve treatment of mental disorders. LL LL LL LL
B) provide food and shelter for the mentally ill. LL LL LL LL LL LL LL
C) punish people with mental illness who were believed to be possessed.
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D) remove dangerous people with mental illness from the community LL LL LL LL LL LL LL LL
. Ans: B
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Feedback:
The asylum was meant to be a safe haven with food, shelter, and humane treatment for
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the mentally ill. Asylums were not used to improve treatment of mental disorders or t
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o punish mentally ill people who were believed to be possessed. The asylum was not
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created to remove the dangerously mentally ill from the community.
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