PMHNP Final Exam 6 -Solved 2023

Scope of practice - ANSWER-**Determined by state legislative statutes (State Board of Nursing) Defines NP roles and actions Standard of practice - ANSWER-**Determined by ANA Carry out care in accordance with what other reasonably prudent nurses would do in a similar circumstance. Confidentiality - ANSWER-Info will not be disclosed Medical auth signed to release records Psychotherapy notes should be kept unless a separate second auth signed Chemical and psychiatric are two separate ROIs Tarasoff Principle - ANSWER--1976 Duty to warn potential victim of imminent danger of homicidal clients #1 Contact state board of nursing-may not have this law in every state Informed consent - ANSWER-Communication process between provider and client that results in the client's acceptance or rejection of proposed treatment An explanation of relevant info that enables the client to make an appropriate and informed decision The right of all competent adults or emancipated minors, Younger than 18 married, parents, self sufficiently living away from family domicile, they have to show documentation. Elements of informed consent: - ANSWER-Competency: a legal not medical concept THE COURT will make this decision Disclosure: risks and benefits of tx and med risks Comprehension: comprehend relevant info Justice - ANSWER-Doing what is fair and free from bias due to insurance or social status Nonmaleficence - ANSWER-Doing no harm (Imminent danger). Finish one month supple in two weeks, do not write the script, that could cause harm to the patient. Write something different. Beneficence- - ANSWER-promoting well-being and doing good. Fidelity: - ANSWER-Loyal Veracity: - ANSWER-Truthful Autonomy- - ANSWER-doing for self-they can accept or refuse life sustaining treatment Respect: - ANSWER-Treating everyone equally Case management: - ANSWER-A system of OVERSIGHT and authorization of SERVICES and benefits provided to clients consisting of coordination care ensuring quality outcomes, monitoring plan of care and advocacy Overall goal is to promote quality and cost effective outcomes Working as a case manager for clients with severe mental health, Maintains in depth and accurate client records: - ANSWER-THE TREATMENT PLANS Research - ANSWER-P- Pt population, Problem I- Intervention C- Comparison to other tx O- Outcome T- Time Level I- - ANSWER-Evidence from a system review or meta analysis of 3 or more Level II- - ANSWER-Evidence obtained from at least one well designed RCT (LARGE MULTI SITE RCT) Recovery model - ANSWER-Focus in future, foster their abilities interests and dreams Does not focus on the illness It is self-directed They choose the plan Four dimensions of Recovery - ANSWER-Health Home Purpose Community Evidence based practice guidelines: - ANSWER-Client's ethnicity and culture Accessing current journals Client goal directed Effective management of illness Start thinking of cultural questions when they mention it in the scenario: always RESPECT Cultural illness: is not mental illness, Brief supportive therapy can be offered, may not need medication Assertive Community Treatment ACT - ANSWER-Community health service delivery Mental health services in the community setting rather than more restrictive hospital setting to those with serious mental illness Primary goal: decrease reliance on hospitals