chapters 1-4 PN MENTAL HEALTH NURSING (With complete answers)

1.American Nurses Association American Psychiatric Nurses Associates 3.International Society of Psychiatric-Mental Health Nurses correct answers Provision of Care to clients in mental health settings based on which standards? what various methods should nurses use to collect data from clients? correct answers observation, interviewing, physical examinations and collaboration. psychosocial history includes correct answers perception of own health, beliefs about illness and wellness-activity/leisure activities, how the client passes times- use of substances/substance use disorder- stress level and coping abilities- usual coping strategies, support systems. - cultural beliefs and practices level of consciences is described using the following terms and observed behavior included in documentation correct answers alert, lethargy, stupor, coma( decorticate rigidity, decelerate rigidity) alert correct answers the client is responsive and able to fully respond by opening her eyes and attending to a normal tone of voice and speech. The client answers questions spontaneously and appropriately. lethargy correct answers the client is able to open her eyes and respond but is drowsy and falls asleep readily. stupor correct answers the client requires vigorous or painful stimuli to elicit a brief response: example would be pinching a tendon or rubbing the sternum. coma correct answers no response can be achieved from repeated painful stimuli abnormal posturing in the client who is comatose correct answers two types: decorticate rigidity and decerebrate rigidity decorticate rigidity correct answers flexion and internal rotation of upper-extremity joints and legs decelerate rigidity correct answers neck and elbow extension, wrist and finger flexion physical appearance correct answers examination includes observation of personal hygiene, grooming and clothing choice. Excepted findings are that the client is well-kept, clean, and dressed appropriately for the given environment.