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,Fortinash: Psychiatric Mental Health Nursing, 5th Edition Chapter n n n n n n n
01: Psychiatric Nursing: Theory, Principles, and Trends
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MULTIPLE CHOICE n
1. Which understanding is the basis for the nursing actions focused on minimizing
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mental health promotion of families with chronically mentally ill members?
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a. Family members are at an increased risk for mental illness.
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b. The mental health care system is not prepared to deal with family crises.
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c. Family members are seldom prepared to cope with a chronically ill individual.
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d. The chronically mentally ill receive care best when delivered in a formal setting.
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ANS: A n n
When families live with a dominant member who has a persistent and severe mental
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disorder the outcomes are often expressed as family members who are at increased riskfor physical
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and mental illnesses. The remaining options are not necessarily true.
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DIF: Cognitive Level: Application REF: Page 3 n n n
2. Which nursing activity shows the nurse actively engaged in the primary prevention
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ofmental disorders?
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a. Providing a patient, whose depression is well managed, with medication on n n n n n n n n n n
tim n
b. Making regular follow-up visits to a new mother at risk for post-partum
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depression n
c. Providing the family of a patient, diagnosed with depression, information on n n n n n n n n n n
suicide prevention
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d. Assisting a patient who has obsessive compulsive tendencies prepare and practice
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for a job interview
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ANS: B
Primary prevention helps to reduce the occurrence of mental disorders by staying
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involved with a patient. Providing medication and information on existing illnesses are
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examples of secondary prevention which helps to reduce the prevalence of mental
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disorders. Assisting a mentally ill patient with preparation for a job interview is tertiary
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prevention since it involves rehabilitation.
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DIF: Cognitive Level: Application REF: Page 4 n n n
3. Which intervention reflects attention being focused on the patient’s intentions
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regarding his diagnosis of severe depression?
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a. Being placed on suicide precautions n n n n
b. Encouraging visits by his family members n n n n n
c. Receiving a combination of medications to address his emotional needs n n n n n n n n n
d. Being asked to decide where he will attend his prescribed therapy sessions
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ANS: D n
A primary factor in patient treatment includes consideration of the patient’s intentions regarding
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his or her own care. Patients are central to the process that determines their care as
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their abilities allow. Under the guidance of PMH nurses and other mental health
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personnel, patients are encouraged to make decisions and to actively engage in
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their own treatment plans to meet their needs. The remaining options are focused
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on specificsof the determined plan of care.
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DIF: Cognitive Level: Application REF: Page 5 n n n
,4. When a patient’s family asks why their chronically mentally ill adult child is being
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discharged to a community-based living facility, the nurse responds:
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a. “It is a way to meet the need for social support.”
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b. “It is too expensive to keep stabilized patients in acute care settings.”
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c. “This type of facility will provide the specialized care that is needed.”
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d. “Being out in the community will help provide hope and purpose for living.” n n n n n n n n n n n n
ANS: D n
Hospitalization may be necessary for acute care, but, when patients are stabilized, they n n n n n n n n n n n n
move into community-based, patient-centered settings or are discharged home with
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continued outpatient treatment in the community. Concentrated efforts are made to
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reduce the patient’s sick role by providing opportunities for the development of a
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purposeful life and instilling hope for each patient’s future. Although social support is
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important, such a living arrangement is not the only way to achieve it. Although acute
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care is expensive, it is not the major concern when determining long-term care options.
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Community-based facilities are not the only option for specialized care. DIF: n n n n n n n n n n
Cognitive Level: Application REF: Page 5 n n n
5. What is the best explanation to offer when the mother of a chronically ill
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teenage patient asks, “Under what circumstances would he be considered incompetent?”
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a. “When you can provide the court with enough evidence to show that he is not
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able to care for himself safely.”
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b. “It is not likely that someone his age would be determined to be incompetent
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regardless of his mental condition.”
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c. “He would have to engage in behavior that would result in harm to himself or
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to someone else; like you or his siblings.”
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d. “If the illness becomes so severe that his judgment is impaired to the point
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whe the decisions he makes are harmful to himself or to others.”
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ANS: D n
When a person is unable to cognitively process information or to make decisions
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n about his or her own welfare, the person may be determined to be mentally
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nincompetent.
Providing self-care is not the only criteria considered. Age is not a factor considered. The
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decision is often based on the potential for such behavior.
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DIF: Cognitive Level: Application REF: Page 6 n n n
6. Which psychiatric nursing intervention shows an understanding of integrated care?
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a. A chronically abused woman is assessed for anxiety.
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b. A manic patient is taken to the gym to use the exercise equipment.
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c. The older adult diagnosed with depression is monitored for suicidal ideations.
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d. A teenager who refuses to obey the unit’s rules is not allow to play video
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game
ANS: A n
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The majority of health disciplines now recognize that mental disorders and physical
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illnesses are closely linked. The presence of a mental disorder increases the risk for
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nthe development of physical illnesses and vice versa. Assessing a chronically abused
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individual for anxiety call should attention to the psychiatric disorder that could
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ndevelop from the abuse. The remaining options show interventions that are appropriate for
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the mental disorder.
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DIF: Cognitive Level: Application REF: Page 6 n n n
7. What reason does the nurse give the patient for the emphasis and attention being
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, paid to the recovery phase of their treatment plan?
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a. Recovery care, even when intensive, is less expensive than acute psychiatric care. n n n n n n n n n n n
b. Effective recovery care is likely to result in fewer relapses and subsequent hospitalizations.
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c. Planning for recovery care is time consuming and involves dealing with many complicated
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details. n
d. Recovery care is usually done on an outpatient basis and so is generally better n n n n n n n n n n n n n
accepted by patients.
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ANS: B
Much attention is paid to recovery care since effective recovery care helps improve
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patient outcomes and thus minimize subsequent hospitalizations. Recovery care is not necessarily
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less expensive than acute care. Although effective recovery care planning may be
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ntime consuming and detail oriented, that is not the reason for implementing it.
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Recovery care is not necessarily well accepted by patients.
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DIF: Cognitive Level: Application REF: Page 7 n n n
8. The nurse is attending a neighborhood meeting where a half-way house is
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being proposed for the neighborhood when a member of the community states,
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“We don’twant the facility; we especially don’t want violent people living near
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us.” The response by the nurse that best addresses the public’s concern is:
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a. “In truth, most individuals with psychiatric disorder are passive and withdrawn
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and pose little threat to those around them.”
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b. “The mentally ill seldom behave in the manner they are portrayed by movies;
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they are people just like the rest of us.”
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c. “Patients with psychiatric disorder are so well medicated that they do not displa y n n n n n n n n n n n n
violent behaviors.”
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d. “The mentally ill deserve a safe, comfortable place to live among people
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who truly care for them.”
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ANS: A n n
A major reason for the existence of the stigma placed on persons with mental illness
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nis lack of knowledge. The main fear is of violence, although only a small percentage of
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patients with mental illness display this behavior. Providing the public with accurate
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information can help reduce stigma. The remaining options do not directly address the
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concerns stated.
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DIF: Cognitive Level: Application REF: Pages 13-14 n n n
9. Which activity shows that a therapeutic alliance has been established between
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thenurse and patient?
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a. The nurse respects the patient’s right to privacy when visitors are spending tim
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with the patient.
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b. The patient is eagerly attending all group sessions and working independently
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oidentifying their personal stressors.
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c. The patient is freely describing their feelings related to the physical and
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emotional trauma they experienced as a child with the nurse.
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d. The nurse dutifully administers the patient’s medications on time and with appropriate
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knowledge of the potential side effects.
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ANS: C n n
A primary aspect of working with patients in any setting and particularly in the
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