PN MENTAL HEALTH PROCTORED EXAM P a g e |
1
PN MENTAL HEALTH PROCTORED EXAM 5
QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% Verified Solutions | Updated
Per Latest Guidelines | Graded A+
A patient diagnosed with a SMI lives independently and attends a psychosocial rehabilitation program.
The patient presents at the emergency department seeking hospitalization. The patient has no acute
symptoms but says, "I have no money to pay my rent or refill my prescription." Select the nurse's best
action.
a. Involve the patient's case manager to provide crisis intervention.
b. Send the patient to a homeless shelter until housing can be arranged.
c. Arrange for a short in-patient admission and begin discharge planning.
d. Explain that one must have active psychiatric symptoms to be admitted.
ANS: A
P a g e 1 | 134
, PN MENTAL HEALTH PROCTORED EXAM P a g e |
2
Impaired stress tolerance and problem-solving abilities can cause persons with SMI to experience
relatively minor stressors as crises. This patient has run out of money, and this has overwhelmed her
ability to cope, resulting in a crisis for which crisis intervention would be an appropriate response.
Inpatient care is not clinically indicated nor is the patient homeless (although she may fear she is).
Telling the patient that she is not symptomatic enough to be admitted may prompt malingering.
The nurse wants to enroll a patient with poor social skills in a training program for patients diagnosed
with schizophrenia. Which description accurately describes social skills training?
a. Patients learn to improve their attention and concentration.
b. Group leaders provide support without challenging patients to change.
c. Complex interpersonal skills are taught by breaking them into simpler behaviors.
d. Patients learn social skills by practicing them in a supported employment setting.
ANS: C
In social skills training, complex interpersonal skills are taught by breaking them down into component
behaviors that are covered in a stepwise fashion. Social skills training is not based in employment
settings, although such skills can be addressed as part of supported employment services. The other
distracters are less relevant to social skills training.
A patient diagnosed with a SMI died suddenly at age 52. The patient lived in the community for 5 years
without relapse and held supported employment the past 6 months. The distressed family asks, "How
could this happen?" Which response by the nurse accurately reflects research and addresses the
family's question?
a. "A certain number of people die young from undetected diseases, and it's just one of those sad
things that sometimes happen."
b. "Mentally ill people tend to die much younger than others, perhaps because they do not take as
good care of their health, smoke more, or are overweight."
c. "We will have to wait for the autopsy to know what happened. There were some medical problems,
but we were not expecting death."
d. "We are all surprised. The patient had been doing so well and saw the nurse every other week."
P a g e 2 | 134
, PN MENTAL HEALTH PROCTORED EXAM P a g e |
3
ANS: B
The family is in distress. Because they do not understand his death, they are less able to accept it and
seek specific information to help them understand what happened. Persons with SMI die an average
of 25 years prematurely. Contributing factors include failing to provide for their own health needs (e.g.,
forgetting to take medicine), inability to access or pay for care, higher rates of smoking, poor diet,
criminal victimization, and stigma. The most accurate answer indicates that seriously mentally ill
people are at much higher risk of premature death for a variety of reasons. Staff would not have been
surprised that the patient died prematurely, and they would not attribute his death to random,
undetected medical problems. Although the cause of death will not be reliably established until the
autopsy, this response fails to address the family's need for information.
Many persons brought before a criminal court have mental illness, have committed minor offenses,
and are off medications. The judge consults the nurse at the local community mental health center for
guidance about how to respond when handling such cases. Which advice from the nurse would be
most appropriate?
a. "Sometimes a little time in jail makes a person rethink what they've been doing and puts them back
on the right track."
b. "Sentencing such persons to participate in treatment instead of incarcerating them has been shown
to reduce repeat offenses."
c. "Arresting these people helps them in the long run. Sometimes we cannot hospitalize them, but in
jail they will get their medication."
d. "Research suggests that special mental health courts do not make much difference so far, but
outpatient commitment does seem to help."
ANS: B
Research supports the use of special mental health courts that can sentence mentally ill persons to
treatment instead of jail. Jail exposes vulnerable mentally ill persons to criminals, victimization, and
high levels of stimulation and stress. Incarceration can also interrupt eligibility for benefits or lead to
the loss of housing and often provides lower-quality mental health treatment in other settings.
Recidivism rates for both mentally ill and non-mentally ill offenders are relatively high, so it does not
appear that incarceration necessarily leads people to behave more appropriately. In addition, a
criminal record can leave them more desperate and with fewer options after release. Research
indicates that outpatient commitment is less effective at improving the mental health of mentally ill
persons than was expected.
P a g e 3 | 134
, PN MENTAL HEALTH PROCTORED EXAM P a g e |
4
A nurse's neighbor says, "My sister has been diagnosed with bipolar disorder but will not take her
medication. I have tried to help her for over 20 years, but it seems like everything I do fails. Do you
have any suggestions?" Select the nurse's best response.
a. "NAMI offers a family education series that you might find helpful."
b. "Since your sister is noncompliant, perhaps it's time for her to be changed to injectable
medication."
c. "You have done all you can. Now it's time to put yourself first and move on with your life."
d. "You cannot help her. Would it be better for you to discontinue your relationship?"
ANS: A
NAMI offers a family education series that assists with the stress caregivers and other family members
often experience. The nurse should not give advice about injectable medication or encourage the
family member to give up on the patient.
SMI is characterized as
a. any mental illness of more than 2 weeks' duration.
b. a major long-term mental illness marked by significant functional impairments.
c. a mental illness accompanied by physical impairment and severe social problems.
d. a major mental illness that cannot be treated to prevent deterioration of cognitive and social
abilities.
ANS: B
"Serious mental illness" has replaced the term "chronic mental illness." Global impairments in function
are evident, particularly social. Physical impairments may be present. SMI can be treated, but
remissions and exacerbations are part of the course of the illness.
Which nursing diagnosis is likely to apply to an individual diagnosed with a SMI who is homeless?
a. Insomnia
P a g e 4 | 134
1
PN MENTAL HEALTH PROCTORED EXAM 5
QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% Verified Solutions | Updated
Per Latest Guidelines | Graded A+
A patient diagnosed with a SMI lives independently and attends a psychosocial rehabilitation program.
The patient presents at the emergency department seeking hospitalization. The patient has no acute
symptoms but says, "I have no money to pay my rent or refill my prescription." Select the nurse's best
action.
a. Involve the patient's case manager to provide crisis intervention.
b. Send the patient to a homeless shelter until housing can be arranged.
c. Arrange for a short in-patient admission and begin discharge planning.
d. Explain that one must have active psychiatric symptoms to be admitted.
ANS: A
P a g e 1 | 134
, PN MENTAL HEALTH PROCTORED EXAM P a g e |
2
Impaired stress tolerance and problem-solving abilities can cause persons with SMI to experience
relatively minor stressors as crises. This patient has run out of money, and this has overwhelmed her
ability to cope, resulting in a crisis for which crisis intervention would be an appropriate response.
Inpatient care is not clinically indicated nor is the patient homeless (although she may fear she is).
Telling the patient that she is not symptomatic enough to be admitted may prompt malingering.
The nurse wants to enroll a patient with poor social skills in a training program for patients diagnosed
with schizophrenia. Which description accurately describes social skills training?
a. Patients learn to improve their attention and concentration.
b. Group leaders provide support without challenging patients to change.
c. Complex interpersonal skills are taught by breaking them into simpler behaviors.
d. Patients learn social skills by practicing them in a supported employment setting.
ANS: C
In social skills training, complex interpersonal skills are taught by breaking them down into component
behaviors that are covered in a stepwise fashion. Social skills training is not based in employment
settings, although such skills can be addressed as part of supported employment services. The other
distracters are less relevant to social skills training.
A patient diagnosed with a SMI died suddenly at age 52. The patient lived in the community for 5 years
without relapse and held supported employment the past 6 months. The distressed family asks, "How
could this happen?" Which response by the nurse accurately reflects research and addresses the
family's question?
a. "A certain number of people die young from undetected diseases, and it's just one of those sad
things that sometimes happen."
b. "Mentally ill people tend to die much younger than others, perhaps because they do not take as
good care of their health, smoke more, or are overweight."
c. "We will have to wait for the autopsy to know what happened. There were some medical problems,
but we were not expecting death."
d. "We are all surprised. The patient had been doing so well and saw the nurse every other week."
P a g e 2 | 134
, PN MENTAL HEALTH PROCTORED EXAM P a g e |
3
ANS: B
The family is in distress. Because they do not understand his death, they are less able to accept it and
seek specific information to help them understand what happened. Persons with SMI die an average
of 25 years prematurely. Contributing factors include failing to provide for their own health needs (e.g.,
forgetting to take medicine), inability to access or pay for care, higher rates of smoking, poor diet,
criminal victimization, and stigma. The most accurate answer indicates that seriously mentally ill
people are at much higher risk of premature death for a variety of reasons. Staff would not have been
surprised that the patient died prematurely, and they would not attribute his death to random,
undetected medical problems. Although the cause of death will not be reliably established until the
autopsy, this response fails to address the family's need for information.
Many persons brought before a criminal court have mental illness, have committed minor offenses,
and are off medications. The judge consults the nurse at the local community mental health center for
guidance about how to respond when handling such cases. Which advice from the nurse would be
most appropriate?
a. "Sometimes a little time in jail makes a person rethink what they've been doing and puts them back
on the right track."
b. "Sentencing such persons to participate in treatment instead of incarcerating them has been shown
to reduce repeat offenses."
c. "Arresting these people helps them in the long run. Sometimes we cannot hospitalize them, but in
jail they will get their medication."
d. "Research suggests that special mental health courts do not make much difference so far, but
outpatient commitment does seem to help."
ANS: B
Research supports the use of special mental health courts that can sentence mentally ill persons to
treatment instead of jail. Jail exposes vulnerable mentally ill persons to criminals, victimization, and
high levels of stimulation and stress. Incarceration can also interrupt eligibility for benefits or lead to
the loss of housing and often provides lower-quality mental health treatment in other settings.
Recidivism rates for both mentally ill and non-mentally ill offenders are relatively high, so it does not
appear that incarceration necessarily leads people to behave more appropriately. In addition, a
criminal record can leave them more desperate and with fewer options after release. Research
indicates that outpatient commitment is less effective at improving the mental health of mentally ill
persons than was expected.
P a g e 3 | 134
, PN MENTAL HEALTH PROCTORED EXAM P a g e |
4
A nurse's neighbor says, "My sister has been diagnosed with bipolar disorder but will not take her
medication. I have tried to help her for over 20 years, but it seems like everything I do fails. Do you
have any suggestions?" Select the nurse's best response.
a. "NAMI offers a family education series that you might find helpful."
b. "Since your sister is noncompliant, perhaps it's time for her to be changed to injectable
medication."
c. "You have done all you can. Now it's time to put yourself first and move on with your life."
d. "You cannot help her. Would it be better for you to discontinue your relationship?"
ANS: A
NAMI offers a family education series that assists with the stress caregivers and other family members
often experience. The nurse should not give advice about injectable medication or encourage the
family member to give up on the patient.
SMI is characterized as
a. any mental illness of more than 2 weeks' duration.
b. a major long-term mental illness marked by significant functional impairments.
c. a mental illness accompanied by physical impairment and severe social problems.
d. a major mental illness that cannot be treated to prevent deterioration of cognitive and social
abilities.
ANS: B
"Serious mental illness" has replaced the term "chronic mental illness." Global impairments in function
are evident, particularly social. Physical impairments may be present. SMI can be treated, but
remissions and exacerbations are part of the course of the illness.
Which nursing diagnosis is likely to apply to an individual diagnosed with a SMI who is homeless?
a. Insomnia
P a g e 4 | 134
