C HAPTER 32: S ERIOUS M ENTAL I LLNESS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. 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 communit y 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 theyve
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 mentall y ill persons to treatment instead of jail. Jail exposes
vulnerable mentall y ill persons to criminals, victimization, and high
levels of stimulation and stress. Incarceration can also interrupt
eligibilit y for benefits or lead to the loss of housing and often provides
lower-qualit y mental health treatment in other settings. Recidivism
rates for both mentally ill and non -mentally ill offenders are relativel y
, high, so it does not appear that incarceration necessaril y leads people
to behave more appropriatel y. In addition, a criminal record can leave
them more desperate and with fewer options afte r release. Research
indicates that outpatient commitment is less effective at improving the
mental health of mentall y ill persons than was expected.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 593 TOP: Nursing Process: Planning MSC:
Client Needs: Safe, Effective Care Environment
2. A nurses 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 nurses best response.
a. The National Alliance on Mental Illness offers a famil y education
series that you might find helpful.
b. Since your sister is noncompliant, perhaps its time for her to be
changed to injectable medication.
c. You have done all you can. Now its 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
The National Alliance on Mental Illness (NAMI) offers a family
education series that assi sts with the stress caregivers and other famil y
members often experience. The nurse should not give advice about
injectable medication or encourage the famil y member to give up on
the patient.
, PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 585 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. Serious mental illness 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 illn ess.
Global impairments in function are evident particularl y social. Physical
impairments may be present. Serious mental illness can be treated, but
remissions and exacerbations are part of the course of the illness.
PTS: 1 DIF: Cognitive Level: Understa nd (Comprehension)
REF: 584 TOP: Nursing Process: Assessment MSC:
Client Needs: Health Promotion and Maintenance
4. Which nursing diagnosis is likel y to apply to an individual diagnosed with
a serious mental illness who is homeless?
a. Insomnia
b. Substance abuse
c. Chronic low self -esteem
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. 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 communit y 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 theyve
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 mentall y ill persons to treatment instead of jail. Jail exposes
vulnerable mentall y ill persons to criminals, victimization, and high
levels of stimulation and stress. Incarceration can also interrupt
eligibilit y for benefits or lead to the loss of housing and often provides
lower-qualit y mental health treatment in other settings. Recidivism
rates for both mentally ill and non -mentally ill offenders are relativel y
, high, so it does not appear that incarceration necessaril y leads people
to behave more appropriatel y. In addition, a criminal record can leave
them more desperate and with fewer options afte r release. Research
indicates that outpatient commitment is less effective at improving the
mental health of mentall y ill persons than was expected.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 593 TOP: Nursing Process: Planning MSC:
Client Needs: Safe, Effective Care Environment
2. A nurses 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 nurses best response.
a. The National Alliance on Mental Illness offers a famil y education
series that you might find helpful.
b. Since your sister is noncompliant, perhaps its time for her to be
changed to injectable medication.
c. You have done all you can. Now its 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
The National Alliance on Mental Illness (NAMI) offers a family
education series that assi sts with the stress caregivers and other famil y
members often experience. The nurse should not give advice about
injectable medication or encourage the famil y member to give up on
the patient.
, PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 585 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. Serious mental illness 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 illn ess.
Global impairments in function are evident particularl y social. Physical
impairments may be present. Serious mental illness can be treated, but
remissions and exacerbations are part of the course of the illness.
PTS: 1 DIF: Cognitive Level: Understa nd (Comprehension)
REF: 584 TOP: Nursing Process: Assessment MSC:
Client Needs: Health Promotion and Maintenance
4. Which nursing diagnosis is likel y to apply to an individual diagnosed with
a serious mental illness who is homeless?
a. Insomnia
b. Substance abuse
c. Chronic low self -esteem
