TEST BANK Adults Varcarolis Essentials of Psychiatric Mental Health Nursing A Communicati, Exams of Advanced Education

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TEST BANK Chapter 27: Adults Varcarolis: EssenƟals of Psychiatric

Mental Health Nursing: A CommunicaƟon Approach to Evidence-Based

Care

Health maintenance and promoƟon efforts for paƟents diagnosed with severe mental illness should include educaƟon about the importance of what regular intervenƟon? a. Home safety inspecƟons b. Monitoring of self-care abiliƟes c. Screening for cancer, hypertension, and diabetes d. DeterminaƟon of adequacy of a paƟent's support system c. Screening for cancer, hypertension, and diabetes How is severe and persistent mental illness best characterized? a. Mental illness with longer than 2 weeks' duraƟon. b. Major ongoing mental illness marked by significant funcƟonal impairments. c. Mental illness accompanied by physical impairment and severe social problems. d. Major mental illness that cannot be treated to prevent deterioraƟon of cogniƟve and social abiliƟes. b. Major ongoing mental illness marked by significant funcƟonal impairments. Which nursing diagnosis is likely to apply to the plan of care for a homeless individual diagnosed with severe and persistent mental illness? a. Insomnia b. Substance abuse c. Chronic low self-esteem d. Impaired environmental interpretaƟon syndrome c. Chronic low self-esteem A paƟent diagnosed with schizophrenia tells the community mental health nurse, "I threw away my pills because they interfere with God's voice." The nurse idenƟfies what as the likely cause of the paƟent's ineffecƟve management of the medicaƟon regimen? a. Inadequate discharge planning b. Poor therapeuƟc alliance with clinicians c. Impaired reasoning secondary to schizophrenia d. Dislike of the side effects of anƟpsychoƟc medicaƟons c. Impaired reasoning secondary to schizophrenia A paƟent diagnosed with severe and persistent mental illness lives independently. This paƟent oŌen has command hallucinaƟons and shouts warnings to neighbors. AŌer a short hospitalizaƟon, the paƟent's landlord says, "You can't come back here. You cause too much trouble." What problem is the paƟent

experiencing? a. Grief b. SƟgmaƟzaƟon c. Recidivism d. Lack of insurance parity b. SƟgmaƟzaƟon ANS: B The inability to obtain shelter because of negaƟve aƫtudes about mental illness is an example of sƟgmaƟzaƟon. SƟgma is defined as damage to reputaƟon, shame, and ridicule society places on mental illness. Data are not present to idenƟfy grief as the paƟent's problem. Recidivism refers to repeƟƟon of a previous offense. Insurance parity is not relevant to this scenario. A person diagnosed with severe and persistent mental illness enters a shelter for the homeless. Which intervenƟon should be the nurse's iniƟal priority? a. Develop a relaƟonship. b. Find supported employment. c. Administer prescribed medicaƟon. d. Teach appropriate health care pracƟces a. Develop a relaƟonship. Basic psychosocial needs do not change because a person is homeless. The nurse's iniƟal priority should be establishing rapport. Once a trusƟng relaƟonship is established, then the nurse can pursue other intervenƟons. A paƟent diagnosed with severe and persistent mental illness lives in a homeless shelter. The priority nursing diagnosis for this paƟent is Powerlessness. Which intervenƟon should be included in the plan of care? a. Encourage mutual goal seƫng. b. Verbally communicate empathy. c. Reinforce parƟcipaƟon in acƟviƟes. d. Demonstrate an accepƟng aƫtude. a. Encourage mutual goal seƫng. For paƟents diagnosed with severe and persistent mental illness, what is the major advantage of case management? a. ModificaƟon of tradiƟonal psychotherapy b. Efficient access and use of resources c. Focus on social skills training and self-esteem building d. Bringing groups of paƟents together to discuss common problems b. Efficient access and use of resources

The parent of an adult diagnosed with severe and persistent mental illness asks the nurse, "Why are you making a referral to that vocaƟonal rehabilitaƟon program? My child won't ever be able to hold a job." Which is the nurse's best reply? a. "We made this referral to maintain eligibility for federal funding." b. "Are you concerned that we're trying to make your child too independent?" c. "If you think the program would be detrimental, we can postpone it for a Ɵme." d. "Most paƟents are capable of employment at some level, compeƟƟve or supported." d. "Most paƟents are capable of employment at some level, compeƟƟve or supported." A paƟent says, "I oŌen make careless mistakes and have trouble staying focused. SomeƟmes it's hard to listen to what someone is saying. I have problems puƫng things in the right order and oŌen lose equipment." Which problem should the nurse document? a. InaƩenƟon b. Impulsivity c. HyperacƟvity d. Social impairment a. InaƩenƟon A nurse prepares for an iniƟal interview with a paƟent with suspected adult aƩenƟon-deficit/hyperacƟvity disorder (ADHD). QuesƟons should be focused to elicit informaƟon about which problem? a. Headaches b. InaƩenƟon c. Sexual impulses d. TrichoƟllomania b. InaƩenƟon A nurse prepares a plan of care for a paƟent diagnosed with adult aƩenƟon-deficit/hyperacƟvity disorder (ADHD). Which intervenƟon should be included? a. Remind the paƟent of prioriƟes and deadlines. b. Teach work-related skills such as basic computer literacy. c. Establish penalƟes for failing to organize and prioriƟze tasks. d. Give encouragement and strategies for managing and organizing. d. Give encouragement and strategies for managing and organizing. The treatment team believes medicaƟon will help a paƟent diagnosed with adult aƩenƟon- deficit/hyperacƟvity disorder (ADHD). Which class of medicaƟons does the nurse expect will be prescribed? a. Benzodiazepines b. SƟmulants c. AnƟpsychoƟcs d. AnxiolyƟcs

b. SƟmulants An adult diagnosed with aƩenƟon-deficit/hyperacƟvity disorder (ADHD) says, "I've always been stupid. I never had friends when I was a child. My parents oŌen punished me because I made mistakes. Now, I can't keep a job." The nurse managing care should consider suggesƟng what intervenƟon? a. Aversive therapy to exƟnguish negaƟve behaviors. b. CogniƟve therapy to help address internalized beliefs. c. Group therapy to allow comparison of feelings with others. d. VocaƟonal counseling to idenƟfy needed occupaƟonal skills. b. CogniƟve therapy to help address internalized beliefs. CogniƟve therapy and knowledge of ADHD will make it possible for the paƟent to reframe the past and present in a more posiƟve and realisƟc light and to challenge internalized false beliefs about self this improving self-image. Aversive therapy would not be useful for the paƟent. Group therapy may be valuable later to allow for the tesƟng of new coping behaviors in a safe environment. VocaƟonal counseling can help the paƟent explore suitable career opƟons while pursuing treatment. A nurse counsels a paƟent diagnosed with serious and persistent mental illness. The paƟent lives at home with family. Which resource could the nurse suggest assisƟng the paƟent and family to cope with the sƟgma of mental illness as well as provide support and educaƟon? a. American Psychiatric AssociaƟon (APA) b. NaƟonal Alliance on Mental Illness (NAMI) c. Community Mental Health Centers (CMHCs) d. Programs of AsserƟve Community Treatment (PACT) b. NaƟonal Alliance on Mental Illness (NAMI) Which nursing acƟon should occur first when preparing to work with a paƟent who has a problem of sexual funcƟoning? a. Acquire knowledge of the paƟent's sexual roles and preferences. b. Develop an understanding of human sexual responses. c. Assess the paƟent's sexual funcƟoning. d. Clarify the nurse's own personal values. d. Clarify the nurse's own personal values. Before working with paƟents regarding sexual concerns, what is a prerequisite for providing nonjudgmental care? a. Sympathy b. AsserƟveness training c. Sexual self-awareness d. EffecƟve communicaƟon c. Sexual self-awareness

An adult has been feeling significant tension since losing a home through foreclosure. This person goes to a park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior? a. Voyeurism b. FroƩeurism c. ExhibiƟonism d. Sexual masochism c. ExhibiƟonism A nurse cares for a paƟent diagnosed with paraphilia. The nurse expects the health care provider may prescribe which type of medicaƟon to reduce paraphilic behaviors? a. SƟmulants b. ErecƟle dysfuncƟon medicaƟon c. Atypical anƟpsychoƟc medicaƟon d. Mood stabilizer d. Mood stabilizer A paƟent diagnosed with severe and persistent mental illness who recently moved to a homeless shelter says, "My life is out of control. I'm like a leaf at the mercy of the wind." The nurse formulates the diagnosis Powerlessness. Outcomes will focus on which goal? a. InsƟlling hope b. Controlling anxiety c. Planning social acƟviƟes d. Developing personal autonomy d. Developing personal autonomy Which informaƟon should a nurse include in health teaching for adults diagnosed with aƩenƟon- deficit/hyperacƟvity disorder (ADHD) and their significant others? (Select all that apply.) a. Tendency for geneƟc transmission b. PrevenƟon strategies related to substance abuse c. NegaƟve reinforcement strategies to help modify behaviors d. SelecƟve serotonin reuptake inhibitors (SSRIs) are usually prescribed for hyperacƟvity e. CogniƟve therapy may help resolve internalized negaƟve beliefs about self a. Tendency for geneƟc transmission b. PrevenƟon strategies related to substance abuse e. CogniƟve therapy may help resolve internalized negaƟve beliefs about self An adult paƟent tells the case manager, "I don't have bipolar disorder anymore, so I don't need medicine. AŌer I was in the hospital last year, you helped me get an apartment and disability checks. Now I'm bored and don't have any friends." Which resources should the nurse suggest for the paƟent? (Select all that apply.)

a. PsychoeducaƟon classes b. VocaƟonal rehabilitaƟon c. Social skills training d. Homeless shelter e. Crisis intervenƟon a. PsychoeducaƟon classes b. VocaƟonal rehabilitaƟon c. Social skills training Which economic factors are most criƟcal to the success of discharge planning for a paƟent diagnosed with severe and persistent mental illness? (Select all that apply.) a. Access to housing b. Individual psychotherapy c. Income to meet basic needs d. Availability of health insurance e. Ongoing interdisciplinary evaluaƟon a. Access to housing c. Income to meet basic needs d. Availability of health insurance