Test Bank: Essentials of Psychiatric Mental Health Nursing - Chapter 27: Adults, Exams of Nursing

Download Test Bank: Essentials of Psychiatric Mental Health Nursing - Chapter 27: Adults and more Exams Nursing in PDF only on Docsity!

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

Health maintenance and promotion efforts for patients diagnosed with severe mental illness should include education about the importance of what regular intervention? a. Home safety inspections b. Monitoring of self-care abilities c. Screening for cancer, hypertension, and diabetes d. Determination of adequacy of a patient's support system - correct answer ✅✅c. Screening for cancer, hypertension, and diabetes How is severe and persistent mental illness best characterized? a. Mental illness with longer than 2 weeks' duration. b. Major ongoing mental illness marked by significant functional impairments. c. Mental illness accompanied by physical impairment and severe social problems. d. Major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities. - correct answer ✅✅b. Major ongoing mental illness marked by significant functional 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 interpretation syndrome - correct answer ✅✅c. Chronic low self-esteem

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

A patient diagnosed with schizophrenia tells the community mental health nurse, "I threw away my pills because they interfere with God's voice." The nurse identifies what as the likely cause of the patient's ineffective management of the medication regimen? a. Inadequate discharge planning b. Poor therapeutic alliance with clinicians c. Impaired reasoning secondary to schizophrenia d. Dislike of the side effects of antipsychotic medications - correct answer ✅✅c. Impaired reasoning secondary to schizophrenia A patient diagnosed with severe and persistent mental illness lives independently. This patient often has command hallucinations and shouts warnings to neighbors. After a short hospitalization, the patient's landlord says, "You can't come back here. You cause too much trouble." What problem is the patient experiencing? a. Grief b. Stigmatization c. Recidivism d. Lack of insurance parity - correct answer ✅✅b. Stigmatization ANS: B The inability to obtain shelter because of negative attitudes about mental illness is an example of stigmatization. Stigma is defined as damage to reputation, shame, and ridicule society places on mental illness. Data are not present to identify grief as the patient's problem. Recidivism refers to repetition of a previous offense. Insurance parity is not relevant to this scenario.

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

A person diagnosed with severe and persistent mental illness enters a shelter for the homeless. Which intervention should be the nurse's initial priority? a. Develop a relationship. b. Find supported employment. c. Administer prescribed medication. d. Teach appropriate health care practices - correct answer ✅✅a. Develop a relationship. Basic psychosocial needs do not change because a person is homeless. The nurse's initial priority should be establishing rapport. Once a trusting relationship is established, then the nurse can pursue other interventions. A patient diagnosed with severe and persistent mental illness lives in a homeless shelter. The priority nursing diagnosis for this patient is Powerlessness. Which intervention should be included in the plan of care? a. Encourage mutual goal setting. b. Verbally communicate empathy. c. Reinforce participation in activities. d. Demonstrate an accepting attitude. - correct answer ✅✅a. Encourage mutual goal setting. For patients diagnosed with severe and persistent mental illness, what is the major advantage of case management?

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

a. Modification of traditional psychotherapy b. Efficient access and use of resources c. Focus on social skills training and self-esteem building d. Bringing groups of patients together to discuss common problems - correct answer ✅✅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 vocational rehabilitation 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 time." d. "Most patients are capable of employment at some level, competitive or supported." - correct answer ✅✅d. "Most patients are capable of employment at some level, competitive or supported." A patient says, "I often make careless mistakes and have trouble staying focused. Sometimes it's hard to listen to what someone is saying. I have problems putting things in the right order and often lose equipment." Which problem should the nurse document? a. Inattention b. Impulsivity c. Hyperactivity d. Social impairment - correct answer ✅✅a. Inattention

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

A nurse prepares for an initial interview with a patient with suspected adult attention-deficit/hyperactivity disorder (ADHD). Questions should be focused to elicit information about which problem? a. Headaches b. Inattention c. Sexual impulses d. Trichotillomania - correct answer ✅✅b. Inattention A nurse prepares a plan of care for a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which intervention should be included? a. Remind the patient of priorities and deadlines. b. Teach work-related skills such as basic computer literacy. c. Establish penalties for failing to organize and prioritize tasks. d. Give encouragement and strategies for managing and organizing. - correct answer ✅✅d. Give encouragement and strategies for managing and organizing. The treatment team believes medication will help a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which class of medications does the nurse expect will be prescribed? a. Benzodiazepines b. Stimulants c. Antipsychotics

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

d. Anxiolytics - correct answer ✅✅b. Stimulants An adult diagnosed with attention-deficit/hyperactivity disorder (ADHD) says, "I've always been stupid. I never had friends when I was a child. My parents often punished me because I made mistakes. Now, I can't keep a job." The nurse managing care should consider suggesting what intervention? a. Aversive therapy to extinguish negative behaviors. b. Cognitive therapy to help address internalized beliefs. c. Group therapy to allow comparison of feelings with others. d. Vocational counseling to identify needed occupational skills. - correct answer ✅✅b. Cognitive therapy to help address internalized beliefs. Cognitive therapy and knowledge of ADHD will make it possible for the patient to reframe the past and present in a more positive and realistic light and to challenge internalized false beliefs about self this improving self- image. Aversive therapy would not be useful for the patient. Group therapy may be valuable later to allow for the testing of new coping behaviors in a safe environment. Vocational counseling can help the patient explore suitable career options while pursuing treatment. A nurse counsels a patient diagnosed with serious and persistent mental illness. The patient lives at home with family. Which resource could the nurse suggest assisting the patient and family to cope with the stigma of mental illness as well as provide support and education? a. American Psychiatric Association (APA)

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

b. National Alliance on Mental Illness (NAMI) c. Community Mental Health Centers (CMHCs) d. Programs of Assertive Community Treatment (PACT) - correct answer ✅✅b. National Alliance on Mental Illness (NAMI) Which nursing action should occur first when preparing to work with a patient who has a problem of sexual functioning? a. Acquire knowledge of the patient's sexual roles and preferences. b. Develop an understanding of human sexual responses. c. Assess the patient's sexual functioning. d. Clarify the nurse's own personal values. - correct answer ✅✅d. Clarify the nurse's own personal values. Before working with patients regarding sexual concerns, what is a prerequisite for providing nonjudgmental care? a. Sympathy b. Assertiveness training c. Sexual self-awareness d. Effective communication - correct answer ✅✅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. Frotteurism

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

c. Exhibitionism d. Sexual masochism - correct answer ✅✅c. Exhibitionism A nurse cares for a patient diagnosed with paraphilia. The nurse expects the health care provider may prescribe which type of medication to reduce paraphilic behaviors? a. Stimulants b. Erectile dysfunction medication c. Atypical antipsychotic medication d. Mood stabilizer - correct answer ✅✅d. Mood stabilizer A patient 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. Instilling hope b. Controlling anxiety c. Planning social activities d. Developing personal autonomy - correct answer ✅✅d. Developing personal autonomy Which information should a nurse include in health teaching for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and their significant others? (Select all that apply.) a. Tendency for genetic transmission b. Prevention strategies related to substance abuse

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

c. Negative reinforcement strategies to help modify behaviors d. Selective serotonin reuptake inhibitors (SSRIs) are usually prescribed for hyperactivity e. Cognitive therapy may help resolve internalized negative beliefs about self

- correct answer ✅✅a. Tendency for genetic transmission b. Prevention strategies related to substance abuse e. Cognitive therapy may help resolve internalized negative beliefs about self An adult patient tells the case manager, "I don't have bipolar disorder anymore, so I don't need medicine. After 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 patient? (Select all that apply.) a. Psychoeducation classes b. Vocational rehabilitation c. Social skills training d. Homeless shelter e. Crisis intervention - correct answer ✅✅a. Psychoeducation classes b. Vocational rehabilitation c. Social skills training Which economic factors are most critical to the success of discharge planning for a patient diagnosed with severe and persistent mental illness? (Select all that apply.)

Varcarolis: Essentials of Psychiatric

Mental Health Nursing: A Communication

Approach to Evidence-Based Care

a. Access to housing b. Individual psychotherapy c. Income to meet basic needs d. Availability of health insurance e. Ongoing interdisciplinary evaluation - correct answer ✅✅a. Access to housing c. Income to meet basic needs d. Availability of health insurancea