(Test Bank) Psychiatric-Mental Health Nursing

Potter, 2

Nursing

Test Bank

2nd Edition

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Test Bank for Psychiatric-Mental Health Nursing, The downloadable file consists of 690 pages, and the total size of the file is 4.37 MB. Purchase now only for highly discounted price.

Author(s): Potter

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1Test Bank for Psychiatric-Mental Health Nursing, 2e (Potter/Moller) Chapter 1 Framework of Psychiatric-Mental Health Nursing 1) A staff member who is unlicensed assistive personnel (UAP) is overheard saying that a patient with a mental illness is not really "sick." Which response should the nurse make to the UAP? 1. "Patients with mental illness believe they are ill." 2. "A mental illness disrupts thinking and daily functioning." 3. "Mental illnesses are more debilitating than physical illnesses." 4. "Since so few people have mental illnesses, it really does not matter." Answer: 2 Explanation: 2. A mental illness is a medical con dition that disrupts a person's thinking, feeling, mood, ability to relate to others, and daily functioning. The response that patients wit h mental illness believe they are ill is not accurate or therapeutic. Mental illnesses are not always more debilitating than physical illnesses. Many individuals are affected by mental illness. Page Ref: 3 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.C.1. Value seeing health care situations "through patients' eyes." | AACN Essential Competencies: VI.2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence -based, patient-centered care | NLN Competencies: Context and Environment: Ethical Comportment: Examine personal beliefs, value s, and biases with regard to respect for persons, human dignity, equality, and justice; explore ideas of nurse caring and compassion | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1. Discuss the epidemiology of psychiatric and mental health disorders. MNL LO: 1. Recognize the epidemiology and classification of psychiatric -mental health disorders.2 Copyright © 2020 Pearson Education, Inc. 2) A staff nurse states that adolescents are too young to develop a mental illness. Which information should the nurse manager include in response? 1. More than 12 million adolescents were treated for a mental illness in 2016. 2. Adolescents are not usually diagnosed with a mental illness until they are older. 3. Mental illness in adolescents is really an undiagnosed physical illness. 4. Mental illness develops in adolescents who live in toxic environments. Answer: 1 Explanation: 1. In 2016, 12.5 million or 50% of the total population with mental illnesses are adolescents ages 12 to 17. Adolescents can be diagnosed with a mental illness at any age. Mental illness in adolescents is not really an undiagnosed physical illness. Mental illness can develop in any type of environment. Page Ref: 4 Cognitive Level: Understanding Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: I.3. Use skills of inquiry, analysis, and information literacy to address practice issues | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1. Discuss the epidemiology of psychiatric and mental health disorders. MNL LO: 1. Recognize the epidemiology and classification of psychiatric-mental health disorders. 3 Copyright © 2020 Pearson Education, Inc. 3) The nurse is preparing a presentation on serious mental illness. Which health problem should be included? (Select all that apply.) 1. Major depressive disorder 2. Schizophrenia 3. Adjustment reaction 4. Bipolar disorder 5. Social phobia Answer: 1, 2, 4 Explanation: 1. Serious mental illnesses create significant disability in the individual's ability to achieve life goals. Serious mental illnesses include major depressive disorder, schizophrenia, and bipolar disorder. 2. Serious mental illnesses create significant disability in the individual's ability to achieve life goals. Serious mental illnesses include major depressive disorders, schizophrenia, and bipolar disorder. 3. Although they can have distressing and disabling effects, adjustment reactions do not necessarily interfere with the achievement of life goals. 4. Serious mental illnesses create significant disability in the individual's ability to achieve life goals. Serious mental illnesses include major depressive disorder, schizophrenia, and bipolar disorder. 5. Although they can have distressing and disabling effects, social phobias do not necessarily interfere with the achievement of life goals. Page Ref: 4 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: I.3. Use skills of inquiry, analysis, and information literacy to address practice issues | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching and Learning Learning Outcome: 1. Discuss the epidemiology of psychiatric and mental health disorders. MNL LO: 1. Recognize the epidemiology and classification of psychiatric-mental health disorders. 4 Copyright © 2020 Pearson Education, Inc. 4) A nursing student is writing a research paper on ways to improve psychiatric nursing outcomes for serious mental illness. Which type of research would be most useful? 1. Nursing 2. Psychosocial 3. Educational 4. Improved functioning Answer: 4 Explanation: 4. More emphasis needs to be placed on improved functioning, a hallmark of recovery in mental illness. A significant amount of research is focused on small goals or gains and minimization of medication side effects. Nursing, psychosocial, and educational research have not been identified as the most useful. Page Ref: 8 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: I.3. Use skills of inquiry, analysis, and information literacy to address practice issues | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Planning/Teaching and Learning Learning Outcome: 2. Distinguish the unique contributions of psychiatric-mental health nursing to other areas of nursing. MNL LO: 2. Relate the practice skills and domains of wellness to care of patients with psychiatric-mental health disorders. 5 Copyright © 2020 Pearson Education, Inc. 5) The parents of a young adult patient who is hospitalized for depression asks what they should be doing to help. What is the most appropriate response the nurse should make? 1. Refuse to talk with family members because of confidentiality restrictions. 2. Provide the family with education, information, and referral resources. 3. Tell the family members that their son is too old for them to be involved in his care. 4. Inform the family that only the psychiatrist can discuss their son's care. Answer: 2 Explanation: 2. Although confidentiality must be observed, there are many aspects of care in which a patient's family can help. An important role of the psychiatric-mental health nurse is to ensure that the family is involved in the provision of care. Work with the family includes crisis intervention, education about the illness, and referral to support groups. Family involvement in care is not limited by the patient's age. A psychiatric nurse is qualified to discuss mental health treatment. Page Ref: 6 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Knowledge: family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 2. Distinguish the unique contributions of psychiatric-mental health nursing to other areas of nursing. MNL LO: 2. Relate the practice skills and domains of wellness to care of patients with psychiatric-mental health disorders. 6 Copyright © 2020 Pearson Education, Inc. 6) The nurse is asked to identify the most important skill in psychiatric-mental health nursing. Which response should the nurse make? 1. "Making correct nursing diagnoses." 2. "Supporting advocacy." 3. "Developing a therapeutic relationship and the corresponding therapeutic use of self." 4. "Involving the patient in treatment planning." Answer: 3 Explanation: 3. The skill set for psychiatric nursing involves all the skills important in all nursing practice, such as making accurate nursing diagnoses, supporting advocacy, and involving the patient in treatment planning. However, the key skill is development of the therapeutic relationship and corresponding therapeutic use of self. Page Ref: 7 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: I.3. Use skills of inquiry, analysis, and information literacy to address practice issues | NLN Competencies: Context and Environment: Practice-Know-How: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 2. Distinguish the unique contributions of psychiatric-mental health nursing to other areas of nursing. MNL LO: 2. Relate the practice skills and domains of wellness to care of patients with psychiatric-mental health disorders. 7 Copyright © 2020 Pearson Education, Inc. 7) A patient is demonstrating manifestations of obsessive-compulsive disorder. Which action should the nurse take if unfamiliar with the assessment data and behaviors associated with this disorder? 1. Document all subjective and objective data provided by the patient. 2. Ask the primary health provider to identify needed subjective and objective assessment data. 3. Research obsessive-compulsive disorder in the medical dictionary. 4. Consult the Diagnostic and Statistical Manual of Mental Disorders for diagnostic criteria. Answer: 4 Explanation: 4. The Diagnostic and Statistical Manual of Mental Disorders provides diagnostic criteria that all members of the health care team will use in the diagnosis process and that will serve as a resource for assessment and analysis of data. Asking the primary health provider to identify assessment data is not appropriate. A medical dictionary is not specific enough for this purpose. Documentation of all subjective and objective data is not the most appropriate action to determine the assessment and behaviors associated with obsessive-compulsive disorder. Page Ref: 5 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IV.6. Evaluate data from all relevant sources, including technology, to inform the delivery of care | NLN Competencies: Context and Environment: Practice-Know-How: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 1. Discuss the epidemiology of psychiatric and mental health disorders. MNL LO: 1. Recognize the epidemiology and classification of psychiatric-mental health disorders. 8 Copyright © 2020 Pearson Education, Inc. 8) The nurse reviews the Murphy-Moller wellness model before assessing a patient. On which element should the nurse focus when assessing the sociological domain? (Select all that apply.) 1. Environment 2. Relationships with others 3. Religious faith 4. Moral development 5. Nutrition Answer: 1, 2 Explanation: 1. According to the Murphy-Moller wellness model, five major wellness domains are used to approach the understanding and treatment of psychiatric illnesses: biological, psychological, sociological, cultural, and spiritual. Environmental factors, such as living conditions and relationships with others, occur within the sociological domain. 2. According to the Murphy-Moller wellness model, five major wellness domains are used to approach the understanding and treatment of psychiatric illnesses: biological, psychological, sociological, cultural, and spiritual. Environmental factors, such as living conditions and relationships with others, occur within the sociological domain. 3. Religious faith falls within the spiritual domain. 4. Moral development is a part of the psychological domain. 5. Nutrition is a part of the biological domain. Page Ref: 12 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.8. Describe the limits and boundaries of therapeutic patient-centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 3. Evaluate a recovery-focused, wellness approach to patient care based on five domains: biological, psychological, sociological, cultural, and spiritual. MNL LO: 2. Relate the practice skills and domains of wellness to care of patients with psychiatric-mental health disorders. 9 Copyright © 2020 Pearson Education, Inc. 9) The nurse is planning care for a male patient who is homeless and diagnosed with bipolar disorder. Based on a wellness model, which service would support this patient's sociological domain? 1. Medication monitoring 2. Housing assistance 3. Nutrition counseling 4. Individual psychotherapy Answer: 2 Explanation: 2. Medication monitoring and nutritional counseling address the biological domain in the wellness model. Housing assistance would support this patient's sociological domain. Individual psychotherapy addresses the psychological domain. Page Ref: 12 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 3. Evaluate a recovery-focused, wellness approach to patient care based on five domains: biological, psychological, sociological, cultural, and spiritual. MNL LO: 2. Relate the practice skills and domains of wellness to care of patients with psychiatric-mental health disorders. 10 Copyright © 2020 Pearson Education, Inc. 10) The nurse develops a daily exercise program for patient in a mental health facility. Which wellness domain does this type of program address? 1. Psychological 2. Sociological 3. Biological 4. Cultural Answer: 3 Explanation: 3. The psychological domain consists of understanding our attitudes and behaviors. The sociological domain focuses on all aspects of the environment, including interpersonal relationships. The biological domain refers to the ability of all body systems to function in a manner compatible with life and social function and includes exercise. The cultural domain includes customs and beliefs that are rooted in patients' cultural background. Page Ref: 11 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 3. Evaluate a recovery-focused, wellness approach to patient care based on five domains: biological, psychological, sociological, cultural, and spiritual. MNL LO: 2. Relate the practice skills and domains of wellness to care of patients with psychiatric-mental health disorders. 11 Copyright © 2020 Pearson Education, Inc. 11) A patient with a history of depression intends to take sleeping pills and "just end it all." In which level of the Murphy-Moller wellness model is the patient demonstrating characteristics? 1. Recovery 2. Restoration 3. Rehabilitation 4. Relapse Answer: 4 Explanation: 4. In level 1, the patient's return of symptoms or relapse can be life-threatening, as evidenced by the comment about taking sleeping pills to "end it all." In level 2, recovery, symptoms have stabilized. In level 3, rehabilitation, symptoms no longer interfere with normal activities of daily living or regular conversation. Restoration is not an identified part of the wellness model. Page Ref: 13 Cognitive Level: Analyzing Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4. Identify patient care needs within three levels of wellness: initial onset/ relapse, recovery, and rehabilitation. MNL LO: 3. Examine the levels of wellness and factors that affect health and recovery for patients with psychiatric-mental health disorders. 12 Copyright © 2020 Pearson Education, Inc. 12) A patient recently diagnosed with schizophrenia is taking antipsychotic medication to control hallucinations. Which is an appropriate activity for level 2 of wellness that could be included in this patient's treatment? (Select all that apply.) 1. Referral to a job training program 2. Medication management education 3. Group therapy 4. Inpatient admission 5. Family support group Answer: 2, 3, 5 Explanation: 1. Referral to a job training program would be appropriate in the level 3 phase. 2. At level 2 of wellness, the patient is stable but is not yet ready to focus on activities related to the future. Psychoeducational activities, such as providing medication education, are important at this stage. 3. Mutual support groups, including the sharing of experiential knowledge and skills, play an invaluable role in recovery. 4. Inpatient admission might be appropriate in the level 1 phase. 5. Family members, peers, providers, faith groups, community members, and other allies form vital support networks in the level 2 phase. Page Ref: 13, 15 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 4. Identify patient care needs within three levels of wellness: initial onset/ relapse, recovery, and rehabilitation. MNL LO: 3. Examine the levels of wellness and factors that affect health and recovery for patients with psychiatric-mental health disorders. 13 Copyright © 2020 Pearson Education, Inc. 13) The nurse is preparing a teaching tool on the treatment of mental health disorders. Which fundamental principle of mental health recovery should the nurse include? 1. Recovery is culturally unrelated. 2. Recovery is holistic. 3. Recovery begins with despair. 4. Recovery is solitary. Answer: 2 Explanation: 2. Recovery is culturally based and influenced. Recovery encompasses an individual's whole life, including mind, body, spirit, and community. Recovery emerges from hope. Recovery is supported through relationship and social networks. Page Ref: 14-15 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Planning/Teaching and Learning Learning Outcome: 4. Identify patient care needs within three levels of wellness: initial onset/ relapse, recovery, and rehabilitation. MNL LO: 3. Examine the levels of wellness and factors that affect health and recovery for patients with psychiatric-mental health disorders. 14 Copyright © 2020 Pearson Education, Inc. 14) It is reported during an interprofessional conference that a patient being treated for a mental health disorder refuses to continue group therapy. Which response should the nurse make? 1. "Recovery is probably unlikely for this patient." 2. "The patient is experiencing a setback, not an end to recovery." 3. "The patient should be told that group therapy is the only route to recovery." 4. "The patient should be punished for refusing to participate." Answer: 2 Explanation: 2. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist in recovery and resilience. Setbacks are a natural, though not inevitable, part of the recovery process. Recovery pathways are highly personalized. Recovery is based on respect; punishment is not appropriate. Page Ref: 14 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation Learning Outcome: 4. Identify patient care needs within three levels of wellness: initial onset/ relapse, recovery, and rehabilitation. MNL LO: 3. Examine the levels of wellness and factors that affect health and recovery for patients with psychiatric-mental health disorders. 15 Copyright © 2020 Pearson Education, Inc. 15) The nurse is caring for patients who have experienced traumatic events. Which should the nurse identify as a goal of care for these patients? (Select all that apply.) 1. Understand symptoms as attempts to cope. 2. Provide regular medication education and monitoring. 3. Collaborate between provider and consumer at all phases of service delivery. 4. Protect patients with a history of trauma from physical harm and re-traumatization. 5. Focus on what has happened to the person rather than what is wrong with the person. Answer: 1, 3, 4, 5 Explanation: 1. Trauma-informed care (TIC) is designed to inform caregivers about and sensitize them to trauma-related issues present in trauma survivors. One goal of TIC is to understand that the patient's symptoms are an attempt at coping. 2. Medication management is not an essential part of TIC. 3. TIC is designed to inform caregivers about and sensitize them to trauma-related issues present in trauma survivors. One goal of TIC is to collaborate between provider and consumer at all phases of service delivery. 4. TIC is designed to inform caregivers about and sensitize them to trauma-related issues present in trauma survivors. One goal of TIC is to protect patients with a history of trauma from physical harm and re-traumatization. 5. TIC is designed to inform caregivers about and sensitize them to trauma-related issues present in trauma survivors. One goal of TIC is to focus on what has happened to the person rather than what is wrong with the person. Page Ref: 18 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: I.B.4. Assess presence and extent of pain and suffering | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Practice-Know-How: apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 6. Examine significant concepts related to providing psychiatric and mental health. MNL LO: 4. Apply the significant concepts related to providing nursing care to patients with psychiatric-mental disorders.