Nokea
The appropriate action for a student nurse who says the wrong thing is to
- A. Pretend that the student nurse did not say it.
- B. Restate it by saying, 'That didn't come out right. What I meant was...'
- C. State that it was a joke.
- D. Ignore the error, since no one is perfect.
Correct Answer: B
Rationale: No one magic phrase can solve a client's problems, likewise, no single statement can significantly worsen them. Listening carefully, showing genuine interest, and caring about the client are extremely important. A nurse who possesses these elements but says something that sounds out of place can simply restate it by saying, 'That didn't come out right. What I meant was...' Pretending, joking, or ignoring the error are not likely to help the student nurse build and maintain credibility with the client.
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Which of the following statements is true of treatment of people with mental illness in the United States today?
- A. Substance abuse is effectively treated with brief hospitalization
- B. Financial resources are reallocated from state hospitals to community programs and support
- C. Only 25% of people needing mental health services are receiving those services
- D. Emergency department visits by persons who are acutely disturbed are declining.
Correct Answer: C
Rationale: Only one in four adults needing mental health care receives the needed services. Substance abuse issues cannot be dealt with in the 3 to 5 days typical for admissions in the current managed care environment. Money saved by states when state hospitals were closed has not been transferred to community programs and support. Emergency department visits for acutely disturbed persons have increased in some cities.
The goal of the 1963 Community Mental Health Centers Act was to
- A. Ensure patients' rights for the mentally ill.
- B. Deinstitutionalize state hospitals.
- C. Provide funds to build hospitals with psychiatric units.
Correct Answer: B
Rationale: The 1963 Community Mental Health Centers Act initiated the movement toward treating those with mental illness in a less restrictive environment. This legislation resulted in the shift of clients with mental illness from large state institutions to care based in the community.
Which of the following is a standard of practice?
- A. Quality of care
- B. Outcome identification
- C. Collegiality
- D. Performance appraisal
Correct Answer: B
Rationale: Standards of practice include assessment, diagnosis, outcomes identification, planning, implementation, coordination of care, health teaching and health promotion, and milieu therapy. The standards of professional performance include quality of practice, education, professional practice evaluation, collegiality, collaboration, ethics, research, resource utilization, and leadership.
Which is included in Healthy People 2020 objectives?
- A. To decrease the incidence of mental illness
- B. To increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives
- C. To provide mental health services only in the community
- D. To decrease the numbers of people who are being treated for mental illness
Correct Answer: B
Rationale: One of the Healthy People 2020 objectives is to increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives. It may not be possible to decrease the incidence of mental illness or to provide services only in the community.
What is meant by the term revolving door effect in mental health care?
- A. An overall reduction in incidence of severe mental illness
- B. Shorter and more frequent hospital stays for persons with severe and persistent mental illness
- C. Flexible treatment settings for mentally ill
- D. Most effective and least expensive treatment settings
Correct Answer: B
Rationale: The revolving door effect refers to shorter, but more frequent, hospital stays. Clients are quickly discharged into the community where services are not adequate; without adequate community services, clients become acutely ill and require rehospitalization.