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The major problems with large state institutions are:
- A. Attendants were accused of abusing the residents.
- B. Stigma associated with residence in an insane asylum.
- C. Clients were geographically isolated from family and community.
- D. Increasing financial costs to individual residents.
Correct Answer: A,C
Rationale: Clients were often far removed from the local community, family, and friends because state institutions were usually in rural or remote settings. Stigma and financial costs were not identified as major problems.
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The legislation enacted in 1963 was largely responsible for which of the following shifts in care for the mentally ill?
- A. The widespread use of community-based services
- B. The advancement in pharmacotherapies
- C. Improved rights for clients in long-term institutional care
Correct Answer: A
Rationale: The Community Mental Health Centers Construction Act of 1963 accomplished the release of individuals from long-term stays in state institutions, the decrease in admissions to hospitals, and the development of community-based services as an alternative to hospital care.
Which is a positive aspect of treating clients with mental illness in a community-based care?
- A. You will not be allowed to go out with your friends while in the program.
- B. You will have to have supervision when you want to go anywhere else in the community.
- C. You will be able to live in your own home while you still see a therapist regularly.
- D. You will have someone in your home at all times to ask questions if you have any concerns.
Correct Answer: C
Rationale: Clients can remain in their communities, maintain contact with family and friends, and enjoy personal freedom that is not possible in an institution. Full-time home care is not included in community-based programs.
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.
The nurse is assessing the factors contributing to the well-being of a newly admitted client. Which of the following would the nurse identify as having a positive impact on the individual's mental health?
- A. Not needing others for companionship
- B. The ability to effectively manage stress
- C. A family history of mental illness
- D. Striving for total self-reliance
Correct Answer: B
Rationale: Individual factors influencing mental health include biologic makeup, autonomy, independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities. Interpersonal factors such as intimacy and a balance of separateness and connectedness are both needed for good mental health, and therefore a healthy person would need others for companionship. A family history of mental illness could relate to the biologic makeup of an individual, which may have a negative impact on an individual's mental health, as well as a negative impact on an individual's interpersonal and social/cultural factors of health. Total self-reliance is not possible, and a positive social/cultural factor is access to adequate resources.
Which of the following statements about mental illness are true?
- A. Mental illness can cause significant distress, impaired functioning, or both.
- B. Mental illness is only due to social/cultural factors.
- C. Social/cultural factors that relate to mental illness include excessive dependency on or withdrawal from relationships.
- D. Individuals suffering from mental illness are usually able to cope effectively with daily life.
- E. Individuals suffering from mental illness may experience dissatisfaction with relationships and self.
Correct Answer: A,C,E
Rationale: Mental illness can cause significant distress, impaired functioning, or both. Mental illness may be related to individual, interpersonal, or social/cultural factors. Excessive dependency on or withdrawal from relationships are interpersonal factors that relate to mental illness. Individuals suffering from mental illness can feel overwhelmed with daily life. Individuals suffering from mental illness may experience dissatisfaction with relationships and self.