Nokea
The nurse consults the DSM for which of the following purposes?
- A. To devise a plan of care for a newly admitted client
- B. To predict the client's prognosis of treatment outcomes
- C. To document the appropriate diagnostic code in the client's medical record
- D. To serve as a guide for client assessment
Correct Answer: D
Rationale: The DSM provides standard nomenclature, presents defining characteristics, and identifies underlying causes of mental disorders. It does not provide care plans or prognostic outcomes of treatment. Diagnosis of mental illness is not within the generalist RN's scope of practice, so documenting the code in the medical record would be inappropriate.
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Which one of the following is one of the American Nurses Association standards of practice for psychiatric mental health nursing?
- A. Prescriptive authority is granted to psychiatric mental health registered nurses.
- B. All aspects of Standard 5. Implementation may be carried out by psychiatric mental health registered nurses.
- C. Some aspects of Standard 5. Implementation may only be carried out by psychiatric mental health advanced practice nurses.
- D. Psychiatric mental health advanced practice nurses are the only ones who may provide milieu therapy.
Correct Answer: C
Rationale: Prescriptive authority is used by psychiatric mental health advanced practice registered nurses in accordance with state and federal laws and regulations. Some aspects of Standard 5 are advanced practice interventions and may be performed by the psychiatric mental health advanced practice registered nurse. Psychiatric mental health registered nurses may provide milieu therapy according to Standard 5c.
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.
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 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.
Before the period of the enlightenment, treatment of the mentally ill included
- A. Creating large institutions to provide custodial care.
- B. Focusing on religious education to improve their souls.
- C. Placing the mentally ill on display for the public's amusement.
- D. Providing a safe refuge or haven offering protection.
Correct Answer: C
Rationale: In 1775, visitors at St. Mary's of Bethlehem were charged a fee for viewing and ridiculing the mentally ill, who were seen as animals, less than human. Custodial care was not often provided, and primitive beliefs often led to harsh treatments like exorcisms or witch hunts.