Nokea
What is an example of a lack of parity in health care delivery today?
- A. Payment for psychiatric health care is not equal to that of physical health care.
- B. Medicare is provided for only those 65 years of age and older.
- C. There is a sufficient need for mental health care providers.
- D. Most psychiatric care is provided on an outpatient basis.
Correct Answer: A
Rationale: Financing psychiatric care has been complicated by lack of parity, or equal payment for physical as compared to psychiatric disorders. None of the other options relate to parity.
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Which patient would a nurse refer to partial hospitalization?
- A. One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal.
- B. One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy.
- C. One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up.
- D. One who states, 'I'm not sure I can avoid using alcohol when my spouse goes to work every morning.'
Correct Answer: D
Rationale: This patient could profit from the structure and supervision provided by spending the day at the partial hospitalization program. During the evening, at night, and on weekends, the spouse could assume supervision responsibilities. The patient who is actively suicidal needs inpatient hospitalization. The patient in need of psychoeducation can be referred to home care. The patient who reports regularly for blood tests and clinical follow-up can continue on the same plan.
A nurse can best address factors of critical importance to successful community treatment for persons with mental illness by including assessments related to which of the following?
- A. Housing adequacy and stability
- B. Income adequacy and stability
- C. Family and other support systems
- D. Early psychosocial development
- E. Substance abuse history and current use
Correct Answer: A,B,C,E
Rationale: Early psychosocial developmental history is less relevant to successful outcomes in the community than the assessments listed in the other options. If a patient is homeless or fears homelessness, focusing on other treatment issues is impossible. Sufficient income for basic needs and medication is necessary. Adequate support is a requisite to community placement. Substance abuse undermines medication effectiveness and interferes with community adjustment.
To provide comprehensive care to patients, which competency is more important for a nurse who works in a community mental health center than a psychiatric nurse who works in an inpatient unit?
- A. Problem-solving skills
- B. Calm and caring manner
- C. Ability to cross service systems
- D. Knowledge of psychopharmacology
Correct Answer: C
Rationale: A community mental health nurse must be able to work with schools, corrections facilities, shelters, health care providers, and employers. The mental health nurse working in an inpatient unit needs only to be able to work within the single setting. Problem-solving skills are needed by all nurses. Nurses in both settings must have knowledge of psychopharmacology.
Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for a patient presenting with what characteristic?
- A. Presents a clear danger to self or others.
- B. Consistently noncompliant with medications at home.
- C. Has no reliable support systems in the local community.
- D. Develops new symptoms during the course of an illness.
Correct Answer: A
Rationale: Hospitalization is justified when the patient is a danger to self or others, has dangerously decompensated, or needs intensive medical treatment. The incorrect options do not necessarily describe patients for whom less restrictive treatment is indicated.
Which assessment finding for a patient living in the community requires priority intervention by the nurse?
- A. Receives Social Security disability income plus a small check from a trust fund.
- B. Lives in an apartment with two patients who attend day hospital programs.
- C. Has a sibling who is interested and active in care planning.
- D. Purchases and uses marijuana on a frequent basis.
Correct Answer: D
Rationale: Patients who regularly buy illegal substances often become medication noncompliant. Medication noncompliance, along with the disorganizing influence of illegal drugs on cellular brain function, promotes relapse. The remaining options do not suggest problems.