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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.
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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.
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.
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 would be a reason for a student nurse to use the DSM?
- A. Identifying the medical diagnosis
- B. Treat clients
- C. Evaluate treatments
- D. Understand the reason for the admission and the nature of psychiatric illnesses.
Correct Answer: D
Rationale: Although student nurses do not use the DSM to diagnose clients, they will find it a helpful resource to understand the reason for the admission and to begin building knowledge about the nature of psychiatric illnesses. Identifying the medical diagnosis, treating, and evaluating treatments are not a part of the nursing process.
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.