Nokea
Which of the following factors is primarily responsible for the changes in inpatient hospital treatment between the 1980s and the present?
- A. Progress in treatment options for mentally ill persons
- B. The growth of managed care
- C. Less stigma associated with mental illness
- D. The current use of milieu therapy
Correct Answer: B
Rationale: Managed care introduced cost-control measures like recertification, utilization review, and case management, significantly altering inpatient treatment. While treatment options and stigma have evolved, they are not the primary drivers. Milieu therapy, common in the 1980s, required longer stays and is less relevant today.
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A nurse is orienting to a new position working the infirmary in the state penitentiary. When working with prisoners who are also mentally ill, the nurse examines her own attitudes. Which of the following beliefs should the nurse discuss with her supervisor before caring for incarcerated patients?
- A. People with mental illness are inherently violent.
- B. The mentally ill can get better treatment in prison than in the community.
- C. People with mental illness are more vulnerable to victimization when incarcerated.
- D. Many mentally ill would not be in prison if they were stabilized on medication.
Correct Answer: A
Rationale: The belief that mentally ill individuals are inherently violent is a stereotype that needs addressing, as most are not significantly dangerous, unlike the other beliefs which align with evidence.
A patient with bipolar disorder has a long history of both hospitalizations and incarcerations. The patient has no permanent residence and has infrequent contact with his family. Upon admission to the inpatient psychiatric unit for stabilization, the nurse documents all of the following in the record. Which of the following data most suggests a positive outcome for this patient?
- A. Reporting meeting with the same case manager monthly for the last 3 years
- B. History of residential stays at several local homeless shelters
- C. Last contact with siblings 4 years ago
- D. Income from day labor for 10 days last month
Correct Answer: A
Rationale: Consistent case manager contact indicates stable support, a positive factor for outcomes, unlike transient shelter stays, family disconnection, or inconsistent income.
A patient has been started on antidepressants. The interdisciplinary team member most responsible for monitoring effectiveness and side effects of this new medication is the
- A. Pharmacist.
- B. Psychiatrist.
- C. Psychiatric nurse.
- D. Psychologist.
Correct Answer: C
Rationale: The psychiatric nurse monitors medication effectiveness and side effects due to frequent patient interaction, unlike pharmacists, psychiatrists, or psychologists who have different primary roles.
What is an important role of the nurse with regard to residents opposing plans to establish a group home or residential facility in their neighborhood?
- A. To provide information to correct misinformation related to stereotypes of persons with mental illnesses
- B. To persuade neighborhood residents that mentally ill people need safe, affordable, and desirable housing
- C. To provide for the safety and security of the neighborhood
- D. To ensure the security of persons in the group home
Correct Answer: A
Rationale: Nurses advocate by educating communities to dispel stereotypes about mental illness, addressing fears about violence or property values. Persuasion, neighborhood safety, and group home security are not primary nursing roles.
A patient has just been referred to a psychosocial rehabilitation program. The nurse explains that the benefits of being involved in such a program include.
- A. Continuous monitoring of symptoms.
- B. Increased independence.
- C. Increased involvement in treatment decisions.
- D. Recovery from mental illness.
- E. Increased community integration.
- F. Greater opportunities for personal growth.
Correct Answer: B,C,D,E,F
Rationale: Psychosocial rehabilitation promotes recovery, independence, community integration, treatment involvement, and personal growth, not continuous symptom monitoring.