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Which of the following statements is true of treatment of people with mental illness in the United States today?
- A. Substance abuse is effectively treated with brief hospitalization
- B. Financial resources are reallocated from state hospitals to community programs and support
- C. Only 25% of people needing mental health services are receiving those services
- D. Emergency department visits by persons who are acutely disturbed are declining.
Correct Answer: C
Rationale: Only one in four adults needing mental health care receives the needed services. Substance abuse issues cannot be dealt with in the 3 to 5 days typical for admissions in the current managed care environment. Money saved by states when state hospitals were closed has not been transferred to community programs and support. Emergency department visits for acutely disturbed persons have increased in some cities.
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A new graduate nurse has accepted a staff position at an inpatient mental health facility. The graduate nurse can expect to be responsible for basic-level functions, including
- A. Providing clinical supervision.
- B. Using effective communication skills.
- C. Adjusting client medications
- D. Directing program development.
Correct Answer: B
Rationale: Basic-level functions include counseling, milieu therapy, self-care activities, psychobiologic interventions, health teaching, case management, and health promotion and maintenance. Advanced-level functions include psychotherapy, prescriptive authority for drugs, consultation and liaison, evaluation, program development and management, and clinical supervision.
A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided at the center includes
- A. Medical management of symptoms.
- B. Daily psychotherapy.
- C. Constant staff supervision.
- D. Psychological stabilization.
Correct Answer: A
Rationale: Community mental health centers focus on rehabilitation, vocational needs, education, and socialization, as well as on management of symptoms and medication. Daily therapies, constant supervision, and stabilization require a more acute care inpatient setting.
What is meant by the term revolving door effect in mental health care?
- A. An overall reduction in incidence of severe mental illness
- B. Shorter and more frequent hospital stays for persons with severe and persistent mental illness
- C. Flexible treatment settings for mentally ill
- D. Most effective and least expensive treatment settings
Correct Answer: B
Rationale: The revolving door effect refers to shorter, but more frequent, hospital stays. Clients are quickly discharged into the community where services are not adequate; without adequate community services, clients become acutely ill and require rehospitalization.
A client grieving the recent loss of her husband asks if she is becoming mentally ill because she is so sad. The nurse's best response would be,
- A. You may have a temporary mental illness because you are experiencing so much pain.
- B. You are not mentally ill. This is an expected reaction to the loss you have experienced.
- C. Were you generally dissatisfied with your relationship before your husband's death?
- D. Try not to worry about that right now. You never know what the future brings.
Correct Answer: B
Rationale: Mental illness includes general dissatisfaction with self, ineffective relationships, ineffective coping, and lack of personal growth. Additionally the behavior must not be culturally expected. Acute grief reactions are expected and therefore not considered mental illness. False reassurance or overanalysis does not accurately address the client's concerns.
The first training of nurses to work with persons with mental illness was in 1882 in which state?
- A. California
- B. Illinois
- C. Massachusetts
- D. New York
Correct Answer: C
Rationale: The first training for nurses to work with persons with mental illness was in 1882 at McLean Hospital in Belmont, Massachusetts.