Psychotherapy for the Advanced Practice Psychiatric Nurse, Second Edition: A How-To Guide for Evidence- Based Practice 2nd Edition Test Bank
Chapter 1. ... [Show More] The Nurse Psychotherapist and a Framework for Practice
Question 1
The nurses new job description at the generalist level of practice reflects the definition of psychiatricmental health nursing and the PsychiatricMental Health Nursing Standards of Practice (ANA, APNA, ISPN). In which of the following areas might the nurse plan programs and intervention to fulfill employment expectations?
Standard Text: Select all that apply.
1. Stress management strategies
2. Early diagnosis of psychiatric disorders
3. Parenting classes for new parents
4. Family and group psychotherapy
5. Medication teaching for anti-anxiety medications
Correct Answer: 1,3,4,5
Rationale 1: Stress management strategies address health, wellness, and care of mental health problems and are appropriate for psychiatricmental health nursing at the generalist level of practice.
Rationale 2: Early diagnosis of psychiatric disorders is generally not consistent with the definition or practice of psychiatricmental health nursing especially at the generalist level.
Rationale 3: Parenting classes for new parents provide teaching that is consistent with the prevention of mental health problems and is consistent with psychiatricmental health nursing at the generalist level of practice.
Rationale 4: Family and group psychotherapy is consistent at the advanced practice registered nurse level but not the generalist level.
Rationale 5: Medication teaching for anti-anxiety medications promotes quality of care for persons with psychiatric disorders and is vital for psychiatricmental health nursing practice at the generalist level of practice.
Global Rationale:
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: Apply knowledge of current practice and professional performance standards to the delivery of contemporary psychiatricmental health nursing.
Question 2 Type: MCSA
The nurse is serving on a committee charged with reviewing the roles and responsibilities of the nurses on the psychiatric unit. Which publication should the nurse bring to the first meeting?
1. Diagnostic and Statistical Manual of Mental Disorders
2. American Nurses Credentialing Center certification requirements
3. American Nurses Association, Code of Ethics
4. PsychiatricMental Health Nursing Standards of Practice
Correct Answer: 4
Rationale 1: The PsychiatricMental Health Nursing Standards of Practice delineates psychiatricmental health nursing roles and functions and serves as guidelines for providing quality care. The Diagnostic and Statistical Manual of Mental Disorders is used by the mental health care team, particularly the psychiatrist, to diagnose clients with mental disorders and is not specific to nursing care issues. The Code of Ethics helps to clarify right and wrong actions by the nurse, but does not clarify roles and nursing care actions. Certification requirements outline steps toward certification that acknowledge knowledge and expertise, but do not delineate roles and responsibilities.
Rationale 2: The PsychiatricMental Health Nursing Standards of Practice delineates psychiatricmental health nursing roles and functions and serves as guidelines for providing quality care. The Diagnostic and Statistical Manual of Mental Disorders is used by the mental health care team, particularly the psychiatrist, to diagnose clients with mental disorders and is not specific to nursing care issues. The Code of Ethics helps to clarify right and wrong actions by the nurse, but does not clarify roles and nursing care actions. Certification requirements outline steps toward certification that acknowledge knowledge and expertise, but do not delineate roles and responsibilities.
Rationale 3: The PsychiatricMental Health Nursing Standards of Practice delineates psychiatricmental health nursing roles and functions and serves as guidelines for providing quality care. The Diagnostic and Statistical Manual of Mental Disorders is used by the mental health care team, particularly the psychiatrist, to diagnose clients with mental disorders and is not specific to nursing care issues. The Code of Ethics helps to clarify right and wrong actions by the nurse, but does not clarify roles and nursing care actions. Certification requirements outline steps toward certification that acknowledge knowledge and expertise, but do not delineate roles and responsibilities.
Rationale 4: The PsychiatricMental Health Nursing Standards of Practice delineates psychiatricmental health nursing roles and functions and serves as guidelines for providing quality care. The Diagnostic and Statistical Manual of Mental Disorders is used by the mental health care team, particularly the psychiatrist, to diagnose clients with mental disorders and is not specific to nursing care issues. The Code of Ethics helps to clarify right and wrong actions by the nurse, but does not clarify roles and nursing care actions. Certification requirements outline steps toward certification that acknowledge knowledge and expertise, but do not delineate roles and responsibilities.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: Apply knowledge of current practice and professional performance standards to the delivery of contemporary psychiatricmental health nursing.
Question 3
Type: MCSA
The psychiatricmental health nurse reflecting on professional role activities is referred to the standards of professional performance by a colleague. To which organization should the nurse look for guidance?
1. North American Nursing Diagnosis Association
2. American Nurses Credentialing Center
3. National League for Nursing
4. American Nurses Association
Correct Answer: 4
Rationale 1: The American Nurses Association will be the best resource as professional performance is addressed in standards 715 of ANAs PsychiatricMental Health Nursing Standards of Practice. The National League for Nursing primarily addresses nursing education, while the American Nurses Association Credentialing Center focuses on certification. The North American Nursing Diagnosis Association develops a classification system for nursing diagnoses.
Rationale 2: The American Nurses Association will be the best resource as professional performance is addressed in standards 715 of ANAs PsychiatricMental Health Nursing Standards of Practice. The National League for Nursing primarily addresses nursing education, while the American Nurses Association Credentialing Center focuses on certification. The North American Nursing Diagnosis Association develops a classification system for nursing diagnoses.
Rationale 3: The American Nurses Association will be the best resource as professional performance is addressed in standards 715 of ANAs PsychiatricMental Health Nursing Standards of Practice. The National League for Nursing primarily addresses nursing education, while the American Nurses Association Credentialing Center focuses on certification. The North American Nursing Diagnosis Association develops a classification system for nursing diagnoses.
Rationale 4: The American Nurses Association will be the best resource as professional performance is addressed in standards 715 of ANAs PsychiatricMental Health Nursing Standards of Practice. The National League for Nursing primarily addresses nursing education, while the American Nurses Association Credentialing Center focuses on certification. The North American Nursing Diagnosis Association develops a classification system for nursing diagnoses.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: Apply knowledge of current practice and professional performance standards to the delivery of contemporary psychiatricmental health nursing.
Question 4 Type: MCSA
The psychiatricmental health nurse is working with the new graduate nurse who is orienting to the psychiatric unit. Which comment by the new graduate indicates further clarification of the generalist-nursing role is needed?
1. I would feel better if you would look at my documentation that addresses progress toward treatment goals.
2. I will spend time each day evaluating the effectiveness of the therapeutic milieu.
3. I am a little nervous about conducting psychotherapy with clients.
4. I am doing some reading on how to incorporate complementary interventions into treatment plans.
Correct Answer: 3
Rationale 1: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at the generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward treatment goals, and incorporating complementary interventions are consistent with the roles of the psychiatricmental health nurse practicing at the generalist level.
Rationale 2: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at the generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward treatment goals, and incorporating complementary interventions are consistent with the roles of the psychiatricmental health nurse practicing at the generalist level.
Rationale 3: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at the generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward treatment goals, and incorporating complementary interventions are consistent with the roles of the psychiatricmental health nurse practicing at the generalist level.
Rationale 4: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at the generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward treatment goals, and incorporating complementary interventions are consistent with the roles of the psychiatricmental health nurse practicing at the generalist level.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: Apply knowledge of current practice and professional performance standards to the delivery of contemporary psychiatricmental health nursing.
Question 5 Type: MCSA
The client on the psychiatric unit is asking questions about prevention of sexually transmitted diseases. Given the PsychiatricMental Health Nursing Standards of Practice, which action would be most appropriate for the nurse to take at this time?
1. Consult with the mental health care team.
2. Teach safer sexual practices.
3. Investigate the questions in individual psychotherapy.
4. Notify the attending psychiatrist.
Correct Answer: 2
Rationale 1: The psychiatricmental health nurse employs strategies to promote health and a safe environment and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and consulting with the mental health care team is not necessary as health teaching is within the independent practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist nurse.
Rationale 2: The psychiatricmental health nurse employs strategies to promote health and a safe environment and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and consulting with the mental health care team is not necessary as health teaching is within the independent practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist nurse.
Rationale 3: The psychiatricmental health nurse employs strategies to promote health and a safe environment and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and consulting with the mental health care team is not necessary as health teaching is within the independent practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist nurse.
Rationale 4: The psychiatricmental health nurse employs strategies to promote health and a safe environment and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and consulting with the mental health care team is not necessary as health teaching is within the independent practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist nurse.
Global Rationale:
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: Apply knowledge of current practice and professional performance standards to the delivery of contemporary psychiatricmental health nursing.
Question 6
Type: MCSA
The client asks the nurse if certain changes can be made in the unit milieu. Which action by the nurse indicates understanding of the nursing role in the therapeutic milieu?
1. The nurse refers the clients requests to the psychiatric social worker.
2. The nurse discusses the desired changes with the client.
3. The nurse refers the clients requests to the psychosocial rehabilitation worker.
4. The nurse instructs the client that no changes can be made.
Correct Answer: 2
Rationale 1: The psychiatricmental health nurse has major responsibility for the milieu; therefore, it is appropriate to discuss requested changes in order to gather information regarding the effectiveness of the milieu. The psychiatric social worker identifies community resources and may perform counseling. It is non- therapeutic to instruct the client that no changes can be made before gathering data in relation to the clients requests. The psychosocial rehabilitation worker teaches day-to-day skills for living and may provide case management services.
Rationale 2: The psychiatricmental health nurse has major responsibility for the milieu; therefore, it is appropriate to discuss requested changes in order to gather information regarding the effectiveness of the milieu. The psychiatric social worker identifies community resources and may perform counseling. It is non- therapeutic to instruct the client that no changes can be made before gathering data in relation to the clients requests. The psychosocial rehabilitation worker teaches day-to-day skills for living and may provide case management services.
Rationale 3: The psychiatricmental health nurse has major responsibility for the milieu; therefore, it is appropriate to discuss requested changes in order to gather information regarding the effectiveness of the milieu. The psychiatric social worker identifies community resources and may perform counseling. It is non- therapeutic to instruct the client that no changes can be made before gathering data in relation to the clients requests. The psychosocial rehabilitation worker teaches day-to-day skills for living and may provide case management services.
Rationale 4: The psychiatricmental health nurse has major responsibility for the milieu; therefore, it is appropriate to discuss requested changes in order to gather information regarding the effectiveness of the milieu. The psychiatric social worker identifies community resources and may perform counseling. It is non-
therapeutic to instruct the client that no changes can be made before gathering data in relation to the clients requests. The psychosocial rehabilitation worker teaches day-to-day skills for living and may provide case management services.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: Compare and contrast the differences and similarities among the roles of the psychiatricmental health nurse and other members of the mental health team.
Question 7 Type: MCSA
The nurse assesses that the mental health client has problems choosing productive, safe leisure activities. Which member of the mental health team should the nurse consult with?
1. Recreational therapist
2. Occupational therapist
3. Attending psychiatrist
4. Clinical psychologist
Correct Answer: 1
Rationale 1: The recreational therapist plans and guides recreational activities to provide socialization, healthful recreation, and desirable interpersonal and intrapsychic experiences and will be the member of the healthcare team to take the lead in the implementation of this portion of the treatment plan. While all members of the team work together, the psychiatrist is responsible for the diagnosis and treatment of the mental illness. The occupational therapist teaches self-help activities and helps prepare the client for employment. The clinical psychologists foci are psychotherapy, behavior modification, and psychological testing.
Rationale 2: The recreational therapist plans and guides recreational activities to provide socialization, healthful recreation, and desirable interpersonal and intrapsychic experiences and will be the member of the healthcare team to take the lead in the implementation of this portion of the treatment plan. While all members of the team work together, the psychiatrist is responsible for the diagnosis and treatment of the mental illness. The occupational therapist teaches self-help activities and helps prepare the client for employment. The clinical psychologists foci are psychotherapy, behavior modification, and psychological testing.
Rationale 3: The recreational therapist plans and guides recreational activities to provide socialization, healthful recreation, and desirable interpersonal and intrapsychic experiences and will be the member of the healthcare team to take the lead in the implementation of this portion of the treatment plan. While all members of the team work together, the psychiatrist is responsible for the diagnosis and treatment of the mental illness. The occupational therapist teaches self-help activities and helps prepare the client for employment. The clinical psychologists foci are psychotherapy, behavior modification, and psychological testing.
Rationale 4: The recreational therapist plans and guides recreational activities to provide socialization, healthful recreation, and desirable interpersonal and intrapsychic experiences and will be the member of the healthcare team to take the lead in the implementation of this portion of the treatment plan. While all members of the team work together, the psychiatrist is responsible for the diagnosis and treatment of the mental illness. The occupational therapist teaches self-help activities and helps prepare the client for employment. The clinical psychologists foci are psychotherapy, behavior modification, and psychological testing.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: Compare and contrast the differences and similarities among the roles of the psychiatricmental health nurse and other members of the mental health team.
Question 8 Type: MCSA
Upon arrival on the psychiatric unit this morning, which activity should be the nurses focus? The nurse should do which of the following?
1. Review psychological testing results for all clients.
2. Schedule the individual therapy sessions for all clients.
3. Identify community resources for clients to be discharged this morning.
4. Assess each client for whom the nurse will be providing care.
Correct Answer: 4
Rationale 1: The nurse is responsible for implementing the nursing process and nursing care for clients. The psychiatric social worker has major responsibility for the identification of post-discharge community resources. The clinical psychologists primary foci are psychotherapy and psychological testing.
Rationale 2: The nurse is responsible for implementing the nursing process and nursing care for clients. The psychiatric social worker has major responsibility for the identification of post-discharge community resources. The clinical psychologists primary foci are psychotherapy and psychological testing.
Rationale 3: The nurse is responsible for implementing the nursing process and nursing care for clients. The psychiatric social worker has major responsibility for the identification of post-discharge community resources. The clinical psychologists primary foci are psychotherapy and psychological testing.
Rationale 4: The nurse is responsible for implementing the nursing process and nursing care for clients. The psychiatric social worker has major responsibility for the identification of post-discharge community resources. The clinical psychologists primary foci are psychotherapy and psychological testing.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: Compare and contrast the differences and similarities among the roles of the psychiatricmental health nurse and other members of the mental health team.
Question 9
Type: MCSA
Due to a staff members absence, the nurse is reviewing staff assignments for the day. Which task can the nurse delegate to the psychosocial rehabilitation worker?
1. Conflict resolution teaching to a small group of clients
2. Comparison of physicians orders with the medication records
3. Routine medication administration to a stable client
4. Assessment of a long-term client
Correct Answer: 1
Rationale 1: The psychiatric rehabilitation worker teaches clients practical, day-to-day skills for living in the community, which might include conflict resolution. Medication administration, comparison of physician orders with medication records, and assessment fall within the nursing role and cannot be delegated.
Rationale 2: The psychiatric rehabilitation worker teaches clients practical, day-to-day skills for living in the community, which might include conflict resolution. Medication administration, comparison of physician orders with medication records, and assessment fall within the nursing role and cannot be delegated.
Rationale 3: The psychiatric rehabilitation worker teaches clients practical, day-to-day skills for living in the community, which might include conflict resolution. Medication administration, comparison of physician orders with medication records, and assessment fall within the nursing role and cannot be delegated.
Rationale 4: The psychiatric rehabilitation worker teaches clients practical, day-to-day skills for living in the community, which might include conflict resolution. Medication administration, comparison of physician orders with medication records, and assessment fall within the nursing role and cannot be delegated.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: Compare and contrast the differences and similarities among the roles of the psychiatricmental health nurse and other members of the mental health team.
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