Chapter 01: History of Mental Health Nursing Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The
... [Show More] act of developing a clean environment is a factor in providing effective health care as demonstrated by: 1. Nightingale. 2. Benner. 3. Swanson. 4. King. Florence Nightingales commitments to improved outcomes at a military hospital were directly related to introducing sanitation methods. ____ 2. What is the name of the publication written by Florence Nightingale? 1. Nursing Sanitation Notes 2. Nursing 101 3. Notes on Nursing 4. Nursing Notes Florence Nightingale wrote the book Notes on Nursing, which specified the importance of a clean environment. ____ 3. A long-term goal for in-patient mental health treatment is generally to: 1. Return the patient to the community. 2. Locate a facility for long term care. 3. Be arrested and placed in prison. 4. Be completely cured of the disorder. To eventually return the patient to the community by creating a good support system and appropriate medication if needed is generally the long-term goal. ____ 4. The mentally ill were once housed in mental institutions known as: 1. Hospitals. 2. Long-term care facilities. 3. Asylums. 4. Free-standing treatment centers. Asylums were known as a refuge for the mentally ill as well as the poor in the past. contact: [email protected] __ 5. Which nursing theorists promoted the interpersonal theory between the nurse and the patient? 1. Hildegard Peplau 2. Hattie Bessent 3. Mary Mahoney 4. Linda Richards Dr. Peplau brought together theories from psychiatry and merged them with theories for nursing and communication. Completion Complete each statement. 6.Phenothiazines were discovered in what year? ____1955 Phenothiazine is a group of psychotropics that have a calming effect on patients with psychotic through processes. 7. The first psychiatric program of study was established by which nursing leader? _Effie Jane Taylor In 1913 the first psychiatric program for nurses was established. Ms. Taylor also believed in patient-centered care. 8. Who was the nurse theorist who was the first American-trained nurse credited with teaching how to provide care for people with mental illness? Linda Richards Linda Richards wanted to upgrade the nursing education field and the Boston city hospital training school for nurses to teach the specialty of caring for the mentally ill. 9. The greatest advance in the early years of mental health care was the introduction of phenothiazines 10. The legislation that provided funding for improving the care of the mentally ill is known as the National Mental Health Act of what year? 1946 Money was provided by this legislation for research and training for the improvement of care for patients with mental health issues. 11. Which nursing organization established the first certification of psychiatric nursing? ANA The American Nurses Association (ANA) developed the certification criteria for psychiatric nurses. The ANA has developed standards for professional nursing. 12. One of the goals of the American Nurses Association (ANA) is to promote standardization of nursing care in the United States. The ANA has developed standards for a number of different specialties. 13. Florence Nightingale has always been called the founder of nursing. Florence Nightingale observed that a clean environment improved the health of the soldiers in the Crimean War. As a result, deaths from infection decreased. 14. A schoolteacher by the name of Dorothea Dix established asylums and a psychiatric hospital for the mentally ill. Dorothea Dix was not a nurse but was concerned about the treatment of the mentally ill and prisoners. 15. Special facilities designed to care for the mentally ill in the past were known as asylums In the early days of health care asylums were special facilities designed for care of the needy including prisoners and the mentally ill. 16. The first psychotropic drug category was known as phenothiazines Phenothiazine medications were introduced in the 1950s. These drugs had a calming and tranquilizing effect and treated psychotic thought processes. 17. Each state adopts its own set of rules and guidelines that govern the nurses performance. These rules are known as the Nurse Practice Act. The Nurse Practice Act of each state is based on federal guidelines. Each state has its own Nurse Practice Act. 18. The first major federal law to address mental illness was called the Hill-Burton Act. The Hill-Burton Act of 1946 provided much needed funding for psychiatric care in the United States. Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 19. What trends contributed to the deinstitutionalization of mental health facilities to outpatient care (select all that apply): 1. Cost of the facilities. 2. The increased use of phenothiazines. 3. Staff cost. 4. Establishment of Outpatient clinics. Chapter 02: Basics of Communications Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which question by the nurse would gain the most information from a patient experiencing a marital crisis? 1. Do you hate your spouse? 2. Do you get along with your in-laws? 3. Do you talk out your problems with your spouse? 4. What is it like at home with your spouse? Encourages expression of feelings rather than a yes/no answer. Use of open-ended questions facilitates more open communication. ____ 2. Mrs. R., the mother of a young schizophrenic patient, seeks you out and begins to cry. She expresses concern over her daughters behavior. Your best response to this woman is: 1. What is it that concerns you the most, Mrs. R.? 2. Well, you know, that is part of the illness. 3. Here is a book on schizophrenia. This will help you. 4. Are you afraid your daughter will always be like this? The correct response is open ended to seek out more specifically why she is upset. Responses B and C shut down communication. Response D is making an assumption of why she is upset. ____ 3. Linda is pacing the floor and appears extremely anxious. The day shift nurse approaches Linda in an attempt to lessen her anxiety. The most therapeutic statement by the nurse would be: 1. How about watching a football game? 2. Tell me how you are feeling today. 3. What do you have to be upset about now? 4. Ignore the client. To keep open communication with the patient, the nurse should ask open-ended questions. ____ 4. A patient states, I dont know what the pills are for or why I am taking them, so I dont want them. What therapeutic communication would help this patient? 1. Ask for what you need 2. Silence 3. Using general leads 4. Giving information 5. To practice effectively in mental health, the nurse should be able to: 1. Solve his or her own personal problems without assistance from others. 2. Comfortably point out the patient shortcomings and provide advice about how to improve. 3. Bring patients and coworkers into compliance with societal rules and norms. 4. Demonstrate therapeutic communication. Good communication skills are essential for working in mental health. Good communication skills center around being able to promote open communication with such techniques as good listening, use of open-ended questions, and appropriate use of silence to be therapeutic. Completion Complete each statement. 6. The nurse plans to have a therapeutic communication with the client. To begin that therapeutic communication the nurse must first establish rapport with the client. Rapport implies there is mutual understanding and trust. The communication can be both verbal and nonverbal. 7. Communication has three parts: the sender, the message, and the receiver Communication is not just about getting your message out, it also includes how the message is received. 8. When appropriate, the nurse can use silence as part of an interaction when there is no talking. This can communicate support. Silence allows the nurse and the patient time to collect their thoughts. It is a therapeutic technique of communication and demonstrates support and acceptance. 9. A theory of communication that emphasizes the three ways to communicate hearing, seeing, and touching is called neurolinguistic programming Neurolinguistic programming (NLP) was developed by Milton Erickson, John Grinder, and Richard Bandler. NLP can be used in conjunction with hypnosis and other treatment modalities giving insight into how one views the world. 10. Expressive, receptive, and global are types of aphasia Patients with speech difficulties or challenges have an aphasic disorder. Expressive is difficulty in verbal expression, receptive is difficulty with interpretation of written or verbal communication, and global is a combination of receptive and expressive. 11. Advising, asking closed-ended questions, and changing the subject are examples of blocks or barriers to therapeutic communication. These blocks to communication interfere with patient-nurse interaction to inhibit good communication. Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 12. A nurse is working with a patient and attempts to communicate effectively with him or her. Techniques the nurse can use to help communication include (select all that apply): 1. Clarifying terms. 2. Remaining silent. 3. Asking open-ended questions. 4. Offering false reassurance 5. Discouraging the person from expressing feelings that are unacceptable. Effective communication between the nurse and the patient includes approaches that give the patient opportunities to express himself or herself. ___ 13. The nurse may find that patients from other countries use different terminology than the nurse born in the United States. The difference in terminology may seem harmless to us but offensive to the foreign patient. Differences noted between different cultures are (select all that apply): 1. Eye contact. 2. Slang terms. 3. Hand gestures. 4. Gender references. Verbal and nonverbal communication doesnt always have the same meaning in other cultures. The same communication can be understood by another culture as offensive. 14. The three components of communication are (select all that apply): 1. Impairment. 2. Message. 3. Sender. 4. Receiver. Communication with others requires these three components. ____ 15. Nurses understand that when caring for patients with mental illnesses, a nurses communication is (select all that apply): 1. An active process that includes participating and listening and speaking. 2. A complex activity. 3. Exchanging information. 4. Verbal and nonverbal. 5. A one way path from nurse to patient. 6. Advising. Communication is important when determining the patients needs. It is not a passive process but an active, two-way activity between patient and nurse. Generally the nurses role is not to advise patients but to listen and support. ____ 16. The patient is concerned about his doctor and what the doctor has prescribed. The nurse making rounds notices the patient sitting on the side of the bed in deep thought. The nurse comes into the room and the patient begins to tell her his concerns about a new order. The nurse advises the patient, If I were you, I would find another doctor. How does this statement by the nurse block communication (select all that apply)? A. It tells the patient that his concerns are not valid. B. It gives the idea that the nurses values are the correct ones. C. It puts words in the patients mouth. D. It hurts the nurses credibility if the solution doesn’t help the patient. E. It discourages yes or no answers. F. It inhibits the patient from telling you what his concerns are. Communication with patients should be purposeful and unbiased. Giving advice when the patient has not fully expressed his concerns inhibits and distracts the patient from what he is trying to communicate. ___ 17. The following types of patients require adaptive communication techniques (select all that apply): 1. A patient who is blind. 2. A patient who has dysphasia. 3. A patient who is schizophrenic. 4. A patient who is elderly. 5. A patient with dysphagia. 6. A patient who has language differences from the staff. Although communication can be challenging, there may be temporary or permanent techniques to assist with communication. Patients with challenges to sight, sound, and speech require adaptive techniques. Those who speak a different language than the provider also need adaptive techniques. ____ 18. Which of the following are characteristics of assertive communication (select all that apply)? 1. Statements begin with the word you. 2. Statements deal with thoughts and feelings. 3. It is a form of blaming. 4. It puts responsibility for the interaction on the other person. 5. It is a technique of personal empowerment. 6. It is self-responsible. Assertive communication begins with the word I. Other characteristics include speaking up for oneself in a respectful manner, verbalizing ones thoughts and feelings, and being honest. 17. ANS: A, B, F Although communication can be challenging, there may be temporary or permanent techniques to assist with communication. Patients with challenges to sight, sound, and speech require adaptive techniques. Those who speak a different language than the provider also need adaptive techniques. PTS: 1 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension 18. ANS: B, E, F Assertive communication begins with the word I. Other characteristics include speaking up for oneself in a respectful manner, verbalizing ones thoughts and feelings, and being honest. Chapter 03: Ethics and Law Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A patient is expressing anger when the nurse attempts to make him take a medication that he is refusing. If the nurse pushes to give the medication against his will, the nurse is: 1. Violating the patient’s rights. 2. Achieving a treatment goal to get the medication in the patient any way possible. 3. Supporting the family’s demand that he take the medication. 4. Following orders from the charge nurse. The Patient Bill of Rights provides the patients right to refuse medications and treatments. The nurse has a responsibility to advocate for the patients and assure them of their rights. In addition, patients have the right to be educated about medications and treatment, which allows them to make an informed decision. ____ 2. A mental health nurse bumps into a member of her church, who begins questioning her about a former neighbor. The woman from the church asks the nurse, How is Rachael? We have been friends for over 20 years and I have seen her come out of your clinic a few times. Is she seeing one of the psychiatrists? The nurses response is: 1. The HIPAA law prevents me from disclosing any information about any patient. 2. All I can say is she is seeing Dr. Leone. 3. Rachael is seeing Dr. Leone because she is concerned about feeling extremely happy sometimes and about feeling extremely depressed other times. 4. Rachael was only there to renew her medication. HIPAA (Health Insurance Portability and Accountability Act) states what can be disclosed about a patient and emphasizes patient privacy. _ 3. You are working on a mental health unit and have a diverse group of patients. Some of the patients are of Middle Eastern descent. These patients have communicated to you that they would like to follow the same period for praying as they did prior to admission. What is your response? 1. You are in America now. 2. You can go back to your regular time for praying when you are discharged. 3. How can I accommodate you with your prayer time? 4. Would you like to learn another prayer? It is within the nurses scope of practice to advocate for the patient. The nurse is the voice for the patient when needed. The nurse defends the patient’s rights to their beliefs and values. ____ 4. The nursing student uses the clients full name on the assigned care plan during her recent clinical rotation. What is the instructors priority intervention? A. Express the importance of factual documentation and that it should include the patients name. B. Remind the student of the importance of maintaining patient confidentiality. C. Discuss with student that the patient is homeless and illiterate. As a result of this, maybe the patient will not be embarrassed about their homelessness status; therefore confidentiality is not an issue. D. Explain to the student because the patient was committed involuntary, confidentiality is not an issue. All patient information is confidential, and only initials should be used during the student clinical rotation. ____ 5. While shopping in the local supermarket, a mental health nurse encounters an individual who recently was a patient on her unit. Which is the proper response by the nurse? 1. Stop the person and ask how they are doing since discharge. 2. The closer you get to the patient, look in another direction. 3. Speak to the patient, but not by name. 4. If eye contact is made and the patient responds, then you should respond back. Confidentiality is maintained, whether in a facility or out in public. If the patient initiates contact, then responding back is appropriate. ____ 6. The telephone rings at the nurses station of an inpatient psychiatric facility. The caller asks to speak with Ms. Honey. Which nursing response protects the patient’s rights and confidentiality? 1. I cannot confirm or deny that Ms. Honey was admitted here. 2. Ms. Honey is in group therapy at present. 3. Hold on, Ill go see if she is in her room. 4. Are you a family member? Ms. Honey can only receive calls from family members. Patient information is confidential this includes even acknowledging the presence of that person in the facility. Completion Complete each statement. 7. In the group therapy session, the nurse speaks up to remind a patient of a recent improvement in his coping. The nurses action is an example of patient advocacy The nurse understands that patients learn from their peers and can help others. The nurse is providing information in the group to help this patient acknowledge a recent success. 8. Another term to describe the ethical principle of veracity is honesty Veracity is telling the truth. 9. The name of a law that provides immunity to a citizen who offers medical aid is Good Samaritan law The basis for all Good Samaritan laws is that a third party cannot be charged with negligence unless help is given recklessly or that person makes the situation significantly worse, according to the guidelines for that particular state. 10. The patient is upset because her doctor has not been to see her today. The nurse tells the patient the doctor will be in by 3 p.m., even though the nurse does not know this to be true. This nurse has violated the ethical principle of honesty, or veracity The professional choice is to tell the truth. Even though giving false information to the patient reassured the patient, it is not ethical. 11. The basic concepts and fundamental moral principles that govern conduct are known as ethics Ethics provide a framework of action to address conflicting principles. 12. Another term for accepting responsibility is accountability Accountability is accepting responsibility for any actions performed while caring for a patient. 13. Proxemics relates to space, time, and waiting and is influenced by culture. Study of spatial relationships including space, time, and waiting, which are all influenced by ones culture. 14. The National Federation of Licensed Practical Nurse organization adopted the standards of practice that include ethics for the LPN/LVN. Ethical guidelines and practice standards for the LPN/LVN have been developed by NFLPN. 15. The American Nurse Association has written guidelines for minimum standards of care. The standards of care are written at a minimum level and for each discipline of nursing. A nurse below the minimum competency is unsafe. 16. The Nurse Practice Act indicates the acceptable scope of nursing practice for the different levels of nursing. The Nurse Practice Act defines the level of practice for the nurse. A nurse can consult with the Nurse Practice Act when unsure about a specific skill. The Nurse Practice Acts varies from state to state. 17. HIPAA addresses the security and privacy involved with medical records and how that information is identified and passed between care providers. 18. The _____________ ________________ is the leading national accreditation body of health care organizations. 19. Immunity for citizens who stop to assist someone in need of medical help is protected by the Good ___________ Act. 20. This document protects patients who are receiving care in a facility: Patient Bill of _________. 21. Abuse should be reported by ________________________. 22. Nurses are expected to be respectful of the beliefs of their patients and coworkers and not to force their personal beliefs on others at work. This is a demonstration of the trait of ______________, which is required to be nurse. 23. The _________Commission is the leading accrediting body of health care organizations. Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 24. Patients Bill of Rights includes the right(s) to (select all that apply): 1. Open mail and make personal phone calls. 2. Have privacy and visitors. 3. Treat staff in a disrespectful manner. 4. Be identified as a client. 5. Choose ones own nurse. [Show Less]