1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice
nurse to perform which additional
... [Show More] intervention?
Prescribe psychotropic medication.
In most states, prescriptive privileges are granted to master's-prepared nurse practitioners who have
taken special courses on prescribing medication. The nurse prepared at the basic level is permitted to
perform mental health assessments, establish relationships, and provide individualized care planning.
2. When a nursing student expresses concerns about how mental health nurses "lose all their nursing
skills," the best response by the mental health nurse is:
"Psychiatric nurses use complex communication skills as well as critical thinking to solve
multidimensional problems. I am challenged by those situations."
The practice of psychiatric nursing requires a different set of skills than medical-surgical nursing, though
there is substantial overlap. Psychiatric nurses must be able to help patients with medical as well as
mental health problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios
and workloads in psychiatric settings have increased, just like other specialties. Psychiatric nursing
involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical
pain and suffering.
3. When a new bill introduced in Congress reduces funding for care of persons with mental illness, a
group of nurses writes letters to their elected representatives in opposition to the legislation. Which role
have the nurses fulfilled?
Advocacy
An advocate defends or asserts another's cause, particularly when the other person lacks the ability to do
that for self. Examples of individual advocacy include helping patients understand their rights or make
decisions. On a community scale, advocacy includes political activity, public speaking, and publication in
the interest of improving the human condition. Since funding is necessary to deliver quality programming
for persons with mental illness, the letter- writing campaign advocates for that cause on behalf of
patients who are unable to articulate their own needs.
4. Which comment best indicates that a patient perceived the nurse was caring? "My nurse:
“Spends time listening to me talk about my problems. That helps me feel like I am not alone."
Caring evidences empathetic understanding as well as competency. It helps change pain and suffering
into a shared experience, creating a human connection that alleviates feelings of isolation. The
distracters give examples of statements that demonstrate advocacy or giving advice.
5. Which assessment finding most clearly indicates that a patient may be experiencing a mental illness?
The patient:
Reports a consistently sad, discouraged, and hopeless mood.
The correct response describes a mood alteration, which reflects mental illness. The distracters describe
behaviors that are mentally healthy or within the usual scope of human experience.
6. Which finding best indicates that the goal "Demonstrate mentally healthy behavior" was achieved? A
patient:
Sees self as capable of achieving ideals and meeting demands.
The correct response describes an adaptive, healthy behavior. The distracters describe maladaptive
behaviors.
7. A nurse encounters an unfamiliar psychiatric disorder on a new patient's admission form. Which
resource should the nurse consult to determine criteria used to establish this diagnosis?
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
The DSM-5 gives the criteria used to diagnose each mental disorder. The distracters may not contain
diagnostic criteria for a psychiatric illness.
8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would
have the most complete information?
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
The DSM-5 details the diagnostic criteria for psychiatric clinical conditions. The other references are good
resources but do not define the diagnostic criteria.
9. Which individual is demonstrating the highest level of resilience? One who:
Takes a temporary job to maintain financial stability after loss of a permanent job.
Resilience is closely associated with the process of adapting and helps people facing tragedies, loss,
trauma, and severe stress. It is the ability and capacity for people to secure the resources they need to
support their well-being. Repression and depression are unhealthy. Living in a shelter for two years
shows a failure to move forward after a tragedy. See related audience response question.
10. Complete this analogy. NANDA: clinical judgment: NIC: _________________
Nursing actions
Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association,
identifies diagnostic statements regarding human responses to actual or potential health problems.
These statements represent clinical judgments. NIC (Nursing Interventions Classification) identifies
actions provided by nurses that enhance patient outcomes. Nursing care activities may be direct or
indirect.
11. A college student said, "Most of the time I'm happy and feel good about myself. I have learned that
what I get out of something is proportional to the effort I put into it." Which number on this mental
health continuum should the nurse select?
Mental Illness Mental Health
1 2 3 4 5
5
The student is happy and has an adequate self-concept. The student is reality-oriented, works effectively,
and has control over own behavior. Mental health does not mean that a person is always happy.
12. Which disorder is a culture-bound syndrome?
Running amok
Culture-bound syndromes occur in specific sociocultural contexts and are easily recognized by people in
those cultures. A syndrome recognized in parts of Southeast Asia is running amok, in which a person
(usually a male) runs around engaging in furious, almost indiscriminate violent behavior.
13. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies:
Mental disorders people have
The DSM-5 classifies disorders people have rather than people themselves. The terminology of the tool
reflects this distinction by referring to individuals with a disorder rather than as a "schizophrenic" or
"alcoholic," for example. Deviant behavior is not generally considered a mental disorder. Present
disability or distress is only one aspect of the diagnosis. [Show Less]