PMHN chapter 1 Exam 69 Questions with Verified Answers
- CORRECT ANSWER is a state of emotional, psychological, and social wellness evidenced by
... [Show More] satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability.
Is mental health considered to be static - CORRECT ANSWER mental health is a dynamic state with multiple influences
What are the categories of factors influencing a person's mental health - CORRECT ANSWER individual, interpersonal, social/cultural
What are examples of individual factors of mental health - CORRECT ANSWER a person's biologic makeup, autonomy and independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities.
What are examples of interpersonal factors of mental health - CORRECT ANSWER include effective communication, ability to help others, intimacy, and a balance of separateness and connectedness.
What are examples of social/cultural factors of mental health - CORRECT ANSWER a sense of community, access to adequate resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive, yet realistic, view of one's world.
Mental health disorders are those that affect - CORRECT ANSWER mood, behavior, and thinking; cause distress or dysfunction or both
General criteria for diagnosis - CORRECT ANSWER Dissatisfaction with characteristics, abilities, accomplishments; Ineffective or unsatisfying relationships; Dissatisfaction with one's place in the world; Ineffective coping with life events; Lack of personal growth
• Diagnostic and Statistical Manual of Mental Disorders (DSM-5) - CORRECT ANSWER describes all mental disorders, outlining specific diagnostic criteria for each based on clinical experience and research.
DSM 5 is published by - CORRECT ANSWER the American Psychiatric Association.
Who is the DSM-5 used by - CORRECT ANSWER all mental health clinicians that diagnose mental disorders.
The DSM-5 has three purposes - CORRECT ANSWER • To provide a standardized nomenclature • defining characteristics or symptoms that differentiate specific diagnoses • To assist in identifying the underlying causes of disorders
The DSM-5 allows the practitioner to identify what factors affecting a patient's condition - CORRECT ANSWER major psychiatric conditions, medical conditions that are relevant to understanding or treating psychiatric condition, and psychosocial or environmental problems that might impact diagnosis, treatment, and prognosis
How did ancient civilizations view mental disorders - CORRECT ANSWER as divine or demonic, individuals were either worshipped or ostracized/killed based on which category their illness was believed to be
What was Aristotle's theory of mental illness - CORRECT ANSWER body had 4 humors (blood, water, black and yellow bile) that corresponded to happiness, calmness, anger, and sadness. "Treatment" aimed at restoring the balance included bloodletting, starving and purging and continued into the 19th century
How did early Christianity (1-1000AD) treat mental illness - CORRECT ANSWER source was demons, initial treatment was exorcism by priests, if that failed treatments included starvation, locking in dungeons, or starving
Renaissance Era England made this distinction in managing mental illness - CORRECT ANSWER "harmless lunatics" allowed to roam country side or live in rural communities while "dangerous lunatics" were locked away, chained and starved
The concept of the asylum, first introduced in the 1790's began where - CORRECT ANSWER Phillipe Pinel in France and William Tuke in England
• asylum - CORRECT ANSWER a safe refuge or haven offering protection at institutions where people had been whipped, beaten, and starved just because they were mentally ill
After Dorothea Dix visited one of Tuke's institutions, she returned to the US and - CORRECT ANSWER began a crusade to reform the treatment of mental illness; instrumental in opening 32 state hospitals that offered asylum; advocated adequate shelter, nutritious food, and warm clothing
100 years after opening this change occurred in insane asylums in general - CORRECT ANSWER negative connotation, allegations of abuse, seen as isolating patients from family
The first psychotropic drugs to be introduced were - CORRECT ANSWER cholorpromazine (Thorazine) - antipsychotic and lithium - antimanic
The impact of the availability of psychotropic medications to the mentally ill - CORRECT ANSWER reduced agitation, psychotic thinking, and depression; shortened hospital stays, chaos and violence in hospital setting reduced
The Community Mental Health Centers Construction Act focused (1963) on this - CORRECT ANSWER deinstitutionalization
• deinstitutionalization - CORRECT ANSWER a deliberate shift from institutional care in state hospitals to community facilities,
What is the estimated percentage of Americans aged 18 years and older that have some form of mental illness - CORRECT ANSWER 18.6% (43.7 million persons)
What does the phrase "revolving door effect" refer to - CORRECT ANSWER those with mental illness have shorter hospital stays, but they are readmitted more frequently
• boarding - CORRECT ANSWER in hospital setting, keeping a patient in the emergency department to see if the emergency de-escalates or until a psychiatric bed becomes available
These two conditions are frequently seen in the homeless population accounting for 42% of the overall homeless population and up to two-thirds of the chronically homeless population - CORRECT ANSWER severe substance abuse disorder
Although deinstitutionalization was supposed to fund community health clinics - CORRECT ANSWER the majority of mental health money is still spent on inpatient psychiatric stays, with community health suffering underfunding
Healthy People 2020 Mental Health Objectives included reducing - CORRECT ANSWER suicide rate, teen suicide attempts, disordered eating as an attempt to control wt in adolescents, incidence of major depressive episodes
Healthy People 2020 Mental Health Objectives included Increasing - CORRECT ANSWER # of primary care facilities providing mental health services, mental health screenings in juvenile residential facilities, rates of employment of those with severe mental illness, treatment of mental health disorders, treatment of both mental health and substance disorders, depression screening by primary care, mentally ill homeless treatment
Community support service programs - CORRECT ANSWER focus on rehabilitation, vocational needs, education, and socialization as well as on management of symptoms and medication.
Despite its consistently under-funded status, community based health services serve to prevent what complications of institutional treatment - CORRECT ANSWER institutionalized tend to lose hope and motivation, and functional daily living skills (shopping, cooking)
• case management - CORRECT ANSWER represented an effort to provide necessary services while containing cost. The client is assigned to a case manager, who coordinates all types of care needed by the client. In theory, designed to decrease fragmented care from a variety of sources, eliminate unneeded overlap of services, provide care in the least restrictive environment, and decrease costs for the insurers. In reality, expenditures are often reduced by withholding services deemed unnecessary or by substituting less expensive treatment alternatives for more expensive care, such as hospital admission.
• managed care - CORRECT ANSWER people receive care based on need rather than on request. Those who work for the organization providing the care assess the need for care, began 1970's
How is mental health care dealt with by insurance companies - CORRECT ANSWER separate from medical care, often set number of days for hospitalization per year
Medicare covers - CORRECT ANSWER people 65 years and older, people with permanent kidney failure, and people with certain disabilities.
Medicaid is - CORRECT ANSWER jointly funded by the federal and state governments and covers low-income individuals and families; varies depending on the state; each state determines eligibility requirements, scope of services, and rate of payment for services.
In 1996, Congress passed the Mental Health Parity Act - CORRECT ANSWER eliminated annual and lifetime dollar amounts for mental health care for companies with more than 50 employees.
What are the loop holes of the Mental Health Parity Act - CORRECT ANSWER substance abuse was not covered by this law, and companies could still limit the number of days in the hospital or the number of clinic visits per year. Some chose to simply not offer mental health coverage at all
"the mentally sick should be at least as well cared for as the physically sick" - CORRECT ANSWER Linda Richards, 1st psychiatric nurse, graduated nursing school 1873
Standards of care are - CORRECT ANSWER authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable.
The American Psychiatric Nurses Association (APNA) Standards of practice and standards of professional performance. This document also outlines - CORRECT ANSWER the areas of practice and phenomena of concern for today's psychiatric- mental health nurse.
Categories of Nursing interventions in mental health - CORRECT ANSWER Counseling, Milieu therapy, Psychobiologic interventions, health teaching, case management, health promotion and maintenance
Counseling nursing intervention examples - CORRECT ANSWER Interventions and communication techniques • Problem solving • Crisis intervention • Stress management • Behavior modification
Milieu therapy nursing intervention examples - CORRECT ANSWER • Maintain therapeutic environment • Teach skills • Encourage communication between clients and others • Promote growth through role modeling • Self-care activities • Encourage independence • Increase self-esteem • Improve function and health •
Psychobiologic intervention examples - CORRECT ANSWER • Administer medications • Teach • Observe
• Mental health and mental illness are difficult to define and are influenced by - CORRECT ANSWER one's culture and society.
• The World Health Organization defines health as - CORRECT ANSWER a state of complete physical, mental, and social wellness, not merely the absence of disease or infirmity.
• Mental health is influenced by individual factors, including - CORRECT ANSWER biologic makeup, autonomy and independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities; by interpersonal factors, including effective communication, helping others, intimacy, and maintaining a balance of separateness and connectedness; and by social/cultural factors, including sense of community, access to resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive yet realistic view of the world.
• Historically, mental illness was viewed as - CORRECT ANSWER demonic possession, sin, or weakness, and people were punished accordingly.
• Today, mental illness is seen as - CORRECT ANSWER a medical problem with symptoms causing dissatisfaction with one's characteristics, abilities, and accomplishments; ineffective or unsatisfying interpersonal relationships; dissatisfaction with one's place in the world; ineffective coping with life events; and lack of personal growth.
• Factors contributing to mental illness are - CORRECT ANSWER biologic makeup; anxiety, worries, and fears; ineffective communication; excessive dependence or withdrawal from relationships; loss of emotional control; lack of resources; and violence, homelessness, poverty, and discrimination.
• The DSM-5 is - CORRECT ANSWER a taxonomy used to provide a standard nomenclature of mental disorders, define characteristics of disorders, and assist in identifying underlying causes of disorders.
• A significant advance in treating persons with mental illness was the development of - CORRECT ANSWER psychotropic drugs in the early 1950s.
• The shift from institutional care to care in the community began in the 1960s, allowing many people - CORRECT ANSWER to leave institutions for the first time in years.
• One result of deinstitutionalization is the revolving door - CORRECT ANSWER repetitive hospital admission without adequate community follow-up.
• It is estimated that one third of the homeless population have a mental illness and one half have - CORRECT ANSWER substance abuse problems.
• Treatment rates for children and adults are 68% and 57%, respectively, but only 37% for - CORRECT ANSWER homeless individuals and 3% for persons with a dual diagnosis of mental illness and substance abuse.
• Community-based programs are the trend of the future, but they are - CORRECT ANSWER underfunded and too few in number.
• Managed care, in an effort to contain costs, has resulted in - CORRECT ANSWER withholding of services or approval of less expensive alternatives for mental health care.
• The population in the United States is becoming increasingly diverse in terms of - CORRECT ANSWER culture, race, ethnicity, and family structure.
• Psychiatric nursing was recognized in the late 1800s, although it was not required in nursing education programs until - CORRECT ANSWER 1950.
• Psychiatric nursing practice has been profoundly influenced by Hildegard Peplau and June Mellow, who wrote about - CORRECT ANSWER the nurse-client relationship, anxiety, nurse therapy, and interpersonal nursing theory.
• The ANA has published standards of care that - CORRECT ANSWER guide psychiatric-mental health nursing clinical practice.
• Common concerns of nursing students beginning a psychiatric clinical rotation include - CORRECT ANSWER fear of saying the wrong thing, not knowing what to do, being rejected by clients, being threatened physically, recognizing someone they know as a client, and sharing similar problems or backgrounds with clients.
• Awareness of one's feelings, beliefs, attitudes, values, and thoughts, called - CORRECT ANSWER self-awareness, is essential to the practice of psychiatric nursing.
• The goal of self-awareness is to - CORRECT ANSWER know oneself so that one's values, attitudes, and beliefs are not projected to the client, interfering with nursing care. Self-awareness does not mean having to change one's values or beliefs, unless one desires to do so. [Show Less]