Which qualifications are appropriate to the scope of practice of the psychiatric/mental health registered nurse generalist?
-The nurse generalist is
... [Show More] qualified to implement crisis intervention.
-Part of the professional responsibilities of the psychiatric/mental health registered nurse generalist is crisis intervention.
The test taker must be familiar with the scope of practice of various educational levels of the registered nurse and the roles and responsibilities within this scope.
Which is the overall, priority goal of in-patient psychiatric treatment?
- Stabilization and return to the community.
-Stabilization and return to the community is the overall priority goal of in-patient psychiatric treatment.
Understanding the current trends in the delivery of mental health care is in the community and in-patient settings assists the test taker in answering this question correctly. Note the keywords, "priority" and "in-patient," which determine the correct answer to this question.
When the nurse creates an environment to facilitate healing, the nurse's actions are based on which of the following assumptions? Select all that apply.
- A therapeutic relationship can be a healing experience.
- Group settings can support ego strengths.
- Treatment plans can be formulated by observing social behaviors.
- A therapeutic relationship is characterized by rapport, genuineness, and respect and can be a healing experience.
- Group processes provide learning experiences and support a client's ego strengths.
- During group processes and interactions, staff members can observe social behaviors, and this can determine client needs. Treatment plans can be customized to meet these needs.
Reviewing the nurse's actions that assist in creating an environment that facilitates healing assists the test taker in determining the correct answer to this question. Understanding the meaning of counterttansference eliminates option 5.
Which of the folloing was the reason for the establishment of large hospitals or asylums that addressed the care of the mentally ill?
- Mental illness was perceived as incurable.
- Clients with mental illness were perceived as a threat to self and others.
- Dorothea Dix saw a need for humane care for the mentally ill.
- Because there was no treatment for mental illness before 1840, it was perceived as incurable and there was a need to provide continuous supervision in hospitals or asylums.
- Clients with mental illness were thought to be violent toward themselves and others, and a "reasonable" solution to care was to remove them from contract with the general population and observe them continuously in hospitals or asylums.
- Dorothea Dix advocated for humane treatment for the mentally ill, and this led to the establishment of many hospitals devoted to their care.
Reviewing the history of mental health care assists the test taker in inderstanding how care was delivered in the past.
Which of the following are examples of primary prevention in a community mental health setting? Select all that apply
- Teaching physical and psychosocial effects of stress to elementary school students.
- Teaching a class on child-rearing skills for a group of new parents.
- This is an example of primary prevention, which is focused on educational programs to help prevent the incidence of mental illness.
- This is an example of primary prevention, which is focused on educational programs to help prevent the incidence of mental illness.
Understanding the public health model that describes primary, secondary, and tertiary prevention assist the test taker in answering this question correctly.
Which nursing intervention within the community is aimed at reducing the residual defects that are associated with severe or chronic mental illness?
- Referring clients for various aftercare services such as day treatment programs.
- Tertiary prevention is aimed at reducing the residual defects that are associated with severe or chronic mental illness. Providing aftercare services, such as day treatment programs, is one way to accomplish this.
Reviewing the functions of the nurse at all levels of community mental health prevention helps the test taker to distinguish interventions in each prevention category.
In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states, "The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted?
- Short-term, in-patient, locked unit.
- A short-term, in patient, locked unit would be most appropriate for this client. This setting provides containment and structure for clients who are at risk for harming themselves or others.
Understanding the types of care available to mentally ill clients and the types of clients these various settings serve assists the test taker in answering this question.
Which action of a mental health nurse case manager reflects the activity of service planning?
- Holding a care conference for a client who is having difficulty returning to school.
- Holding a care conference for a client who is having difficulty returning to school reflects the activity of service planning. A service care plan is devised with client participation and should include mutually agreed on goals, specific actions directed toward goal achievement, and selection of essential resources and services.
Reviewing examples of case management activities, such as identification and outreach, assessment, service planning, linkage with needed services, monitoring service delivery, and advocacy, assists the test taker in recognizing nursing actions that reflect these activities.
A client with a long history of alcohol use disorder has been diagnosed with Wernicke-Korakoff syndrome. With which member of the mental health-care team would the nurse collaborate to meet this client's discribed need?
- The dietitian to help the client increase consumption of thiamine-rich foods.
- The dietitan can help the client to increase the intake of thiamine-rich foods. Thiamine deficiency is the cause of Wernicke-Koraskoff syndrome.
The test taker needs to recognize the signs, symptoms, and cause of Wernicke-Korsakoff syndrome.
A client on an in-patient psychiatric unit has a nursing diagnosis of nonadherence R/T antipsychotic medications. In which role is the nurse functioning when checking for "cheeking"?
"Cheeking" is when the client hides medication between the cheek and gum. Complete inspection of the mouth, with potential use of a tongue blade, is neccessary to discover cheeking. Another way to ensure that the client has swallowed medications is to talk to the client for a few minutes after medication administration. During this time, the medication would begin to dissolve if cheeking has occured.
- Medication manager.
- In the role of medication manager, the nurse has the resonsibility of ensuring that clients are given the correct medication, in the correct dosage, by the correct route, and at the correct time, and that correct documentation occurs. By checking for "cheeking," the nurse is fulfilling this role.
The test taker must look at the nursing action presented in the question. In what role is the nurse functioning when performing this action?
On an in-patient psychiatric unit, which of the following actions exemplify the nurse's role of teacher? Select all that apply.
- The nurse presents information to help the client and family members to understand the effects of mental illness.
- The nurse holds a group to discuss medication side effects.
- In the role of teacher, the nurse assists the client and family members in coping with the effects of mental illness. Helping the client to understand his or her illness, its signs and symptoms, the medications and potential side effects, and various coping techniques all are interventions of the nurse functiong in the role of teacher.
- In the role of the teacher, the nurse assists the client to understand treatments, including medication actions and their side effects. Holding this teaching group is an intervention that reflects the nurse's role of teacher.
To assist the test taker in distinguishing the various roles of the nurse, he or she should consider clinical examples that reflect these roles.
Which of the following actions reflect the nurse's role of advocate in an in-patient psychiatric setting? Select all that apply.
- The nurse speaks on behalf of a mentally ill client to ensure adequate access to needed mental health services.
- The nurse talks with the treatment team to support a shy client's request for less-sedating medications
- Advocacy is an essential role of the psychiatric nurse. Often, mentally ill clients cannot identify their personal problems or communicate their needs effectively. A nurse advocate stands alongside clients and empowers them to have a voice when they are weak and vulnerable.
- Advocay is an essential role for the psychiatric nurse. A nurse advocate stands alongside of, and empowers, clients to have a voice when they are weak and vulnerable.
Understanding the interventions used by the nurse in a psychiatric setting when assuming various roles assists the test taker in categorizing the behaviors presented in the question correctly.
A resource person's function is to give specific answers to specific questions, as a counselor's function is to:
- Listen as a client reviews feelings related to difficulties experienced in life.
- The nurse functioning as a couselor uses interpersonal communication techniques to assist clients in learning to adapt to difficulties or changes in life experiences. These techniques allow the experiences to be integrated with, rather than dissociated from, other experiences in life.
An anology is a comparison. Test takers should look at what is being compared and choose an answer that provides information that reflects a similar comparison.
On an in-patient psychiatric unit, a client diagnosed with borderline personality disorder is challenging other clients and splitting staff. Which response by the nurse relfects the nurse's role of milieu manager?
Ongoing assessment, diagnosis, outcome identification, planning, implementation, and evaluation of the environment are necessary for the successful management of a therapeutic milieu.
- Setting strict limits and communicating these limits to all staff members.
- By setting strict limits on inappropriate or unacceptable behaviors, the nurse functions in the role of the milieu manager. The safety of the milieu is always the highest priority. The environment of the milieu should be constrcted to provide many opportunities for personal growth and social interaction to build interpersonal skills.
To assist in correctly choosing the actions of the nurse that reflect the role of milieu manager, the test taker should review this role and its components.
On an in-patient psychiatric unit, a client who is anxious and distressed states. "God has abandoned me." Which nursing action would initiate collaboration with the member of the mental health-care team who can assist this client with this assessed problem?
- Consult with the chaplin and describe the client's concerns.
- The chaplain provides spiritual counseling. Experiencing anger at God or a higher power can indicate spiritual distress that can be addressed by the chaplain.
The test taker should review the roles of the members of the health-care team in a psychiatric setting and how the nurse would collaborate with each team member.
A client on an in-patient psychiatric unit exhibits traits of borderline personality disorder. Which action by the nurse would initiate collaboration with the member of the mental health-care team who can best confirm this diagnosis?
Personality testing must be done initially to diagnose a client with a personality disorder. This testing is administered by a psychologist.
- Colaborate with the clinical psychologist to prepare the client for personality testing.
- The clinical psychologist selects, administers, and interprets psychological tests. Clients with personality disorder traits need personality testing such as the Minnesota Multiphasic Personality Inventory (MMPI) to confirm a personality disorder diagnoisis.
The test taker must know that the primary function of the psychologist in an in-patient setting is testing. The psychologist performs personality inventiories and IQ testing
A client with a long history of alcohol use disorder comes to the out-patient clinic after losing a job and driver's license because of a driving under the influence (DUI) infraction. With which member of the mental health-care team would the nurse collaborate to meet this client's described need?
- The occupational therapist for retraining and job placement.
- The occupational therapist in a mental health setting focuses on rehabilitation and vocational training to assist clients in becoming productive. The occupational therapist uses manual and creative techniques to elicit desired interpersonal and intrapsychic responses. The occupational therapist helps the client with job training and employment placement, which is the direct problem described in the question.
The test taker shoud review the roles of the members of the health-care team in a psychiatric setting and how the nurse would collaborate with each team member.
A client states, "My wife is unfaithful. I think I am not worth anything." Which of the following describes this assessment information? Select all that apply.
Statements by clients are considered subjective data.
- This is subjective information or a "chief complaint."
- This information needs objective measurement by a mood rating scale.
- Subjective data are reported by the client and significant others in their own words. An example of this is the "chief complaint," which is expressed by the client during the intake interview.
- Subjective data are data expressed in the client's own words and can be made objective by the use of a mood scale measurement tool. Mood or anxiety scales objectively measure subjective data.
The test taker must understand that subjective data consist of the client's perception of his or her health problems. Objective data are observations or measurements made by the data collector.
Which of the following assessment information would be evaluated as objective data?
- Clinical Institute Withdrawal Assessement (CIWA) score of 10.
- Client's mood rating of 5 on a 10-point scale.
- Objective data include scores of rating scales developed to quantify data. A CIWA score rates symptoms of alcohol withdrawal.
- Objective data include scores of rating scales developed to quantify data. A mood scale has a client objectively rate his or her mood from 0 to 10 scale. These scales take the subjective data of mood and presents it as objective data.
The test taker must understand that the measurement of objective data is based on an accepted standard or scale and may require the use of a measurement tool.
The nurse is interviewing a client admitted to an in-patient psychiatric unit with a diagnosis of depressive disorder. Which is the primary goal in the assessment phase of the nursing process for this client?
- To collect and organize information.
- The primary goal in the assessment phase of the interview is to collect and organize data, which would be used to identify and prioritize the client's problems.
The test taker should write the steps of the nursing process next to the goals presented. Which goal reflects the assessment phase?
The nurse uses the clock face assessment test to obatain which assessment data?
-Early signs of neurocognitive disorder.
- The clock face assessmetn is a sensitive way to assess early signs of neurocognitive disorder. The client is asked to place numbers appropriately on a clock face.
The test taker should be aware of the purpose of various assessment tools, including the clock face assessment.
A welder who recently lost his leg in a work-related accident is being admitted to an in-patient psychiatric unit. The client states, "I'm worried because I can't support my family anymore!" Which nursing diagnosis is most reflective of this client's presenting problem?
- Ineffective role performance R/T loss of job.
- A defining characteristic of the nursing diagnosis of ineffective role performance is a change in physical capacity to resume a role. The client presented has had a change in body image that affects his ability to perform his role as welder and provider for his family.
Test taker must use only the situtaion and client data presented in the question to formulate an appropriate nursing diagnosis and must not read into the question any daya that are not presented.
An 85- year-old client has become agitated and physically aggressive after having a stroke with right-sided weakness. The client is started on risperidone (Risperdal) PO 0.5 mg qhs. Which is a priority nursing diagnosis for this client?
- Risk for falls R/T right-sided weakness and sedation from risperidon (Risperdal).
- Risk for falls R/T right-sided weakness and sedation from risperidone (Risperdal) is the priority diagnosis for this client. A fall would endanger this client, and safety issues always take priority.
When evaluating what is being asked for in the question, the test taker should factor in common side effects of medications that the client s receiving. Safety is always prioritized. [Show Less]