MH Exam 1 Test Bank Q&As. Ch. 1 (practicing the science & art of psychiatric nursing) 1. Which outcome, focused on recovery, would be expected in the plan
... [Show More] of care for pt living in the community w/ serious and persistent mental illness? Within 3 months, the patient will: a. B- report a sense of well-being i. Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving role performance. 2. A pt is hospitalized for depression and SI after their spouse asks for a divorce. Nurse’s most caring comment: a. A- “let’s discuss some means of coping other than suicide when you have these feelings” 3. In the shift-change report, an off-going nurse criticizes a pt who wears heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy? a. “Our pts need our help to learn behaviors that will help them get along in society” i. Accepting pt’s need for self expression. 4. A nurse assesses a newly admitted pt w/ depression. Which statement is an example of “attending”? a. “I’d like to sit with you a while so you may feel more comfortable talking with me” i. Attending is a technique that demonstrates the nurse’s commitment to the relationship & reduces feelings of isolation 5. One descriptive research study rarely provides evidence to change practice 6. “Psychiatric nurses use complex communication skills, as well as critical thinking, to solve multidimensional problems. I’m challenged by those situations” 7. Which research evidence would most influence a group of nurses to change their practice? a. Systematic review of ran trials 8. An informal group of pts discuss their perceptions of nursing care. Which comment best indicates a pt’s perception that his or her nurse is caring? a. “My nurse spends time listening to me talk about my problems. That helps me feel like i’m not alone” 9. Clinical algorithm- guideline that describes diagnostic and/or treatment approaches drawn from large databases of information 10. Which historical nursing leader helped focus practice to recognize the importance of science in psychiatric nursing? a. Hildegard Peplau 11. A nurse consistently strives to demonstrate caring behaviors during interactions w/ pts. Which reaction by a pt indicates this nurse is effective? A pts reports feeling: a. Connected with others 12. An experienced nurse says to a new grad, “when you’ve practiced as long as i have, you’ll instantly know how to take care of psychotic pts”. What is the new graduate’s best analysis of this comment? a. The experienced nurse may have lost sight of pts individuality, which may compromise the integrity of practice. New research findings must be continually integrated into a nurse’s practice to provide the most effective care 13. Which pt statements identify qualities of nursing practice w/ high therapeutic value? “The nurse…” a. Talks in language I can understand”, ...helps me keep track of my medications”, ...looks at me as a whole person w/ different needs” Ch. 2 (mental health and mental illness) 1. A nurse explains multiaxial diagnosis to a psychiatric technician. Which information is accurate? a. Assessments of several aspects of functioning are included i. Relevant medical conditions, psychosocial and environmental problems, and global assessment of functions. 2. Which documentation of diagnosis would a nurse expect for a person with mental illness? a. I generalized anxiety disorder. II avoidant personality disorder. III fibromyalgia. IV declared bankruptcy 6 months ago. V 60 i. Axis I- a clinical disorder ii. Axis II- a personality disorder iii. Axis III- a medical problem iv. Axis IV- a psychosocial problem v. Axis V- global assessment of functioning (GAF) 3. A pt is admitted to the psychiatric hospital for assessment and evaluation. Which assessment finding best indicated that the pt has a mental illness? The patient: a. Describes mood as consistently sad, discouraged, and hopeless 4. The goal for a pt is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the pt will: a. Identify healthy coping behaviors in response to stressful events 5. A nurse's insurance form. Which resource should the nurse consult to discern the criteria used at a facility sees an unfamiliar psychiatric diagnosis on a po establish this diagnosis? a. DSM-IV-TR 6. A nurse must assess several new pts at a community mental health center. Conclusions concerning current functioning should be made on the basis of: a. A continuum from mentally healthy to unhealthy 7. Problems with self-concept: pt feels the need for multiple explanations of new tasks at work, despite being 40 years old, allows both parents to make all decisions. 8. A pt tells a nurse, “I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems.” The nurse’s best response: a. “It sounds like you are concerned that others don’t experience the same challenges as you” 9. A critical care nurse asks a psychiatric nurse about the difference between a DSM-4-TR diagnosis & a nursing diagnosis. The psychiatric nurse’s best response: a. “The DSM diagnosis influences the medical treatment; the nursing diagnosis offers a framework to identify interventions for problems a pt has or may experience.” 10. A nurse finds a new pt uncommunicative about recent life events. The nurse suspects marital and economic problems. The social worker’s assessment is not available. The most effective action the nurse can take is to: a. Consult Axis IV of the DSM in the medical record 11. A newly admitted pt is profoundly depressed, mute, motionless. The pt has refused to bathe & eat for a week. Which score would be expected on the pt’s global assessment of functioning? a. 10 i. Pt is unable to maintain personal hygiene, oral intake, or verbal communication 12. Nurse’s best response to the wife of a pt w/ schizophrenia: a. “Although this disorder more likely has a biological rather than psychological origin, the support and involvement of caregivers is very important” 13. Which belief by the nurse supports the highest degree of pt advocacy during a multidisciplinary pt care planning session? a. Some symptoms of mental disorders reflect a person’s cultural patterns. 14. A pt’s history shows intense and unstable relationships w/ others. The pt initially idealizes the individual and devalues the person when the pt’s needs are not met. What aspect of mental health is a problem? a. Fulfilling relationships 15. In the majority culture of the U.S., which individual is at greatest risk to be incorrectly labeled mentally ill? a. Person who attends a charismatic church and describes hearing God’s voice 16. A psychiatric nurse addresses Asic I of the DSM as the focus of care but also considers the presence of other long-term, nonmedical disorders that may affect treatment. To which axis should the nurse refer for this information? a. Axis II- refers to personality disorder and mental retardation 17. A mentally ill person’s current global assessment of functioning (GAF) score is 10. Select the nurse’s highest priority relates to this pt’s care? a. Safety- low score indicated a consistent risk for self-harm 18. A participant at a community education conference asks, “What is the most prevalent mental disorder in the U.S.?” Nurse’s best response: a. Anxiety disorders 19. A nurse wants to find a description of diagnostic criteria for a person w/ schizophrenia. Which resource should the nurse consult? a. DSM 20. Psychosocial factors that influence depression: a. Having a hostile family, having an over- or under involved family, experiencing sudden death of a parent or loved one, feeling strong guilt over having an abortion when one’s relogion forbids it. Ch. 5 1. Planning for pts w/ mental illness is facilitated by understanding that inpatient hospitalizations is generally reserved for pts who: a. Present a clear danger to self or others 2. Members of the healthcare team report their assessment on a newly admitted pt. What outcome can be expected from this meeting? a. A treatment plan will be determined 3. A pt’s family thinks the pt needs to be admitted for longer, they are upset about the pt being discharged after 5 days. The nurse should: a. Explain that the pt will continue to improve if medication is taken regularly. 4. A nurse assessing an inpatients psychiatric unit for exit obstruction, so smacking, locked closets, and sharp objects are locked away under supervision is an example of: a. Management of milieu safety *************************CONTINUED********************* [Show Less]