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Mental Health Nursing Exam Questions
And Answers
biologically based mental illness - answer A mental disorder caused by neurotransmitter dysfunction, abnormal brain srtructure, inherited genetic factors, or other biological causes. Also called psychobiological disorder culture-related syndromes - answer These are more influenced by culture alone and are not seen in all areas of the world. Diagnostic and Statistical Manual of Mental Disorders (DSM) - answer The DSM is the manual that classifies mental disorders and is considered the "bible" for mental health workers (e.g. psychiatrists, psychiatric nurses, psychologists, and others who plan care for people experiencing mental distress/dysfunction) epidemiology - answer The quantitative study of the distribution of disorders in a human population mental disorders - answer A medical disease that is categorized in the DSM mental health - answer successful performance of mental functions, resulting in the ability to engage in productive activities, enjoy fulfilling relationships, and adapt to change and cope with adversity. mental illness - answer A medical condition that affects a person's thinking, feeling, mood, ability to relate to others, and daily functioning. Can be seen as the result of a chain of events that include flawed biological, psychosocial, social, and cultural processes. myths and misconceptions - answer Incorrect thinking about someone's mental health prevalence rate - answer The proportion of a population with a mental disorder at a given time. psychiatry's definition of normal mental health - answer changes over time and reflects changes in cultural norms, society's expectations and values, professional biases, individual differences, and even the political climate of the time. psychobiological disorder - answer A mental disorder caused by neurotransmitter
dysfunction, abnormal brain srtructure, inherited genetic factors, or other biological causes. Also called biologically based mental illness resiliency - answer The ability to recover from or adjust easily to misfortune and change. Resiliency is closely related to the process of adapting stigma/stigmatizing - answer Stigma ia an attribute that is deeply discrediting where a person is reducedfrom a whole unusual personto a tainted, discounted one. Stigmatizing comes from stereotyping, labeling, separating, status, loss, and discrimination in a context of power imbalance all leading to stigmatization OBJECTIVE 1 - Assess mental health using the seven signs of mental health identified in this chapter. - answer Happiness Control of Behavior Appraisal of Reality Effective in Work Healthy Self Concept Satisfying Relationships Effective Coping OBJECTIVE 2 - Summarize factors that can affect the mental health of an individual and the ways that these factors influence conducting a holistic nursing assessment. - answer - Available support systems: ----friends ----family ----community
- Spirituality, religious influences
- family influences
- developmental events
- personality traits and states
----Make different decisions at different times. ----Choose to or choose not to evaluate their behaviors. ----Grow within themselves. ----Have or have no spiritual beliefs OBJECTIVE 4 - Identify the processes leading up to stigmatizing and some of the effects stigma can have on the medical and psychologic well-being of an individual, group, and/or culture. - answer - Stigma has been acknowledged to be a major barrier to mental health treatment and recovery over the last 13 to14 years.
- Stigmatizing attitudes toward individuals who are mentally ill have harmful effects on the individual and family.
- Stigma is a "collection" of: ----Negative attitudes, beliefs, thoughts, and behaviors that influence the individual and general public.
- Psychosocial processes that lead to stigmatization include: ----Stereotyping, labeling, separating, and status loss or discrimination in a context of power imbalance, social isolation, and reduced opportunities. OBJECTIVE 5- Demonstrate how the Diagnostic Statistic Manual (DSM) multiaxial system can influence a clinician to consider a broad range of information before making a DSM diagnosis. - answer -In the DSM, each of the mental disorders is conceptualized as a clinically significant behavioral syndrome or pattern that occurs in an individual and is associated with present distress (e.g., painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. NOTE: It is important to stress that a DSM diagnosis classifies a disorder that a person has and not the person. For this reason, the text of the DSM avoids the use of expressions such as a schizophrenic or an alcoholic and instead uses the more accurate expression, an
individual with schizophrenia or an individual with alcohol dependence. OBJECTIVE 6- Compare and contrast a DSM diagnosis with a nursing diagnosis. - answer - DSM focuses on research and clinical observation when constructing diagnostic categories of a mental disorder.
- DSM is considered the "bible" for mental health workers (e.g., psychiatrists, psychiatric nurses, psychologists -North American Nursing Diagnoses Association (NANDA) International describes a nursing diagnosis as a clinical judgment about responses to health problems. -Psychiatric-mental health nursing includes the diagnosis and treatment responses to mental health problems. OBJECTIVE 7- Give examples of how the consideration of norms and other cultural influences can affect making an accurate DSM diagnosis. - answer - The DSM is used to diagnose a psychiatric disorder.
- The DSM includes information specifically related to culture in three areas: ----Discusses cultural variations for each clinical disorder. ----Describes culture-bound syndromes. ----Outline assists clinicians in evaluating and reporting the impact of an individual's cultural context. True or False. Mental illness is defined in relation to the culture, time in history, political system, and group in which it occurs. - answer TRUE What is Axis V of the DSM multiaxial system? - answer It describes a person's level of functioning.
clinical/critical pathways - answer serve as a "map" for specified treatments and interventions to occur within a specific time frame, often days. clinical practice guidelines - answer systematically developed statements that identify, appraise, and summarize the best evidence about prevention, diagnosis, prognosis, therapy, and other knowledge necessary to make informed decisions about specific health problems evidence-based practice - answer The method for using treatment approaches to medical illness and mental health illness that are scientifically grounded or evidence-based. Strives to decrease the gap between research and practice. nurse-patient partnership - answer more in line with the emphasis on "relationships" in the recovery model patient advocate - answer one who speaks up for another's cause, who helps others by defending and comforting them, especially when the other person lacks the skills, ability, or knowledge to speak up for himself/herself Psychiatric mental health nursing - answer a core mental health profession, employing a purposeful use of self as its art and a wide range of nursing, psychosocial, and neurobiological theries and research as its science recovery model - answer originated from the 12 step program of AA in the 1980 and 1990s. Recovery model refers primarily to managing symptoms, reducing psychosocial disability, and improving role performance. OBJECTIVE 1 - Contrast and compare the focus and approach of the mental health recovery
model to the evidence-based practice (EBP) model - answer The mental health recovery model is one of helping people with psychiatric disabilities effectively manage their symptoms, reduce psychosocial disability, and find a meaningful life in the community of their choosing. Evidence-based practice (EBP) is a process by which the best available research evidence, clinical expertise, and patient preferences are used for making clinical decisions OBJECTIVE 2 - Identify the "5 A's" in the simple multistep process of evidence-based practice, and describe what is inherent in each step of this process. - answer 1. Ask a question. - Identify a problem or need for change for a specific patient or situation
- Acquire the literature. - Search the literature for scientific studies and articles that address the issue(s) of concern.
- Appraise the literature. - Evaluate and synthesize the research evidence as to validity, relevance, and applicability.
- Apply the evidence. - Choose intervations based on evidence applied to the patient's preference and needs
- Assess the performance. - Evaluate the outcomes, using clearly defined criteria and reports, and document results. OBJECTIVE 3 - Discuss at least three current dilemmas nurses face when they seek the best evidence for their interventions. - answer 1. Who interprets the best evidence?
- Not all nursing problems are able to be reduced to a clear issue solvable by scientific experiments
- Few studies are available form which to select nursing interventions and guide psychiatric nursing practices OBJECTIVE 4 - Identify four resources that nurses can use as guidelines for best-evidence interventions. - answer Internet mental health resources
Q: The "art" of psychiatric mental health nursing, according to Benner, includes what principles? - answer A: C - A - P pneumonic Caring Attending Patient advocacy Q: The "science" of psychiatric mental health nursing includes three things. What are they?
- answer A: 1. nursing theory
- psychosocial theory
- neurobiological theory Q: What is caring? - answer A: giving of self Q: What does patient advocacy demand? - answer A: It requires courage Q: An experienced psychiatric nurse listens carefully as a client recounts a traumatic emotional experience. The nurse is doing what? - answer A: Using an attending behavior automatic thoughts - answer thoughts that come to mind quickly and without intention, causing emotions such as fear or sadness boundaries - answer A concept used in structural family therapy to describe emotional barriers that protect and enhance the integrity of individuals, subsystems, and families. cognitive distortions - answer Inaccurate and irrational automatic thoughts or ideas that lead to false assumptions and misinterpretations.
conscious - answer Your current awareness - thoughts, beliefs, and feelings conservation - answer the principle (which Piaget believed to be a part of concrete operational reasoning) that properties such as mass, volume, and number remain the same despite changes in the forms of objects ( Ex. two small cups can equal one tall glass) countertransference - answer tendency for therapists to relate to clients in ways that mirror their relationships with important figures in their own lives curative factors - answer Altruism Cohesiveness interpersonal learning guidance catharsis identification family reenactment self-understanding installation of hope universality existential factors ego - answer Our sense of self and acts as the intermediary, between the id and the world by using ego defense mechanisms, such as repression, denial, and rationalization.
superego - answer the part of the personality in Freud's theory that is responsible for making moral choices (the conscience) transference - answer in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships. Safe expression of these feelings is crucial to successful therapy. unconscious - answer part of the mind where primitive feelings, drives, and memories reside, especially those that are unbearable and traumatic Objective 1: Discuss the contribution of theories and therapies from a variety of disciplines and areas of expertise. - answer ... Objective 2: Choose two of the major theories that you believe are among the most relevant to psychiatric and mental health nursing care, and defend your choices by giving examples. - answer ... Objective 3: Identify the origins and progression of the dominant theories and treatment modalities. - answer ... Objective 4: Discuss the relevance of these theories and treatments to the provision of psychiatric and mental health care. - answer ... Objective 5: Demonstrate a comprehensive understanding of Peplau's theoretical base for practice that is beneficial to all settings. - answer ... Objective 6: Identify three different theoretical models of mental health care,
and demonstrate how each could be used in specific circumstances. - answer ... Objective 7: Distinguish the models of care used in clinical settings, and cite the benefits and limitations of these models. - answer ... Q: The theory of interpersonal relationships developed by Hildegard Peplau is based on the works of which theorist? - answer A: Sullivan Q: What is the contribution to modern psychiatric nursing practice that was made by Freud? - answer A: The theory of personality structure and levels of awareness. Q: According to Maslow's Heirarchy of Needs,what is the most basic need for psychiatric mental health nursing? is - answer A: physiological Q: The premise that an individual's behavior and affect are largely determined by the attitudes and assumptions the person has developed about the world underlies: - answer A: cognitive behavioral therapy Q: Providing a safe environment for patients with impaired cognition, referring a spouse to a "safe" house, and conducting a community meeting are nursing interventions that are examples of what? - answer A: Milieu therapy comorbid conditions (co-occurring) - answer a term that refers to the occurrence of two or more illnesses or disorders at the same time elopement - answer Escape or leaving a psychiatric treatment facility without medical authorization, recommendation or being discharged.
Medicaid.
1999 Olmstead decision: -Supreme Court decreed: Keeping people in psychiatric hospitals is "unjustified isolation." Community-care systems have largely replaced state hospitals. Today: The number of state-run psychiatric hospitals have reduced to approximately 220 facilities. Objective 2: Compare and contrast inpatient and outpatient treatment environments in which psychiatric care is provided. - answer Inpatient 24-hour nursing care Locked units (for safety) Crisis care Residential treatment programs State acute care systems General hospital psychiatric units Private psychiatric hospital acute care Outpatient Primary care providers Patient-centered medical homes Primary care medical homes Community mental health centers Psychiatric home care Intensive outpatient programs
Objective 3: Discuss the role of mental health professionals in assisting people with mental illness symptoms or mental illnesses. - answer Multidisciplinary Treatment Team
Role of the nurse in Outpatient care settings Role of the nurse in the Inpatient care settings Advanced-practice psychiatric nurse Mental health technician Occupational therapist Recreational therapist Physicians' assistant Psychiatrist Psychologist Objective 4: Explain the methods for financing psychiatric care. - answer >Private insurance and/or managed care Medicaid, Medicare,Social Security, Veterans' Administration (VA) Social Security Disability Insurance (SSDI)—disability Supplemental Security Income (SSI)—economic need 1996: Mental Health Parity Law Wellstone-Domenici Mental Health Parity Act Problematic coverage for mental illnesses: -Annual and lifetime caps All states must provide: -Inpatient care, primary care physician services, treatment for those younger than age 21 years
Q: Who are some of the health team members that could provide initial screening, and a treatment plan for a 45-year old, who lives 100 miles from the nearest psychiatrist, and is experiencing increased anxiety symptoms? - answer A: Primary care provider Q: What is the most suitable rationale for a nurse supervisor to ask a student nurse to develop a stress reduction class for the residents in a surrounding community? - answer A: An imortant concept for community health nursing is to view the entire community as a patient. assault - answer Threat to use force (words not enough) with opportunity and ability. autonomy - answer Respecting the rights of others to make their own decisions battery - answer harmful or offensive touching, which includes treatment of a patient without their consent. beneficence - answer The duty to act so as to promote the good of others bioethics - answer A more specific term that refers to the ethical questions that arise in health care. It has five principles:
- Beneficence
- Autonomy
- Justice
- Fidelity
- Veracity
child abuse reporting statutes - answer Differs from state-to-state. Generally includes a definition of child abuse, a list of individuals required or encouraged to report abuse, and the government agency designated to receive and investigate the reports. civil rights - answer Include the right to vote, to civil service ranking, rights to related to granting, forfeit, or denial of a driver's license, to right to make purchases, and to enter into contractual relationships, and the right to press charges against another person. commitment - answer emergency involuntary hospitalization for a specified period (1 to 10 days on average) to prevent dangerous behavior that is likely to cause harm to self or others. conditional release - answer usually requires outpatient treatment for a specified period to determine the patient's adherence with medication protocols, ability to meet basic needs and ability to reintegrate into the community. confidentiality - answer Any discussion or consultation involving a patient should be conducted discreetly and only with individuals who have a need and a right to know this privileged information. defamation of character - answer Slander (spoken) or libel (written) which harms a patient's reputation and results in divulgence of confidential information. Truth is a defense against same. discharge - answer the termination of a patient-institution relationship duty to warn a third party - answer Includes three points:
- Assessing and predicting the patient's danger of violence toward another
