Lone Star College System, North Harris - PSYC 1301

Chapter 9: Policy and Advocacy in Mental Health Care Test Bank

MULTIPLE CHOICE

1)Health professionals planning treatment initiatives should be most concerned with the burden of disease created by:

1. 1. violence and injury.
   2. environmental quality.
   3. behavioral health problems.
   4. irresponsible sexual behavior.

2. Which disorder is the leading psychiatric cause of disability in the world?
   1. Depression
   2. Schizophrenia
   3. Bipolar disorder
   4. Obsessive-compulsive disorder

3. To work effectively within the health care system, a nurse must understand the current interface between mental health care and the environment. Which statement accurately reflects this interface?
   1. The once simple system has grown from two to six parts, which has significantly complicated the interface.
   2. Biases on the part of providers have largely been abolished, greatly improving the effectiveness of the interface.
   3. Reimbursers and insurers are primarily concerned with protecting the patient’s constitutional rights regarding access to care and treatment received.
   4. In general, families are becoming less concerned with education and empowerment for family members who are patients.

4. Managed behavioral health care settings are involved in:
   1. health care reform.
   2. universal health care.
   3. health care for the underserved.
   4. treating mental and substance abuse disorders.

5. A committee is formed to increase the public’s understanding that mental health is essential to overall health. A nurse would expect that the focus of this group’s work would be:
   1. improving access to quality care that is culturally competent.
   2. protecting and enhancing the rights of people with mental illness.
   3. developing and implementing integrated electronic health record and personal health information systems.
   4. collaborating with the emergency department to treat mental health problems with the same urgency as physical health problems.

6. A patient receiving mental health services complains about having to get a referral from a primary care physician in order to obtain mental health services. The nurse should explain to the patient that this is a cost control practice used in managed care that is described as:
   1. gatekeeping.
   2. utilization review.
   3. case management.
   4. preadmission certification.

7. A patient tells a nurse, “I belong to a health maintenance organization (HMO) that advertises being a capitated system. What does that mean?” The nurse replies:
   1. “It’s complicated but if you like I’ll have the payments office discuss it with you.”
   2. “You pay a sliding fee for each illness based on your monthly take-home income.”
   3. “You pay a fixed fee per month while the HMO provides all medically necessary care.”
   4. “The HMO pays your physician a flat fee for a particular episode of illness regardless of the number of office visits you make.”

8. Access to care refers to the:
   1. availability of health care.
   2. degree to which services are comprehensive.
   3. overall use of mental health services in a community.
   4. convenience and ease of obtaining service and information.

9. In many rural communities the ratio of consumers to doctors is higher than it is in cities. This is an example of:
   1. a health access problem in rural areas.
   2. a lack of compassion among physicians.
   3. reimbursement barriers in rural states.
   4. appropriate distribution of health care providers.

10. A psychiatric nurse advocating for behavioral health system change would focus on which topic?
    1. Abolishing the health maintenance organization (HMO) system
    2. Strengthening current utilization review guidelines
    3. Limiting consumer empowerment initiative options
    4. Increasing resources for chronic care mental health services

11. A case manager at the local mental health center evaluates the clinical appropriateness of a patient’s current level of care. To do this, the case manager will assess:
    1. the type of service currently provided.
    2. the vigor of the patient to whom the service is provided.
    3. the type, amount, and level of care needed to achieve positive outcomes.
    4. whether the level of the patient’s care is currently considered cost effective.

12. A nurse works in an organization that provides an integrated behavioral continuum of care. The goal of treatment in the crisis clinic is:
    1. remission.
    2. recovery.
    3. stabilization.
    4. optimal level of wellness.

13. Which is a suitable goal and expected outcome for a patient who is admitted for the recurrence of psychotic symptoms related to noncompliance with medication therapy?
    1. Goal, safety; outcome, no risk for violence
    2. Goal, remission; outcome, symptom relief
    3. Goal, recovery; outcome, improved functioning
    4. Goal, rehabilitation; outcome, attain optimal quality of life

14. Which type of managed care plan allows the most flexibility in choosing health services and providers?
    1. Health maintenance organization (HMO)
    2. Independent practice organization (IPO)
    3. Preferred provider organization (PPO)
    4. Point of service plan (POS)

15. A nurse who advocates for consumer empowerment will seek to help psychiatric patients:
    1. achieve a sense of self-responsibility.
    2. comply with provider-prescribed treatment programs.
    3. understand that their viewpoints are flawed by mental illness.
    4. use resources predominantly from the formal mental health system.

16. Which nurse in a managed care setting has the greatest responsibility for allocating resources to an individual patient?
    1. Treatment nurse
    2. Case manager
    3. Risk manager
    4. Patient educator

17. A trend in psychiatric nursing related to cost controls imposed in the managed care environment is:
    1. reduced emphasis on utilization review.
    2. a marked increase in the use of risk managers.
    3. reduced use of patient and family educators to promote compliance.
    4. a shift from acute inpatient to community-based positions.

18. A health provider study group should explore which option as a means to improve access to care in rural areas servicing a scattered population?
    1. Installation of telehealth services
    2. An increased number of satellite centers
    3. Implementation of mobile mental health clinics
    4. Federal grants to supplement the agency budget for personnel

19. A psychiatric nurse notes that the expected outcome of treatment for a patient with depression is the relief of symptoms. The nurse determines that this patient is in which stage of treatment in an integrated behavioral continuum of care?
    1. Crisis
    2. Acute
    3. Maintenance
    4. Health promotion

20. A patient’s goal of treatment is stabilization. The patient is in which stage of treatment in an integrated behavioral continuum of care?
    1. Crisis
    2. Acute
    3. Maintenance
    4. Health promotion

21. A patient is transferred to a rehabilitation-oriented residential mental health program. Which expected outcome applies to the new care setting?
    1. Symptom relief
    2. Improved functioning
    3. No harm to self or others
    4. Attain optimal quality of life

MULTIPLE RESPONSE

1. A patient asks a nurse, “How do managed care systems control costs?” The nurse should reply that the HMO’s cost saving strategies include using: (Select all that apply.)
   1. utilization reviews.
   2. case management.
   3. easy repayment plans.
   4. preadmission certifications.
   5. inexpensive health care plans.