Lone Star College System, North Harris - PSYC 1301

Chapter 34: Community-Based Psychiatric Nursing Care Test Bank

MULTIPLE CHOICE

1)Which health care setting is most likely to meet the mental health care needs of an urban community?

1. 1. A physician’s office associated with diagnostic testing located near a community shopping center
   2. A community mental health clinic with a wide range of multidisciplinary services
   3. A hospital emergency room with fast tracking and minimum patient waiting time
   4. An inpatient specialty unit located in a large urban hospital

2. A psychiatric nurse is focusing on the fifth area of service, based on the Community Mental Health Centers Act of 1963, when:
   1. assisting with electroconvulsive therapy (ECT) treatments.
   2. providing stress management technique classes to new mothers.
   3. assessing patients for admission into an outpatient group program.
   4. providing emergency psychiatric care to a rape victim demonstrating psychoses.

3. A community mental health center is adjusting to severe budget cuts. Which service is most likely to be considered for elimination?
   1. Toll-free suicide prevention telephone hotline services
   2. Community education regarding the risk factors of depression
   3. Transitional housing for a parent diagnosed with chronic depression
   4. Follow-up laboratory testing regarding therapeutic medication levels

4. When considering mental health issues, deinstitutionalization is best demonstrated when a:
   1. patient newly diagnosed with bipolar disorder is admitted to a mental health unit for medication and therapy stabilization.
   2. patient who has been hospitalized for 5 years for persistent depression is being discharged to an outpatient program.
   3. suburban community’s shelter for its persistently mentally ill and cognitively impaired population receives renewed funding.
   4. homeless adolescent newly diagnosed with obsessive compulsive disorder (OCD) is discharged earlier than expected when a foster home becomes available.

5. The primary nursing responsibility of a community psychiatric nurse managing caring for patients diagnosed with serious and persistent mental illnesses residing in a group home is to conduct an ongoing:
   1. assessment of the patients’ life needs.
   2. evaluation of care provided for the patients.
   3. management of the funds allotted for individual patient care.
   4. oversight of all day-to-day operations of the group home and its services.

6. Which situation would be considered discrimination under the Americans with Disabilities Act?
   1. A Hispanic with poor English-speaking skills is hospitalized for possible late-onset

schizophrenia.

1. 2. A patient hospitalized for detoxification after a drunk driving accident is not allowed to leave the unit.
   3. Staff is responsible for bathing, dressing, and feeding a patient diagnosed with mild Alzheimer disease (AD) on a daily basis.
   4. After evaluation a cognitively impaired individual diagnosed with obsessive compulsive disorder (OCD) is identified as being “unemployable.”

7. An example of the primary responsibility of a nurse case manager for psychiatric patients in a residential home is to:
   1. assure each patient is bathed and clothed appropriately.
   2. conduct the unit’s socialization group session daily.
   3. participate in the feeding of a severely depressed patient.
   4. arrange for a patient to move into a private apartment.

8. Which intervention demonstrates effective management of two contradictory goals of case management?
   1. Arranging for outpatient patients to car pool to group meetings
   2. Assessing patients to determine who is able to shower independently
   3. Scheduling a patient to have in-home help with cooking and cleaning
   4. Helping a patient appropriately fill a personal 5-day medication container

9. A key component of focused treatment directed toward the homeless population that has been shown to be most successful is the facilitation of:
   1. nutrition in the form of finger foods left in a visible, well-lit location daily.
   2. health care services and screening through community-based free clinics.

1. 3. frequent and consistent staff contact through assertive but nonthreatening outreach services.
   4. access to clothing and hygiene products through community-based support networks.

10. Rural suicide rates:
    1. have surpassed urban suicide rates over the past 20 years.
    2. are not tracked as effectively as urban rates.
    3. cannot be determined with accuracy.
    4. are very low in the United States.

11. When assessing a new prison inmate the correctional nurse conducts a particularly thorough mental illness screening because:
    1. the rate of serious mental illness among inmates is three to four times that of the general U.S. population.
    2. this may be the only opportunity this individual has ever had for a mental health assessment to be conducted.
    3. the prison system is prepared to deal with underlying mental health disorders that may have previously gone untreated.
    4. medication dosages being used to treat existing mental health disorders may need to be reevaluated to address the stressors of incarceration.

12. A community mental health nurse is often a member of a multidisciplinary Assertive Community Treatment (ACT) team. An example of a nursing intervention that focuses on the primary concentration of care for such a team is:
    1. providing medication education to all patients.

1. 2. volunteering to counsel homeless abused women.
   3. involving a patient in the various aspects of his or her discharge planning.
   4. conducting a support group for patients recovering from depression.

13. The National Alliance on Mental Illness (NAMI) believes that which program offers the most comprehensive treatment for severely mentally ill individuals living in the community?
    1. The multisystem therapy model
    2. The rural mental health model
    3. The Program of Assertive Community Treatment
    4. The National Mental Health Treatment Program

14. A community mental health nurse is conducting a home visit when the patient states, “I never want to go back to that hospital again.” Which response has the greatest therapeutic value in terms of appropriate assurance for the patient’s concerns?
    1. “It’s likely that you won’t need to go to the hospital again if you are compliant with the plan of care we have created for you.”
    2. “I can’t promise that you will never need to go back to the hospital, but I will work to provide the care you need here in the community.”
    3. “Any inpatient hospitalization that you need in the future will be very brief now that you are receiving such effective home psychiatric care.”
    4. “Sometimes you will need to be re-hospitalized because of your mental health disorder, but I will work with you throughout your stay in the inpatient setting.”

15. Which statement made by a psychiatric community nurse reflects a need for further education regarding Medicare criteria for home health reimbursement for mental health services?
    1. “Medicare policies have limited the growth of psychiatric home care programs.”
    2. “Medicare requires that the patient be incapable of independently accessing psychiatric follow-up care.”
    3. “A patient may be considered psychiatrically homebound by Medicare if 24-hour supervision is required.”
    4. “A patient must be diagnosed with a persistent mental illness before Medicare will reimburse for home services.”

16. Which patient would benefit from in-home psychiatric nursing services?
    1. A patient with schizophrenia who still experiences hallucinations and is taking medication for treatment of the disorder
    2. A patient with chronic depression with repeated crisis hospitalizations who is currently experiencing side effects from a newly prescribed medication
    3. A patient with bipolar disorder successfully being treated with medication who also has diabetes
    4. A patient newly diagnosed with HIV who is experiencing situational depression

17. A psychiatric home care nurse’s greatest patient care challenge is:
    1. effectively assessing the home care needs of the patient.
    2. documenting care to reflect the skilled service given.
    3. providing all the attention each patient wants.
    4. evaluating family situations accurately.

18. Forensic nursing has two very different and sometimes conflicting goals. These goals are:
    1. ensuring easy identification of psychiatrically impaired inmates and protecting their right to privacy.
    2. implementing effective individualized patient care and providing protection for the community.
    3. acting as a patient advocate while remaining a representative of the judicial system.
    4. facilitating patient treatment while minimizing cost to the community.

MULTIPLE RESPONSE

1. The outcome that resulted from the fundamental flaw with the deinstitutionalization of mental health patients was that: (Select all that apply.)
   1. patients had to be readmitted to state hospitals because of the lack of adequate community services.
   2. there was insufficient financial support to care for the psychiatric patients at the homeless shelters currently in place.
   3. funds for services were misused since policymakers did not require adequate documentation of patient service needs.
   4. there were insufficient numbers of community health professionals available to care for the psychiatric patients who qualified for deinstitutionalization care.
   5. patients refused to seek out or accept mental health care from community-based facilities since they were unfamiliar with them and therefore generally distrustful of them.

2. Individuals may seek treatment for mental health disorders from their primary care provider. Which assessment questions are directed towards identifying the most common of these conditions? (Select all that apply.)
   1. “Do you see yourself as a depressed individual?”
   2. “What is your opinion of recreational drug use?”

1. 3. “Would you consider yourself an anxious person?”
   4. “Is your daily routine controlled by ritual behaviors?”
   5. “Have you ever been told you drink too much alcohol?”

3. Which interventions are directed toward achieving the goals of integrated health care? (Select all that apply.)
   1. The terminally ill patient is referred to a grief counselor.
   2. The homeless mentally ill patient is screened for tuberculosis.
   3. The new mother is assessed for possible postpartum depression.
   4. The diabetic patient is monitored every 3 months with an A_1C test.
   5. The schizophrenic patient is provided with a yearly flu vaccination.

4. Which interventions would be provided by an employee assistance program (EAP) when an employee is suspected of having an alcohol abuse problem? (Select all that apply.)
   1. A consultation with their immediate supervisor
   2. Referral to an alcohol abuse treatment program
   3. Financial help while at an alcohol treatment center
   4. Guarantee that one’s job will be held until treatment is successful
   5. Evaluation of the employee’s need for a leave of absence from their job

5. Which patient meets the criteria for psychiatric homebound care? (Select all that apply.)
   1. A 68-year-old whose moderate Alzheimer disease (AD) symptoms are progressing
   2. A 19-year-old who refuses to leave his room because of paranoid delusions
   3. A 45-year-old who is so persistently depressed she rarely gets out of bed