Exam 29: Living With Recurrent and Persistent Mental Illness

A patient living independently had command hallucinations to shout warnings to neighbours. After a short hospitalization, the patient was prohibited from returning to the apartment. The landlord said, "You cause too much trouble." What problem is the patient experiencing?

An outpatient diagnosed with schizophrenia tells the nurse, "I am here to save the world. I threw away the pills because they make God go away." The nurse identifies the patient's reason for medication nonadherence as which of the following?

A person diagnosed with a serious mental illness enters a shelter for the homeless. Which intervention should be the nurse's initial priority?

An outpatient diagnosed with schizophrenia attends programming at a community mental health centre. The patient says, "I threw away the pills because they keep me from hearing God." Which response by the nurse would most likely benefit this patient?

An adult patient tells the case manager, "I don't have bipolar disorder anymore, so I don't need medicine. After I was in the hospital last year, you helped me get an apartment and disability cheques. Now I'm bored and don't have any friends." Where should the nurse refer the patient?

Serious mental illness is characterized as which of the following?

The nurse wants to enroll a patient with poor social skills in a training program for patients diagnosed with schizophrenia. Which description accurately describes social skills training?

Which nursing diagnosis is likely to apply to an individual diagnosed with a serious mental illness who is homeless?

A homeless patient diagnosed with a serious mental illness became suspicious and delusional. Depot antipsychotic medication began, and housing was obtained in a local shelter. One month later, which statement by the patient indicates significant improvement?

After 5 years in a psychiatric hospital, an adult diagnosed with schizophrenia was discharged to the community. This patient now requires persistent direction to accomplish activities of daily living and expects others to provide meals and do laundry. The nurse assesses this behaviour as the probable result of which of the following?

A patient diagnosed with schizophrenia tells the community mental health nurse, "I threw away my pills because they interfere with God's voice." The nurse identifies the etiology of the patient's ineffective management of the medication regime as which of the following?

A patient diagnosed with a serious mental illness lives independently and attends a psychosocial rehabilitation program. The patient presents at the emergency department seeking hospitalization. The patient has no acute symptoms but says, "I have no money to pay my rent or refill my prescription." Select the nurse's best action.

A patient diagnosed with a serious mental illness died suddenly at age 52. The patient lived in the community for 5 years without relapse and held supported employment the past 6 months. The distressed family asks, "How could this happen?" Which response by the nurse accurately reflects research and addresses the family's question?

A patient diagnosed with schizophrenia has had multiple relapses. The patient usually responds quickly to antipsychotic medication but soon discontinues the medication. Discharge plans include follow-up at the mental health centre, group home placement, and a psychosocial day program. Which strategy should apply as the patient transitions from hospital to community?

An adult diagnosed with a serious mental illness says, "I do not need help with money management. I have excellent ideas about investments." This patient usually does not have money to buy groceries by the middle of the month. The nurse assesses the patient as demonstrating which of the following?

The parent of a seriously mentally ill adult asks the nurse, "Why are you making a referral to a vocational rehabilitation program? My child won't ever be able to hold a job." Which is the nurse's best reply?

A homeless individual diagnosed with serious mental illness, anosognosia, and a history of persistent treatment nonadherence is persuaded to come to the day program at a community mental health centre. Which intervention should be the team's initial focus?

For patients diagnosed with serious mental illness, what is the major advantage of case management?

A person diagnosed with serious mental illness has frequent relapses, usually precipitated by situational stressors such as running out of money or the absence of key staff at the mental health centre. Which interventions would the nurse suggest to reduce the risk of stressors to cause relapse?

A family discusses the impact of having a seriously mentally ill member. Insurance partially covered treatment expenses, but the family spent much of their savings for care. The patient's sibling says, "My parents have no time for me." The parents are concerned that when they are older, there will be no one to care for the patient. Which response by the nurse would be most helpful?