Question 1

A nurse surveys medical records. Which finding signals a violation of patients' rights?

Accepted Answer

A)   A patient was not allowed to send letters to family.
B)   A patient's belongings were searched at admission.
C)   A patient with suicidal ideation was placed on continuous observation.
D)   Physical restraint was used after a patient was assaultive toward a staff member. A

Question 2

Which statements by patients diagnosed with a serious mental illness best demonstrate that the case manager has established an effective long-term relationship?

Accepted Answer

A)   "My case manager talks in language I can understand."
B)   "My case manager helps me keep track of my medication."
C)   "My case manager gives me little gifts from time to time."
D)   "My case manager looks at me as a whole person with many needs."
E)   "My case manager lets me do whatever I choose without interfering." A, B, D

Question 3

A Category V tornado hits a community, destroying many homes and businesses. Which nursing intervention would best demonstrate compassion and caring?

Accepted Answer

A)   Encouraging people to describe their memories and feelings about the event
B)   Arranging transportation to the local community mental health centre
C)   Referring a local resident to a community food bank
D)   Coordinating psychiatric home care services A

Question 4

A nurse can best address factors of critical importance to successful community treatment by including making assessments relative to which of the following:

Accepted Answer

A)   Source of income
B)   Family and support systems
C)   Housing adequacy and stability
D)   Early psychosocial development
E)   Substance abuse history and current use

Question 5

A psychiatrist prescribed depot injections every 3 weeks at the clinic for a patient with a history of medication noncompliance. For this plan to be successful, which factor will be of critical importance?

Accepted Answer

A)   The attitude of significant others toward the patient
B)   Nutrition services in the patient's neighbourhood
C)   The level of trust between the patient and nurse
D)   The availability of transportation to the clinic

Question 6

The nurse assigned to assertive community treatment (ACT) should explain the program's treatment goal as which of the following?

Accepted Answer

A)   Assisting patients to maintain abstinence from alcohol and other substances of abuse
B)   Providing structure and a therapeutic milieu for mentally ill patients whose symptoms require stabilization
C)   Maintaining medications and stable psychiatric status for incarcerated inmates who have a history of mental illness
D)   Providing services for mentally ill individuals who require intensive treatment to continue to live in the community

Question 7

A suspicious, socially isolated patient lives alone, eats one meal a day at a local shelter, and spends the remaining daily food allowance on cigarettes. Select a community psychiatric nurse's best initial action.

Accepted Answer

A)   Explore ways to help the patient stop smoking.
B)   Report the situation to the manager of the shelter.
C)   Assess the patient's weight; determine foods and amounts eaten.
D)   Arrange hospitalization for the patient in order to formulate a new treatment plan.

Question 8

Select the response that is an example of primary prevention.

Accepted Answer

A)   Assisting a person diagnosed with a serious mental illness to fill a pill-minder
B)   Helping school-age children identify and describe normal emotions
C)   Leading a psychoeducational group in a community care home
D)   Medicating an acutely ill patient who assaulted a staff person

Question 9

Clinical pathways are used by the multidisciplinary team, in managed care settings, to do which of the following?

Accepted Answer

A)   Stabilize aggressive patients
B)   Identify obstacles to effective care
C)   Relieve nurses of planning responsibilities
D)   Streamline the care process and improve outcomes

Question 10

A patient with which of the following diagnoses would be most appropriate to refer for assertive community treatment (ACT)?

Accepted Answer

A)   A phobic fear of crowded places.
B)   A single episode of major depression.
C)   A catastrophic reaction to a tornado in the community.
D)   Schizophrenia and four hospitalizations in the past year.

Question 11

A nurse makes an initial visit to a homebound patient diagnosed with a serious mental illness. A family member offers the nurse a cup of coffee. Select the nurse's best response.

Accepted Answer

A)   "Thank you. I would enjoy having a cup of coffee with you."
B)   "Thank you, but I would prefer to proceed with the assessment."
C)   "No, but thank you. I never accept drinks from patients or families."
D)   "Our agency policy prohibits me from eating or drinking in patients' homes."

Question 12

The health care team at an inpatient psychiatric facility drafts these criteria for admission. Which criteria should be included in the final version of the admission policy?

Accepted Answer

A)   Clear risk of danger to self or others
B)   Adjustment needed for doses of psychotropic medication
C)   Detoxification from long-term heavy alcohol consumption needed
D)   Respite for caregivers of persons with serious and persistent mental illness
E)   Failure of community-based treatment, demonstrating need for intensive treatment

Question 13

A psychiatric nurse discusses rules of the therapeutic milieu and patients' rights with a newly admitted patient. Which rights should be included?

Accepted Answer

A)   The right to received information
B)   The right to confidentiality
C)   The right to retain legal counsel
D)   The right to an independent panel review, if certified
E)   The right to select the nurse assigned to their care

Question 14

Select the response that is an example of tertiary prevention.

Accepted Answer

A)   Helping a person diagnosed with a serious mental illness learn to manage money
B)   Restraining an agitated patient who has become aggressive and assaultive
C)   Teaching school-age children about the dangers of drugs and alcohol
D)   Genetic counselling with a young couple expecting their first child

Question 15

A nurse performed these actions while caring for patients in an inpatient psychiatric setting. Which action violated patients' rights?

Accepted Answer

A)   Prohibited a patient from using the telephone
B)   In patient's presence, opened a package mailed to patient
C)   Remained within arm's length of patient with homicidal ideation
D)   Permitted a patient with psychosis to refuse oral psychotropic medication

Question 16

A nurse receives the following three phone calls regarding a community patient.
.The psychiatrist wants to complete a follow-up assessment.
.An internist wants to schedule a physical examination.
.The patient's attorney wants an appointment with the patient.
The nurse schedules the activities for the patient. Which role has the nurse fulfilled?

Accepted Answer

A)   Advocate
B)   Case manager
C)   Milieu manager
D)   Provider of care

Question 17

The patients below were evaluated in the emergency department. The psychiatric unit has one bed available. Which patient should be admitted?

Accepted Answer

A)   The patient who is feeling anxiety and a sad mood after separation from a spouse of 10 years.
B)   The patient who self-inflicted a superficial cut on the forearm after a family argument.
C)   The patient experiencing dry mouth and tremor related to taking haloperidol (Haldol) .
D)   The patient who is a new parent and hears voices saying, "Smother your baby."

Question 18

The case manager plans to discuss the treatment plan with a patient's family. Select the case manager's first action.

Accepted Answer

A)   Determine an appropriate location for the conference.
B)   Support the discussion with examples of the patient's behaviour.
C)   Obtain the patient's permission for the exchange of information.
D)   Determine which family members should participate in the conference.

Question 19

Which statements most clearly reflect the stigma of mental illness?

Accepted Answer

A)   "Many mental illnesses are hereditary."
B)   "Mental illness can be evidence of a brain disorder."
C)   "People claim mental illness so they can get disability cheques."
D)   "Mental illness results from the breakdown of nuclear families."
E)   "If people with mental illness went to church, their symptoms would vanish."

Question 20

Which level of prevention activities would a nurse in an emergency department employ most often?

Accepted Answer

A)   Primary
B)   Secondary
C)   Tertiary

Exam 3: Overview of Psychiatric Mental Health Nursing Care Within Various Settings