NURS 230 QUIZ #1 Mental Health

The nurse is assessing a newly admitted client with cholecystitis. When performing the admission assessment, which statement by the client is an indicator of optimal mental health?

A. "I don't need anyone in my life, I manage well on my own."

B. "I practice yoga regularly since it helps manage any stress I am feeling."

C. "My family has several people with mental health problems."

D. "I had a history of alcohol use disorder and have been sober for 2 months."

ANS: B. "I practice yoga regularly since it helps manage any stress I am feeling."

The nurse is performing an admission assessment for a client admitted to the behavioral health unit. Which social/cultural category will the nurse document that may be contributing to the client's degree of mental illness? Select all that apply.

A. The client is unable to find work and does not have enough money for housing.

B. The client states that they are discriminated against due to their country of origin.

C. The client attributes life's problems to being without family support.

D. The client reports being unable to find anything meaningful within their life.

E. The client reports not belonging anywhere and is without family support.

ANS:

A. The client is unable to find work and does not have enough money for housing.

B. The client states that they are discriminated against due to their country of origin.

A client grieving the recent loss of a spouse, asks, "Am I becoming mentally ill? I feel so sad" Which is the nurse's best response?

A. "You may have a temporary mental illness because you are experiencing so much pain."

B. "You are not mentally ill. This is an expected reaction to the loss you have experienced."

C. "Were you generally dissatisfied with your relationship before your husband's death?"

D. "Try not to worry about that right now. You never know what the future brings."

ANS: B. "You are not mentally ill. This is an expected reaction to the loss you have experienced."

The nurse is using the DSM-5-TR for a newly admitted client diagnosed with bipolar I disorder. Which information will the nurse obtain to assist with the use of this resource?

A. Devise a plan of care for a newly admitted client

B. Predict the client's prognosis of treatment outcomes

C. Document the appropriate diagnostic code in the client's medical record

D. Use as a guide for client assessment

ANS: D. Use as a guide for client assessment

5. A client with the inability to work due to relapsing schizophrenia is receiving Social Security Benefits. Which benefit will this provide to the client experiencing serious mental illness?

A. The client will be able to maintain some level of independence financially.

B. The client will have the option to only obtain inpatient treatment.

C. The client will be able to pay all of their bills as well as purchase medication.

D. The client will have the ability to obtain psychiatric service regardless of setting.

ANS: A. The client will be able to maintain some level of independence financially.

The nurse working in the ED of an urban hospital notifies the manager that there are several clients with mental health disorders still present in the ED that have been there over 48 hours. Which issue related to this phenomenon does the nurse discuss with the manager?

A. Temporary detaining orders for clients

B. Decision to practice boarding

C. The revolving door for clients

D. The cost of holding clients in the ED for over 48 hours

ANS: B. Decision to practice boarding

The nurse is working in an inpatient mental health facility and caring for several clients. Which client is most likely to experience the revolving door phenomenon?

A. A client living with both parents that adheres to a prescribed medication regimen

B. A client with a dual diagnosis of heroin use disorder and bipolar I disorder

C. A client that has depression on antidepressants receiving electroconvulsive therapy.

D. A client with an acute situational crisis due to a natural disaster

ANS: B. A client with a dual diagnosis of heroin use disorder and bipolar I disorder

The nurse is caring for clients in an outpatient facility for those that have persistent or severe mental health disorders. Which factor(s) does the nurse assess that indicates the outcome of nontreatment of this client population? Select all that apply.

A. Seeking assistance from other mental health providers

B. Criminal behavior and incarceration

C. Deterioration of personal relationships

D. Worsening of the untreated mental health disorder

E. Physical health disorders

ANS:

B. Criminal behavior and incarceration

C. Deterioration of personal relationships

D. Worsening of the untreated mental health disorder

E. Physical health disorders

Which significant change in the treatment of people with mental illness occurred in the 1950s?

A. Community support services were established.

B. Legislation dramatically changed civil commitment procedures.

C. The Patient's Bill of Rights was enacted.

D. Psychotropic drugs became available for use.

ANS: D. Psychotropic drugs became available for use.

Prior to the period of the enlightenment, which treatment of the mentally ill was prevalent?

A. Creating large institutions to provide custodial care

B. Focusing on religious education to improve their souls

C. Placing the mentally ill on display for the public's amusement

D. Providing a safe refuge or haven offering protection

ANS: C. Placing the mentally ill on display for the public's amusement

11. The nurse is caring for a young adult client that is unable to work due to chronic schizophrenia and the inability to procure the required medications for treatment. Which referral to the case manager will the nurse make to assist the client in obtaining the needed medications?

A. Social Security Administration

B. A private insurance company

C. Medicaid services

D. Permanent inpatient psychiatric placement

ANS: C. Medicaid services

A client is experiencing a "revolving door effect" due to their mental health disorder. Which is the meaning behind this phenomenon?

A. An overall reduction in incidence of severe mental illness

B. Shorter and more frequent hospital stays for persons with severe and persistent mental illness

C. Flexible treatment settings for the mentally ill

D. Most effective and least expensive treatment settings

ANS: B. Shorter and more frequent hospital stays for persons with severe and persistent mental illness

The nurse is talking with family members of a client with a mental health disorder, and they are relaying their issues with the treatment of their family member in general. Which statement by the nurse to the client's family will provide them with an explanation for this issue?

A. Substance use disorder is effectively treated with brief hospitalization.

B. Financial resources are reallocated from state hospitals to community programs and support.

C. Only one in four people needing mental health services are receiving those services.

D. Emergency department visits by persons who are acutely disturbed are declining.

ANS: C. Only one in four people needing mental health services are receiving those services.

The nurse is providing an educational seminar for the nursing staff including objectives from Healthy People 2030. Which priority objective for mental health does the educator include?

A. Improved inpatient care

B. Primary prevention of emotional problems

C. Stress reduction and management

D. Treatment of mental illness

ANS: D. Treatment of mental illness

A novice nurse is beginning work on a behavioral health unit and states to the preceptor, "What if I encounter a client that is sexually aggressive?" Which is the appropriate response by the preceptor?

A. "It happens frequently so just ignore it, they will stop."

B. "Walk away and have someone else take care of the client."

C. "Set firm limits and boundaries for the client."

D. "Tell the client that you are going to report to the director of the unit"

ANS: C. "Set firm limits and boundaries for the client."

A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Which treatment will be most beneficial that the client will receive in this setting?

A. Medical management of symptoms

B. Daily psychotherapy

C. Constant staff supervision

D. Psychological stabilization

ANS: A. Medical management of symptoms

Nursing education is broad in practice settings. The addition of psychiatric nursing became a requirement in nursing education in 1950 by which regulation?

A. State Boards of Nursing

B. American Nurses Association

C. National League of Nursing

D. Nurse Practice Act

ANS: C. National League of Nursing

A novice nurse accepts a staff position at an inpatient mental health facility. Which basic-level responsibility will the nurse expect to have?

A. Providing clinical supervision

B. Using effective communication skills

C. Adjusting client medications

D. Directing program development

ANS: B. Using effective communication skills

A psychiatric-mental health nurse is conducting an in-service program for a group of nurses which includes a review about the American Nurses Association standards of practice for psychiatric-mental health nursing. After describing these standards, the nurse determines that the teaching was successful when the group identifies which information?

A. Prescriptive authority is granted to any psychiatric-mental health registered nurses.

B. All aspects of the standard for implementation apply to psychiatric-mental health registered nurses

C. Advanced practice nurses have a different set of standards from those of the psychiatric-mental health registered nurse.

D. Psychiatric-mental health advanced practice nurses are the only ones who may provide psychotherapy.

ANS: C. Advanced practice nurses have a different set of standards from those of the psychiatric-mental health registered nurse.

The nurse identifies that mental health issues are constantly evolving. Which is a standard of professional performance to keep in current practice?

A. Assessment

B. Education

C. Planning

D. Implementation

ANS: B. Education

The student nurse is working in a forensic unit of the psychiatric inpatient facility. Which is the nurse's priority action when a client becomes aggressive?

A. Assist other staff on the unit to take down the client safely

B. Maintain a safe distance from the client and call for assistance

C. Keep the client secluded from others

D. Reinforce boundaries when aggression is seen to maintain a safe environment

ANS: B. Maintain a safe distance from the client and call for assistance

The geriatric psychiatry nurse reviews the DSM-5-TR for the specific criteria associated with a client's diagnosis. Which purpose does the nurse identify will be obtained from reviewing this data? Select all that apply.

A. To provide the practitioner with standards of care for all clients

B. To provide a standardized nomenclature and language for all mental health professionals

C. To provide standards for hospital and community-based institutions

D. To present defining characteristics or symptoms that differentiate specific diagnoses

E. To assist in identifying the underlying causes of disorders

ANS:

B. To provide a standardized nomenclature and language for all mental health professionals

D. To present defining characteristics or symptoms that differentiate specific diagnoses

E. To assist in identifying the underlying causes of disorders

If a client states, "I carry this lucky rabbit's foot for luck, my parent did too, and it really works," which statement by the nurse reflects respect for the client's belief?

A. "A rabbit's foot has never brought me luck. I don't know why people carry them."

B. "Yes, the rabbit's foot can bring luck to some."

C. "I can accept that you feel it is lucky, so let's get to our activities for the day."

D. "It is not appropriate to harm small animals for their parts."

ANS: C. "I can accept that you feel it is lucky, so let's get to our activities for the day."

A client with schizophrenia has been noncompliant with medications. The client requires frequent admissions to the psychiatric unit for acute psychotic episodes. Which process does the nurse address when creating a plan of care for the client?

A. Escalated admissions

B. Revolving door

C. Deinstitutionalization

D. Boarding

ANS: B. Revolving door

The nurse is revising policies on the behavioral health unit to align with current standards of practice to ensure safe, quality care. Which regulations that guide the nursing profession will guide the nurse?

A. APNA (American Psychiatric Nurses Association)

B. DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders-5th ed.)

C. ANA (American Nurses Association)

D. USDHHS (U. S. Department of Health and Human Services)

ANS: C. ANA (American Nurses Association)

The nurse is preparing a client for a magnetic resonance imaging (MRI). Which statement(s) by the client would require the nurse to notify the health care provider to cancel the procedure? Select all that apply.

A. "I have such terrible anxiety, I don't know if I can remain still throughout the procedure."

B. "I had a pacemaker inserted a few years ago because my heart was not beating fast enough."

C. "I fell down my basement steps last year and broke my hip and had to have a hip replacement."

D. "When I was diagnosed with mitral valve prolapse, they had to replace the valve with a prosthetic valve."

E. "I have diabetes mellitus type I and have been taking insulin for many years."

ANS:

B. "I had a pacemaker inserted a few years ago because my heart was not beating fast enough."

C. "I fell down my basement steps last year and broke my hip and had to have a hip replacement."

D. "When I was diagnosed with mitral valve prolapse, they had to replace the valve with a prosthetic valve."

A client diagnosed with bipolar disorder states to the nurse, "Why did I get this illness? I don't want to be sick." Which response will the nurse provide to best response to the client's concern?

A. "People who develop mental illnesses often had very traumatic childhood experiences."

B. "There is some evidence that contracting a virus during childhood can lead to bipolar disorder."

C. "Sometimes people with mental illness have an overactive immune system."

D. "The cause is not fully known, but mental illnesses do seem to run in families."

ANS: D. "The cause is not fully known, but mental illnesses do seem to run in families."

A client is prescribed a tricyclic antidepressant for the treatment of depression that has not responded to selective serotonin reuptake inhibitors (SSRI). The client states, "This medication isn't working after 2 weeks of taking it." Which is the best response by the nurse?

A. "You should stop taking the medication since it is not working and try electroconvulsive therapy (ECT)."

B. "It is likely that you are immune to the medication actions and will need something else."

C. "Since you took the SSRIs, this medication may not work as well for you."

D. "This medication may take up to 6 weeks to reach the optimum therapeutic response."

ANS: D. "This medication may take up to 6 weeks to reach the optimum therapeutic response."

The nurse is educating a client about newly prescribed Asenapine for the treatment of schizophrenia. Which statement made by the client indicates the education is effective?

A. "I will swallow the pill and immediately follow with 8 ounces of water or clear fluid."

B. "I will come to the office once a month to have injections done so the medication will be more effective."

C. "The medication will dissolve under my tongue and I won't eat or drink for 10 minutes after it dissolves."

D. "I need to take this medication with a meal to reduce the gastrointestinal side effects."

ANS: C. "The medication will dissolve under my tongue and I won't eat or drink for 10 minutes after it dissolves."

The nurse administers olanzapine pamoate IM to a client with schizophrenia. Which action by the nurse is essential after the administration of the medication to prevent complications from post-injection delirium/sedation syndrome?

A. Directly observe the client for 3 hours after injection and do not discharge until symptom free.

B. Admit the client to the behavioral health unit for 24 hours to monitor for improvement of hallucinations.

C. Administer benztropine to prevent extrapyramidal symptoms after the injection.

D. Have the client eat a full meal before discharge to decrease the rate of absorption.

ANS: A. Directly observe the client for 3 hours after injection and do not discharge until symptom free.

The nurse is preparing a client for a magnetic resonance imaging (MRI) scan of the head. Which question is a priority for the nurse to ask the client?

A. "Have you ever had an allergic reaction to radioactive dye?"

B. "Have you had anything to eat in the last 24 hours?"

C. "Does your insurance cover the cost of this scan?"

D. "Are you anxious about being in tight spaces?"

ANS: D. "Are you anxious about being in tight spaces?"

The nurse is educating a family member of a client suspected to have Alzheimer's disease. Which statement made by the family member indicates that the education is effective?

A. "It is impossible to know for certain that a person has Alzheimer's disease until the person dies and their brain can be examined via autopsy."

B. "If we get a positron emission tomography (PET) scan, it may identify amyloid plaques and tangles of Alzheimer's disease."

C. "It's possible to diagnose Alzheimer's disease by using chemical markers that demonstrate decreased blood flow to the brain."

D. "It will be necessary to undergo positron emission tomography (PET) scans regularly for a long period of time to know if the client has Alzheimer's disease."

ANS: B. "If we get a positron emission tomography (PET) scan, it may identify amyloid plaques and tangles of Alzheimer's disease."

The nurse is performing a medication reconciliation for a client at a high risk for suicide. Which antidepressant drug identified by the nurse will be best in the treatment of this client and reduces the risk of lethal overdose?

A. Tranylcypromine

B. Sertraline

C. Imipramine

D. Phenelzine

ANS: B. Sertraline

A client is prescribed a monoamine oxidase inhibitor (MAOI) for treatment of severe depression. Which statement made by the client indicates that there is understanding of education provided by the nurse related to dietary restrictions?

A. "I am now allergic to foods that are high in the amino acid tyramine."

B. "Certain foods will cause me to have sexual dysfunction when I take this medication."

C. "Foods that are high in tyramine will reduce the medication's effectiveness."

D. "I will avoid foods that are high in the amino acid tyramine since they can cause severe side effects"

ANS: D. "I will avoid foods that are high in the amino acid tyramine since they can cause severe side effects"

A client prescribed disulfiram experiences facial flushing, a throbbing headache, nausea, and vomiting and states to the nurse that "I only drank one beer." Which is the best response by the nurse?

A. "This is a mild side effect of the medication, and one beer shouldn't cause the reaction."

B. "The reaction that you experienced is an expected response with the ingestion of alcohol."

C. "This is an idiosyncratic reaction to the medication and is an expected response to treatment."

D. "You must have a severe allergy to disulfiram that you were not aware of and will need to stop the medication."

B. "The reaction that you experienced is an expected response with the ingestion of alcohol."

When the client asks the nurse how long it will take before the selective serotonin reuptake inhibitor (SSRI) antidepressant medication will be effective, which reply is most accurate and therapeutic?

A. "This medication will be effective within 20 minutes of the first dose."

B. "You will have gradual improvement in symptoms over the next 4 to 6 weeks."

C. "It will probably take months for the medication to work. In the meantime, you should receive psychotherapy."

D. "It is dependent on how depressed you are. It takes longer the more depressed you are."

ANS: B. "You will have gradual improvement in symptoms over the next 4 to 6 weeks."

A client has a lithium level of 1.2 mEq/L (1.2 mmol/L). Which intervention by the nurse is indicated?

A. Call the health care provider for an increase in dosage

B. Do not give the next dose and call the health care provider

C. Increase fluid intake for the next week

D. No intervention is necessary at this time

ANS: D. No intervention is necessary at this time

A client is seen for frequent exacerbation of schizophrenia due to nonadherence to medication regimen. The nurse will assess for which common contributor to nonadherence?

A. The client is symptom-free and therefore does not need to adhere to the medication regimen.

B. The client cannot clearly see the instructions written on the prescription bottle.

C. The client dislikes the weight gain associated with antipsychotic therapy.

D. The client sells the antipsychotics to addicts in the neighborhood.

ANS: C. The client dislikes the weight gain associated with antipsychotic therapy.

The nurse is educating a client and family about strategies to minimize the side effects of antipsychotic drugs. Which will be included in the plan? Select all that apply.

A. Drink plenty of fruit juice.

B. Develop an exercise program.

C. Increase foods high in fiber.

D. Use laxatives as needed.

E. Use sunscreen when outdoors.

F. Take double the dose at the next scheduled time for missed doses

ANS(S):

B. Develop an exercise program.

C. Increase foods high in fiber.

E. Use sunscreen when outdoors.

The nurse has completed health teaching about dietary restrictions for a client taking a monoamine oxidase inhibitor. Which statement made by the client indicates that teaching is effective?

A. "I'm glad I can eat pizza since it's my favorite food."

B. "I must follow this diet or I will have severe vomiting."

C. "It will be difficult for me to avoid pepperoni."

D. "None of the foods that are restricted are part of a regular daily diet."

ANS: C. "It will be difficult for me to avoid pepperoni."

A nurse is formulating a teaching plan for a client with newly diagnosed depression and the client's family. The teaching plan includes medication, activities, and family support. Which statement made by the client indicates teaching is effective?

A. Medication should be taken only when feeling depressed and resists family activities.

B. Medication should be taken on schedule only, and activities should be twice a week to prevent weight gain.

C. Missed dosages should be taken right away, even when it is close to the next dose time, and activities should be increased.

D. It may take a few weeks for the medication to become effective; activity will help to foster compliance

ANS: D. It may take a few weeks for the medication to become effective; activity will help to foster compliance

A nurse is instructing a client on taking lithium for bipolar disorder and the need for blood to be drawn every 2 to 3 days initially. The client states, "I am going to have a hard time getting back every 2 days. Why is this important?" Which is the best response by the nurse?

A. "We want to determine if there is a rebound effect occurring."

B. "It is important to determine if it is having the maximum therapeutic effect."

C. "The drug sample will determine the drugs potency and if it is enough for you."

D. "We want to determine how long the medication stays in your blood stream."

ANS: B. "It is important to determine if it is having the maximum therapeutic effect."

A nurse is administering a monoamine oxidase inhibitor (MAOI) to a client with depression. Prior to administration of the medication, which will the nurse include when providing information? Select all that apply.

A. If foods with tyramine are ingested, a hypertensive crisis may occur.

B. There may be interactions when taking other MAOIs and antidepressants.

C. There is a reduction in suicidal thoughts in clients with depression.

D. There is a risk for experiencing decreased libido and impotence.

E. Contact the health care provider prior to taking any over-the-counter medications.

ANS(S):

A. If foods with tyramine are ingested, a hypertensive crisis may occur.

B. There may be interactions when taking other MAOIs and antidepressants.

D. There is a risk for experiencing decreased libido and impotence.

E. Contact the health care provider prior to taking any over-the-counter medications.

A nurse is recording subjective information from the family of a client with aggressive behaviors brought to the ED via ambulance. Family member states the client does not adhere to the prescribed medication regimen. Which statement by the family determines the family member's understanding of the client's illness?

A. "We know the intention was not to take medications, as it was relayed medication was no longer needed."

B. "Because of mental illness, my sibling cannot think clearly or understand the need for meds."

C. "This situation occurs because of thoughts that no one cares and to get attention."

D. "This 'mental illness' is used as an excuse to get away with aggressive behavior for years."

ANS: B. "Because of mental illness, my sibling cannot think clearly or understand the need for meds."

A child with ADHD just started school and the parent discusses medication administration while the child is in school and effectiveness. The parent asks, "Are there any medications that do not require being given at school?" Which is the appropriate response to the parent?

A. "Yes, there are medications that are sustained release and would not require being given at school."

B. "You will need to speak to the superintendent about medications regarding your child."

C. "Only the nurse can administer stimulants to a child during school hours."

D. "You child will need to bring their medications to me each day."

ANS: A. "Yes, there are medications that are sustained release and would not require being given at school."

The nurse is educating the parent of a child being treated with stimulants for attention-deficit hyperactivity disorder (ADHD). The parent states the child's weight and growth are being affected. Which is the best response by the nurse?

A. "Encourage the child to sit at the table and eat larger meals until finished."

B. "Provide 'drug-holidays' on weekends, holidays, and during summer vacation."

C. "This side effect of the medication does not last and the child will catch-up."

D. "There may be something else going on with the child that is affecting height and weight."

ANS: B. "Provide 'drug-holidays' on weekends, holidays, and during summer vacation."

The nurse is assessing a client weaning from a selective serotonin reuptake inhibitor (SSRI) to a monoamine oxidase inhibitor (MAOI) with a heart rate of 104, profuse diaphoresis, temperature 102°F (38.9°C), BP 98/58 mm Hg, and hyperreflexia. Which condition will the nurse educate the client regarding after stabilization of the current acute phase?

A. Tardive dyskinesia

B. Allergic reaction to the MAOI

C. Malignant hyperthermia

D. Serotonin syndrome

ANS: D. Serotonin syndrome

The nurse is assessing a male client taking antipsychotic medication for the treatment of bipolar I and acute mania. The client reports breast tenderness and breast tissue enlargement, erectile dysfunction and an inability to achieve orgasm. Which action will the nurse perform after notifying the health care provider?

A. Educate that these symptoms will stop soon after taking the medication.

B. Have the client discontinue the use of the medication.

C. Obtain a prolactin level and report results to the health care provider.

D. Have the client take diphenhydramine to counter the allergic reaction.

ANS: C. Obtain a prolactin level and report results to the health care provider.

The nurse is assisting a client being treated with phenelzine to choose from a menu for lunch. Which lunch choice will the nurse educate the client to avoid to prevent the potential for complications?

A. Baked chicken, mashed potatoes, and green peas

B. Lasagna, tossed salad with blue cheese dressing, and garlic bread

C. Pork chop with barbecue sauce, baked sweet potato with butter and cinnamon

D. Hamburger on a bun, French fries, and green beans

ANS: B. Lasagna, tossed salad with blue cheese dressing, and garlic bread

The nurse is educating a client with anxiety that is prescribed alprazolam by the health care provider. Which statement made by the client indicates that further education is required? Select all that apply.

A. "Taking this medication will alleviate the problems associated with the anxiety."

B. "I can still have one or two alcoholic beverages while I am taking this medication."

C. "When I am feeling better in a few months, I can stop taking this medication."

D. "I may have slower response time while driving or operating heavy machinery."

E. "Withdrawing from this medication requires a health care provider's supervision."

ANS:

A. "Taking this medication will alleviate the problems associated with the anxiety."

B. "I can still have one or two alcoholic beverages while I am taking this medication."

C. "When I am feeling better in a few months, I can stop taking this medication."

A client who has continuously experienced severe symptoms of schizoaffective disorder for the past 17 years is experiencing an acute psychotic episode. Which level of care is most appropriate for this client at this time?

• A) Partial hospitalization

• B) Residential treatment

• C) Inpatient hospital treatment

• D) Clubhouse

C) Inpatient hospital treatment

A client with depression is admitted to an inpatient hospital unit for treatment. Which type of therapy will the client receive in this setting to meet the goals of therapy?

• A) Leisure skills

• B) Self-monitoring of treatment

• C) Skills for daily living

• D) Talk therapy

• C) Skills for daily living

A client is being transferred from a group home to a group household. Which is the goal of this transition for the client?

• A) Meet with a therapist on a weekly basis.

• B) Resolve crises within a shorter time period.

• C) Fulfill daily responsibilities without supervision.

• D) Use the increased emotional support of paid staff.

• C) Fulfill daily responsibilities without supervision.

The nurse and health care team identified the benefits of using the transitional care discharge model being used in other countries. Which are the two essential components of this model?

• A) Peer support and bridging staff

• B) Collaboration and funding

• C) Relapse and hospitalization

• D) Poverty and entitlements

• A) Peer support and bridging staff

The nurse is discharging a client into a transitional residential treatment program. Which will the nurse identify as the expectation of the client to be accepted into this program?

• A) No longer need therapy.

• B) Find employment.

• C) No longer need medication.

• D) Relocate to another setting.

D) Relocate to another setting.

A client is attending a psychiatric rehabilitation program after having been in inpatient care for the treatment of relapsing schizophrenia. When creating the plan of care, which will be the primary outcome for this client?

• A) The client will return to prior level of functioning.

• B) The client will be adherent to the medication regimen.

• C) The client will have an improvement in the quality of life.

• D) The client will have stabilization and management of symptoms.

C) The client will have an improvement in the quality of life.

The nurse is discharging a client to a community rehabilitation area that will provide the client with meaningful work, relationships, a place to come to, and a place to return if necessary. Which type of referral will the nurse make?

• A) Clubhouse model

• B) Assertive community treatment

• C) Group homes

• D) Respite housing

A) Clubhouse model

A nurse is meeting with the city council to advocate for mentally ill persons and the establishment of a group home in a neighborhood where the plans have been strongly opposed by the neighbors. The nurse can effectively educate the public on the realities of a group home by citing research that indicates:

• A) property values quickly rebound in neighborhoods that have group homes.

• B) police surveillance will be increased to avert any violence by residents.

• C) most people with mental illness do not represent a significant danger to others.

• D) neighborhoods that provide park areas provide children a centralized and safe place to play.

C) most people with mental illness do not represent a significant danger to others.

The nurse is part of a group setting up a mobile crisis service in conjunction with the local police department. Which will be the team's educational focus for the community?

• A) Teaching police officers counseling skills.

• B) Providing crisis counseling services in the prison system.

• C) Educating about the dangers of the mentally ill in the community.

• D) Assisting police officers to recognize mental illness.

D) Assisting police officers to recognize mental illness.

A client is encouraged to join in daily outdoor games with peers on the unit. Which interdisciplinary team member will monitor the client's involvement?

• A) Occupational therapist

• B) Recreation therapist

• C) Vocational rehabilitation therapist

• D) Psychiatric nurse

B) Recreation therapist

A psychiatric nurse is planning activities aimed at secondary prevention of mental illness. Which activity would be most appropriate to develop?

• A) Self-esteem building with a local after-school program

• B) Social skills training for chronic schizophrenics

• C) Parenthood classes at a local community center

• D) Depression screening in an assisted living facility

D) Depression screening in an assisted living facility

A nurse is planning to discharge a client that has a mental health disorder. Which factor does the nurse identify that is the best chance for the client to remain in the community without readmission?

• A) Living environment

• B) Participation in social events

• C) Taking meals at the food bank

• D) Supporting neighborhood watch programs

A) Living environment

The nurse is performing an admission assessment for a client with exacerbated severe schizophrenia resulting from nonadherence to the prescribed medication regimen. Which priority inpatient care will be initiated for this client?

• A) Symptom management

• B) Family issues

• C) Insight into illness

• D) Social skills

A) Symptom management

A client is diagnosed with a methamphetamine substance use disorder, an intellectual development disorder, and has been repeatedly admitted to inpatient facilities for treatment. Which treatment option will the nurse advocate for the client?

• A) Integrated care

• B) Permanent inpatient commitment

• C) Electroconvulsive therapy

• D) Split care

A) Integrated care

A client is diagnosed with a methamphetamine substance use disorder, an intellectual development disorder, and has been repeatedly admitted to inpatient facilities for treatment. Which treatment option will the nurse advocate for the client?

A) Integrated care

B) Permanent inpatient commitment

C) Electroconvulsive therapy

D) Split care

A) Integrated care

The nurse is preparing the discharge of a client that is hospitalized after an exacerbation of a manic episode due to bipolar I disorder. Which action(s) are a priority during discharge planning from inpatient care for this client? (Select all that apply.)

• A) Finding housing for the client

• B) Finding a job for the client

• C) Finding transportation for the client

• D) Improving family support

• E) Identifying ideal recreational activities

A) Finding housing for the client

C) Finding transportation for the client

The nurse is working with the case manager for the client's discharge to a facility that uses a transitional care model. Which does the nurse identify as the benefit of using this model for the client to prevent relapse and rehospitalization? (Select all that apply.)

• A) Collaboration

• B) Administrative support

• C) Adequate funding

• D) Family support

• E) Completely different providers

• F) Isolation from peers who successfully live in the community

A) Collaboration

B) Administrative support

C) Adequate funding

D) Family support

A client has just begun daily participation in a community-based partial hospitalization program. The client can expect the nurse and staff to assist with which treatment goals? (Select all that apply.)

• A) Stabilizing psychiatric symptoms

• B) Finding a better job

• C) Improving activities of daily living

• D) Learning about the illness

• E) Improved family support

• F) Developing social skills

A) Stabilizing psychiatric symptoms

C) Improving activities of daily living

D) Learning about the illness

F) Developing social skills

A client has been referred to a psychosocial rehabilitation program. When explaining the benefits of such a program, which information will the nurse include? (Select all that apply.)

• A) Continuous close monitoring of symptoms

• B) Increased level of independence

• C) Increased involvement in treatment decisions

• D) Progress to recovery from mental illness

• E) Increased community integration

• F) Greater opportunities for personal growth

B) Increased level of independence

C) Increased involvement in treatment decisions

D) Progress to recovery from mental illness

E) Increased community integration

F) Greater opportunities for personal growth

A nurse is meeting with the city council to advocate for mentally ill persons and the establishment of a group home in a neighborhood where the plans have been strongly opposed by the neighbors. Which education will the nurse provide when discussing the group home? (Select all that apply.)

• A) Property values quickly rebound in neighborhoods that have group homes.

• B) Police surveillance will be increased to avert any violence by residents.

• C) It is designed to assist clients in dealing with mental health crises without hospitalization.

• D) Most people with mental illness do not represent a significant danger to others.

• E) Neighborhoods that provide park areas provide children a centralized and safe place to play.

C) It is designed to assist clients in dealing with mental health crises without hospitalization.

D) Most people with mental illness do not represent a significant danger to others.

The nurse is working with a client diagnosed with depression that recently came home from a deployment in a war zone. Which action(s) can the nurse discuss with the client to help them transition back into a noncombat post? (Select all that apply.)

• A) Finding an effective method for stress relief and relaxation

• B) Incorporating nutritious foods in the diet

• C) Address a spiritual connection to help refocus

• D) Making a referral for family therapy

• E) Consider electroconvulsive therapy to treat the depression

A) Finding an effective method for stress relief and relaxation

B) Incorporating nutritious foods in the diet

C) Address a spiritual connection to help refocus

D) Making a referral for family therapy

A client with bipolar disorder who has been recently hospitalized has a long history of both hospitalizations and incarcerations. The client has no permanent residence and has infrequent contact with family. Which statement by the client would the nurse evaluate as indicating a positive outcome for this client?

• A) "I've been meeting with my case manager on a weekly basis."

• B) "I've been lucky finding places to stay for several days at a time."

• C) "I think I talked with my siblings about a year or so ago."

• D) "I did some day work for a couple of days last month."

A) "I've been meeting with my case manager on a weekly basis."

The nurse experiences resistance from community members when attempting to discharge a client to a group home in the area. What action will a nurse take to address the community resistance?

• A) Provide targeted community education about mental health stigma.

• B) Advocate for compensation for the neighborhood residents.

• C) Arrange services to provide security surveillance of the neighborhood.

• D) Refrain from engaging with community residents until the client has settled in.

• A) Provide targeted community education about mental health stigma.

The nurse and case worker are attempting to discharge a client with mental illness and behavioral concerns into a community-based residential setting. Based on known systemic barriers to community placement, which factor is most likely preventing successful discharge?

• A) Public resistance for mentally ill clients in the community

• B) The client's request to have a private room with a television

• C) Client refusal to adhere to medication regimen

• D) Lack of nearby community green spaces for outdoor activity

A) Public resistance for mentally ill clients in the community

A nurse reviews a client's history and knows that, in preparation for discharge planning, what barriers may impede the achievement of planning goals? (Select all that apply.)

• A) Alcohol and substance use disorder

• B) Violent or criminal behaviors

• C) Medication noncompliance

• D) Inability to secure employment

• E) Evolving community

A) Alcohol and substance use disorder

B) Violent or criminal behaviors

C) Medication noncompliance