NURS 230 Chapter 4: Treatment Settings and Therapeutic Programs

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) "It may be that you are experiencing symptoms of obsessive-compulsive disorder also."

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