ATI - Foundational Concepts of Mental Health Nursing

A nurse is preparing an in-service for nursing staff on the concept of holistic nursing. Which of the following components should the nurse include in the teaching?

a) Holistic nursing considers the client's emotional health

b) Practicing holistic nursing requires certification beyond nursing license

c) Assessment of holistic client practices is limited to outpatient settings

d) Holistic nursing care is limited to spiritual health practices

a) Holistic nursing considers the client's emotional health

***Holistic nursing care considers the client's physical, emotional, social, spiritual, and intellectual health.

A nurse is planning a presentation regarding mental illness for a local health fair. Which of the following should the nurse include as a characteristic of mental illlness?

a) Resilience following a loss of a job

b) Difficulty maintaining social relationships

c) Volunteering at a crisis center

d) Ending a friendship with an individual who demands participation in dangerous activities

b) Difficulty maintaining social relationships

***Mental illnesses are associated with distress and/or problems functioning in social, work, or family activities.

A nurse is reviewing the concept of bias with a newly licensed nurse. Which of the following scenarios should the nurse use to demonstrate biased treatment

a) A client is not permitted to attend the group therapy activity due to wanting to harm another peer in the group.

b) A client is not permitted to attend the group therapy activity due to having a family therapy session during the same time.

c) A client is not permitted to attend the group therapy activity due to having thoughts of harming themselves with "anything they can find."

d) A client is not permitted to attend the group therapy activity because they practice the Buddhist faith.

d) A client is not permitted to attend the group therapy activity because they practice the Buddhist faith.

***Bias is when treatment of a client is verified in the form of stereotyping, prejudice, or discrimination. Therefore, this scenario demonstrates biased treatment.

A nurse is discussing the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revisions (DSM-5 TR) with a newly licensed practical nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the DSM-5?

a) "I would use the DSM-5 TR to diagnose clients who have mental health disorders."

b) "The DSM-5 TR assists in planning nursing interventions for clients who have a mental health disorder."

c) "I would use the DSM-5 TR as a guide instructing what specific criteria or questions should be asked for a suspected mental health diagnosis."

d) "The DSM-5 TR tells how to treat a patient who has a mental health diagnosis."

b) "The DSM-5 TR assists in planning nursing interventions for clients who have a mental health disorder."

***Nurses often use the DSM-5 TR diagnostic information to assist with planning, implementing, and evaluating client care. This information can guide nursing interventions for specific needs.

A nurse is caring for a client who is newly admitted to the acute psychiatric unit for alcohol use disorder. The client reports growing up in a Amish community. Which of the following actions should the nurse take?

a) Inform the client that the nurse follows Judaism.

b) Provide the client with a Bible.

c) Assess for personal bias related to alcohol use disorder before interacting with the client.

d) Ask the client where they grew up practicing Amish traditions.

c) Assess for personal bias related to alcohol use disorder before interacting with the client.

***To ensure the nurse does not have any bias in their treatment of the client, the nurse should first understand what their own culture and biases are to not hinder client care.

A nurse is preparing a poster presentation on the priorities of Healthy People 2030. Which of the following priority goals should the nurse include?

a) The practice of trephination for the treatment of mental illness

b) Prevention practices related to cyber-bullying in teens

c) Increasing institutionalization of clients who have severe mental health disorders

d) Limit screening of mental illness to those individuals who display manifestations

b) Prevention practices related to cyber-bullying in teens.

***Cyber-bullying is a stressor that can result in mental health disorders. By implementing practices targeted at prevention of cyber-bullying, the priority goal of prevention of mental health disorders is met.

A nurse is explaining what a "duty to warn" means to a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding?

a) "If a client threatens to harm another person, health care providers have a responsibility to inform that person."

b) "If a client threatens to harm themselves, there is a responsibility to report that client to their family."

c) "If a client threatens to harm themselves, there is a responsibility to tell their medical provider."

d) "If a client threatens to harm another person, there is a responsibility to inform the other person's family."

a) "If the client threatens to harm another person, health care providers have a responsibility to inform that person."

***A health care provider has a "duty to warn" when there is a threat from a client to another person to cause harm to them.

A nurse is reviewing the chart of a client who has paranoid schizophrenia. The nurse should identify that the DSM-5 TR distinguishes the different types of schizophrenia based on which of the following criteria?

a) Current medication history

b) When the manifestations started

c) Family history of mental illness

d) The client's full history

d) The client's full history.

***The DSM-5 TR criteria can be broken down based on the client's manifestations obtained during the complete health history.

A nurse is discussing different factors of the determinants of mental health during a staff meeting. Which of the following factors should the nurse include in the discussions?

a) Receiving paid maternity leave

b) Unsafe drinking water

c) Exposure to an adverse childhood event

d) A playground in the neighborhood

e) National policy addressing cyber-bullying

b) Unsafe drinking water

c)Exposure to an adverse childhood event

d) A playground in the neighborhood

e) National policy addressing cyber-bullying

***Unsafe drinking would be considered a household factor. Without access to necessary resources such as food and water, the client is at increased risk for the development of mental health disorders. An exposure to an adverse event is in the category of life-course.A playground in the neighborhood is a protective factor that would fall under the category of community. National policies that protect against instances of cyber-bullying would be a protective factor under the category of country level factors.

A nurse is caring for a client who reports that they are having a hard time completing their ADLs due to feeling anxious. The client also reports feeling tired, difficulty sleeping, and having a poor appetite. The nurse should anticipate they would fall in which end of the mental health continuum?

a) The client would fall closer towards the mental illness end or struggling.

b) The client would fall closer towards the mental health end or thriving.

c) The client would not clearly fall on the mental health continuum as they do not have a mental illness diagnosis.

d) The client should be evaluated by the provider before their observance on the mental health continuum is noted, as currently they would fall in the middle.

a) The client would fall closer towards the mental illness end or struggling.

***The mental health continuum is a range of responses a person displays in response to life events. The ends vary between positive and negative responses, often viewed as mental health versus mental illness.

A nurse is presenting information on mental health services over the last 50 years to a group of newly licensed nurses. In 1946, the National Mental Health Act was signed into law which resulted in which of the following?

a) The establishment of the mental health court to determine soundness or fitness to stand trial

b) The development of mental health centers throughout community settings

c) The creation of the National Institute for Mental Health

d) The coverage of mental health services for children and youth

c) The creation of the National Institution for Mental Health.

***The National Mental Health Act created the National Institute of Mental Health. The need for psychiatric services has increased over the years, specifically following World War II. The National Mental Health Act was signed in 1946 by President Harry Truman. This called for a National Institute of Mental Health, and the first meeting of the council took place that same year. The National Institute of Mental Health is a federal agency that researches mental illness and was a pioneer in assisting in the transformation of treatment and understanding of mental illnesses.

A nurse is discussing ethical principles with another nurse. Which of the following should the nurse include as an example of the principle of nonmaleficence?

a) A nurse evaluates the client's desire for autonomy while considering the personal safety of other clients on the unit.

b) A nurse encourages the client to determine which therapeutic activity they would like to participate in.

c) A nurse plans to spend equal amounts of time with each client assigned to their care.

d) A nurse makes a referral to speech therapy for a client who is experiencing dysphagia.

a) A nurse evaluates the client's desire for autonomy while considering the personal safety of other clients on the unit.

***The principle of nonmaleficence involves doing no harm. By weighing the risks and benefits of the client's desire for autonomy while considering the safety of the other clients on the unit, the nurse is practicing nonmaleficence.

A charge nurse is presenting on the topic of mental health diagnoses during a unit meeting. The charge nurse should identify that the DSM-5 TR classification is used in conjuction or paired with what other classification system?

a) Nursing Intervention Classifications

b) Maslow's hierarchy of needs

c) International Classification of Disease

d) Erikson's Stages of Psychosocial Development

c) International Classification of Disease.

***The DSM-5 classification is often used in conjunction or paired with the World Health Organization's International Classification of Disease (ICD).

A nurse is working in a neighborhood where the population is culturally diverse. Which of the following actions should the nurse take to ensure the delivery of culturally competent care?

a) Reflect on their own culture.

b) Read a book about the countries of the residents' ancestry.

c) Talk to the residents of the neighborhood about their culture.

d) Provide care that meets the residents' needs.

c) Talk to the residents of the neighborhood about their culture.

***Cultural competence involves gaining knowledge about another individual's culture. Speaking to the residents of the neighborhood can assist the nurse in gaining this knowledge.

A nurse is providing teaching to a group of newly licensed nurses about stigma. Which of the following client scenarios should the nurse include as an example of self-stigma?

a) A client refuses to go to their provider for manifestations of anxiety until they meet with their cultural leader, a shaman.

b) A client stops taking their medication for anxiety because they do not like how it makes them feel.

c) A client refuses to pick up their prescription for an antidepressant because they do not want the pharmacist to know that they are on an antidepressant.

d) A client refuses a follow-up appointment for their anxiety because they are waiting until they can arrange transportation.

c) Client refuses to pick up their prescription for an antidepressant because they do not want the pharmacist to know that they are on an antidepressant.

***Self-stigma is when an individual has a negative view or internalized shame regarding their mental illness, often due to the public stigma of mental illness.

A newly licensed nurse is reviewing the American Nurses Association's core professional values of nursing. Which of the following actions by the nurse demonstrates the value of empowerment

a) The nurse becomes a trainer for new equipment for other nurses on the unit.

b) The nurse schedules care around the client's religious practices of daily prayer.

c) The nurse supports the autonomy of a client who refuses chemotherapy, even though their family wants it.

d) The nurse provides resources to the client who wants to create a living will before they have surgery.

d) The nurse provides resources to the client who wants to create a living will before they have surgery.

***The value of empowerment involves the use of decision making to solve problems for the client. Assisting a client in accessing the resources needed to create a living will is a demonstration of this value.

A nurse is caring for a newly admitted client who states they are concerned about their privacy and rights while on the psychiatric unit. The nurse should explain to the client that they have which of the following rights?

a) The right to refuse treatment

b) The right for their information to be shared with their family at any time

c) The right for their clinical notes to be shared with anyone at the facility

d) The right for providers to solely decide their treatment options

a) The right to refuse treatment.

***The right to self-determination allows a client to refuse treatment, including medications. Medication refusals for mental illness are often due to side effects of the stigma of taking such a medication.

A nurse is reviewing the medical records of a group of clients. The nurse should identify that which of the following factors places a client at risk for mental illness?

a) A family member with a diagnosis of diabetes

b) A medical diagnosis of diabetes

c) A history of using community support services

d) A history of abuse

d) A history of abuse.

***A history of abuse places a client at risk for mental illness.