Chapter 32 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 32

Question 1

Type: MCSA

The nurse is working with a client who is striving to meet the goal of psychiatric rehabilitation. The nurse knows the client is most likely to meet goals when:

1. Strengths and needs are acknowledged.

2. The nurse takes care of all the clients needs.

3. The client states he wants to go home.

4. The client wants family involved in recovery.

Correct Answer: 1

Rationale 1: Clients are more likely to be able to strive for and achieve treatment goals with an acknowledgement of their strengths and their needs. The client will grow dependent on the nurse who takes care of all the clients needs and this will not help to meet the goals of rehabilitation. The client stating he/she wants to go home or wanting the family involved in recovery are not proven methods for clients meeting their rehabilitative goals.

Rationale 2: Clients are more likely to be able to strive for and achieve treatment goals with an acknowledgement of their strengths and their needs. The client will grow dependent on the nurse who takes care of all the clients needs and this will not help to meet the goals of rehabilitation. The client stating he/she wants to go home or wanting the family involved in recovery are not proven methods for clients meeting their rehabilitative goals.

Rationale 3: Clients are more likely to be able to strive for and achieve treatment goals with an acknowledgement of their strengths and their needs. The client will grow dependent on the nurse who takes care of all the clients needs and this will not help to meet the goals of rehabilitation. The client stating he/she wants to go home or wanting the family involved in recovery are not proven methods for clients meeting their rehabilitative goals.

Rationale 4: Clients are more likely to be able to strive for and achieve treatment goals with an acknowledgement of their strengths and their needs. The client will grow dependent on the nurse who takes care of all the clients needs and this will not help to meet the goals of rehabilitation. The client stating he/she wants to go home or wanting the family involved in recovery are not proven methods for clients meeting their rehabilitative goals.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain the central concepts of recovery and psychiatric rehabilitation.

Question 2

Type: MCSA

The nurse knows that planning for recovery can begin:

1. At discharge.

2. Once the client expresses a need for greater autonomy.

3. At admission.

4. With an inflexible treatment team.

Correct Answer: 2

Rationale 1: Once clients express a need for greater autonomy, planning for recovery can begin. All involved parties must be flexible to the changing circumstances of stress and illness, triggers and relapse, barriers and overcoming them. Recovery is an individualized state defined by each client. It cannot be imposed from without; recovery must be achieved from within.

Rationale 2: Once clients express a need for greater autonomy, planning for recovery can begin. All involved parties must be flexible to the changing circumstances of stress and illness, triggers and relapse, barriers and overcoming them. Recovery is an individualized state defined by each client. It cannot be imposed from without; recovery must be achieved from within.

Rationale 3: Once clients express a need for greater autonomy, planning for recovery can begin. All involved parties must be flexible to the changing circumstances of stress and illness, triggers and relapse, barriers and overcoming them. Recovery is an individualized state defined by each client. It cannot be imposed from without; recovery must be achieved from within.

Rationale 4: Once clients express a need for greater autonomy, planning for recovery can begin. All involved parties must be flexible to the changing circumstances of stress and illness, triggers and relapse, barriers and overcoming them. Recovery is an individualized state defined by each client. It cannot be imposed from without; recovery must be achieved from within.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the central concepts of recovery and psychiatric rehabilitation.

Question 3

Type: MCSA

The nurse is working with a male client undergoing psychiatric rehabilitation. Which of the following actions by the client exhibits reaching a goal of rehabilitation?

1. Eating only one meal per day and drinking many energy drinks

2. Refusing to take prescribed medications

3. Doing his own laundry

4. Having his mother go grocery shopping for him

Correct Answer: 3

Rationale 1: One goal of rehabilitation is for the client to be able to do his own laundry. Having someone go grocery shopping for the client is not a goal of rehabilitation. The client should be eating nutritious meals as a goal of rehabilitation. Refusing to take prescribed medication is not indicative of the client reaching a goal of rehabilitation.

Rationale 2: One goal of rehabilitation is for the client to be able to do his own laundry. Having someone go grocery shopping for the client is not a goal of rehabilitation. The client should be eating nutritious meals as a goal of rehabilitation. Refusing to take prescribed medication is not indicative of the client reaching a goal of rehabilitation.

Rationale 3: One goal of rehabilitation is for the client to be able to do his own laundry. Having someone go grocery shopping for the client is not a goal of rehabilitation. The client should be eating nutritious meals as a goal of rehabilitation. Refusing to take prescribed medication is not indicative of the client reaching a goal of rehabilitation.

Rationale 4: One goal of rehabilitation is for the client to be able to do his own laundry. Having someone go grocery shopping for the client is not a goal of rehabilitation. The client should be eating nutritious meals as a goal of rehabilitation. Refusing to take prescribed medication is not indicative of the client reaching a goal of rehabilitation.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the central concepts of recovery and psychiatric rehabilitation.

Question 4

Type: MCMA

Which of the following community support programs are uniquely suited to meet the needs of clients with severe and persistent mental illness (SPMI)?

Standard Text: Select all that apply.

1. Partial hospitalization programs

2. Nursing homes

3. Depot medication therapy

4. Vocational training programs

5. Residential group homes

Correct Answer: 1,4,5

Rationale 1: Partial hospitalization programs. These programs provide continuity of care between the hospital and the outpatient sector in a less restrictive setting. These programs can also provide an alternative to hospital care for SPMI clients who need complex treatment monitoring.

Rationale 2: Nursing homes. These homes are not uniquely suited for clients with SPMI because they often lack structured programs for mentally ill clients and the opportunity for autonomous decision-making.

Rationale 3: Depot medication therapy. This therapy consists of an injection every two to four weeks and is a valuable strategy for people with SPMI.

Rationale 4: Vocational training programs. These programs provide assessment of work capacities and preferences, technical preparation, and social skills training for clients with SPMI who desire alternatives to the competitive workplace.

Rationale 5: Residential group homes. These homes encourage autonomy and provide a warm, stable environment and can be a good fit for SPMI clients.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Determine the adaptations in programming necessary to meet the needs of the severely and persistently mentally ill.

Question 5

Type: MCSA

A client with chronic paranoid schizophrenia was recently referred to a psychosocial rehabilitation clubhouse program following discharge from the inpatient psychiatric unit. Which of the following client goals is most appropriate for this situation?

1. The client will attend recreational and educational group activities on a daily basis.

2. The client will obtain food, clothing, and transportation services.

3. The client will obtain a sponsor and attend weekly AA meetings.

4. The client will identify career goals and develop a resume of job experiences.

Correct Answer: 1

Rationale 1: Psychosocial rehabilitation centers or clubhouses emphasize a collaborative relationship between staff and members, and provide experiences in a supportive but realistic milieu for the development of abilities for functioning in the real world. Recreational and educational group attendance is a realistic and measurable goal for this environment and is most appropriate for the client with severe and persistent mental illness (SPMI). Identifying career goals and developing a resume is the focus of vocational rehabilitation programs. Obtaining support for basic needs such as food, clothing, and transportation is a goal for case management rather than clubhouse programs. Obtaining an AA sponsor and attending AA meetings is the focus of an outpatient setting that focuses on treatment rather than rehabilitation.

Rationale 2: Psychosocial rehabilitation centers or clubhouses emphasize a collaborative relationship between staff and members, and provide experiences in a supportive but realistic milieu for the development of abilities for functioning in the real world. Recreational and educational group attendance is a realistic and measurable goal for this environment and is most appropriate for the client with severe and persistent mental illness (SPMI). Identifying career goals and developing a resume is the focus of vocational rehabilitation programs. Obtaining support for basic needs such as food, clothing, and transportation is a goal for case management rather than clubhouse programs. Obtaining an AA sponsor and attending AA meetings is the focus of an outpatient setting that focuses on treatment rather than rehabilitation.

Rationale 3: Psychosocial rehabilitation centers or clubhouses emphasize a collaborative relationship between staff and members, and provide experiences in a supportive but realistic milieu for the development of abilities for functioning in the real world. Recreational and educational group attendance is a realistic and measurable goal for this environment and is most appropriate for the client with severe and persistent mental illness (SPMI). Identifying career goals and developing a resume is the focus of vocational rehabilitation programs. Obtaining support for basic needs such as food, clothing, and transportation is a goal for case management rather than clubhouse programs. Obtaining an AA sponsor and attending AA meetings is the focus of an outpatient setting that focuses on treatment rather than rehabilitation.

Rationale 4: Psychosocial rehabilitation centers or clubhouses emphasize a collaborative relationship between staff and members, and provide experiences in a supportive but realistic milieu for the development of abilities for functioning in the real world. Recreational and educational group attendance is a realistic and measurable goal for this environment and is most appropriate for the client with severe and persistent mental illness (SPMI). Identifying career goals and developing a resume is the focus of vocational rehabilitation programs. Obtaining support for basic needs such as food, clothing, and transportation is a goal for case management rather than clubhouse programs. Obtaining an AA sponsor and attending AA meetings is the focus of an outpatient setting that focuses on treatment rather than rehabilitation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Determine the adaptations in programming necessary to meet the needs of the severely and persistently mentally ill.

Question 6

Type: MCSA

A client with chronic paranoid schizophrenia was recently referred to a sheltered workshop and has been participating in a supported employment program for three weeks. Which of the following client outcomes would indicate that the client is demonstrating successful behaviors in this program?

1. The client attended 85% of recreational and educational group activities.

2. The client applied for and obtained subsidized housing from the local housing authority.

3. The client worked four hours per day making protective facemasks for a local company.

4. The client applied for and was approved by the Medicaid program for supplemental income.

Correct Answer: 3

Rationale 1: Working four hours per day making products for a local company is an indicator of successful behavior in a supported employment program. Supported employment is an approach that provides training and support in the workplace. This approach is based on the principle that people with mental illness learn skills best in the environment where they will be practiced. Attending group activities and securing supplemental income or subsidized housing arrangements are client behaviors expected in other community support programs but are not goals within the supported employment program.

Rationale 2: Working four hours per day making products for a local company is an indicator of successful behavior in a supported employment program. Supported employment is an approach that provides training and support in the workplace. This approach is based on the principle that people with mental illness learn skills best in the environment where they will be practiced. Attending group activities and securing supplemental income or subsidized housing arrangements are client behaviors expected in other community support programs but are not goals within the supported employment program.

Rationale 3: Working four hours per day making products for a local company is an indicator of successful behavior in a supported employment program. Supported employment is an approach that provides training and support in the workplace. This approach is based on the principle that people with mental illness learn skills best in the environment where they will be practiced. Attending group activities and securing supplemental income or subsidized housing arrangements are client behaviors expected in other community support programs but are not goals within the supported employment program.

Rationale 4: Working four hours per day making products for a local company is an indicator of successful behavior in a supported employment program. Supported employment is an approach that provides training and support in the workplace. This approach is based on the principle that people with mental illness learn skills best in the environment where they will be practiced. Attending group activities and securing supplemental income or subsidized housing arrangements are client behaviors expected in other community support programs but are not goals within the supported employment program.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Determine the adaptations in programming necessary to meet the needs of the severely and persistently mentally ill.

Question 7

Type: MCMA

The nurse is working with a client who is participating in social skills training. The nurse knows that the client is learning instrumental role behavior, problem solving skills, and intrapersonal skills through:

Standard Text: Select all that apply.

1. Reinforcement

2. Substance abuse

3. Role-playing

4. Practicing

5. Readmission to the hospital

Correct Answer: 1,3,4

Rationale 1: Social skills training methods are based on principles of social learning and use behavioral techniques such as role-playing, practicing, and reinforcement to promote the learning of instrumental role behavior as well as problem-solving abilities and interpersonal skills.

Rationale 2: Social skills training methods are based on principles of social learning and use behavioral techniques such as role-playing, practicing, and reinforcement to promote the learning of instrumental role behavior as well as problem-solving abilities and interpersonal skills.

Rationale 3: Social skills training methods are based on principles of social learning and use behavioral techniques such as role-playing, practicing, and reinforcement to promote the learning of instrumental role behavior as well as problem-solving abilities and interpersonal skills.

Rationale 4: Social skills training methods are based on principles of social learning and use behavioral techniques such as role-playing, practicing, and reinforcement to promote the learning of instrumental role behavior as well as problem-solving abilities and interpersonal skills.

Rationale 5: Social skills training methods are based on principles of social learning and use behavioral techniques such as role-playing, practicing, and reinforcement to promote the learning of instrumental role behavior as well as problem-solving abilities and interpersonal skills.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Relate conditioning and association to the process of human learning.

Question 8

Type: MCSA

The nurse is working with a client who has been diagnosed with bipolar disorder. The nurse has suggested that the client volunteer in community activities with others who have a psychiatric diagnosis. How does this activity reinforce learning?

1. It teaches the client about their own diagnosis.

2. It allows the client to make social connections.

3. It allows the client to offer something to the community.

4. It allows the client to help another cope with problems similar to their own.

Correct Answer: 4

Rationale 1: A benefit of volunteering comes from helping another cope with a problem similar to ones own. This is a feature of adult learning that reinforces learning. Most clients find that teaching others is an excellent way to incorporate meaningful information. This, along with contributing to someone elses recovery, is a powerful message that the client has succeeded to a certain degree on the road to recovery and has something to offer the community. Although the other options are true for a client who volunteers they do not reinforce learning.

Rationale 2: A benefit of volunteering comes from helping another cope with a problem similar to ones own. This is a feature of adult learning that reinforces learning. Most clients find that teaching others is an excellent way to incorporate meaningful information. This, along with contributing to someone elses recovery, is a powerful message that the client has succeeded to a certain degree on the road to recovery and has something to offer the community. Although the other options are true for a client who volunteers they do not reinforce learning.

Rationale 3: A benefit of volunteering comes from helping another cope with a problem similar to ones own. This is a feature of adult learning that reinforces learning. Most clients find that teaching others is an excellent way to incorporate meaningful information. This, along with contributing to someone elses recovery, is a powerful message that the client has succeeded to a certain degree on the road to recovery and has something to offer the community. Although the other options are true for a client who volunteers they do not reinforce learning.

Rationale 4: A benefit of volunteering comes from helping another cope with a problem similar to ones own. This is a feature of adult learning that reinforces learning. Most clients find that teaching others is an excellent way to incorporate meaningful information. This, along with contributing to someone elses recovery, is a powerful message that the client has succeeded to a certain degree on the road to recovery and has something to offer the community. Although the other options are true for a client who volunteers they do not reinforce learning.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Relate conditioning and association to the process of human learning.

Question 9

Type: MCSA

Which of the following nursing interventions is not consistent with the philosophy of psychiatric rehabilitation?

1. Performing a functional assessment of the client

2. Discharging a client from services when treatment goals are reached

3. Planning behavioral interventions that target specific functional deficits

4. Identifying highly individualized goals with the client

Correct Answer: 2

Rationale 1: Rehabilitation approaches emphasize specific interventions to address targeted areas of functioning and are strongly grounded in beliefs about empowerment of clients and emphasizing client feelings of control and worth. From a rehabilitation perspective, it is important to extend support to clients as long as possible. Support is not necessarily withdrawn because a client improves.

Rationale 2: Rehabilitation approaches emphasize specific interventions to address targeted areas of functioning and are strongly grounded in beliefs about empowerment of clients and emphasizing client feelings of control and worth. From a rehabilitation perspective, it is important to extend support to clients as long as possible. Support is not necessarily withdrawn because a client improves.

Rationale 3: Rehabilitation approaches emphasize specific interventions to address targeted areas of functioning and are strongly grounded in beliefs about empowerment of clients and emphasizing client feelings of control and worth. From a rehabilitation perspective, it is important to extend support to clients as long as possible. Support is not necessarily withdrawn because a client improves.

Rationale 4: Rehabilitation approaches emphasize specific interventions to address targeted areas of functioning and are strongly grounded in beliefs about empowerment of clients and emphasizing client feelings of control and worth. From a rehabilitation perspective, it is important to extend support to clients as long as possible. Support is not necessarily withdrawn because a client improves.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design nursing care plans with recovery and rehabilitation goals for people with serious mental illness.

Question 10

Type: MCSA

The nurse is caring for a client who has been diagnosed with schizophrenia and who is currently seeking treatment for drug addiction to crack cocaine. In planning care for this patient, which of the following is a priority goal for psychiatric rehabilitation?

1. Treating the drug addiction

2. Treatment in an integrated program for both diagnoses

3. Medication compliance

4. Treating the schizophrenia

Correct Answer: 2

Rationale 1: The severely mentally ill sometimes do poorly in substance abuse programs that stress confrontation or demand sobriety as a precondition to treatment. Integrated programs for the dually diagnosed mentally ill include inpatient and day treatment programs and group interventions. Adjusting the psychotropic medications for these clients may help them deal with problems such as dysphoria and anxiety that lead to self-medication with drugs and alcohol. There is no evidence that the client was not compliant with the medication regimen for schizophrenia.

Rationale 2: The severely mentally ill sometimes do poorly in substance abuse programs that stress confrontation or demand sobriety as a precondition to treatment. Integrated programs for the dually diagnosed mentally ill include inpatient and day treatment programs and group interventions. Adjusting the psychotropic medications for these clients may help them deal with problems such as dysphoria and anxiety that lead to self-medication with drugs and alcohol. There is no evidence that the client was not compliant with the medication regimen for schizophrenia.

Rationale 3: The severely mentally ill sometimes do poorly in substance abuse programs that stress confrontation or demand sobriety as a precondition to treatment. Integrated programs for the dually diagnosed mentally ill include inpatient and day treatment programs and group interventions. Adjusting the psychotropic medications for these clients may help them deal with problems such as dysphoria and anxiety that lead to self-medication with drugs and alcohol. There is no evidence that the client was not compliant with the medication regimen for schizophrenia.

Rationale 4: The severely mentally ill sometimes do poorly in substance abuse programs that stress confrontation or demand sobriety as a precondition to treatment. Integrated programs for the dually diagnosed mentally ill include inpatient and day treatment programs and group interventions. Adjusting the psychotropic medications for these clients may help them deal with problems such as dysphoria and anxiety that lead to self-medication with drugs and alcohol. There is no evidence that the client was not compliant with the medication regimen for schizophrenia.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design nursing care plans with recovery and rehabilitation goals for people with serious mental illness.

Question 11

Type: MCMA

The nurse is working with a mentally ill client who has just recently been diagnosed with HIV. The client lost her job and has been living in different shelters each night. Which of the following is a priority goal for this client?

Standard Text: Select all that apply.

1. Refer to the client to another physician for medication management

2. Maintain access to support services as needed

3. Avoid exposure to infectious diseases

4. Get adequate amounts of rest

5. Maintain nutritional requirements

Correct Answer: 2,3,4,5

Rationale 1: An increasingly critical problem is the lack of decent, appropriate housing for the growing number of people with HIV disease. HIV disease is disproportionately prevalent among individuals already at the economic edge and those who are targets of discrimination in housing and medical care: people of color, homosexuals, injection drug users, and homeless and runaway youth. Although most people with an impaired immune system can live independently, they require a safe environment that helps them avoid exposure to infectious diseases, get adequate rest, meet their special nutritional needs, and have access to support services and home help when necessary. There is no evidence that the client would need a referral to another physician for medication management.

Rationale 2: An increasingly critical problem is the lack of decent, appropriate housing for the growing number of people with HIV disease. HIV disease is disproportionately prevalent among individuals already at the economic edge and those who are targets of discrimination in housing and medical care: people of color, homosexuals, injection drug users, and homeless and runaway youth. Although most people with an impaired immune system can live independently, they require a safe environment that helps them avoid exposure to infectious diseases, get adequate rest, meet their special nutritional needs, and have access to support services and home help when necessary. There is no evidence that the client would need a referral to another physician for medication management.

Rationale 3: An increasingly critical problem is the lack of decent, appropriate housing for the growing number of people with HIV disease. HIV disease is disproportionately prevalent among individuals already at the economic edge and those who are targets of discrimination in housing and medical care: people of color, homosexuals, injection drug users, and homeless and runaway youth. Although most people with an impaired immune system can live independently, they require a safe environment that helps them avoid exposure to infectious diseases, get adequate rest, meet their special nutritional needs, and have access to support services and home help when necessary. There is no evidence that the client would need a referral to another physician for medication management.

Rationale 4: An increasingly critical problem is the lack of decent, appropriate housing for the growing number of people with HIV disease. HIV disease is disproportionately prevalent among individuals already at the economic edge and those who are targets of discrimination in housing and medical care: people of color, homosexuals, injection drug users, and homeless and runaway youth. Although most people with an impaired immune system can live independently, they require a safe environment that helps them avoid exposure to infectious diseases, get adequate rest, meet their special nutritional needs, and have access to support services and home help when necessary. There is no evidence that the client would need a referral to another physician for medication management.

Rationale 5: An increasingly critical problem is the lack of decent, appropriate housing for the growing number of people with HIV disease. HIV disease is disproportionately prevalent among individuals already at the economic edge and those who are targets of discrimination in housing and medical care: people of color, homosexuals, injection drug users, and homeless and runaway youth. Although most people with an impaired immune system can live independently, they require a safe environment that helps them avoid exposure to infectious diseases, get adequate rest, meet their special nutritional needs, and have access to support services and home help when necessary. There is no evidence that the client would need a referral to another physician for medication management.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design nursing care plans with recovery and rehabilitation goals for people with serious mental illness.

Question 12

Type: MCMA

The nurse knows that when designing a plan of care for a client with serious mental illness, the recovery and rehabilitation goals must be:

Standard Text: Select all that apply.

1. Attainable

2. Realistic

3. Permanent

4. Immediate

5. Flexible

Correct Answer: 1,2,5

Rationale 1: Client goals must be realistic and attainable, keeping in mind the need to be flexible depending on crises and depleted resources (emotional and financial). The goals that will bring change are not immediate, instantaneous, or initially permanent.

Rationale 2: Client goals must be realistic and attainable, keeping in mind the need to be flexible depending on crises and depleted resources (emotional and financial). The goals that will bring change are not immediate, instantaneous, or initially permanent.

Rationale 3: Client goals must be realistic and attainable, keeping in mind the need to be flexible depending on crises and depleted resources (emotional and financial). The goals that will bring change are not immediate, instantaneous, or initially permanent.

Rationale 4: Client goals must be realistic and attainable, keeping in mind the need to be flexible depending on crises and depleted resources (emotional and financial). The goals that will bring change are not immediate, instantaneous, or initially permanent.

Rationale 5: Client goals must be realistic and attainable, keeping in mind the need to be flexible depending on crises and depleted resources (emotional and financial). The goals that will bring change are not immediate, instantaneous, or initially permanent.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design nursing care plans with recovery and rehabilitation goals for people with serious mental illness.

Question 13

Type: MCSA

The nurse is admitting a client to the unit after a substance abuse relapse. The nurse assesses that the clients family has not been supportive of recovery efforts and requires education. Which of the following is a priority for client teaching?

1. Relapse triggers for the client

2. The effects of substance abuse on the client

3. Unit visiting hours

4. Local support group information

Correct Answer: 1

Rationale 1: Although all information presented is valuable information, prevention is more effective when clients and their families understand the likely triggers for relapse; therefore, this would be the priority area for teaching.

Rationale 2: Although all information presented is valuable information, prevention is more effective when clients and their families understand the likely triggers for relapse; therefore, this would be the priority area for teaching.

Rationale 3: Although all information presented is valuable information, prevention is more effective when clients and their families understand the likely triggers for relapse; therefore, this would be the priority area for teaching.

Rationale 4: Although all information presented is valuable information, prevention is more effective when clients and their families understand the likely triggers for relapse; therefore, this would be the priority area for teaching.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Analyze the effectiveness of a plan to promote recovery.

Question 14

Type: MCSA

A client with bipolar disorder is being seen for a follow up appointment in the mental health clinic. The client asks the nurse why she is asked the same questions with each visit. Which of the following is the most appropriate response from the nurse?

1. Does it bother you to have to answer the same questions with each visit?

2. It is important to keep your plan of care up to date. This is why you are asked the same questions at each visit.

3. We dont share information with others because of HIPAA regulations.

4. I will have the doctor address this question for you.

Correct Answer: 2

Rationale 1: During the recovery process it is important that the client gets needed care. You and the client with take the opportunity to look at the whole picture of the clients needs and abilities and keep up to date on changes in the plan. HIPAA regulations prevent the health care provider from sharing information with those that arent involved in the clients care. The patient asked you a question; therefore, it is not therapeutic to answer the patient with a question. The doctor would not address this issue, the nurse would when it is presented.

Rationale 2: During the recovery process it is important that the client gets needed care. You and the client with take the opportunity to look at the whole picture of the clients needs and abilities and keep up to date on changes in the plan. HIPAA regulations prevent the health care provider from sharing information with those that arent involved in the clients care. The patient asked you a question; therefore, it is not therapeutic to answer the patient with a question. The doctor would not address this issue, the nurse would when it is presented.

Rationale 3: During the recovery process it is important that the client gets needed care. You and the client with take the opportunity to look at the whole picture of the clients needs and abilities and keep up to date on changes in the plan. HIPAA regulations prevent the health care provider from sharing information with those that arent involved in the clients care. The patient asked you a question; therefore, it is not therapeutic to answer the patient with a question. The doctor would not address this issue, the nurse would when it is presented.

Rationale 4: During the recovery process it is important that the client gets needed care. You and the client with take the opportunity to look at the whole picture of the clients needs and abilities and keep up to date on changes in the plan. HIPAA regulations prevent the health care provider from sharing information with those that arent involved in the clients care. The patient asked you a question; therefore, it is not therapeutic to answer the patient with a question. The doctor would not address this issue, the nurse would when it is presented.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Analyze the effectiveness of a plan to promote recovery.

Question 15

Type: MCSA

The nurse is reviewing the plan of care with a client who has been diagnosed with schizophrenia. The client is not compliant with the medications he has been placed on for treatment of his illness. Which of the following is the most appropriate response by the nurse in order to modify the plan of care?

1. I am going to tell the doctor you have not been taking your medication and she will be upset with you.

2. Why would you stop taking your medications? That is stupid.

3. Tell me what is going on with your medications.

4. Does your family know you stopped taking your medication?

Correct Answer: 3

Rationale 1: In order to modify the clients plan of care, the nurse must first find out why the client stopped taking the prescribed medications. The nurse will notify the doctor but it is inappropriate to tell the client that the doctor will be upset. Asking about the clients family knowledge is important but not the priority. Telling the client he is stupid is inappropriate and not therapeutic.

Rationale 2: In order to modify the clients plan of care, the nurse must first find out why the client stopped taking the prescribed medications. The nurse will notify the doctor but it is inappropriate to tell the client that the doctor will be upset. Asking about the clients family knowledge is important but not the priority. Telling the client he is stupid is inappropriate and not therapeutic.

Rationale 3: In order to modify the clients plan of care, the nurse must first find out why the client stopped taking the prescribed medications. The nurse will notify the doctor but it is inappropriate to tell the client that the doctor will be upset. Asking about the clients family knowledge is important but not the priority. Telling the client he is stupid is inappropriate and not therapeutic.

Rationale 4: In order to modify the clients plan of care, the nurse must first find out why the client stopped taking the prescribed medications. The nurse will notify the doctor but it is inappropriate to tell the client that the doctor will be upset. Asking about the clients family knowledge is important but not the priority. Telling the client he is stupid is inappropriate and not therapeutic.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Modify a nursing care plan to promote and enhance rehabilitation.

Question 16

Type: MCSA

The nurse is caring for a client with a personality disorder. The client feels as if she is not accomplishing any of her goals. Which of the following is the most appropriate response by the nurse?

1. Would you like to increase your therapy visits?

2. Lets look at the plan of care together.

3. Who told you that you werent accomplishing your goals?

4. I will discuss your feelings with the doctor.

Correct Answer: 2

Rationale 1: Evaluation of the plan of care is made together with the client, incorporating ancillary information when available. The patient has indicated that the process is moving too slowly. Therefore, the plan needs to be adjusted for more realistic shorter-term goals. This process is completed by having the nurse and client look at the plan together to discuss more obtainable goals.

Rationale 2: Evaluation of the plan of care is made together with the client, incorporating ancillary information when available. The patient has indicated that the process is moving too slowly. Therefore, the plan needs to be adjusted for more realistic shorter-term goals. This process is completed by having the nurse and client look at the plan together to discuss more obtainable goals.

Rationale 3: Evaluation of the plan of care is made together with the client, incorporating ancillary information when available. The patient has indicated that the process is moving too slowly. Therefore, the plan needs to be adjusted for more realistic shorter-term goals. This process is completed by having the nurse and client look at the plan together to discuss more obtainable goals.

Rationale 4: Evaluation of the plan of care is made together with the client, incorporating ancillary information when available. The patient has indicated that the process is moving too slowly. Therefore, the plan needs to be adjusted for more realistic shorter-term goals. This process is completed by having the nurse and client look at the plan together to discuss more obtainable goals.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Modify a nursing care plan to promote and enhance rehabilitation.

Question 17

Type: MCSA

The nurse knows that working with clients through rehabilitation and recovery may cause a conflict in value systems. Which of the following circumstances may cause your personal values to influence your effectiveness when working with a client?

1. An insurance company that approves your plan of care for the client

2. A client who chooses a different plan of care than you have mapped out

3. A family that works closely with the treatment team

4. A client who agrees with your opinion on the plan of care

Correct Answer: 2

Rationale 1: Nurses working with clients toward rehabilitation and recovery may be caught in the middle of conflicting value systems. For example, clients with alcoholism or bulimia have been treated traditionally with intensive, extended inpatient treatment programs. Most health care insurance plans may authorize this treatment only in an outpatient setting. The nurse must respond to clients need for autonomy in making decisions regarding treatment as well as negotiate within the limitations of the health care insurance plan. You must use creativity and flexibility in negotiating among the conflicting needs of several parties. Clients and families who are accustomed to specific treatment models for illnesses with relapse potential often feel confused and misunderstood when new treatment approaches are suggested that appear economically motivated.

Rationale 2: Nurses working with clients toward rehabilitation and recovery may be caught in the middle of conflicting value systems. For example, clients with alcoholism or bulimia have been treated traditionally with intensive, extended inpatient treatment programs. Most health care insurance plans may authorize this treatment only in an outpatient setting. The nurse must respond to clients need for autonomy in making decisions regarding treatment as well as negotiate within the limitations of the health care insurance plan. You must use creativity and flexibility in negotiating among the conflicting needs of several parties. Clients and families who are accustomed to specific treatment models for illnesses with relapse potential often feel confused and misunderstood when new treatment approaches are suggested that appear economically motivated.

Rationale 3: Nurses working with clients toward rehabilitation and recovery may be caught in the middle of conflicting value systems. For example, clients with alcoholism or bulimia have been treated traditionally with intensive, extended inpatient treatment programs. Most health care insurance plans may authorize this treatment only in an outpatient setting. The nurse must respond to clients need for autonomy in making decisions regarding treatment as well as negotiate within the limitations of the health care insurance plan. You must use creativity and flexibility in negotiating among the conflicting needs of several parties. Clients and families who are accustomed to specific treatment models for illnesses with relapse potential often feel confused and misunderstood when new treatment approaches are suggested that appear economically motivated.

Rationale 4: Nurses working with clients toward rehabilitation and recovery may be caught in the middle of conflicting value systems. For example, clients with alcoholism or bulimia have been treated traditionally with intensive, extended inpatient treatment programs. Most health care insurance plans may authorize this treatment only in an outpatient setting. The nurse must respond to clients need for autonomy in making decisions regarding treatment as well as negotiate within the limitations of the health care insurance plan. You must use creativity and flexibility in negotiating among the conflicting needs of several parties. Clients and families who are accustomed to specific treatment models for illnesses with relapse potential often feel confused and misunderstood when new treatment approaches are suggested that appear economically motivated.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in working toward recovery with clients.

Question 18

Type: MCSA

The nurse is working with a male client who is approximately the same age as the nurses father. The client is a substance abuser who has relapsed for the third time this year. The nurses father is also a substance abuser. The client asks the nurse a question and the nurse snaps at him in response. Which of the following characteristics that contribute to a positive outcome of rehabilitation is the nurse having issues with concerning this client?

1. Empathy

2. Autonomy

3. Intuition

4. Patience

Correct Answer: 4

Rationale 1: The nurses behavior indicates a lack of patience. Empathy, intuition, and autonomy have not been identified as characteristics that the nurse needs in order to contribute to a positive outcome for the client.

Rationale 2: The nurses behavior indicates a lack of patience. Empathy, intuition, and autonomy have not been identified as characteristics that the nurse needs in order to contribute to a positive outcome for the client.

Rationale 3: The nurses behavior indicates a lack of patience. Empathy, intuition, and autonomy have not been identified as characteristics that the nurse needs in order to contribute to a positive outcome for the client.

Rationale 4: The nurses behavior indicates a lack of patience. Empathy, intuition, and autonomy have not been identified as characteristics that the nurse needs in order to contribute to a positive outcome for the client.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in working toward recovery with clients.

Question 19

Type: MCSA

Which of the following statements made by the nurse displays a positive attitude about client autonomy and self-determination?

1. I comfortable with clients deciding what the programs, schedule, activities, or rules will be.

2. Clients should not be permitted to decide their own treatment goals.

3. Clients should not be permitted to comment on each others behaviors or treatment goals while in group.

4. I am sad when a client does not choose my plan of care.

Correct Answer: 1

Rationale 1: To increase self-awareness of a nurses own attitude about client autonomy and self-determination, there are several questions that one should ask. Stating that the nurse is comfortable with a client deciding what programs, schedules, activities, or rules will be is a positive statement. All the other statements are negative and the nurse should re-evaluate the feelings so that the nurse can be effective with helping the client work toward recovery.

Rationale 2: To increase self-awareness of a nurses own attitude about client autonomy and self-determination, there are several questions that one should ask. Stating that the nurse is comfortable with a client deciding what programs, schedules, activities, or rules will be is a positive statement. All the other statements are negative and the nurse should re-evaluate the feelings so that the nurse can be effective with helping the client work toward recovery.

Rationale 3: To increase self-awareness of a nurses own attitude about client autonomy and self-determination, there are several questions that one should ask. Stating that the nurse is comfortable with a client deciding what programs, schedules, activities, or rules will be is a positive statement. All the other statements are negative and the nurse should re-evaluate the feelings so that the nurse can be effective with helping the client work toward recovery.

Rationale 4: To increase self-awareness of a nurses own attitude about client autonomy and self-determination, there are several questions that one should ask. Stating that the nurse is comfortable with a client deciding what programs, schedules, activities, or rules will be is a positive statement. All the other statements are negative and the nurse should re-evaluate the feelings so that the nurse can be effective with helping the client work toward recovery.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Describe how your personal characteristics might influence your effectiveness in working toward recovery with clients.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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