Test Bank Diagnostic and Statistical Manual of Mental Disorders, 5th Edition by American Psychiatric Association A+

Chapter 1 Introduction
MULTIPLE CHOICE
1. Which understanding is the basis for the nursing actions focused on minimizing mental health promotion of families with chronically mentally ill members?
a.
Family members are at an increased risk for mental illness.
b.
The mental health care system is not prepared to deal with family crises.
c.
Family members are seldom prepared to cope with a chronically ill individual.
d.
The chronically mentally ill receive care best when delivered in a formal setting.
ANS: A
When families live with a dominant member who has a persistent and severe mental disorder the outcomes are often expressed as family members who are at increased risk for physical and mental illnesses. The remaining options are not necessarily true.
2. Which nursing activity shows the nurse actively engaged in the primary prevention of mental disorders?
a.
Providing a patient, whose depression is well managed, with medication on time
b.
Making regular follow-up visits to a new mother at risk for post-partum depression
c.
Providing the family of a patient, diagnosed with depression, information on suicide prevention
d.
Assisting a patient who has obsessive compulsive tendencies prepare and practice for a job interview
ANS: B
Primary prevention helps to reduce the occurrence of mental disorders by staying involved with a patient. Providing medication and information on existing illnesses are examples of secondary prevention which helps to reduce the prevalence of mental disorders. Assisting a mentally ill patient with preparation for a job interview is tertiary prevention since it involves rehabilitation.
3. Which intervention reflects attention being focused on the patients intentions regarding his diagnosis of severe depression?
a.
Being placed on suicide precautions
b.
Encouraging visits by his family members
c.
Receiving a combination of medications to address his emotional needs
d.
Being asked to decide where he will attend his prescribed therapy sessions
ANS: D
A primary factor in patient treatment includes consideration of the patients intentions regarding his or her own care. Patients are central to the process that determines their care as their abilities allow. Under the guidance of PMH nurses and other mental health personnel, patients are encouraged to make decisions and to actively engage in their own treatment plans to meet their needs. The remaining options are focused on specifics of the determined plan of care.
4. When a patients family asks why their chronically mentally ill adult child is being discharged to a community-based living facility, the nurse responds:
a.
It is a way to meet the need for social support.
b.
It is too expensive to keep stabilized patients in acute care settings.
c.
This type of facility will provide the specialized care that is needed.
d.
Being out in the community will help provide hope and purpose for living.
ANS: D
Hospitalization may be necessary for acute care, but, when patients are stabilized, they move into community-based, patient-centered settings or are discharged home with continued outpatient
treatment in the community. Concentrated efforts are made to reduce the patients sick role by providing opportunities for the development of a purposeful life and instilling hope for each patients future. Although social support is important, such a living arrangement is not the only way to achieve it. Although acute care is expensive, it is not the major concern when determining long-term care options. Community-based facilities are not the only option for specialized care.
5. What is the best explanation to offer when the mother of a chronically ill teenage patient asks, Under what circumstances would he be considered incompetent?
a.
When you can provide the court with enough evidence to show that he is not able to care for himself safely.
b.
It is not likely that someone his age would be determined to be incompetent regardless of his mental condition.
c.
He would have to engage in behavior that would result in harm to himself or to someone else; like you or his siblings.
d.
If the illness becomes so severe that his judgment is impaired to the point where the decisions he makes are harmful to himself or to others.
ANS: D
When a person is unable to cognitively process information or to make decisions about his or her own welfare, the person may be determined to be mentally incompetent. Providing self-care is not the only criteria considered. Age is not a factor considered. The decision is often based on the potential for such behavior.
6. Which psychiatric nursing intervention shows an understanding of integrated care?
a.
A chronically abused woman is assessed for anxiety.
b.
A manic patient is taken to the gym to use the exercise equipment.
c.
The older adult diagnosed with depression is monitored for suicidal ideations.
d.
A teenager who refuses to obey the units rules is not allow to play video games.
ANS: A
The majority of health disciplines now recognize that mental disorders and physical illnesses are closely linked. The presence of a mental disorder increases the risk for the development of physical illnesses and vice versa. Assessing a chronically abused individual for anxiety call should attention to the psychiatric disorder that could develop from the abuse. The remaining options show interventions that are appropriate for the mental disorder.
7. What reason does the nurse give the patient for the emphasis and attention being paid to the recovery phase of their treatment plan?
a.
Recovery care, even when intensive, is less expensive than acute psychiatric care.
b.
Effective recovery care is likely to result in fewer relapses and subsequent hospitalizations.
c.
Planning for recovery care is time consuming and involves dealing with many complicated details.
d.
Recovery care is usually done on an outpatient basis and so is generally better accepted by patients.
ANS: B
Much attention is paid to recovery care since effective recovery care helps improve patient outcomes and thus minimize subsequent hospitalizations. Recovery care is not necessarily less expensive than acute care. Although effective recovery care planning may be time consuming and detail oriented, that is not the reason for implementing it. Recovery care is not necessarily well accepted by patients.
8. The nurse is attending a neighborhood meeting where a half-way house is being proposed for the neighborhood when a member of the community states, We dont want the facility; we especially dont want violent people living near us. The response by the nurse that best addresses the publics concern is:
a.
In truth, most individuals with psychiatric disorder are passive and withdrawn and pose little threat to those around them.
b.
The mentally ill seldom behave in the manner they are portrayed by movies; they are people just like the rest of us.
c.
Patients with psychiatric disorder are so well medicated that they do not display violent behaviors.
d.
The mentally ill deserve a safe, comfortable place to live among people who truly care for them.
ANS: A
A major reason for the existence of the stigma placed on persons with mental illness is lack of knowledge. The main fear is of violence, although only a small percentage of patients with mental illness display this behavior. Providing the public with accurate information can help reduce stigma. The remaining options do not directly address the concerns stated.
9. Which activity shows that a therapeutic alliance has been established between the nurse and patient?
a.
The nurse respects the patients right to privacy when visitors are spending time with the patient.
b.
The patient is eagerly attending all group sessions and working independently on identifying their personal stressors.
c.
The patient is freely describing their feelings related to the physical and emotional trauma they experienced as a child with the nurse.
d.
The nurse dutifully administers the patients medications on time and with appropriate knowledge of the potential side effects.
ANS: C
A primary aspect of working with patients in any setting and particularly in the psychiatric setting is the development of a therapeutic alliance with the patient. Such an alliance is established on trust. It is a professional bond between the nurse and the patient that serves as a vehicle for patients to freely discuss their needs and problems in the absence of the nurses criticism or judgment. Any nurse has an obligation to respect the patients rights and administer care effectively. The patients willingness to participate in the plan of care reflects self motivation.
10. Mental health care reform has called for parity between psychiatric and medical diagnoses. Which is an example of such parity?
a.
Depression treatment is not paid for as readily as is treatment for asthma.
b.
The mentally ill patient will be protected by law against social stigma.
c.
Medical practitioners are trained to be proficient at treating mental disorders.
d.
Psychiatric service reimbursement will be equivalent to that of medical services.
ANS: D
The term parity as used here refers to payments for mental health services that equal payment schedules for medical or surgical conditions. The remaining options(B and C) do not relate to financial reimbursement or funds allocated for mental health care being equal to those of medical diagnoses.
MULTIPLE RESPONSE