49 practice questions! Flashcards
The purpose of the ANA’s “Scope and Standards of Psychiatric-Mental Health Clinical Nursing Practice” is to:
A - Define the role and actions for the NP
B - Establish the legal authority for the prescription of psychotropic medications
C - Define the legal statutes of the role of the PMHNP
D - Define the differences between the physician role and the NP role
A
Primary prevention care practices are an essential aspect of the PMHNP role. Which of the following is the best example of a primary prevention care strategy for community behavioral health?
A - Aftercare program for chronically mentally ill clients recently discharged from the hospital
B - Court-ordered counseling for abusive parents
C - 24-hour crisis hotlines
D - Parenting skills classes for pregnant adolescents
D. Information reduces incidence of disease.
The trend in legal rulings on cases involving mental illness over the past 25 years has been to:
A - Encourage juries to find defendants not guilty by reason of insanity
B - Protect the individual’s freedoms or rights when he or she is committed to a mental hospital
C - Place increasing trust in mental health professionals to make good and ethical decisions
D - Decrease the “red tape” associated with commitments so that commitments are faster and easier
B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric clients.
Mr Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to take any of his ordered medication because he believes “Jesus Christ told me I am the prophet and must fast for a year.” Your actions should be based on your knowledge that:
A - Psych clients cannot refuse treatment
B - Psych clients don’t always know what’s good for them
C - Psych clients can refuse treatment
D - Psych clients cannot be trusted to make good healthcare decisions and, therefore, the nurse’s best clinical judgment should guide actions
C. As with any client, psych clients can refuse treatment unless a legal process resulting in a mandatory court order for treatment has been obtained.
Which of the following statements best reflects the difference between the nurse-client (N-C) relationship and a social relationship? In the N-C relationship…
A - the primary focus is on the client and his needs.
B - goals are deliberately left vague and unspoken so that the client can work on any issue.
C - the nurse is solely responsible for making the relationship work.
D - there is no place for social interaction.
A - the primary focus is on the client and his needs.
Social relationships are mutual interpersonal relationships in which the needs of both parties are addressed. The N-C relationship is most concerned with meeting the needs of the client.
A community has an unusually high incidence of depression and drug use among its teenage population. The public health nurses decide to address this problem, in part, by modifying the environment and strengthening the capacities of families to prevent the development of new cases of depression and drug use. This is an example of:
A - primary prevention
B - secondary prevention
C - tertiary prevention
D - protective factorial prevention
A - primary prevention
This action focuses on interventions designed to reduce the incidence of new cases of disease
Mrs Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wants to leave because “this place can’t help me.” The best nursing action that reflects the legal right of the client is:
A - discharge the client
B - explain that the client cannot leave until you can complete further assessment
C - allow the client to leave but have her sign forms stating she is leaving against medical advice
D - immediately start the paperwork to commit the client and to allow you to treat her against her wishes
B - explain that the client cannot leave until you can complete further assessment
Almost every state allows for a brief period of detainment to assess a client for dangerousness to self or others before allowing the client to leave a hospital setting, even if the admission was voluntary
In forming a therapeutic relationship with clients, the PMHNP must consider developing many characteristics that are known to be helpful in relationship-building. These characteristics include all of the following EXCEPT:
A - genuineness
B - acceptance
C - authenticity
D - accuracy in assessment
D - accuracy in assessment
Although an important aspect of the PMHNP role, accuracy in assessment does not in and of itself facilitate relationship building
The DSM-IV provides for holistic client assessment by using a multiaxial assessment format. The general medical conditions experienced by a client that may influence treatment of his or her psychiatric disorders are coded on which of the five axes of the DSM? A - Axis I B - Axis II C - Axis III D - Axis IV
C - Axis III
Medical conditions are coded on Axis III
Mrs French has been in individual therapy for 3 months, and is clinically ready to terminate treatment. After discussing termination, she suddenly begins to demonstrate some of her original symptoms; is hesitant to discharge; and displays regressive defense mechanisms. The best explanation is:
A - An exacerbation of her symptoms related to stress
B - The normal cyclic nature of chronic mental health symptoms
C - A sign of normal resistance to termination seen in the termination phase of therapy
D - A sign of pathological attachment to the therapist that must be addressed
C - A sign of normal resistance to termination seen in the termination phase of therapy
Clients frequently display resistance and regression at the termination of a meaningful therapeutic process. The PMHNP is responsible for planning an effective termination and monitoring clients during the termination period.
A client is displaying low self-esteem, poor self-control, self-doubt, and a high level of dependency. These behaviors indicate developmental failure of which of the following stages of development: A - Infancy B - Early childhood C - Late childhood D - School age
B - Early childhood
Mr Thompson has been forgetful lately, for example forgetting where he has placed his keys or what time appointments are scheduled, and he stated that he thinks these are just random behaviors that have no particular meaning. Which Freudian-based psychodynamic principle assumes that all behavior and actions are purposeful? A - Pleasure principle B - Psychic determinism principle C - Reality principle D - Unconsciousness principle
B - The psychic determinism principle states that all behavior has purpose and meaning, often unconscious in nature, and that no behaviors occur randomly or by coincidence.
An example of a mature, healthy defense mechanism is A - Denial B - Rationalization C - Repression D - Suppression
D - Suppression is the only defense mechanism listed in which the client channels conflicting energies into growth-promoting activities.
Mr Johnson is a 54-year-old client you have been seeing for several weeks in therapy. While discussing his current concerns of marital stress, he lies on the floor and assumes the fetal position. This is most likely an example of
A - Immature regressive defense mechanism
B - Denial of reality
C - Immature fantasy defense mechanism
D - Repressive behavior
A - Immature regressive defense mechanism is a return to a behavior common to an earlier stage of development.
Defense mechanisms are best viewed a function of the ego A - To alert us to harm and danger B - To alert us to problems C - Used to resolve a conflict D - Used to protect the id
C - Defense mechanisms are a function of the ego used to resolve a conflict.
