PSYCHIATRIC MENTAL HEALTH NURSING

PSYCHIATRIC MENTAL HEALTH NURSING

When planning care for a specific client, of what significance to the psychiatric nurse is the fact that the DSM-IV-TR is multiaxial?

a) Pertinent aspects of client functioning and problems are reported.

b) Standardized treatment plans are available for each diagnosis.

c) Nursing diagnoses are included for each medical diagnosis.

d) No particular significance exists. Correct -a) Pertinent aspects of client functioning

and problems are reported.

A nurse conducting research is seeking data about outcomes for depressed patients who have been treated with electroconvulsive therapy. The nurse is engaged in the field of

• experimental epidemiology.
• descriptive epidemiology.
• clinical epidemiology.
• analytic epidemiology. Correct -C) clinical epidemiology.

A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking?

• Control over behavior
• Appraisal of reality
• Effectiveness in work
• Healthy self-concept Correct -B) Appraisal of reality

A 14-year-old who belongs to a neighborhood gang is found by her parents to lie and engage in sexually promiscuous behavior. They bring her to the mental health center.The nurse performing the assessment is told by the 14-year-old that she is happy, does well in school, and sees herself as popular and well regarded by her group. She states her parents are just old fashioned and don't understand her. The assessment the nurse

will most likely make is that she:

• is displaying deviant behavior.
• cannot accurately appraise reality.
• is seriously and persistently mentally ill.
• should be considered for group home placement. Correct -A) is displaying deviant

behavior.

An important concept for nurses to remember when planning care for mentally ill clients

is that each client:

• has areas of strength on which to build.
• has right that must be respected.
• comes with experiences that contribute to their problem.
• share the same fears as mentally healthy individuals. Correct -A) has areas of

strength on which to build.

A nurse suspects that a client has a personality disorder in addition to displaying symptoms of a mood disorder. To determine whether these observations are correct, the nurse could look in the client's medical record on the DSM-IV-TR

• axis I.
• axis II.
• axis III.
• axis IV. Correct -B) axis II.

A man frequently bursts out by loudly singing operatic arias. The neighbors in the next apartment find the noise disturbing. They go to his apartment to confront him and find that in he is wearing only his bathrobe and his apartment is messy. He acts outraged and tells them he must sing several hours daily and will not promise to be quieter. The

conclusion that can be drawn is:

• The man is demonstrating symptoms of bipolar disorder.
• The man is socially deviant.
• The man is egocentric.
• The man may or may not be mentally ill. Correct -D) The man may or may not be

mentally ill.

A nursing diagnosis for a client with a psychiatric disorder serves the purpose of

• justifying the use of certain psychotropic medication.
• providing data essential for insurance reimbursement.
• providing a framework for selecting appropriate interventions.
• identifying information to be placed on DSM-IV-TR axis III. Correct -C) providing a

framework for selecting appropriate interventions.

A client has begun to neglect her appearance, is withdrawn and stays in her room. Her mother hears her seemingly talking to others, but no one is in the room with her. Last night she threw a chair and broke the window of her bedroom. She tells the nurse nothing is wrong. The nurse rating her current global assessment of functioning would probably assign the code

A) 100.

B) 70.

C) 40.

• Correct -C) 40.

The mental health or mental illness of a particular client can best be assessed by considering

• the degree of conformity of the individual to society's norms.
• the degree to which an individual is logical and rational.
• placement on a continuum from healthy to psychotic.
• the rate of intellectual and emotional growth. Correct -C) placement on a

continuum from healthy to psychotic.

The quantitative study of the distribution of mental disorders in human populations is

called:

• mortality.
• prevalence.
• epidemiology.
• clinical epidemiology Correct -C) epidemiology.

What phrase best describes the DSM-IV-TR?

• Is a multiaxial psychiatric assessment system
• Is a compendium of treatment modalities
• Offers a complete list of nursing diagnoses
• Suggests common interventions for mental disorders. Correct -A) Is a multiaxial

psychiatric assessment system

Current information suggests that the most disabling mental disorders are the result of:

• biological influences.
• psychological trauma.
• learned ways of behaving.
• faulty patterns of early nurturance. Correct -A) biological influences.

A nurse's identification badge includes the wording, 'Psychiatric Mental Health Nurse'. A client with a history of paranoia asks, "What does that title mean?" The nurse responds

best when answering:

• "Don't be afraid, it means I'm here to help not hurt you."
• "Psychiatric Mental Health nurses care for people with mental illnesses."
• "We have the specialized skills needed to care for those with mental illnesses."
• "The nurses who work in mental health facilities have that title." Correct -C) "We

have the specialized skills needed to care for those with mental illnesses."

Regarding individuals with mental disorders, distress refers to a painful symptom, and

disability refers to:

• the presence of deviant behavior.
• impairment in important areas of functioning.
• culturally appropriate responses to an event.
• a conflict between the individual and society. Correct -B) impairment in important

areas of functioning.

While caring for a client who is very ill with a mental disorder, the nurse wonders if the client has always been so regressed or if he has functioned at a higher level in the

recent past. The best way to obtain this information would be to:

• ask the client.
• ask the family.
• refer to the progress notes.
• look at axis V of the client's DSM-IV-TR sheet. Correct -D) look at axis V of the

client's DSM-IV-TR sheet.

Which statement about diagnosis of a mental disorder is true?

• The symptoms of each disorder are common among all cultures.
• Culture may cause variations in symptoms for each clinical disorder.
• All mental disorders listed in the DSM-IV-TR are seen in all other cultures.
• Global assessment of functioning is more diagnostic than symptoms noted.

Correct -B) Culture may cause variations in symptoms for each clinical disorder.

The prevalence rate over a 12-month period for major depressive disorder is:

• lower than the prevalence rate for panic disorders.
• greater than the prevalence rate for psychotic disorders.
• equal to the prevalence rate for psychotic disorders.
• greater than the prevalence rate for generalized anxiety. Correct -D) greater than

the prevalence rate for generalized anxiety.

Nick, a college student, comes to the mental health clinic with symptoms of feeling blue and having occasional difficulty sleeping. He is able to manage his course work with lowered grades but states he just doesn't get as much pleasure from life as he did several months ago. The nurse making his global assessment of functioning would

probably assign the rating of:

A) 100.

B) 70.

C) 40.

• Correct -B) 70.

Mental illnesses recognized across cultures include:

• antisocial and borderline personality disorders.
• schizophrenia and bipolar disorder.
• bulimia and anorexia nervosa.
• amok and social phobia Correct -B) schizophrenia and bipolar disorder.

An important difference between the developmental theories of Freud and Erikson is:

• Freud considers the entire lifespan from birth to old age.
• Freud focuses to a greater extent on cognitive development.
• Erikson viewed individual growth in terms of social setting.
• Erikson focuses on development of individual moral thinking. Correct -C) Erikson

viewed individual growth in terms of social setting.

Maslow's theory of Humanistic Psychology has provided nursing with a framework for:

• holistic assessment.
• determining moral development.
• identifying potential for success in therapy.
• conducting nurse-client interpersonal interactions. Correct -A) holistic

assessment.

The premise underlying behavioral therapy is:

• behavior is learned and can be modified.