Chapter 12: The Therapeutic Environment

Chapter 12: The Therapeutic Environment

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Crisis stabilization provides care to clients in treatment settings with the purpose of reestablishing homeostasis; it usually lasts for _____ days.

a.	1 to 2
b.	2 to 4
c.	4 to 6
d.	6 to 8

 

 

ANS:  A

Intensive counseling is given to assist clients with the immediate problem that is causing the crisis. This usually is accomplished within 1 to 2 days, and the client is discharged with follow-up care.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 129             OBJ:   1

TOP:   Crisis Stabilization                          KEY:  Nursing Process Step: Intervention

MSC:  Client Needs: Psychosocial Integrity

 

2. Which is an accepted criterion for inpatient admission to a mental health facility?

a.	The client likes the security and comfort of the mental health facility.
b.	The client feels that he is no longer able to cope with life stressors or maintain control of his behavior.
c.	A client’s behavior becomes unusual.
d.	The client suffers from depression.

 

 

ANS:  B

This situation meets the criteria for an inpatient admission. Other criteria include being a threat to one’s safety or the safety of others and having people who are a part of the client’s environment who that are not willing or able to support him. The other options do not meet the criteria.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 129             OBJ:   1

TOP:   Use of the Inpatient Setting              KEY:  Nursing Process Step: Planning

MSC:  Client Needs: Psychosocial Integrity

 

3. A male client with a diagnosis of schizophrenia refuses to take his medication because of his paranoia that the medication may be poisoned. Frequent inpatient readmissions to the facility occur as a result. Which term is given to repeated inpatient admissions?

a.	Milieu
b.	Chronicity
c.	Noncompliance
d.	Recidivism

 

 

ANS:  D

Recidivism often occurs as a result of noncompliance with prescribed therapy, as in the case of this client who is not taking his medications. Adequate community resources help to prevent recidivism. Milieu refers to the mental health care environment; chronicity refers to a long duration, such as occurs with a chronic illness such as schizophrenia; and noncompliance describes a situation in which the client does not follow the prescribed plan of care, often resulting in recidivism.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 130             OBJ:   2

TOP:   The Chronically Mentally Ill Population

KEY:  Nursing Process Step: Planning        MSC:  Client Needs: Psychosocial Integrity

 

4. An adult female inpatient client with a diagnosis of paranoid schizophrenia will not take her medications from the nurse. She states, “I know you are poisoning that medicine.” Which nursing action is most appropriate?

a.	Promise the client that the staff would not do anything to harm her.
b.	Let the client watch the medication preparation process.
c.	Administer medications to her in unit dose packages so that she can open the packages herself.
d.	Allow the client to retrieve the medications out of the medication cart with supervision.

 

 

ANS:  C

Administering medications in unit dose packages would help to prevent the client from thinking that the nurse is poisoning the medications. The client would be allowed to open the packages herself. Promising the client that the staff would not harm her will not alleviate her paranoia. Letting the client watch the medication preparation process may help, but if she feels that the poisoning is happening when the nurse is placing the medication in the cup, the client will remain paranoid. Allowing the client to retrieve medications from the medication cart would go against facility policy.

 

DIF:    Cognitive Level: Application           REF:   p. 131             OBJ:   3

TOP:   Physiological Needs                        KEY:  Nursing Process Step: Intervention

MSC:   Client Needs: Psychosocial Integrity