Chapter 04: Settings for Psychiatric Care

Chapter 04: Settings for Psychiatric Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Inpatient hospitalization for persons with mental illness is generally reserved for patients who:

ANS:  A

Hospitalization is justified when the patient is a danger to self or others, has dangerously decompensated, or needs intensive medical treatment. The distracters do not necessarily describe patients who require inpatient treatment.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 74-75     TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe, Effective Care Environment

2. A patient was hospitalized for 24 hours after a reaction to a psychotropic medication. While planning discharge, the case manager learned that the patient received a notice of eviction immediately prior to admission. Select the case manager’s most appropriate action.

ANS:  C

The case manager should intervene by arranging temporary shelter for the patient until an apartment can be found. This activity is part of the coordination and delivery of services that falls under the case manager role. None of the other options is a viable alternative.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 69-72     TOP:   Nursing Process: Implementation

MSC:  Client Needs: Safe, Effective Care Environment

3. Select the example of tertiary prevention.

ANS:  A

Tertiary prevention involves services that address residual impairments, with a goal of improved independent functioning. Restraint is a secondary prevention. Genetic counseling and teaching school-age children about substance abuse and dependence are examples of primary prevention.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 70          TOP:   Nursing Process: Implementation

MSC:  Client Needs: Health Promotion and Maintenance

4. A patient diagnosed with schizophrenia had an exacerbation related to medication noncompliance and was hospitalized for 5 days. The patient’s thoughts are now more organized, and discharge is planned. The patient’s family says, “It’s too soon for discharge. We will just go through all this again.” The nurse should:

ANS:  C

Patients do not stay in a hospital until every symptom disappears. The nurse must assume responsibility to advocate for the patient’s right to the least restrictive setting as soon as the symptoms are under control and for the right of citizens to control health care costs. The health care provider will use the same rationale. Shifting blame will not change the discharge. Security is unnecessary. The nurse can handle this matter.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 73-76     TOP:   Nursing Process: Implementation

MSC:  Client Needs: Safe, Effective Care Environment

5. A nurse inspects an inpatient psychiatric unit and finds that exits are free of obstructions, no one is smoking, and the janitor’s closet is locked. These observations relate to:

ANS:  B

Nursing staff are responsible for all aspects of milieu management. The observations mentioned in this question directly relate to the safety of the unit. The other options, although part of the nurse’s concerns, are unrelated to the observations cited.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 75-77     TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Safe, Effective Care Environment