Chapter 27: Community Mental Health Nursing

Chapter 27: Community Mental Health Nursing

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A nursing instructor is teaching about the Community Health Centers Act of 1963. What was a deterring factor to the proper implementation of this act?

1.	Many prospective clients did not meet criteria for mental illness diagnostic-related groups.
2.	Zoning laws discouraged the development of community mental health centers.
3.	States could not match federal funds to establish community mental health centers.
4.	There was not a sufficient employment pool to staff community mental health centers.

 

 

____     2.   A nurse is implementing care within the parameters of tertiary prevention. Which nursing action is an example of this type of care?

1.	Teaching an adolescent about pregnancy prevention
2.	Teaching a client the reportable side effects of a newly prescribed neuroleptic medication
3.	Teaching a client to cook meals, make a grocery list, and establish a budget
4.	Teaching a client about his or her new diagnosis of bipolar disorder

 

 

____     3.   A nursing instructor is teaching about case management. What student statement indicates that learning has occurred?

1.	“Case management is a method used to achieve independent client care.”
2.	“Case management provides coordination of services required to meet client needs.”
3.	“Case management exists mainly to facilitate client admission to needed inpatient services.”
4.	“Case management is a method to facilitate physician reimbursement.”

 

 

____     4.   A client at the mental health clinic tells the case manager, “I can’t think about living another day, but don’t tell anyone about the way I feel. I know you are obligated to protect my confidentiality.” Which case manager response is most appropriate?

1.	“The treatment team is composed of many specialists who are working to improve your ability to function. Sharing this information with the team is critical to your care.”
2.	“Let’s discuss steps that will resolve negative lifestyle choices that may have increased your suicidal risk.”
3.	“You seem to be preoccupied with self. You should concentrate on hope for the future.”
4.	“This information is secure with me because of client confidentiality.”

 

 

____     5.   When intervening with a married couple experiencing relationship discord, which nursing action reflects an intervention at the secondary level of prevention?

1.	Teaching assertiveness skills in order to meet assessed needs
2.	Supplying the couple with guidelines related to marital seminar leadership
3.	Teaching the couple about various methods of birth control
4.	Counseling the couple related to open and honest communication skills

 

MULTIPLE CHOICE

 

1. ANS:  3

Chapter: Chapter 27, Community Mental Health Nursing

Objective Discuss the changing focus of care in the field of mental health.

Page: 723

Heading: The Changing Focus of Care

Integrated Processes: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Mood

Difficulty: Moderate

 

	Feedback
1	A client who did not meet criteria for mental illness was not a deterring factor.
2	Zoning laws were not a deterring factor.
3	A deterring factor to the proper implementation of the Community Mental Health Centers Act of 1963 was that states could not match federal funds to establish community mental health centers. This act called for the construction of comprehensive community mental health centers to offset the effect of deinstitutionalization, the closing of state mental health hospitals.
4	Insufficient staffing was not a deterring factor.

 

 

PTS:   1                    CON:  Mood

 

2. ANS:  3

Chapter: Chapter 27, Community Mental Health Nursing

Objective: Discuss tertiary prevention of mental illness within the community as it relates to the seriously mentally ill and homeless mentally ill.

Page: 725

Heading: The Public Health Model

Integrated Process: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Mood

Difficulty: Moderate

 

	Feedback
1	Teaching about pregnancy prevention is primary prevention.
2	Teaching about side effects of a new medication and bipolar disorder is secondary prevention.
3	The nurse who teaches a client to cook meals, make a grocery list, and establish a budget is implementing care within the parameters of tertiary prevention. Tertiary prevention consists of services aimed at reducing the residual effects that are associated with severe and persistent mental illness. It is accomplished by preventing complications of the illness and promoting rehabilitation that is directed toward achievement of maximum functioning.
4	Teaching about bipolar disorder to a newly diagnosed client is secondary prevention.

 

 

PTS:   1                    CON:  Mood

 

3. ANS:  2

Chapter: Chapter 27, Community Mental Health Nursing

Objective: Apply steps of the nursing process to care of the seriously mentally ill and homeless mentally ill within the community.

Page: 739

Heading: The Community as Client > Tertiary Prevention

Integrated Process: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Mood

Difficulty: Moderate

 

	Feedback
1	This statement indicates that further education is needed.
2	The instructor evaluates that learning has occurred when a student defines case management as providing coordination of services required to meet client needs. Case management strives to organize client care so that specific outcomes are achieved within allotted time frames.
3	This statement indicates that learning has not occurred.
4	This statement indicates that further teaching is required.

 

 

PTS:   1                    CON:  Mood

 

4. ANS:  1

Chapter: Chapter 27, Community Mental Health Nursing

Objective: Apply steps of the nursing process to care of the seriously mentally ill and homeless mentally ill within the community.

Page: 739

Heading: The Public Health Model

Integrated Processes: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Mood

Difficulty: Moderate

 

	Feedback
1	The most appropriate response by the case manager is to explain that sharing the information with the treatment team is critical to the client’s care. This case manager’s priority is to ensure client safety and to inform others on the treatment team of the client’s suicidal ideation.
2	Stating “Let’s discuss steps that will resolve negative lifestyle choices that may have increased your suicidal risk” does not protect the client’s safety, which is the priority.
3	Stating “You seem to be preoccupied with self. You should concentrate on hope for the future” does not protect the client’s safety, which is the priority.
4	Stating “This information is secure with me because of client confidentiality” does not protect the client’s safety, which is the priority.

 

 

PTS:   1                    CON:  Mood

 

5. ANS:  4

Chapter: Chapter 27, Community Mental Health Nursing

Objective: Discuss secondary prevention of mental illness within the community

Page: 726–727

Heading: The Community as Client > Primary Prevention > Maturational Crises

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Health Promotion

Difficulty: Moderate

 

	Feedback
1	Teaching assertiveness skills in order to meet assessed needs is tertiary prevention.
2	Supplying the couple with guidelines related to marital seminar leadership is primary prevention.
3	Teaching the couple about various methods of birth control is primary prevention.
4	Counseling the couple related to open and honest communication skills is a reflection of a nursing intervention at the secondary level of prevention. Secondary prevention aims at minimizing symptoms and is accomplished through early identification of problems and prompt initiation of effective treatment.

 

 

PTS:     1          CON:   Health Promotion