Chapter 28: Severe Mental Illness: Crisis Stabilization and Rehabilitation

Chapter 28: Severe Mental Illness: Crisis Stabilization and Rehabilitation

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1)   When asked by a client’s wife what characterizes severe mental illness, the nurse should reply, “It is

ANS:   C

“Severe mental illness” has replaced the term “chronic mental illness.” Thus option C is the best explanation. Neither option A nor option B considers the long-term aspect of severe mental illness. Option D: Severe mental illness can, in fact, be treated, but remissions and exacerbations are part of the course of the illness.

DIF:    Cognitive Level: Application             REF:    Text Page: 579

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

2)   A client with residual schizophrenia, aged 60 years, spent 5 years in a state hospital before being discharged to a community residence. The client, who is now monitored by the community mental health nurse, requires much encouragement to voice her needs and take independent action to get her needs met. The nurse assesses this passive behavior as being the probable result of

ANS:   A

Institutionalization brought about a decreased sense of self, resulting in lack of autonomy in many clients. Clients became dependent on the hospital and its staff to meet their needs. When these clients were discharged into the community many continued to demonstrate passive behaviors despite efforts to rehabilitate them. Option B: Although the long-term effects of the disease process may contribute to passivity, institutionalization was probably a greater determinant of the behavior. Option C: The scenario does not suggest recreational drug use. Option D: Neuroleptic drug side effects would result in different behaviors.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 576

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Psychosocial Integrity

3)   A client, aged 30 years, tells his case manager “I do not have bipolar disorder anymore, so I do not need the medicine and the blood tests. I was in the hospital twice for a few days a year or so ago. Then you got into the act to get me a place to live and SSI checks. All that is wrong now is I am bored and I do not have any friends.” The nurse assesses the client as demonstrating

ANS:   A

The client scenario describes denial. Many young clients with severe mental illness have limited experience with hospital-based formal treatment programs. Short-term hospitalizations and community follow-up contribute to these clients failing to see that they have a problem. Option B: The client is not blaming another for a personal weakness. Option C: The client is not making socially acceptable excuses. Option D: The client is not identifying with another.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 576

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Psychosocial Integrity

4)   A nursing diagnosis that should be considered for individuals who are severely mentally ill and homeless is

ANS:   B

Of the 40% to 70% of individuals with severe mental illness who do not live with their families, many become homeless. Life on the street or in a shelter has a negative influence on the individual’s self-esteem, making this nursing diagnosis one that should be considered. Option A: Substance abuse is not an approved North American Nursing Diagnosis Association diagnosis. Option C: Disturbed sleep pattern may be noted in some clients but is not a universal problem. Option D refers to persistent disorientation, which is not seen in a majority of the homeless.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 577, Text Page: 578

TOP:    Nursing Process: Nursing Diagnosis

MSC:   NCLEX: Psychosocial Integrity