Chapter 34: Community-Based Psychiatric Nursing Care

Chapter 34: Community-Based Psychiatric Nursing Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which health care setting is most likely to meet the mental health care needs of an urban community?

a.	A physician’s office associated with diagnostic testing located near a community shopping center
b.	A community mental health clinic with a wide range of multidisciplinary services
c.	A hospital emergency room with fast tracking and minimum patient waiting time
d.	An inpatient specialty unit located in a large urban hospital

 

 

ANS:  B

According to the report from the New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America (NFCMH, 2003), evidence shows that offering a full range of community-based alternatives is more effective than physician- or hospital-based or emergency-room treatment.

 

DIF:    Cognitive Level: Comprehension     REF:   Text Pages: 651-652

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

 

2. A psychiatric nurse is focusing on the fifth area of service, based on the Community Mental Health Centers Act of 1963, when:

a.	assisting with electroconvulsive therapy (ECT) treatments.
b.	providing stress management technique classes to new mothers.
c.	assessing patients for admission into an outpatient group program.
d.	providing emergency psychiatric care to a rape victim demonstrating psychoses.

 

 

ANS:  B

The goal of the fifth service of the Community Mental Health Centers Act of 1963 is consultation and education. One focus for education is primary prevention.

 

DIF:    Cognitive Level: Application           REF:   Text Pages: 657-658

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

 

3. A community mental health center is adjusting to severe budget cuts. Which service is most likely to be considered for elimination?

a.	Toll-free suicide prevention telephone hotline services
b.	Community education regarding the risk factors of depression
c.	Transitional housing for a parent diagnosed with chronic depression
d.	Follow-up laboratory testing regarding therapeutic medication levels

 

 

ANS:  B

Major amendments to the Community Mental Health Centers Act in 1975 required that community mental health centers continue to offer five areas of service. Because of the funding cuts, the services that most community mental health centers reluctantly reduce are their preventive efforts directed toward mental health education, focusing resources on the care of people with diagnosed mental illness.

 

DIF:    Cognitive Level: Analysis                REF:   Text Pages: 657-658

TOP:   Nursing Process: Outcome Identification

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

 

4. When considering mental health issues, deinstitutionalization is best demonstrated when a:

a.	patient newly diagnosed with bipolar disorder is admitted to a mental health unit for medication and therapy stabilization.
b.	patient who has been hospitalized for 5 years for persistent depression is being discharged to an outpatient program.
c.	suburban community’s shelter for its persistently mentally ill and cognitively impaired population receives renewed funding.
d.	homeless adolescent newly diagnosed with obsessive compulsive disorder (OCD) is discharged earlier than expected when a foster home becomes available.

 

 

ANS:  B

Deinstitutionalization refers to the transfer of a patient hospitalized for extended periods of time to a community setting. At the mental health care system level, it refers to a shift in the focus of care from long-term institution to the community, accompanied by discharging long-term patients and avoiding unnecessary admissions.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 660

TOP:   Nursing Process: N/A

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

 

5. The primary nursing responsibility of a community psychiatric nurse managing caring for patients diagnosed with serious and persistent mental illnesses residing in a group home is to conduct an ongoing:

a.	assessment of the patients’ life needs.
b.	evaluation of care provided for the patients.
c.	management of the funds allotted for individual patient care.
d.	oversight of all day-to-day operations of the group home and its services.

 

 

ANS:  A

A systems model of community mental health operates on the philosophy that all aspects of a person’s life need care—basic human needs, physical health needs, and needs for psychiatric treatment and rehabilitation—if a person is to live successfully in the community. The initial step is to assess the individual patient’s needs.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 661

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care