Chapter 5: Settings for Psychiatric Care

Chapter 5: Settings for Psychiatric Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Planning for patients with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for patients who:

a.	present a clear danger to self or others.
b.	are noncompliant with medications at home.
c.	have no support systems in the community.
d.	develop new symptoms during the course of an illness.

 

 

ANS:  A

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

 

DIF:    Cognitive Level: Comprehension     REF:   Pages: 72-74   TOP:   Nursing Process: Planning

MSC:  NCLEX: Safe, Effective Care Environment

 

2. A patient is hospitalized for a reaction to a psychotropic medication and then is closely monitored for 24 hours. During a predischarge visit, the case manager learns the patient received a notice of eviction on the day of admission. The most appropriate intervention for the case manager is to:

a.	cancel the patient’s discharge from the hospital.
b.	contact the landlord who evicted the patient to further discuss the situation.
c.	arrange a temporary place for the patient to stay until new housing can be arranged.
d.	document that the adverse medication reaction was feigned because the patient had nowhere to live.

 

 

ANS:  C

The case manager should intervene by arranging temporary shelter for the patient until suitable housing can be found. This is part of the coordination and delivery of services that falls under the case manager role. The other options are not viable alternatives.

 

DIF:    Cognitive Level: Application           REF:   Page: 73

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment

 

3. A multidisciplinary health care team meets 12 hours after an adolescent is hospitalized after a suicide attempt. Members of the team report their assessments. What outcome can be expected from this meeting?

a.	A treatment plan will be determined.
b.	The health care provider will order neuroimaging studies.
c.	The team will request a court-appointed advocate for the patient.
d.	Assessment of the patient’s need for placement outside the home will be undertaken.

 

 

ANS:  A

Treatment plans are formulated early in the course of treatment to streamline the treatment process and reduce costs. It is too early to determine the need for alternative postdischarge living arrangements. Neuroimaging is not indicated for this scenario.

 

DIF:    Cognitive Level: Application           REF:   Pages: 72-74

TOP:   Nursing Process: Outcomes Identification

MSC:  NCLEX: Safe, Effective Care Environment

 

4. The relapse of a patient with schizophrenia is related to medication noncompliance. The patient is hospitalized for 5 days, medication is restarted, and the patient’s thoughts are now more organized. The patient’s family members are upset and say, “It’s too soon about the patient being scheduled for discharge. Hospitalization is needed for at least a month.” The nurse should:

a.	call the psychiatrist to come explain the discharge rationale.
b.	explain that health insurance will not pay for a longer stay for the patient.
c.	call security to handle the disturbance and escort the family off the unit.
d.	explain that the patient will continue to improve if medication is taken regularly.

 

 

ANS:  D

Patients no longer stay in the hospital until every vestige of a 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. Calling security is unnecessary. The nurse can handle this matter.

 

DIF:    Cognitive Level: Application           REF:   Pages: 74-75

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment