Solutions Manual for Psychiatric-Mental Health Nursing 1st Edition by Puchkors, Saunders, Sharp
ISBN: 9781711472911
OpenStax Psychiatric-Mental Health
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
Review Questions
1. Nurse Jon is caring for a client with severe anxiety. Their anxiety has recently increased so much that the client is unable to go to work. Nurse Jon realizes that according to the mental health to mental illness continuum, this client is in the category of:
a. emotional problems or concerns
b. well-being
c. mental illness
d. between well-being and emotional problems
[Answer: C]
2. Student nurse DeShawna just began clinical on a behavioral health unit. The nursing instructor realizes that DeShawna needs assistance when DeShawna states:
a. “I have completed all parts of the nursing assessment.”
b. “This client seems fine so I did not complete a mental status exam.”
c. “I have gathered the names of all the medications this client takes.”
d. “I have assessed for suicidal ideation.”
[Answer: B]
3. What is the scope of psychiatric-mental health nursing practice?
a. assessment, education, medication administration, and screening for suicide risk
b. assessment, medical diagnosis, giving orders, writing prescriptions, admitting, and discharging
c. assisting providers, assisting with ADLs, monitoring clients, offering support, promoting safety
d. assessment, counseling, teaching coping skills, giving advice, listening
[Answer: A]
4. A psychiatric nurse is working in a community mental health center. They are completing an assessment on a 32-year-old pregnant woman presenting with depression. They note that the client has not answered the questions about alcohol and tobacco use. Why is it important to gather this information?
a. This information is not a pertinent part of the assessment process for a community mental health client.
b. This information will help the health-care team in all aspects of caring for the client, especially since she is pregnant.
c. This information is not important as it will have no long-term effects on the client’s unborn child.
d. This information is optional in relation to mental health care.
[Answer: B]
5. A client of the local mental health clinic arrives for their appointment out of breath, hair a mess, and clothing askew. The receptionist tells the client, “You are fifteen minutes late. I will have to see if the doctor can still see you.” The client responds, “I know I am late. I can
explain, my mother-in-law had a bad night. She lives with my husband and me. I am just so tired of taking care of her.” This example falls under which category of risk factors?
a. genetic comorbidities
b. psychological factors
c. social factors
d. victimization
[Answer: C]
6. Nurse Simon has just completed a psychosocial assessment of his client Juan. During the assessment, Nurse Simon listens to Juan and tries to make Juan feel respected by showing compassion and empathy. Nurse Simon is utilizing
a. the therapeutic relationship
b. risk assessment
c. spiritual awareness
d. resilience strategy
[Answer: A]
7. To keep the plan of care client-centered, what important assessment should the nurse do after identifying several risk factors for substance abuse in a client?
a. contact a rehab center for an intake assessment
b. perform a client strengths assessment
c. ask the psychiatrist to screen for depression
d. complete a health assessment
[Answer: B]
8. A nurse is teaching a therapeutic group about reducing the stigma of taking psychiatric medications. One of the participants raises his hand and states, “I don’t want to take medication because I am afraid what other people will think of me.” What is an appropriate response by the nurse?
a. “Why do you care what other people think?”
b. “You don’t need to tell anyone you are taking medication.”
c. “Medication to help your brain is just as important as it is for any other body part.”
d. “People can be really mean sometimes, can’t they?”
[Answer: C]
9. A person with mental illness does not want to seek care because of the shame they feel for being sick. What type of stigma is this related to?
a. self-stigma
b. caregiver stigma
c. institutional stigma
d. public stigma
[Answer: A]
10. A 45-year-old man with schizophrenia has been denied the rental of an apartment due to his mental health. Besides being illegal, what is this most closely related to?
a. stigma
b. prejudice
c. discrimination
d. hate crimes
[Answer: C]
11 A student nurse is studying for an exam on the recovery process. It is evident that they understand the concept when they explain to their study group:
a. “The majority of people with mental illness or substance use do not recover.”
b. “The recovery process is dictated by the health-care team.”
c. “Recovery is a nonlinear process based on instilling hope.”
d. “In recovery, a client needs to advocate for themselves right from the start.”
[Answer: C]
12. Maria is trying to create a psychiatric-mental health wellness routine. She has just seen her therapist and is writing notes from their session about wellness. She demonstrates an understanding of what was discussed when her notes include:
a. exercising sixty minutes three to five days per week
b. exercising thirty minutes three to five days per week
c. exercising forty-five minutes three to five days per week
d. exercising sixty minutes seven days per week
[Answer: C]
13. What should the psychiatric nurse do to assist individuals and families to understand the recovery process and the resources available to them?
a. psychoeducation
b. create a care plan for them
c. refer them to a psychiatrist
d. refer them to a website to read on their own
[Answer: A]
14 A nurse wants to head a project to improve medication administration on their unit. They work with other nurses on the unit to find evidence-based practice. What type of a research project is this?
a. qualitative
b. PICOT
c. mixed methods
d. QI
[Answer: D]
15 Nurse Sheila makes adjustments to the client’s plan of care after talking with the client. This is most likely an example of the ________ component of the EBP model.
a. best available research
b. client preferences
c. nursing expertise
d. review of evidence
[Answer: B]
16. A community psychiatric nurse is reviewing data to find gaps in the local health-care system. Which type of service yields the best outcomes for the acutely ill client?
a. wraparound services
b. community health services
c. facility mental health services
d. individual therapy services
[Answer: A]
17 What should the nurse do to locate credible sources of research in order to practice evidence-based interventions?
a. The nurse should ask a supervisor for help locating credible sources.
b. The nurse should access CINAHL or another professional database.
c. The nurse should perform a Wikipedia search.
d. The nurse should ask a librarian to gather information for them.
[Answer: B]
Check Your Understanding Questions
1. Define psychiatric-mental health.
[Answer: Psychiatric-mental health is a state of well-being in which an individual realizes their own abilities, copes with the normal stresses of life, works productively, and contributes to their community.]
2. What are some common physical responses related to stress?
[Answer: Answers may vary, but should include high blood pressure, insomnia, anxiety, depression, poor appetite or overeating, and substance use.]
3. Why do nurses complete a spiritual assessment as part of the psychosocial assessment?
[Answers may vary, but should include that spirituality is a protective factor. Knowing the importance of spirituality to the client helps the nurse create interventions specific to that client’s needs.]
4. Describe barriers to getting mental health treatment.
[Answers may vary, but should include stigma, cultural perceptions, lack of services, and cost.]
5. Identify the five stages of psychiatric-mental health recovery.
[Answer should include (1) starting treatment, (2) mental illness education, (3) making a change, (4) finding new meaning, and (5) sticking with recovery.]
What Should the Nurse Do?
An experienced psychiatric RN is caring for a 60-year-old male client without a home who just arrived on a hospital behavioral health unit. The nurse has asked the client to describe in his own words his reason for seeking care. The client has shared that he is often bullied on the streets due to his unkempt appearance. The nurse notes that in addition to body odor, the client smells of alcohol and urine. The client relates that he wasn’t always homeless; he used to have a good job, a house, and was married. He lost his job due to a layoff, and then everything else seemed to fall apart. His wife left him after the bank took the house when he could no longer make the payments. He did not have any close friends or family who he could stay with long-term. He found that he quickly wore out his welcome of sleeping on their couches. He tells the nurse he began drinking alcohol to cope with his losses. He cannot give the nurse an exact number of drinks that he takes per day.
1. What additional aspects of the psychosocial assessment should the nurse explore?
[Answer: Answers will vary, but should include asking about previous health history and length of time the client has been using alcohol. The next thing to ask about is if the client has any thoughts of self-harm or suicide. Due to the many losses the client has had, his safety is of concern to the nurse. In order to address the client’s physical needs, the nurse should ask when the client last had a meal and offer him a set of clean clothes and towels so that the client can shower. Meeting the needs of food and cleanliness will help the client’s nutritional needs and self-esteem.]
Reflection Questions
1. What is an example of therapeutic communication that might take place during the nursing assessment?
[Answer: Answers may vary, but should include something like “Tell me more about how you are feeling today.”]
2. As a nurse, what ways could you educate people to help decrease the stigma surrounding mental health?
[Answers will vary, but could contain information about the importance of education, reminding them that the mind is part of the body and important to overall health, or asking them if they would encourage a family member to seek help for a mental health problem.]
3. In what ways can nurses help their clients who have the potential for or are experiencing a mental illness or substance abuse?
[Answers will vary, but should include education, advocacy, instilling hope, and interventions that focus on prevention.]
4. Using the chart in this chapter describing the levels of evidence, what are two examples of a high- and a low-level source?
[Answer: High-level sources are meta-analysis and systematic review. Low-level sources are quality study and expert opinions.]
5. Which level do you think you would use if you wanted to make a hospital unit’s admission procedures more effective?
[Answer: A qualitative or descriptive study, or a quality improvement project, or higher level would be helpful for making admission procedures more effective.]
6. If your clinical question was: “Would the addition of a checklist for unit admissions result in more relevant data being obtained over six months?” What would your PICOT format look like?
[Answer: P = nursing admission process; I = use of admission checklist; C = routine practice without a checklist; O = 50 percent increase in relevant data being obtained; T = over six months]
Competency-Based Questions
1. Look at the mental health continuum and give examples for each level of functioning.
[Answer: Answers should include:
Well-being = occasional stress, no impairment
Emotional problems or concerns = mild to moderate distress, mild or temporary impairment
Mental illness = marked distress, moderate to disabling or chronic impairment]
2. View the video [link to URL: https://www.ted.com/talks/hailey_hardcastle_why_students_should_have_mental_health _days?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare Why Students Should Have Mental Health Days[/link]. Write two paragraphs connecting this video’s main focus on overall health (that includes taking time to protect your own mental health) to what you could teach a client about taking care of their mental health.
[Answers will vary, but should include that although schools may not have specific policies for students to manage stress, the importance of mental health is equal to physical well-being; reference the resource list provided.]
3. Search the internet and find two local resources that you could share with a client who needs a safe place to receive mental health care.
[Answers will vary, but could include local community mental health centers, NAMI contacts, veterans’ services, or child and adolescent services.]