Test bank for foundations of mental health care 5th edition by michelle morrison valfre

129 OBJ: 1 TOP: Use of the Inpatient Setting KEY: Nursing Process Step: Planning MSC: Client Needs: Psychosocial Integrity 3.. 131 OBJ: 3 TOP: Physiological Needs KEY: Nursing Process St

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Link full download:https://getbooksolutions.com/download/test-bank-for-foundations-of-mental-health-care-5th-edition-by-michelle-morrison-valfre Foundations of Mental Health Care: 5th Edition Test Bank – Morrison-Valfre

Sample

Chapter 12: The Therapeutic Environment

Test Bank

MULTIPLE CHOICE

1 Crisis stabilization provides care to clients in treatment settings with the purpose of reestablishing homeostasis; it usually lasts for _ days

a 1 to 2

b 2 to 4

c 4 to 6

d 6 to 8

ANS: A

Intensive counseling is given to assist clients with the immediate problem that is causing the

crisis This usually is accomplished within 1 to 2 days, and the client is discharged with follow-up care

DIF: Cognitive Level: Knowledge REF: p 129 OBJ: 1

TOP: Crisis Stabilization KEY: Nursing Process Step: Intervention

MSC: Client Needs: Psychosocial Integrity

2 Which is an accepted criterion for inpatient admission to a mental health facility?

a The client likes the security and comfort of the mental health facility

b The client feels that he is no longer able to cope with life stressors or maintain

control of his behavior

c A client’s behavior becomes unusual

d The client suffers from depression

ANS: B

This situation meets the criteria for an inpatient admission Other criteria include being a threat to one’s safety or the safety of others and having people who are a part of the client’s

environment who that are not willing or able to support him The other options do not meet

the criteria

DIF: Cognitive Level: Comprehension REF: p 129 OBJ: 1

TOP: Use of the Inpatient Setting KEY: Nursing Process Step: Planning

3 A male client with a diagnosis of schizophrenia refuses to take his medication because

of his

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paranoia that the medication may be poisoned Frequent inpatient readmissions to the facility

occur as a result Which term is given to repeated inpatient admissions?

a Milieu

b Chronicity

c Noncompliance

d Recidivism

ANS: D

Recidivism often occurs as a result of noncompliance with prescribed therapy, as in the case

of this client who is not taking his medications Adequate community resources help to prevent recidivism Milieu refers to the mental health care environment; chronicity refers

to a

long duration, such as occurs with a chronic illness such as schizophrenia; and

noncompliance

describes a situation in which the client does not follow the prescribed plan of care, often resulting in recidivism

TOP: The Chronically Mentally Ill Population

KEY: Nursing Process Step: Planning MSC: Client Needs: Psychosocial Integrity

4 An adult female inpatient client with a diagnosis of paranoid schizophrenia will not take her

medications from the nurse She states, “I know you are poisoning that medicine.” Which nursing action is most appropriate?

a Promise the client that the staff would not do anything to harm her

b Let the client watch the medication preparation process

c Administer medications to her in unit dose packages so that she can open the

packages herself

d Allow the client to retrieve the medications out of the medication cart with

supervision

ANS: C

Administering medications in unit dose packages would help to prevent the client from thinking that the nurse is poisoning the medications The client would be allowed to open the

packages herself Promising the client that the staff would not harm her will not alleviate her

paranoia Letting the client watch the medication preparation process may help, but if she feels that the poisoning is happening when the nurse is placing the medication in the cup, the

client will remain paranoid Allowing the client to retrieve medications from the

medication

cart would go against facility policy

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DIF: Cognitive Level: Application REF: p 131 OBJ: 3

TOP: Physiological Needs KEY: Nursing Process Step: Intervention

5 A male inpatient client who is experiencing depression has no interest in eating He skips

meals frequently and has been losing weight What is the best nursing action in this situation?

a Ask the client to “Please eat one meal for me.”

b Leave food with him at mealtime and offer snacks frequently

c Give the client information on the benefits of good nutrition

d Remove client privileges every time he doesn’t eat

ANS: B

Trying not to make an ordeal out of mealtime and food may allow the client to choose to eat,

especially as his condition improves Asking the client to “please eat one meal” for the nurse

is bargaining and trying to make the client feel that he owes the nurse Giving the client information about nutrition is not important to this client; his refusal to eat is not related

to

good or bad nutrition Removing client privileges each time he doesn’t eat goes against the

client’s rights

6 Encouragement for clients to practice good hygiene habits not only meets basic

physiological

needs, it also meets the hierarchal need of:

a Love and belonging

b Safety and security

c Infection control

d Self-care

ANS: A

Good hygiene meets the need for love and belonging by conveying to others willingness for

social interaction Safety and security needs relate more to the client’s feeling secure in his

environment and providing measures to keep clients safe; infection control and self-care are

not actual needs, but the concepts fall into the category of physiological needs

TOP: Physiological Needs KEY: Nursing Process Step: Planning

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7 With regard to the environment, it is important for the nurse to be aware of lighting for some

clients Clients with a diagnosis of schizophrenia may be bothered by lights that are flickering

because this may trigger:

a Overstimulation

b Hallucinations

c Aggressive behaviors

d Photophobia

ANS: B

The flickering of a light bulb can trigger hallucinations and delusions; therefore, it is important for the nurse to monitor the physical environment Overstimulation, aggressive behaviors, and photophobia usually occur when light is too bright

8 A female client on the mental health unit experiences periods of psychosis at intervals She

often asks what day she came to the facility and what day it is now, and she seems never

to be

aware of the time Which nursing intervention would help this client the most?

a Remind her of the time of day every time she asks

b Assist her to keep a written schedule, including her day of admission, on a

calendar posted in her room and a clock beside the calendar

c Tell her it doesn’t really matter what day she came to the facility; what matters is what day and time it is now

d Instruct the staff to not answer her repetitive questions because she has been told

numerous times her day of admission, and there is a clock on the wall

ANS: B

A written schedule in her room and a clock will assist her in learning to monitor this information on her own, and this will help to keep her oriented and will foster

independence

Reminding her of the time will not help the client monitor the time on her own; it allows the

ineffective cycle to continue Telling the client that it doesn’t matter when she entered the facility and instructing the staff not to answer her questions are belittling to the client DIF: Cognitive Level: Application REF: p 133 OBJ: 3

TOP: Safety and Security Needs KEY: Nursing Process Step: Intervention

9 A 15-year-old female client is noted to often sit alone in the activity room of the

facility while

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watching television She often begins to join in activities on the unit but then retreats back to

her room Which intervention is most appropriate in this situation?

a Encourage her to join in on a group activity and actively participate in the activity with her until she feels more comfortable on her own

b Keep encouraging her to participate in the group activity

c Offer her rewards, such as extended television privileges, for joining in a group

activity

d Offer her support as she tries to become more involved in activities

ANS: A

Encouraging the client to join the activity and participating with her will offer her

security and

will help her to meet others in the group and feel less alone Love and belonging needs are

met by socializing with others Offering encouragement to participate in the group

activity

and supporting her as she tries to become more involved are helpful, but these actions do not

give her the same sense of security as she receives with encouragement and participation

in

the group activity until she is comfortable Offering her rewards defeats the purpose of instilling motivation and the improvement in self-esteem that results from participating according to her own desire

TOP: Love and Belonging Needs KEY: Nursing Process Step: Intervention

10 The nurse can assist a client best in meeting his or her needs for self-esteem and/or self-actualization by:

a Setting rules and regulations

b Allowing the client to set rules and regulations for the inpatient unit

c Informing the client of what the treatment team has decided regarding the plan of care

d Allowing the client to make choices involving his or her care when appropriate

ANS: D

Self-esteem needs must be met before self-actualization can occur, but this is also a part

of

self-actualization This intervention allows the client to practice decision-making skills and

assists in improving his or her self-esteem Rules and regulations are necessary for limit setting, but the nurse can include the client and improve his or her self-esteem by

informing

the client of the rules and regulations, so the client is able to follow them Allowing the

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client

to set rules is difficult in that the ability for limit setting often is lacking in clients with mental

health disorders Sharing with the client should reflect a combined effort between the client

and the treatment team

TOP: Self-Esteem Needs KEY: Nursing Process Step: Intervention

11 The nurse is aware that during the admission process to a mental health facility, the anxious

client:

a Is acutely aware of his or her surroundings

b Often forgets some of what is said in the unfamiliar surroundings

c Has a keen memory in his or her heightened state of awareness

d Frequently has no recollection of what is said by the staff during admission

ANS: B

High levels of anxiety can prevent an individual from remembering things that he has been

told It is helpful to limit the amount of information thrust on a client during the early admission process Written information about rules, regulations, and expectations on the unit

is often helpful The anxious client is not acutely aware of his or her surroundings and does

not have a keen memory during this time Having no recollection of what the staff has said is

an extreme reaction

TOP: Admission and Discharge KEY: Nursing Process Step: Planning

12 Bright colors in the environment of the client are often:

a Depressing

b Stimulating

c Calming

d Frightening

ANS: B

Colors are important to consider, depending on the needs of the client Bright colors can

be

stimulating to clients Mental health settings often have warm, more neutral colors because

these colors promote calm emotions and behavior Dark colors are considered more depressing Color usually is not associated with eliciting fright

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TOP: Physiological Needs KEY: Nursing Process Step: Assessment

13 The nurse should monitor the temperature of the environment of a client who

becomes easily

agitated, with awareness that increased temperatures sometimes may cause the client to become:

a Calm

b Confused

c Cooperative

d More distressed

ANS: D

Increased environmental temperatures often cause easily agitated clients to become more agitated It is important for the nurse to monitor a client’s individual response to his or her

environment

TOP: Physiological Needs KEY: Nursing Process Step: Assessment

14 A male client is in the process of being admitted to a mental health facility He is sure that the

nurse is the administrator of the hospital, despite the nurse’s insistence that he is a staff nurse

on the unit This client is experiencing:

a Acute confusion

b Visual hallucinations

c Delusions

d Auditory hallucinations

ANS: C

Delusions are thoughts or beliefs that cannot be changed by rational explanations Acute confusion is seen as disorientation to person, place, time, or purpose A visual

hallucination

involves seeing something that is not there, and an auditory hallucination is hearing something

that is not present

DIF: Cognitive Level: Comprehension REF: p 136 OBJ: N/A

TOP: Admission and Discharge KEY: Nursing Process Step: Assessment

15 When establishing a client’s level of consciousness, the nurse is aware that this is determined

by assessing the client’s:

a Level of awareness

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b Ability to tell the nurse where he or she is at any given time

c Accuracy in expressing the current month, date, or year

d Capability to explain why he or she is in the facility

ANS: A

Level of awareness determines the client’s level of consciousness The other options refer

to

other aspects of the client’s level of orientation

DIF: Cognitive Level: Comprehension REF: p 136 OBJ: N/A

TOP: Admission and Discharge KEY: Nursing Process Step: Assessment

16 A 16-year-old client is in the lounge with other clients on the inpatient unit when he suddenly

becomes agitated Which action by the nurse would be most appropriate in this situation?

a Turn up the volume on the television to distract the client

b Bring him to sit at the nurses’ station while the staff is doing shift report

c Keep him in the lounge and attempt to converse with him

d Accompany him to a room where soft music is playing

ANS: D

High noise levels can lead to distorted perceptions, altered thinking, and sensory

overload

Calm music, the sound of ocean waves, or a light rain can produce relaxation When noise

levels become too intense, clients tend to become distracted and agitated Turning up the volume on the television, bringing him to a crowded nurses station, and keeping him in the

lounge do not decrease noise levels and may increase his agitation

TOP: Therapeutic Environment and Client Needs

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

17 The goal in treating a client with a chronic mental illness is to prevent recidivism Which

factor is crucial in this effort?

a Increased use of psychotherapeutic medications

b Increased lengths of stay on the inpatient unit

c Increased commitment to the plan of care by the client

d Group residential homes with vocational training

ANS: D

One of the most important factors in preventing recidivism is adequate community

resources

where clients receive support and educational and vocational opportunities With the focus on

the “least restrictive environment,” many chronically mentally ill clients now live in

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small,

homelike, sheltered group settings within the community

TOP: The Chronically Mentally Ill Population

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

18 The use of therapeutic touch as a relaxation technique in the mental health setting is beneficial

for clients displaying which symptoms?

a Aggression

b Paranoia

c Depression

d Anxiety

ANS: C

Depressed persons may need touch and physical contact—an excellent opportunity for therapeutic touch Aggressive clients may interpret the close presence of a caregiver as threatening Touch must be used cautiously as a therapeutic tool and with the client’s best interest in mind People with paranoid or anxious feelings usually feel more comfortable when

caregivers are outside their intimate space

TOP: Safety and Security Needs KEY: Nursing Process Step: Assessment

19 A 22-year-old woman is brought to the inpatient unit for attempting suicide Her clothes are

clean, and her general appearance is neat and well groomed She appears to be well nourished

In considering Maslow’s hierarchy of needs, which is a priority for this client?

a Physiological

b Love and belonging

c Self-actualization

d Safety and security

ANS: D

The safety and security of the therapeutic environment are the most important factors in mental health care Safety and security needs within the therapeutic environment include the

feeling of physical safety, the security of a limited setting, and the ability to feel secure with

others For clients who are depressed or suicidal, the therapeutic environment offers special

protection from self-harm with the client’s best interest in mind

TOP: Safety and Security Needs KEY: Nursing Process Step: Assessment

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MULTIPLE RESPONSE

20 Inpatient services provide care mainly for mental health clients who are experiencing which

conditions? (Select all that apply.)

a Acute mental or emotional problems

b Chronic mental or emotional problems

c Depression

d Crisis

e Bipolar disorder

ANS: A, B, D

Inpatient services provide intensive therapy and support for clients with acute and chronic mental health disorders as well as those in crisis situations, and they usually require short stays The goal is to transition the client from the facility to the community Depression and

bipolar disorder are specific disorders that are not necessarily seen more frequently than other

disorders within an inpatient setting

TOP: Use of the Inpatient Setting KEY: Nursing Process Step: Intervention

21 Which are common causes for client noncompliance in the plan of care? (Select all that

apply.)

a Financial concerns

b Lack of support by family

c Staff dislike of a client

d Inability to understand the treatment plan

e Lack of access to treatment services

ANS: A, B, D, E

Financial concerns, lack of family support, and lack of access to treatment often make the client feel that he or she is unable to continue in the planned treatment The social worker

is

the best person to contact in these instances because he or she is aware of programs that may

meet needs in these problem areas Education and involvement of other caregivers will assist

the client in eliminating the problem of inability to understand the treatment plan Staff dislike

of a patient should never be a reason for client noncompliance

TOP: Compliance KEY: Nursing Process Step: Evaluation

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