NR 607 final Exam Questions and
Answers| Latest Update
Inpatient treatment primary goal
Crisis stabilization
define seclusion
involuntary confinement of an individual alone in a room or area from which the individual is
prevented from leaving
use of seclusion
-Imminent risk of harm to themselves/others
-Laws differ state to state
-Only to ensure the immediate physical safety of pt and others
-Never as means of discipline, coercion, or for staff convenience
Evaluating a clients capacity for decision making
-Assess for communication barriers: language, hearing or vision impairments, dysarthria
-Evaluate for reversible causes of incapacity: infection, medications or other substances, acute
neurologic and psychiatric disorders
-Identify values and cultural influences that may impact client decision making
,-Ask questions: determine the pt's ability to understand the treatment and how treatment
applies to their situation.
-Identify a surrogate if needed: healthcare advance directive, medical power of attorney, spouse,
adult children, other close relatives
-Document
involuntary civil commitment
-legal intervention directed by a judge to order a person w serious symptoms to either remain in
psych hospital/ attend supervised outpt tx.
-May be initiated by family member/mental health professional/ law enforcement
-The person in question may have the right to appear at their hearing w counsel and present
evidence to dispute the case
-The max length of inpatient commitment varies by state.
-Outpatient commitment/assisted outpatient treatment (AOT)= may consist of supported
housing, intensive case management, meds, and frequent therapy
--Tx may last 6- 12 mo
use of restraints-seclusion criteria
-Only to ensure the immediate physical safety of pt and others
-No evidence that restraints decrease risk of falls
-Last resort
-Never as means of discipline, coercion, or for staff convenience
-Face to face eval and written order required, eval must be completed within 1 hr of application
of restraint/seclusion
--not allowed PRN
--must reevaluate q24h
,risk factors of suicide
-History of substance abuse
-Physical disability/illness
-Losing a friend or family member to suicide
-Ongoing exposure to bullying behavior
mental health condition
-Recent death of a family member/close friend
-Access to harmful means
-Relationship problems
-Previous suicide attempts
physical risk assessment
-quick visual exam to evaluate
--skin color, sweating, pupil size, level of consciousness, or obvious injuries to ensure adequate
airway, breathing, and circulation.
-Vital signs may be obtained if the pt permits; if not, continue assessment w/o getting vs.
define psychiatric emergency
-involve acute disturbances in thought, mood, behavior /social interactions that negatively
impact a pt's ability to function in their environment and require immediate intervention to
keep the pt/others from harm
--a state of crisis that has overwhelmed their coping mechanisms
, psychiatric emergencies occur when
-a danger to self
-a danger to others
-unable to meet their own basic needs for food/clothing/shelter d/t a psychological impairment
common psych emergencies
suicidality, acute psychosis, agitation and aggression, mania, substance-related concerns,
decompensation r/t personality d/o, severe anxiety, and med-related emergencies
early signs of aggressive behavior
threatening comments, clenched fists, shifts in body position towards a fighting stance, loud
vocalizations, agitated movements / striking inanimate objects
interventions for aggressive behavior
When aggression is unavoidable- prioritize security, sedation, and supervision
AEIO risk assessment categories
Agitation/Arousal: sit still? pacing? demonstrating aggressive behaviors?
Environment: Is the pt in a safe location? Id potential exits, equipment in the room, and the
distance of the room from the rest of the unit.
Answers| Latest Update
Inpatient treatment primary goal
Crisis stabilization
define seclusion
involuntary confinement of an individual alone in a room or area from which the individual is
prevented from leaving
use of seclusion
-Imminent risk of harm to themselves/others
-Laws differ state to state
-Only to ensure the immediate physical safety of pt and others
-Never as means of discipline, coercion, or for staff convenience
Evaluating a clients capacity for decision making
-Assess for communication barriers: language, hearing or vision impairments, dysarthria
-Evaluate for reversible causes of incapacity: infection, medications or other substances, acute
neurologic and psychiatric disorders
-Identify values and cultural influences that may impact client decision making
,-Ask questions: determine the pt's ability to understand the treatment and how treatment
applies to their situation.
-Identify a surrogate if needed: healthcare advance directive, medical power of attorney, spouse,
adult children, other close relatives
-Document
involuntary civil commitment
-legal intervention directed by a judge to order a person w serious symptoms to either remain in
psych hospital/ attend supervised outpt tx.
-May be initiated by family member/mental health professional/ law enforcement
-The person in question may have the right to appear at their hearing w counsel and present
evidence to dispute the case
-The max length of inpatient commitment varies by state.
-Outpatient commitment/assisted outpatient treatment (AOT)= may consist of supported
housing, intensive case management, meds, and frequent therapy
--Tx may last 6- 12 mo
use of restraints-seclusion criteria
-Only to ensure the immediate physical safety of pt and others
-No evidence that restraints decrease risk of falls
-Last resort
-Never as means of discipline, coercion, or for staff convenience
-Face to face eval and written order required, eval must be completed within 1 hr of application
of restraint/seclusion
--not allowed PRN
--must reevaluate q24h
,risk factors of suicide
-History of substance abuse
-Physical disability/illness
-Losing a friend or family member to suicide
-Ongoing exposure to bullying behavior
mental health condition
-Recent death of a family member/close friend
-Access to harmful means
-Relationship problems
-Previous suicide attempts
physical risk assessment
-quick visual exam to evaluate
--skin color, sweating, pupil size, level of consciousness, or obvious injuries to ensure adequate
airway, breathing, and circulation.
-Vital signs may be obtained if the pt permits; if not, continue assessment w/o getting vs.
define psychiatric emergency
-involve acute disturbances in thought, mood, behavior /social interactions that negatively
impact a pt's ability to function in their environment and require immediate intervention to
keep the pt/others from harm
--a state of crisis that has overwhelmed their coping mechanisms
, psychiatric emergencies occur when
-a danger to self
-a danger to others
-unable to meet their own basic needs for food/clothing/shelter d/t a psychological impairment
common psych emergencies
suicidality, acute psychosis, agitation and aggression, mania, substance-related concerns,
decompensation r/t personality d/o, severe anxiety, and med-related emergencies
early signs of aggressive behavior
threatening comments, clenched fists, shifts in body position towards a fighting stance, loud
vocalizations, agitated movements / striking inanimate objects
interventions for aggressive behavior
When aggression is unavoidable- prioritize security, sedation, and supervision
AEIO risk assessment categories
Agitation/Arousal: sit still? pacing? demonstrating aggressive behaviors?
Environment: Is the pt in a safe location? Id potential exits, equipment in the room, and the
distance of the room from the rest of the unit.
