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Chapter 1 .,
1. Thenurse is assessingthe factors contributing to the well-
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being of a newly admitted client. Which of the following
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wouldthenurseidentifyashavingapositiveimpactonthe
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individual's mental health?
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A) Notneedingothers forcompanionship ., ., ., .,
B) Theabilityto effectivelymanage stress ., ., ., ., .,
C) A family historyof mental illness ., ., ., ., .,
D) Strivingfortotalself-reliance ., ., .,
Ans: B
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Feedback:
Individual factors influencing mental health include biologic ., ., ., ., ., .,
makeup, autonomy, independence, self-esteem, capacityfor
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growth, vitality, abilityto find meaningin life, emotional
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resilience or hardiness, sense of belonging, reality
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orientation, and coping or stress management abilities.
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Interpersonal factors such as intimacy and a balanceof
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separatenessandconnectednessarebothneeded
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for good mental health, and therefore ahealthy person would need others for
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companionship. A family history of mental illnesscould relate to the biologic makeup of an
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individual, which mayhave a negative impacton an individual's mental health, as well as a
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negativeimpact onanindividual's interpersonal and socialñcultural factors of health. Total
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self-reliance is not possible, and a positive social/cultural factor is access to adequate
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resources.
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2. Whichofthe followingstatements aboutmental illness are true? Select all that apply.
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A) Mentalillness can cause significant distress, impaired functioning, or both. ., ., ., ., ., ., ., ., .,
B) Mental illness is onlydue to social/cultural factors. ., ., ., ., ., ., .,
C) Social/cultural factorsthatrelatetomentalillnessincludeexcessivedependency on ., ., ., ., ., ., ., ., ., .,
or withdrawal from relationships.
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D) Individualssufferingfrommentalillness areusuallyableto copeeffectivelywith daily ., ., ., ., ., ., ., ., ., ., ., .,
life. .,
E) Individualssufferingfrommentalillnessmayexperiencedissatisfaction with ., ., ., ., ., ., ., .,
relationships and self. ., ., .,
Ans: A, D, E ., ., .,
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental illness
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may be related to individual, interpersonal, or social/cultural factors. Excessive
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dependencyon or withdrawal from relationships are interpersonal factors that relate to
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mental illness. Individuals suffering from mental illness can feel overwhelmed with daily
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life.Individuals sufferingfrommentalillnessmayexperiencedissatisfaction with
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relationships and self.
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,3. Whichof the followingaretrue regarding mental health and mental illness?
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A) Behaviorthat maybe viewedasacceptablein onecultureisalways unacceptable in ., ., ., ., ., ., ., ., ., ., ., ., .,
other cultures. ., .,
B) It is easyto determine if a person is mentallyhealthyor mentallyill.
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C) In most cases, mental health is a state of emotional, psychological, and social
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wellnessevidencedbysatisfyinginterpersonalrelationships,effectivebehavior
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and coping, positive self-concept, and emotional stability.
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D) Personswhoengageinfantasiesarementallyill. ., ., ., ., ., ., .,
Ans: C
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Feedback:
Whatonesocietymayview asacceptable and appropriate behavior,another societymay see
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that as maladaptive, and inappropriate. Mental health and mental illness are difficult to define
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precisely. In most cases, mental health is a state of emotional, psychological, and social
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wellness evidenced by satisfying interpersonal relationships, effective behavior and
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coping, positive self-concept, and emotionalstability. Persons who engage in fantasies may
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be mentallyhealthy, but the inabilityto distinguish reality from fantasy is an individual factor
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that may contribute to mental illness.
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4. Aclient grievingthe recent loss ofher husband asksif she is becomingmentallyill
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because she is so sad. The nurse's best response would be,
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A) ìYoumayhave atemporarymentalillnessbecause you areexperiencingsomuch pain.î ., ., ., ., ., ., ., ., ., ., ., ., .,
B) ìYouarenot mentallyill. This isanexpectedreactiontotheloss youhave ., ., ., ., ., ., ., ., ., ., ., ., ., .,
experienced.î .,
C) ìWereyougenerallydissatisfiedwith yourrelationshipbeforeyourhusband's ., ., ., ., ., ., ., ., .,
death?î .,
D) ìTrynottoworryaboutthatright now.Youneverknowwhat thefuture brings.î Ans: ., ., ., ., ., ., ., ., ., ., ., ., ., ., .,
.B ,
Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships,
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ineffective coping, and lack of personal growth. Additionally the behavior must not be
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culturally expected. Acute grief reactions are expected and therefore not considered
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mentalillness. False reassuranceoroveranalysis does notaccuratelyaddress theclient's
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concerns.
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,5. The nurse consults the DSM for which of the following purposes?
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A) To devise a plan of care for anewlyadmitted client ., ., ., ., ., ., ., ., ., .,
B) Topredict theclient's prognosisoftreatment outcomes ., ., ., ., ., ., .,
C) Todocumentthe appropriate diagnostic code in theclient's medical record ., ., ., ., ., ., ., ., ., .,
D) Toserveasaguideforclientassessment ., ., ., ., ., ., ., ., . ,
. Ans: D
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Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and
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identifies underlying causes of mental disorders. It does not provide care plans or
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prognostic outcomes of treatment. Diagnosis of mental illness is not within the generalist
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RN's scopeof practice, sodocumenting thecodeinthemedicalrecordwould be
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inappropriate.
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6. Which would be a reason for a student nurse to use the DSM?., ., ., ., ., ., ., ., ., ., ., ., . ,
A) Identifyingthemedicaldiagnosis ., ., .,
B) Treatclients .,
C) Evaluate treatments .,
D) Understand the reason for theadmission andthenatureofpsychiatric illnesses.
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Ans: D
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Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a helpful
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resource to understand the reason for the admission and to begin building knowledgeabout
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thenatureof psychiatricillnesses. Identifyingthemedical diagnosis, treating, and evaluating
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treatments are not a part of the nursing process.
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7. Thelegislation enacted in 1963 waslargelyresponsible forwhich ofthe followingshifts in
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care for the mentally ill?
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A) Thewidespread useof community-based services ., ., ., ., .,
B) Theadvancementinpharmacotherapies ., ., .,
C) Increasedaccess tohospitalization ., ., .,
D) Improvedrightsforclientsinlong-terminstitutionalcare ., ., ., ., ., ., .,
Ans: A
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Feedback:
TheCommunityMental Health Centers Construction Actof 1963accomplished the release
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of individuals from long-term stays in state institutions, the decrease in admissions to
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hospitals, and the development of community-based services as an alternative to hospital
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care.
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, 8. Whichoneof the following is a result of federal legislation?
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A) Makingit easier to commit people formental health treatment against their will. ., ., ., ., ., ., ., ., ., ., ., .,
B) Makingitmoredifficulttocommit people formentalhealthtreatment against their ., ., ., ., ., ., ., ., ., ., ., .,
will. .,
C) Statemental institutions being the primarysource of care for mentallyill persons. ., ., ., ., ., ., ., ., ., ., ., .,
D) Improvedcareformentallyillpersons. ., ., ., ., .,
Ans: B
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Commitment laws changed in the early 1970s, making it more difficult to commit ., ., ., ., ., ., ., ., ., ., ., .,
people for mental health treatment against their will. Deinstitutionalization
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accomplished the release of individuals from long-term stays in state institutions.
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Deinstitutionalization also had negative effects in that some mentallyill persons are
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subjectedto the revolving door effect, which may limit care for mentallyill persons.
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9. Thegoal of the 1963 CommunityMental Health Centers Act was to
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A) ensurepatients' rights for the mentallyill. ., ., ., ., ., .,
B) deinstitutionalizestatehospitals. ., .,
C) providefunds to build hospitals with psychiatric units. ., ., ., ., ., ., .,
D) treatpeoplewithmentalillnessinahumanefashion. ., ., ., ., ., ., ., .,
Ans: B
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Feedback:
The 1963 Community Mental Health Centers Act intimated the movement toward treating
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those with mental illness in a less restrictive environment. This legislation resulted in the
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shift of clients with mental illness from large state institutions to care basedin thecommunity.
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Answer choices A,C, andDwerenot purposes of the1963 Community Mental Health
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Centers Act.
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10. The creation of asylums duringthe 1800s was meant to
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A) improvetreatment ofmental disorders. ., ., ., .,
B) provide food and shelter for the mentallyill. ., ., ., ., ., ., .,
C) punishpeople with mental illness who werebelieved tobe possessed. ., ., ., ., ., ., ., ., ., .,
D) removedangerouspeoplewithmentalillnessfromthecommunity. ., ., ., ., ., ., ., .,
Ans: B
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Theasylum was meant to be asafehaven with food, shelter,and humane treatment for the
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mentallyill. Asylums werenot used to improve treatment of mental disorders orto punish
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mentally ill people who were believed to be possessed. The asylum was not created to
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remove the dangerously mentally ill from the community.
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