Test Bank Populations Affected by Mental Illness Nies: Community/Public Health Nursing,7th Edition

1. Which provides the best description of severe mental illness (SMI)? a. Having been clearly diagnosed with at least two mental health disorders within thepast year b. Having a diagnosable mental disorder with moderate functional behavior in aspecific area of lifestyle at any time during the past year c. Being unable to function in society because of a mental illness d. Being convicted of several impulsive crimes during the past year ANS: B SMI occurs in adults who currently or at any time during the past year have a diagnosable mental, behavioral, or emotional disorder with moderate, severe, or extreme functional behavior in specific areas of lifestyle. These mental health disorders afflicting persons who are18 years of age or older present emotional or behavioral functioning that is so impaired as to interfere substantially with their capacity to remain in the community without supportive treatment or services of a long-term or indefinite duration. DIF: Cognitive Level: Remember (Knowledge) 2. Which event occurred in 1965? a. State mental hospitals were created. b. The mentally ill were deiN nstiR tutioI nalG izedB . .C M c. Electroconvulsive therapy UwasSdiscNoveTred to hOelp depression. d. Community mental health centers for outpatient care were established. ANS: B Deinstitutionalization is the release of institutionalized people, especially mental health patients, from an institution for placement and care in the community and was initiated in 1965. From 1955 to the mid-1980s, the number of patients in state facilities fell from 560,000to 155,000 because patients moved back out into the communities. The Community Mental Health Centers Act of 1964 provided federal support for mental health services. The act supported measures to implement facilities to care for those who were mentally retarded and to construct community mental health centers. The creation of state mental hospitals and the discovery of electroconvulsive therapy occurred before 1965. Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 DIF: Cognitive Level: Remember (Knowledge) 3. Which best describes how brain imaging scans are being used? a. To deliver electroconvulsive therapy to high-risk individuals b. To help detect and diagnose medical disorders and illnesses c. To help determine treatment options for mental disorders d. To help determine the effects of psychotherapy ANS: B Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 N R I G B.C M Brain imaging scans, also called neuroimaging scans, are being used more and more to help detect and diagnose a number of medical disorders and illnesses. Currently, the main use of brain scans for mental disorders is in research studies to learn more about the disorders. Theseresearchers study healthy brain development, effects of mental illnesses, or effects of mental health treatments on the brain. Brain neuroimaging helps researchers study healthy brain development, effects of mental illnesses, or effects of mental health treatments on the brain. DIF: Cognitive Level: Remember (Knowledge) 4. Which best describes how people with mental illness are viewed by the general public? a. Individuals in need of assistance b. Criminals who need to be institutionalized c. Lazy, weak, and immoral d. Contributing members of society ANS: C Throughout history, the symptoms of mental illness have been perceived as permanent, dangerous, frightening, and shameful. People with a diagnosis of mental illness have beendescribed as lazy, idle, weak, immoral, irrational, and, too often, criminal. DIF: Cognitive Level: Understand (Comprehension) 5. Which would be most upsetting for American families when their loved one, after serving inIraq or some other battlefield, returns home? a. Many families, especially those with children, do not want guns in the house. b. Reabsorbing them into the family structure is challenging and difficult. c. The suicide rate is twice as high as among nonveteran adults. d. They must use the VeteranUs AfSfairNs mTedical sOystem for medical care. ANS: C Male veterans in communities are twice as likely to die by suicide as their civilian counterparts. There is nothing to support that these veterans will have guns in their homes. The veterans will be able to use the Veteran Affairs system for medical care and there may be challenges with their return home, but that should not be as upsetting as the risk for suicide fortheir loved one. DIF: Cognitive Level: Understand (Comprehension) 6. Which was required by the Paul Wellstone and Pete Domenici Mental Health Parity andAddiction Equity Act of 2008? a. That alcoholism be recognized as a disease and treatment be given in residentialfacilities Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 b. That drug addiction be accepted as a mental health diagnosis and addicts be treatedrather than jailed when caught c. That health insurance must cover treatment for mental illness on the same termsand conditions as physical illness d. That community clinics must treat clients for mental illness just as they treatprisoners who have a physical illness ANS: C Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 N R I G B.C M In 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was enacted. The law requires health insurance to cover treatment for mental illness on the same terms and conditions as physical illness. This law does not require that alcoholism berecognized as a disease, that drug addiction be accepted as a mental health diagnosis, or that community clinics must treat clients for mental illness. DIF: Cognitive Level: Understand (Comprehension) 7. Which mental illness is most frequently diagnosed among adults in the United States? a. Acute stress disorder b. Bipolar disorder c. Depression d. Schizophrenia ANS: C Depression is the most frequently diagnosed and one of the most disabling mental illnesses inthe United States. Depression affected approximately 16.1 million American adults, or about 6.7%, of the U.S. population age 18 and older, in the past year. Acute stress disorder, bipolar disorder, and schizophrenia are not diagnosed as frequently as depression. DIF: Cognitive Level: Remember (Knowledge) 8. Which best explains why having parity in insurance coverage does not always help personswith depression? a. Many persons find that the medications do not relieve symptoms. b. Most depressed persons do not seek treatment. c. Most depression is situational, and having insurance does not change the situation. d. Psychotherapists will not aUccepSt thNe loTw reimbOursement offered by insurance plans. ANS: B Although effective treatments and medications exist, most people (almost two thirds) with depressive illness do not seek help. Parity in insurance coverage helps for depressed personswho are encountering situational depression to receive services and promotes care being provided by a variety of providers. DIF: Cognitive Level: Understand (Comprehension) 9. Which best summarizes the symptoms of a person with bipolar disorder? a. Chronic, unrealistic, and exaggerated worry about life b. Ongoing hallucinations and delusions c. Changes in mood from depression to mania d. A persistent abnormally elevated or irritable mood Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 ANS: C Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 Bipolar disorder refers to a group of mood disorders that present with changes in mood fromdepression to mania. The depressed phase is manifested by symptoms seen in major depressive disorder. The manic phase is characterized by a persistent abnormally elevated orirritable mood, impaired judgment, flight of ideas, pressured speech, grandiosity, distractibility, excessive involvement in goal-directed activities, few hours sleeping, and impulsivity. These symptoms may co-occur with psychotic features, such as hallucinations and delusions. Generalized anxiety disorder is characterized by chronic, unrealistic, and exaggerated worry and tension about one or more life circumstances lasting 6 months or longer. DIF: Cognitive Level: Understand (Comprehension) 10. A patient with severe panic attacks refuses to come to the mental health clinic to get help evenafter being assured there is no charge for the initial assessment. Which provides the best explanation for this behavior? a. People know that the treatment is to confront your fears in small doses, and thevery idea is overwhelming and frightening. b. Such persons have anticipatory anxiety, so they try to avoid situations that maylead to a panic attack, such as leaving their house. c. The recurring symptoms such as tachycardia, chest pain, nausea, and sweating areseen as symptoms of a physical illness, not a mental illness. d. They are too depressed to take action. ANS: B As the avoidance behavior intensifies, the client begins to withdraw further to avoid being inplaces or situations from which escape may be difficult. Individuals with agoraphobia frequently progress to the poN int wR heI re thG ey B ca. nnC ot lM eave their homes without experiencing anxiet y. U S N T O DIF: Cognitive Level: Apply (Application) 11. A person with obsessive-compulsive disorder (OCD) knows the ritual is senseless but isunable to stop. Which best explains why he does not quit doing the ritual? a. As rituals become habit, others will worry about the person if he or she suddenlystops engaging in the ritual behavior. b. Engaging in rituals allows the individual to feel in control. c. If the compulsion is resisted, anxiety increases. d. Rituals, even if nonsensical, are comforting and reassuring. Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 ANS: C The person with OCD feels compelled to engage in some ritual to avoid a persistent frightening thought, idea, image, or event. Obsessions are recurrent thoughts, emotions, orimpulses that cannot be dismissed. Compulsions are the rituals or behaviors that are repeatedly performed to prevent, neutralize, or dispel the dreaded obsession. When the individual tries to resist the compulsion, anxiety increases. DIF: Cognitive Level: Apply (Application) 12. Which female would be at greatest risk for developing bulimia nervosa? a. A 13-year-old who is constantly snacking on food from her backpack all day b. A 14-year-old student who is known as a nerd Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 c. A 15-year-old cheerleader who wants to be a professional ballerina d. An 11-year-old student with the highest Grade Point Average (GPA) in the school ANS: C Bulimia nervosa typically begins in adolescence or during the early 20s, usually in conjunction with a diet. High school and college students, as well as members of certain professions that emphasize weight and/or appearance (e.g., dancers, flight attendants, cheerleaders, athletes, actors, models), are at a high risk. Based on these descriptors and the typical characteristics of a person who has bulimia, the 15-year-old cheerleader demonstratesthe greatest risk. DIF: Cognitive Level: Apply (Application) 13. Which female would be at greatest risk for developing anorexia nervosa? a. A young woman who had been badly hurt in a car accident and is now living withher grandparents but managing to retain her high school Grade Point Average (GPA) b. A young woman who is a fantastic athlete but acts out and does what she feels isbest, regardless of what others think c. A “good girl,” obedient to her parents’ wishes, who always agrees with peers inher clique and strives to do everything perfectly d. A student under a lot of stress from family events at home but who has goodcoping skills and recognizes that she is coping with major life changes ANS: C Risk factors for eating disorders are perfectionism, low self-esteem, stress, poor coping skills,sexual/physical abuse, poor self-image, dependency on others’ opinions and deference to others’ wishes, and being emNotUioRnaSllIyNreGseTrvBe.d.CBOasMed on these descriptors and the typical characteristics of a person who has anorexia, the “good girl” demonstrates the greatest risk. DIF: Cognitive Level: Apply (Application) 14. A nurse is picking up her child from nursery school when the daycare teacher says to her, “One of the boys we care for does not seem able to sit still and listen, but is always running around and getting into things. His parents are not worried. His mother said her brother was the same way when he was a kid. Since you are a nurse, do you have any ideas on how I cancalm him down?” Which would be the most appropriate response by the nurse? a. “I’m not a pediatric nurse; I really don’t know what to tell you.” b. “I’m sorry you’re concerned, but being impulsive and very physically active isquite normal for 3- to 4-year-old children.” c. “Tell the parents he has to see the doctor as he’s not doing well in nursery school.” Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :34:35 GMT -05:00 d. “Why not suggest that it’s time for him to have a complete assessment and suggestthe physician call you for an update on how he is doing in nursery school?” ANS: D The three major characteristics of attention-deficit hyperactivity disorder/attention-deficit disorder (ADHD/ADD) are inattention, hyperactivity, and impulsivity. Although parents maynotice symptoms and signs, it is often teachers who recognize the behaviors consistent with ADHD/ADD and suggest referral for assessment and treatment. Suggesting a referral is the most appropriate response for the nurse because of the symptoms that have been reported.