Chapter 04: Treatment Settings |Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. Inpatient hospitalization for persons with mental illness is generally reserved for patients who a. present a clear danger to self or others. b. are noncompliant with medication at home. c. have limited support systems in the community. d. develop new symptoms during the course of an illness. ANS: A Hospitalization is justified when the patient is a danger to self or others, has dangerously decompensated, or needs intensive medical treatment. The distracters do not necessarily describe patients who require inpatient treatment. PTS:1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 4-18 to 20 TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment 2. A patient was hospitalized for 24 hours after a reaction to a psychotropic medication. While planning discharge, the case manager learned that the patient received a notice of eviction immediately prior to admission. Select the case manager‘s most appropriate action. a. Postpone the patient‘s discharge from the hospital. b. Contact the landlord who evicted the patient to further discuss the situation. c. Arrange a temporary place for the patient to stay until new housing can be arranged. d. Determine whether the adverse medication reaction was genuine because the patient had nowhere to live. ANS: C The case manager should intervene by arranging temporary shelter for the patient until an apartment can be found. This activity is part of the coordination and delivery of services that falls under the case manager role. None of the other options is a viable alternative. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 4-10, 40 (Table 4-1) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 3. Select the example of tertiary prevention. a. Helping a person diagnosed with a serious mental illness learn to manage money b. Restraining an agitated patient who has become aggressive and assaultive c. Teaching school-age children about the dangers of drugs and alcohol d. Genetic counseling with a young couple expecting their first child ANS: A Tertiary prevention involves services that address residual impairments, with a goal of improved independent functioning. Restraint is a secondary prevention. Genetic counseling and teaching school-age children about substance abuse and dependence are examples of primary prevention. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 4-16, 17 TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 4. A patient diagnosed with schizophrenia had an exacerbation related to medication non- adherence and was hospitalized for 5 days. The patient‘s thoughts are now more organized and discharge is planned. The patient‘s family says, ―It‘s too soon for discharge. We will just go through all this again.‖ The nurse should a. ask the case manager to arrange a transfer to a long-term care facility. b. notify hospital security to handle the disturbance and escort the family off the unit. c. explain that the patient will continue to improve if the medication is taken regularly. d. contact the health care provider to meet with the family and explain the discharge rationale.