CMN 350 Psychiatric-Mental Health Nursing Exam #1 Questions and Answers Best rated A+ Guaranteed Success Latest Update

CMN 350 Psychiatric-Mental Health
Nursing Exam #1
The nurse's role in psychopharmacological management - CORRECT ANSWER--
assess patients' responses to medication, plan to respond to side effects should they
occur, implement those plans, and evaluate for desired results.
-has a pivotal role, particularly in an inpatient setting, allows intervention before serious
drug-related problems occur. In addition, administers medications and makes decisions
regarding as needed (prn) medications.
-needs a sound foundation in it to teach patients about drugs.
-must have immediate access to information about psychotropic drugs.

The nurse's role in the therapeutic nurse-patient relationship - CORRECT ANSWER--is
therapeutic not a therapist
-communication skills
-respect and a desire to help
-understanding
•mental mechanisms
•adaptation styles
•coping strategies
•theraputic intervention skillls

Why would someone need to be admitted into a psychiatric hospital? - CORRECT
ANSWER-If they are:
-Dangerous to self or others
-Gravely disabled
-Acutely psychotic
-Suicidal or homicidal

If patient is acutely psychotic - CORRECT ANSWER--They could be placed in a long
term care facility (e.g., group home)
-they can't take care of themselves
-most likely have schizophrenia
-may be going home with family who can take care of them


The nurse's role in milieu management - CORRECT ANSWER--can change the
environment
-The five environmental elements that nurses must consider in creating a therapeutic
atmosphere are the following:

1. Safety: keeping the patient free from danger or harm

,2. Structure: the physical environment, regulations, and schedules
3. Norms: specific expectations of behavior (e.g., acceptance, nonviolence, privacy)
4. Limit setting: clear and enforceable limitations on behaviors
5. Balance: negotiating the line between dependence and independence.

Nurses don't/aren't - CORRECT ANSWER--therapist
-order drugs
-interpret testing

A nurse can disclose patient information when - CORRECT ANSWER--the patient is a
harm to self or others
-under a subpoena
-court order

you need a court order to - CORRECT ANSWER-force medication or you could be
accused of assault and battery

assault - CORRECT ANSWER-making a threat to a client's person, such as
approaching the client in a threatening manner with a syringe in hand, is considered
assault

battery - CORRECT ANSWER-touching a client in a harmful or offensive way. This
could occur if the nurse threatening a client with a syringe actually grabbed the client
and gave an injection.

serotonin - CORRECT ANSWER-↑______________ syndrome
↓depression

dopamine - CORRECT ANSWER-↑Schizophrenia
↓Parkinson's

norepinephrine - CORRECT ANSWER-↑hypertensive crisis
↓depression

GABA - CORRECT ANSWER-↑seizures
↓anxiety

Glutamate - CORRECT ANSWER-↑ Excitotoxicity leading to neuronal death
↓Psychotic thinking

Acetylcholine - CORRECT ANSWER-↓Alzheimer disease

Priority when dealing with patients from a different culture - CORRECT ANSWER--
Communication

1. Do you speak any foreign languages?

, 2. Is English your first language?
3. Does the patient speak English fluently?
4. Does the patient prefer an interpreter?
5. Does the patient believe that appropriate touching is acceptable?
6. Does the patient use ethnic behaviors?

5 areas of the milieu (environment) - CORRECT ANSWER-1. Safety: keeping the
patient free from danger or harm
2. Structure: the physical environment, regulations, and schedules
3. Norms: specific expectations of behavior (e.g., acceptance, nonviolence, privacy)
4. Limit setting: clear and enforceable limitations on behaviors
5. Balance: negotiating the line between dependence and independence.

What the nurse must know/ do about restraints and seclusion? - CORRECT ANSWER-
Nurses who are aware of the potential negative physical, psychological, and legal
consequences associated with restraint and seclusion are more apt to look for
alternative strategies. The most valuable interventions are aimed at preventing a
patient's escalation in behavior and loss of control. Attention to the nurse-patient
relationship, therapeutic milieu, and principles of pharmacologic management can
reduce the need for restrictive measures. Guidelines issued by the CMS for use of
restraint and seclusion are substantially different in medically necessary and behavioral
control situations. Although laws differ from state to state, general guidelines for use in
psychiatry include multiple elements important for the nurse to document.

During the use of restraints and seclusion the nurse must document - CORRECT
ANSWER-1. Staff members involved in decisions to restrain or seclude and staff who
apply or remove restraints must receive special training and demonstrate competency.
2. Alternatives must be considered before the use of restraint and seclusion.
3. Might be allowed to implement restraint or seclusion in emergent situations, a
physician's order is required within 1 hour. Physician assistants and advanced practice
nurses can also write restraint and seclusion orders.
4. The least restrictive method or device possible must be chosen.
5. Should carefully write down events leading to the intervention and justification for
use.
6. Orders must contain the type of restraint, rationale for use, and time limitations.
7. As needed (prn) orders are not permitted. Each episode must be based on eminent
risk.
8. Restraint and seclusion are used for the shortest possible time. Must tell the patients
what behaviors are expected before release and reevaluate the patients at least every 2
hours for continued need of restraint and seclusion.
9. Patients must be observed constantly during restraint and seclusion, with
documentation of safety and comfort interventions at least every 15 minutes.
10. Patients must be debriefed after restrictive interventions.
11. Patients have the right to request notification of a family member or other person in
the event that restraints or seclusion are implemented.