Chapter 2: Current Mental Health Care Systems(FREE) Nursing School Test Banks

Chapter 2: Current Mental Health Care Systems
Test Bank

MULTIPLE CHOICE

1. Because mental health care is not covered in Australia under the basic health plan, which citizens are more likely to receive mental health care?
a. Wealthy
b. Homeless
c. Disabled
d. Low-income
ANS: A
Wealthy citizens, as well as those with private insurance, are more likely to receive mental health care in Australia because they are better able to afford the care than are homeless, disabled, or low-income citizens on the basic health plan with no mental health care coverage.

DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 1
TOP: Mental Health Care in Australia KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

2. Mental health care is available under the universal health care system in Britain, which is funded primarily by:
a. Employers
b. Private donations
c. Small businesses
d. Tax revenues
ANS: D
Tax revenues are the primary funding source for Britains universal health care system. All aspects of health care, except for eye care and limited dental care, are covered under the standard benefit package for citizens of Britain.

DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 1
TOP: Mental Health Care in Britain KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

3. The __________ model views clients holistically with the goal of creating a support system designed to encourage independence in the client with a mental health disorder.
a. Community support systems
b. Case management
c. Multidisciplinary health care team
d. Client population
ANS: A
The community support systems (CSS) model works by coordinating social, medical, and psychiatric services. Case management refers to individual management of clients and takes into consideration psychosocial rehabilitation, consults, referrals, therapy, and crisis intervention. A multidisciplinary health care team is made up of all of the professionals who work within a mental health care system, and client population simply refers to individuals who may potentially seek mental health care.

DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 3
TOP: Outpatient Care KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

4. The home mental health nurse visits a female client to assess her ability to care for herself at home after discharge from an inpatient setting. Which component of the case management system does this demonstrate?
a. Consultation
b. Crisis intervention
c. Resource linkage
d. Psychosocial rehabilitation
ANS: D
Psychosocial rehabilitation assists clients in gaining independence in activities of daily living to the best of their individual capabilities. Consultation refers to assistance obtained from specialists, such as a psychiatrist; crisis intervention refers to care provided during a crisis event; and resource linkage indicates referral to community resources.

DIF: Cognitive Level: Comprehension REF: p. 14 OBJ: 5
TOP: Case Management KEY: Nursing Process Step: Intervention
MSC: Client Needs: Health Promotion and Maintenance

5. A client with a severe, treatment-resistant mental illness has been assigned to an assertive community treatment (ACT) team. An ACT treatment strategy that helps to prevent recurrent hospitalizations for mental health reasons is to meet with the client in the community setting _____ per week.
a. Once
b. Two to four times
c. Five to six times
d. Seven to eight times
ANS: B
The continuous care team that meets with a client two to four times per week has been found to be effective in directing the clients treatment on a more continuous basis, resulting in greater stability for the client who is living in the community with the help of appropriate systems.

DIF: Cognitive Level: Knowledge REF: p. 15 OBJ: 5
TOP: Case Management KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment

6. Which member of the multidisciplinary mental health care team is primarily responsible for evaluating the family of the client, as well as the environmental and social surroundings of the client, and plays a major role in the admission of new clients?
a. Psychiatric nurse
b. Clinical psychologist
c. Psychiatrist
d. Psychiatric social worker
ANS: D
These are the primary responsibilities of the psychiatric social worker. The psychiatric nurses primary responsibilities include assisting with the clients activities of daily living and managing individual, family, and group psychotherapy. The clinical psychologist is involved in the planning of treatment and diagnostic processes, and the psychiatrist is the leader of the team.

DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 6
TOP: Multidisciplinary Mental Health Care Team
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment

7. It is estimated that approximately __________ of adults experience some form of mental or emotional disorder.
a. 11%
b. 19%
c. 27%
d. 35%
ANS: B
It is difficult to obtain exact statistics on mental health disorders because many conditions remain undiagnosed and many affected individuals may become homeless or incarcerated.

DIF: Cognitive Level: Knowledge REF: p. 17 OBJ: 7
TOP: Impact of Mental Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

8. A male client with a diagnosis of bipolar disorder is admitted to an inpatient unit during a severe manic episode. As a result of guidelines implemented by the Health Care Financing Administration in 1983, the clients Medicare will pay for his stay in this unit for:
a. The length of time necessary for his condition to be stabilized
b. Up to 6 months with appropriate documentation
c. A predetermined length of time based on the diagnosis
d. 2 to 4 weeks
ANS: C
Medicare payment guidelines are based on the diagnosis, which is classified under a diagnosis-related group (DRG), and specify a predetermined payment for a particular diagnosis. This cost containment strategy has also been adopted by some private insurance companies. After the pre-determined time, the facility is responsible for additional costs incurred by the clients stay.

DIF: Cognitive Level: Comprehension REF: p. 18 OBJ: 1
TOP: Economic Issues of Mental Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment

9. A female client was given the diagnosis of schizophrenia and recently has lost her job. She tells the nurse that she has enough money for only two more house payments, and if she does not find a job, she fears she will become homeless. The nurse knows that this client falls in the group of nearly __________ of U.S. citizens who live below poverty level.
a. 1%
b. 6%
c. 12%
d. 25%
ANS: C
Approximately 12% of Americans (or 33 million people) live below poverty level. Living in poverty often precipitates mental disorders, or mental disorders may occur while an individual is living in poverty.

DIF: Cognitive Level: Knowledge REF: p. 18 OBJ: 7
TOP: Social Issues of Mental Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

10. Addiction to recreational drugs, such as crack, cocaine, and heroin, combined with use of psychotherapeutic drugs is associated with:
a. Permanent psychotic states
b. Bipolar disorder
c. Generalized anxiety disorder
d. Obsessive-compulsive disorder
ANS: A
Permanent psychotic states are occurring in mental health clients who combine their psychotherapeutic medications with the abuse of recreational drugs. The combination of these two types of drugs is not commonly associated with bipolar disorder, generalized anxiety disorder, or obsessive-compulsive disorder.

DIF: Cognitive Level: Knowledge REF: p. 18 OBJ: 7
TOP: Social Issues of Mental Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

11. A female client who is undergoing therapy for depression is divorced and has two children, ages 2 and 4. She has just enrolled in a local community college and is worried about providing food and clothes for her family while holding down a minimum wage job and also devoting the time needed to be successful in school. The nurse determines that the best community resource for assisting this client to meet these needs is:
a. A shelter for victims of domestic violence
b. Women, Infants, and Children (WIC)
c. Family-planning agency
d. Family recreation center
ANS: B
WIC gives assistance to low-income women and children up to the age of 5 who are at nutritional risk by providing foods to supplement the diet and information on healthy eating habits. The other options do not address her situation because she has not voiced needs related to domestic violence or family planning, and a family recreation center will not meet her financial needs.

DIF: Cognitive Level: Application REF: p. 13 OBJ: 4
TOP: Delivery of Community Mental Health Services
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment

12. The home care nurse is providing care to an older adult client with a diagnosis of depression who is caring for his wife who has Alzheimers disease. He states that he hardly has enough energy to cook and clean the house. The couple has no children, and no relatives live within a close distance. Which community agency would be of greatest benefit to this client?
a. A recreational club
b. An adult education program
c. A daycare center for elderly
d. Meals on Wheels
ANS: D
By providing food, Meals on Wheels would remove one responsibility for this client. A recreational club or an adult education program might be beneficial, but the priority need for this couple is food. A daycare center for the elderly may be necessary in the future, but it is not a priority at this time.

DIF: Cognitive Level: Application REF: p. 13 OBJ: 4
TOP: Delivery of Community Mental Health Services
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment

13. A 9-year-old girl is given the diagnosis of depression. She has low self-esteem, does not enjoy group therapy, and does not show her emotions. The nurse has had difficulty establishing rapport with this client and decides to ask for assistance from another treatment team member. Which team member would be the best choice to assist in this situation?
a. Psychiatric assistant
b. Dietitian
c. Occupational therapist
d. Expressive therapist
ANS: D
Expressive therapists work well with children who have difficulty expressing their thoughts and feelings. Expressive therapists use creative methods that appeal to children. The dietitian would not be the best team member to meet the needs of the client at this time. The psychiatric assistant, or technician, assists the nurse with daily activities and in monitoring clients during leisure activities. The occupational therapist works primarily with rehabilitation therapy, such as socialization and vocational retraining.

DIF: Cognitive Level: Application REF: p. 16 OBJ: 6
TOP: Multidisciplinary Mental Health Care Team
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment

14. Nearly __________ of all countries in the world have no clear governmental policy that addresses mental health issues.
a. 7%
b. 26%
c. 50%
d. 75%
ANS: C
In addition to nearly half of the countries in the world that have no policy on mental health issues, approximately one third have no program for coping with the increasing numbers of mental health disabilities.

DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 1
TOP: Current Mental Health Care Systems
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

15. A woman is admitted to an inpatient psychiatric unit after a suicide attempt by overdose. The primary rationale for her admission is to:
a. Have limited supervision by health care personnel.
b. Maintain responsibility for her own behavior.
c. Receive treatment in the least restrictive manner.
d. Provide her with a safe and secure environment.
ANS: D
The most important advantage of inpatient psychiatric care is that it provides clients with a safe and secure environment where they can focus on and work with the problems that brought them there.

DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 2
TOP: Inpatient Care KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

16. A client suffering from chronic mental illness often forgets to take her medication and needs to be reminded to take care of daily hygiene. She does not have family or other support persons living in the area. The care delivery provider facility that would be most beneficial for this client is:
a. Emergency departments
b. Residential program
c. Community mental health center
d. Psychiatric home care
ANS: B
Residential programs offer a protected, supervised environment, which is what this client needs to be compliant. Emergency department care has stabilization and crisis as its focus, psychiatric home care works with clients and families in transition, and community mental health centers deal with crisis, counseling, and education.

DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 4
TOP: Community Mental Health Care Delivery
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

17. A 35-year-old client with a long history of schizophrenia who often forgets to take his medication is admitted to an inpatient unit after police found him threatening passengers on a bus. This is his fourth admission in 3 months. This frequent re-hospitalization is an example of:
a. Recidivism
b. Symptom exacerbation
c. Noncompliance
d. Rejection
ANS: A
Unable to cope in the community setting, people with chronic psychiatric problems often return to institutions or use community services on a revolving-door basis. This behavior pattern is known as recidivism and means a relapse of a symptom, disease, or behavior. Recidivism is a major problem in mental health care.

DIF: Cognitive Level: Application REF: p. 12 OBJ: 4
TOP: Outpatient Care KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

18. Arranging community resource linkages for a client and her children who are victims of domestic violence, which resource would be the most immediately appropriate community resource link for a client and her children who are victims of domestic violence?
a. Adult education program
b. Family recreation center
c. Mediation group
d. Womens shelter
ANS: D
The womens domestic abuse shelter is the most appropriate resource for immediate safety needs of the family. While education programs, family recreation centers, and mediation groups also provide benefit to the family, they do not address the initial safety of the woman and her children.

DIF: Cognitive Level: Application REF: p. 14 OBJ: 4
TOP: Case Management: Resource Linkages
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

19. Which principles characterize mental health care in Canada? (Select all that apply.)
a. Portability
b. Universality
c. Accessibility
d. Comprehensiveness
e. Private insurance models
f. Public administration
ANS: A, B, C, D, F
Portability refers to retaining services in the event of moving; universality means that everyone in the nation of Canada is covered; accessibility indicates that everyone has access to health care; comprehensiveness means that all necessary treatment is covered; and public administration reveals that the health care system is publicly run and accountable. Private insurance models are the type of insurance provided in the United States.

DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 1
TOP: Mental Health Care in Canada KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity

20. In the United States, which factors determine whether a client requires inpatient rather than outpatient care? (Select all that apply.)
a. Severity of the illness
b. Level of dysfunction
c. Suitability of the setting for treating the problem
d. Anticipated diagnosis
e. Level of client cooperation
f. Ability to pay
ANS: A, B, C, E, F
These options are the determining factors for inpatient mental health care. If a client meets the criteria, the diagnosis does not matter in the determination of whether the client requires inpatient or outpatient care.

DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 2
TOP: Care Settings KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment

21. Which client populations are at greater risk for the development of mental health disorders? (Select all that apply.)
a. Homeless
b. Clients infected with HIV or AIDS
c. Those in crisis
d. Nurses
e. Clients living in rural areas
f. Older adults
g. Psychiatrists
h. Children
ANS: A, B, C, E, F, H
These individuals are considered to be at high risk for various reasons. Nurses and psychiatrists are not considered at high risk for developing mental health disorders.

DIF: Cognitive Level: Knowledge REF: p. 17 OBJ: 7
TOP: Client Populations KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

22. The case management for a client requiring community mental health services would include which of the following? (Select all that apply.)
a. Advocacy
b. Crisis intervention
c. Provision of referrals to a shelter
d. Administration of psychotropic medications
e. Developing a clients plan of care
ANS: A, B, C
Case management is a system of interventions designed to support mentally ill clients living in the community. The major components of case management are psychosocial rehabilitation, consultation, resource linkage (referral), advocacy, therapy, and crisis intervention. Administration of medications is performed by an individual, not a system, and clients are involved in planning their care.

DIF: Cognitive Level: Knowledge REF: p. 14 OBJ: 5
TOP: Case Management KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

COMPLETION

23. The __________ therapist of the mental health team uses methods such as pet therapy and music therapy when working with clients and is responsible for providing leisure-time activities and for teaching inpatient clients useful ways to pass time.

ANS:
Recreational
These are the primary responsibilities of the recreational therapist, who has an advanced degree and specialized training in recreational therapy.

DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 6
TOP: Multidisciplinary Mental Health Care Team
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment

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