Chapter 36: Mental Health Issues Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 36: Mental Health Issues

Test Bank

MULTIPLE CHOICE

1. Who led reform efforts to correct types of inhumane practices in the care of criminals, those with mental disorders, and victims of the Civil War?
a. Dorothea Dix
b. Philippe Pinel
c. Benjamin Rush
d. Clifford Beers
ANS: A
Dorothea Dix led reform efforts to correct types of inhumane practices in the care of criminals, those with mental disorders, and victims of the Civil War.

DIF: COG: Remembering REF: 788 OBJ: 1

2. The first major piece of legislation to influence mental health services in the United States was the:
a. National Mental Health Act
b. Mental Health Study Act
c. Social Security Act
d. Protection and Advocacy for Mentally Ill Individuals Act
ANS: C
This was in response to economic and social problems of the era and shifted the responsibility of care for ill people from the state to the federal government.

DIF: COG: Understanding REF: 789 OBJ: 1

3. Many clients with mental disorders were institutionalized because:
a. There was a continued fear of people with mental disorders.
b. The success rate was higher with hospital treatment.
c. It was easier to stabilize clients with psychotropic medications.
d. It provided a less stressful environment for clients to recuperate.
ANS: A
Many clients with mental disorders were institutionalized because of a continued fear of people with mental disorders.

DIF: COG: Understanding REF: 788 OBJ: 1

4. An individual living during which era would have viewed physical and mental illness as interrelated, resulting from physical conditions?
a. Ancient times
b. Middle Ages
c. Colonial
d. Greco-Roman
ANS: D
During the ancient times, Middle Ages, and colonial times, mental illness was viewed as resulting from supernatural forces.

DIF: COG: Applying REF: 788 OBJ: 1

5. A nurse working in a psychiatric institution during the hospital expansion era would have most likely worked in which location?
a. Near small communities with access to families and activities
b. In rural areas removed from family and social activities
c. Near urban areas with access to families and low-paying jobs
d. In urban areas without access to families and jobs
ANS: B
During the hospital expansion era, most psychiatric institutions were located in rural areas removed from family and social activities.

DIF: COG: Analyzing REF: 788 OBJ: 1

6. Why must a nurse have specialized knowledge and skills in mental health illness and problems in order to provide effective nursing care for this population?
a. Services for people with mental disorders are inadequate.
b. The effects of mental health are universal.
c. Mental health disorders affect small sectors of the population.
d. Current health objectives cannot be met without the influence of nursing.
ANS: A
There are two universal truths that require nurses to have specialized knowledge and skills in this area: services for people with mental disorders are inadequate in all countries, and mental illness has a major impact on families, communities, and nations.

DIF: COG: Analyzing REF: 785 OBJ: 1

7. An employee of the National Institute for Mental Health would most likely be involved in the:
a. Expansion of psychiatric units in general hospitals
b. Development of education programs for community mental health treatment
c. Legislation and advocacy for the rights of people with mental disorders
d. Deinstitutionalization of patients
ANS: B
After the National Mental Health Act was passed in 1946, the National Institute of Mental Health (NIMH) administered its programs. Objectives included development of education and research programs for community mental health treatment approaches.

DIF: COG: Evaluating REF: 789 OBJ: 1

8. Approximately what percentage of the adult population (ages 18 and older) suffers from a mental disorder in a given year in the United States?
a. 6
b. 14
c. 26
d. 30
ANS: C
Approximately 26% of the adult population has a mental disorder in the United States.

DIF: COG: Remembering REF: 785 OBJ: 2

9. According to the National Institutes of Mental Health (NIMH), which is the leading cause of disability among adults?
a. Schizophrenia
b. Major depression
c. Obsessive-compulsive disorder
d. Anxiety
ANS: B
Major depression is pervasive and is the leading cause of disability among adults ages 15 to 44.

DIF: COG: Remembering REF: 786 OBJ: 3

10. A client who has been diagnosed with major depression works with other mental health consumers to advocate for establishment of additional self-help services for individuals and families with mental illness in a community. This client is likely involved with which organization?
a. Community Support Program (CSP)
b. National Institute of Mental Health (NIMH)
c. Mental Health Study
d. National Alliance for the Mentally Ill (NAMI)
ANS: D
NAMI was the first consumer group to advocate for better services. This consumer advocacy group worked to establish education and self-help services for individuals and families with mental illness.

DIF: COG: Applying REF: 786 OBJ: 3

11. A nurse is working with a client who is concerned about discrimination in the workplace based on a current mental health diagnosis. Which legislation has prohibited discrimination for persons with mental disorders?
a. National Mental Health Act
b. American with Disabilities Act
c. Developmental Disabilities Act
d. Protection and Advocacy for Mentally Ill Individuals Act
ANS: B
The Americans with Disabilities Act prohibited discrimination and promoted opportunities for persons with mental disorders.

DIF: COG: Applying REF: 790 OBJ: 3

12. A client who was deinstitutionalized during the 1960s may have experienced difficulties living in the community because of:
a. Insufficient community mental health services
b. Difficulties connecting with community resources
c. Lack of affordable housing
d. Increased cost of care
ANS: A
Families were not prepared for treatment responsibilities. There were no education and support programs for families. Staff in nursing homes lacked skills to treat people with mental disorders, and clients had little or no supervision in independent settings.

DIF: COG: Analyzing REF: 790 OBJ: 3

13. Which factor has influenced the advancement in the treatment of mental illness?
a. The movement of clients out of mental institutions to the community
b. A better understanding of the neurobiology of mental illness
c. More interest in helping persons with mental illness
d. A change in the culture about what constitutes mental illness
ANS: B
Two major movements have influenced the treatment of mental illness: consumer advocacy and a better understanding of neurobiology.

DIF: COG: Understanding REF: 786 OBJ: 4

14. A nurse considers the effects of biology and environment, or nature and nurture, on the development of mental illness when providing care for clients with mental illness. Which nursing model/theory is being applied?
a. Community mental health model
b. Holistic model
c. Systems theory
d. Diathesis-stress model
ANS: D
The diathesis-stress model integrates the effects of biology and environment on the development of mental illness. Certain genes or genetic combinations produce a predisposition to a disorder. When an environmental stressor challenges an individual with a predisposition to a disorder, the expression of a mental disorder may result.

DIF: COG: Applying REF: 791 OBJ: 5

15. A nurse categorizes mental illness as a biopsychosocial disorder. What is meant by this classification?
a. Mental illness is an abnormal brain vasculature that can be detected with angiography.
b. Antipsychotic drugs can be used for all types of mental illness.
c. Experience and psychosocial factors affect the etiology and treatment of mental illness.
d. Mental illness can be cured with the right drugs and therapy.
ANS: C
Biochemical changes of the brain are being studied as causes of mental illness.

DIF: COG: Applying REF: 791 OBJ: 5

16. An example of primary prevention concerning mental health is:
a. Group psychotherapy
b. Stress reduction education
c. Case management
d. Monitoring illness symptoms
ANS: B
Primary prevention refers to the reduction of health risks, thus stress reduction education is the correct response. Group psychotherapy and case management are secondary preventions, and monitoring illness symptoms is a tertiary prevention.

DIF: COG: Applying REF: 791-792 OBJ: 6

17. An example of tertiary prevention concerning mental health is:
a. Screening for anxiety
b. Depression education
c. Counseling following a natural disaster
d. Coordination transition from the hospital to the community
ANS: D
Tertiary prevention efforts attempt to restore and enhance functioning, thus coordination of transition from the hospital to the community is tertiary prevention. Screening and counseling are secondary prevention activities, and depression education is a primary prevention.

DIF: COG: Applying REF: 791 OBJ: 6

18. The nurse working in the role of educator with groups of clients may:
a. Care for clients in acute care settings.
b. Coordinate activities with staff members in community settings.
c. Use learning principles to increase understanding about mental illness.
d. Act as an advocate for mental health support groups.
ANS: C
The educator role is foundational to health maintenance, health promotion, and community action.

DIF: COG: Applying REF: 793 OBJ: 6

19. Which role would be most appropriate for an undergraduate-level prepared nurse working with a mental health population?
a. Prescribe medications and have hospital admission privileges.
b. Work as a case manager for large groups of persons with mental illness.
c. Assess clients in acute psychiatric hospital settings.
d. Provide basic primary, secondary, and tertiary services.
ANS: D
The undergraduate levelprepared nurse is prepared to implement primary, secondary, and tertiary services. Roles of the nurse may include clinician, educator, and coordinator.

DIF: COG: Evaluating REF: 792 OBJ: 6

20. A nurse is counseling a client following an unexpected loss. If given adequate support and adaptation, the client will most likely:
a. Recover from the crisis and become mentally ill
b. Avoid the loss and potential mental illness
c. Be able to ignore the grief
d. Resume previous lifestyle in spite of sadness
ANS: D
When people do not have adequate resources, there is an increased risk of altered mental health. However, when given adequate support and adaptation, most persons will resume their lifestyles.

DIF: COG: Applying REF: 795 OBJ: 6

21. When providing care to an African American population in the community, which would be the most appropriate intervention for the nurse to implement?
a. Build on the cultural traditions of the community.
b. Develop a support system in a nearby community.
c. Integrate mental health services into primary care settings.
d. Focus on migrant health issues.
ANS: C
Nurses can promote the mental health of this population by integrating mental health services into primary care settings, providing services in community centers, collaborating with faith communities, providing education to decrease the stigma, working toward the provision of safer communities, and recruiting members of this population to work as community mental health providers. Focusing on migrant health issues would occur with the Latino population. Building on cultural traditions is important in the Native American population. Developing a support system outside of the community would not be an appropriate intervention for any population.

DIF: COG: Evaluating REF: 799 OBJ: 7

22. Which intervention is most appropriate for a nurse to implement when working with older adults and their caregivers?
a. Work with legislators to advocate for policies which support families.
b. Refer clients and families to community support groups to reduce stress.
c. Involve clients and families in case management programs to coordinate care.
d. Conduct depression screenings with clients and families on a regular basis.
ANS: B
Family caregivers and older adults are at risk for health disruptions. Involvement in a community support group can help reduce stress of caregiving and provide networking opportunities for the older adult.

DIF: COG: Evaluating REF: 798 OBJ: 7

23. When a nurse is involved with a group who advocates for improved and effective psychiatric services and consumer empowerment, the nurse is working with the:
a. National Alliance for Mentally Ill (NAMI) Consumer Council
b. National Mental Health Consumers Association (NMHCA)
c. National Association of Psychiatric Survivors (NAPS)
d. Consumer/Survivor Mental Health Research and Policy Work Group
ANS: A
The NAMI Consumer Counsel advocates for improved and effective psychiatric services and consumer empowerment.

DIF: COG: Applying REF: 791 OBJ: 8

24. A nurse who is working with persons with serious mental illness should recognize that:
a. Persons with severe mental illness require institutionalization until they are functional.
b. Inadequate community resources have caused problems with homelessness among this population.
c. Serious mental illness originates from childhood events and therapy is ineffective.
d. Motivation influences a persons ability to earn a living and purchase necessary medications.
ANS: B
Many people with serious mental illness live in poverty because they lack the ability to maintain a suitable standard of living. Brief hospital stays and inadequate community resources have resulted in an increased number of persons with serious mental illness living on the streets or in jail.

DIF: COG: Analyzing REF: 797 OBJ: 8

25. Which intervention would a nurse most likely use when implementing relapse management?
a. Use a holistic view of the system.
b. Identify triggers.
c. Understand the individuals personality.
d. Provide crisis intervention.
ANS: B
Recognizing triggers that may lead to illness helps the consumer manage the illness and promotes recovery. Examples of triggers are poor social skills, hopelessness, and poor symptom management.

DIF: COG: Analyzing REF: 792 OBJ: 8

MULTIPLE RESPONSE

1. According to the Surgeon Generals report, how can people receive assistance for mental health problems? Select all that apply.
a. Specialty mental health systems
b. General medical or primary care sectors
c. Human service sectors
d. Voluntary support networks
ANS: A, B, C, D
The Surgeon Generals report defined specialty mental health systems, general medical or primary care sectors, human service sectors, and voluntary support networks as ways through which people could receive assistance.

DIF: COG: Understanding REF: 787-788 OBJ: 5

2. A nurse is using Healthy People 2020 as a guide to develop community programming for mental health. Which objectives for mental health would be found in this document? Select all that apply.
a. Reduce suicide rates.
b. Increase employment of persons with severe mental illness.
c. Increase the proportion of children treated for mental health problems.
d. Decrease the number of juvenile facilities that screen new admissions for mental health problems.
ANS: A, C
Reducing suicide attempts and increasing the proportion of children with mental health problems who receive treatment are two objectives for mental health targeted by Healthy People 2020.

DIF: COG: Applying REF: 795 OBJ: 8

3. A nurse is referring a client with a mental illness to a community group for additional information and support. Where would the nurse most likely refer a client? Select all that apply.
a. Alcoholics Anonymous
b. Obsessive-Compulsive Foundation
c. Schizophrenics Anonymous
d. Anxiety Disorders Association of America
ANS: A, B, C, D
Alcoholics Anonymous, Obsessive-Compulsive Foundation, Schizophrenics Anonymous, and Anxiety Disorders Association of America are all sources of information and help for people with mental illness.

DIF: COG: Applying REF: 799 OBJ: 8

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