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20 Cards in this Set
- Front
- Back
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When planning care for a particular client, of what significance to the psychiatric nurse is the fact that the DSM-IV-TR is multiaxial?
A) Pertinent aspects of client functioning and problems are reported. B) Standardized treatment plans are available for each diagnosis. C) Nursing diagnoses are included for each medical diagnosis. D) No particular significance exists. |
A) Pertinent aspects of client functioning and problems are reported.
The DSM-IV-TR axis system, by requiring judgments to be made on each of the five axes, forces the diagnostician to consider a broad range of information. The North American Nursing Diagnosis Association describes a nursing diagnosis as a clinical judgment about individual, family, or community responses to actual or potential health problems and life processes. Therefore the DSM-IV-TR is used to diagnose a psychiatric disorder, whereas a well-defined nursing diagnosis provides the framework for identifying appropriate nursing interventions for dealing with the phenomena a client with a mental health disorder is experiencing, such as hallucinations, low self-esteem issues, and ability to function (job/family). Text pages: 12, 13 |
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A nurse conducting research is seeking data about outcomes for depressed patients who have been treated with electroconvulsive therapy. The nurse is engaged in the field of
A) Experimental epidemiology B) Descriptive epidemiology C) Clinical epidemiology D) Analytic epidemiology |
C) Clinical epidimeology
Clinical epidemiology represents a broad field that addresses what happens to people with illnesses who are seen by providers of clinical care. Studies use traditional epidemiological methods and are conducted in groups that are usually defined by illness or symptoms or by diagnostic procedures or treatments given for the illness or symptoms. Text page: 10 |
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A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking?
A) Control over behavior B) Appraisal of reality C) Effectiveness in work D) Healthy self concept |
B) Appraisal of reality
The appraisal of reality is lacking for this client. The client does not have a picture of what is happening around himself or herself. Text page: 3 |
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A 14-year-old who belongs to a neighborhood gang is found by her parents to lie and engage in sexually promiscuous behavior. They bring her to the mental health center. The nurse performing the assessment is told by the 14-year-old that she is happy, does well in school, and sees herself as popular and well regarded by her group. She states her parents are just old fashioned and don't understand her. The assessment the nurse will most likely make is that she
A) is displaying deviant behavior B) cannot accurately appraise reality C) is seriously and persistently mentally ill D) should be considered for group home placement |
A) is displaying deviant behavior
This client is demonstrating deviant behavior. This client demonstrates undersocialized, aggressive behavior such as a repetitive and persistent pattern of aggressive conduct in which the basic rights of others are violated. Text page: 3 |
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An important concept for nurses to remember when planning care for mentally ill clients is that each client:
A) has areas of strength on which to build B) has rights that must be respected C) comes with experiences that contribute to their problem D) share the same fears as many mentally healthy individuals |
A) has areas of strength on which to build.
We are taught to evaluate our clients with mental health issues for their strengths and their areas of high functioning. You will find many attributes of mental health in some of your clients with mental health issues. These strengths should be built upon and encouraged. Text page: 4 |
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A nurse suspects that a client has a personality disorder in addition to displaying symptoms of a mood disorder. To determine whether these observations are correct, the nurse could look in the client's medical record on the DSM-IV-TR
A) axis I B) axis II C) axis III D) axis IV |
B) axis II
Axes I and II were separated to ensure that the possible presence of long-term disturbance is considered when attention is directed to the current one. For example, a heroin addict would be diagnosed on axis I as having a substance-related disorder; this client might also have a longstanding antisocial personality disorder, which would be noted on axis II. Text page: 13 |
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A man frequently bursts out by loudly singing operatic arias. The neighbors in the next apartment find the noise disturbing. They go to his apartment to confront him and find that in he is wearing only his bathrobe and his apartment is messy. He acts outraged and tells them he must sing several hours daily and will not promise to be quieter. The conclusion that can be drawn is:
A) The man is demonstrating symptoms of bipolar disorder B) The man is socially deviant C) The man is egocentric D) The man may or may not be mentally ill. |
D) The man may or may not be mentally ill.
One myth about mental illness is that to be mentally ill is to be different and odd. Another misconception is that to be healthy, a person must be logical and rational. Everyone dreams "irrational" dreams at night, and "irrational" emotions are universal human experiences and are essential to a fulfilling life. Some people show extremely abnormal behavior and are characterized as mentally ill who are far more like the rest of us than different from us. No obvious and consistent line between mental illness and mental health exists. Text page: 3, 4 |
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A nursing diagnosis for a client with a psychiatric disorder serves the purpose of
A) justifying the use of certain psychotropic medication B) providing information essential for insurance reimbursement C) providing a framework for choosing appropriate interventions D) identifying information to be placed on DSM-IV-TR axis III. |
C) providing a framework for choosing appropriate interventions.
Nursing diagnoses provide the framework for identifying appropriate nursing interventions for dealing with the phenomena a client with a mental health disorder is experiencing. Text page: 17 |
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A client has begun to neglect her appearance, is withdrawn and stays in her room. Her mother hears her seemingly talking to others, but no one is in the room with her. Last night she threw a chair and broke the window of her bedroom. She tells the nurse nothing is wrong. The nurse rating her current global assessment of functioning would probably assign the code
A) 100 B) 70 C) 40 D) 0 |
C) 40
According to the global assessment of functioning scale (Box 1-2), this client exhibits some impairment in reality testing or communication (speech is at times illogical, obscure, or irrelevant, as demonstrated by talking when no one was with her) or major impairment in several areas, such as work or school, family relations (neglects her appearance, stays in her room) and demonstrates impairment in mood (throwing a chair and breaking a window). Text page: 15 |
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The mental health or mental illness of a particular client can best be assessed by considering
A) the degree of conformity of the individual to society's norms B) the degree to which a client is logical and rationale C) placement on a continuum from healthy to psychotic D) the rate of intellectual and emotional growth |
C) the placement on a continuum from healthy to psychotic
Many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Therefore these disorders can be regarded as "diseases." Visualizing these disorders along the mental health continuum is helpful. Text page: 4 |
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The quantitative study of the distribution of mental disorders in human populations is called
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Epidimiology
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What phrase best describes the DSM-IV-TR?
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Is a multiaxial psychiatric assessment system
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Current information suggests that the most disabling mental disorders are the result of
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Biological influences
The biologically influenced illnesses include schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress disorder, and autism. Therefore many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Text page: 7 |
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A nurse's identification badge includes the wording, 'Psychiatric Mental Health Nurse'. A client with a history of paranoia asks, "What does that title mean?" The nurse responds best when answering:
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"We have the specialized skills needed to care for those with mental illnesses."
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Regarding individuals with mental disorders, distress refers to a painful symptom, and disability refers to
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impairment in important areas of functioning.
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While caring for a client who is very ill with a mental disorder, the nurse wonders if the client has always been so regressed or if he has functioned at a higher level in the recent past. The best way to obtain this information would be to
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look at axis V of the client's DSM-IV-TR sheet.
Axis V is called the Global Assessment of Functioning and gives an indication of the client's best level of psychological, social, and occupational functioning during the preceding year. Text page: 14 |
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Which statement about diagnosis of a mental disorder is true?
A) The symptoms of each disorder are common among all cultures. B) Culture may cause variations in symptoms for each clinical disorder. C) All mental disorders listed in the DSM-IV-TR are seen in all other cultures. D) Global assessment of functioning is more diagnostic than symptoms noted. |
B) Culture may cause variations in symptoms for each clinical disorder.
Every society has its own view of health and illness and the types of behavior categorized as mental illness. Culture also influences the symptoms of a particular disorder. For example, individuals of certain cultures are more likely to express depression through somatic symptoms than through affect and feeling tone. Text page: 12 |
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The prevalence rate over a 12-month period for major depressive disorder is
A) lower than the prevalence rate for panic disorders. B) greater than the prevalence rate for psychotic disorders. C) equal to the prevalence rate for psychotic disorders. D) greater than the prevalence rate for generalized anxiety. |
D) greater than the prevalence rate for generalized anxiety
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N, a college student, comes to the mental health clinic with symptoms of feeling blue and having occasional difficulty sleeping. He is able to manage his course work with lowered grades but states he just doesn't get as much pleasure from life as he did several months ago. The nurse making his global assessment of functioning would probably assign the rating of
A) 100 B) 70 C) 40 D) 10 |
B) 70
A global assessment of functioning in the 70s indicates some mild symptoms are present or some difficulty in social, occupational, or school functioning is present but the individual is functioning well enough to have some meaningful interpersonal relationships. Text page: 15, Box 1-4 |
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Mental illnesses recognized across cultures include:
A) antisocial and borderline personality disorders. B) schizophrenia and bipolar disorder. C) bulimia and anorexia nervosa. D) amok and social phobia |
B) schizophrenia and bipolar disorder
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