N5 lecture test 2nd class

Varcarolis: Foundations of Psychiatric Mental Health Nursing, 4th Edition
1.
Which activity best exemplifies an important focus for a case manager?
A. arranging for rapid assessment of a newly hospitalized client
B.providing a comprehensive client social history to the treatment team
C. writing a report describing best practices in care for clients with depression
D. gathering data for a research study concerning side effects of a new medication

2.
In which situation is the nurse functioning in the role of advocate?
A. Nurse A provides 1:1 supervision for a client on suicide precautions.
B. Nurse B co-leads a medication education group for clients and families.
C. Nurse C attends an in-service education program to obtain re-certification in CPR.
D. Nurse D negotiates with the client's HMO for extension of a three-day hospitalization to five days.

3.
Managed care integrates quality care and cost management. Clinical pathways are tools that assist the multidisciplinary team in prospectively detailing the course of daily treatments and interventions for a client with a particular psychiatric diagnosis. A case manager is a behavioral health professional who serves as a client advocate while assessing and arranging for delivery of appropriate services to address client needs, monitoring services delivered and evaluating client goal attainment. Does this explanation adequately explain the relationship of managed care, clinical pathways and the role of case manager?
A. Yes
B. No. The explanation of clinical pathways is incorrect.
C. No. The case manager's primary role is that of financial watchdog.
D. No. The sole focus of managed care is cost containment.

4.
A client is admitted to the behavioral health unit. Her husband comes to visit and she tells the nurse she does not wish to see him. The best action for the nurse would be to tell the client's husband that
A. his wife does not wish to see him at this time.
B. he is welcome to visit, but may receive a cool reception.
C. the client's plan of care calls for limiting visitors for two days.
D. the client is acutely psychotic and not responsible for her present behavior.

5.
A client was admitted to the behavioral health unit for evaluation and diagnosis after being found wandering the streets. His personal hygiene is poor and his responses to questions are bizarre and inappropriate. Which of the following would constitute a violation of his rights?
A. A nurse states, "We will help you make decisions that will keep you safe."
B. A psychiatric technician states, "I'm going to help you shower so you won't smell too bad."
C. A nurse states, "Your pocket knife and nail clippers will be kept in the nurses' station."
D. A physician states, "Tomorrow you'll be having a number of tests to help us learn about your condition."

6.
Which client displays a symptom that gives priority for admission to an inpatient behavioral health unit?
A. Ms. E, who has severe anxiety and feels as though she is suffocating.
B. Mrs. F, who is grieving over the recent death of her identical twin sister.
C. Ms. G, who hears voices telling her she is "Exalted Queen of the Universe."
D. Mr. H, who had a seizure related to his elevated lithium level.

7.
A nurse is assigned to care for clients on the unit during the time other staff are engaged in the management of a behavioral crisis with a client in the dining room. Which action would be inappropriate for the nurse to take?
A. lock each client in his/her room
B. remove clients to the day room/solarium
C. allow clients to express their reactions to the incident
D. reassure clients that staff will care for the client without hurting him/her

8.
When a number of staff gather to provide silent support for a staff member who has given a directive to a client in an attempt to de-escalate a crisis, the intervention is called
A. show of force.
B. milieu management.
C. behavioral contingency.
D. management by coercion.

9.
A client with prolonged mental illness was readmitted when symptoms exacerbated after she stopped taking prescribed medication. The client lives alone and has few outside activities. To prepare the client for discharge the nurse will focus on
A. improving client-family relationships.
B. placing the client in a sheltered workshop.
C. psychoeducation to promote medication compliance.
D. involving the client in daily visits to a psychosocial club.

10.
A basic nursing student assigned to the psychiatric inpatient unit should
A. view clients as potential threats to personal safety.
B. take unilateral action to make changes in client care plans.
C. maintain open communication with staff, managers and instructors.
D. seek opportunities to inform interdisciplinary staff of less restrictive alternatives.

11.
Three of the following sets of initials are associated with managed care organizations. Which set of initials will NOT signify to a nurse the specific use of managed care business practices?
A. HMO
B. PPO
C. MBHO
D. IDTP

12.
The primary advantage of using a case manager is to
A. increase collaborative practice.
B. enhance resource management.
C. increase client satisfaction with care.
D. promote evidence-based psychiatric nursing.

13.
A client is admitted to the psychiatric in-patient unit for the first time following a suicide attempt. The nurse can expect that like most clients, he will experience some
A. elation.
B. anxiety.
C. aggression.
D. dissociation.

14.
When a client is admitted to a behavioral health unit, how are the client's rights affected?
A. Rights as citizens remain intact.
B. The right to legal counsel is lost.
C. The right to refuse treatment is lost.
D. The right to publicly complain is restricted.

15.
When a client is admitted to a behavioral health unit, which of the following does he/she NOT have a patient's right to do?
A. refuse treatment
B. send and receive mail
C. seek legal counsel
D. retain all possessions brought to the hospital

16.
In a behavioral managed care system, if a client who has stopped taking psychotropic medication requires hospitalization for crisis management, what length of stay would be identified in the treatment plan?
A. two weeks
B. one month
C. one week
D. less than one week

17.
An ongoing critically important responsibility of nurses working on an in-patient psychiatric unit is
A. fostering research.
B. milieu management.
C. sympathetic listening.
D. providing negative feedback.

18.
Which is a characteristic of a therapeutic in-patient milieu?
A. It provides for client safety.
B. Clients are responsible for all decisions about privileges.
C. Rules and behavioral limits are inconsistently enforced.
D. Staff provide frequent and ongoing negative feedback to clients.

19.
In most in-patient psychiatric units it can be expected that administration of medications will involve
A. the nurse taking a medication cart from client to client.
B. the nurse taking medications to one client at a time.
C. clients coming to a central location to receive medication.
D. less than one-quarter of the clients receiving medication.

20.
Which would not be considered a crisis on a psychiatric unit?
A. Mr. R. goes into shock.
B. Ms. T goes into cardiopulmonary arrest.
C. Mr. S demonstrates anger that escalates to physical assault.
D. Mrs. U, who hears voices telling her to hit others, asks for and receives prn medication.