Foundations Of Mental Health Care, 5th Edition Test Bank
Preview Extract
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 Britainโs 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 clientโs 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.
b.
c.
d.
Psychiatric nurse
Clinical psychologist
Psychiatrist
Psychiatric social worker
ANS: D
These are the primary responsibilities of the psychiatric social worker. The psychiatric nurseโs
primary responsibilities include assisting with the clientโs 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
TOP: Multidisciplinary Mental Health Care Team
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
OBJ: 6
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 clientโs 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 clientโs 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
TOP: Delivery of Community Mental Health Services
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
OBJ: 4
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 Alzheimerโs 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
TOP: Delivery of Community Mental Health Services
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
OBJ: 4
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
TOP: Multidisciplinary Mental Health Care Team
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
OBJ: 6
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. Womenโs shelter
ANS: D
The womenโs 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
TOP: Mental Health Care in Canada
REF: p. 10
OBJ: 1
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 clientโs 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
TOP: Multidisciplinary Mental Health Care Team
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
OBJ: 6
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