Question 1

A group of nurses are reviewing information about the evolution of mental health care and are discussing the recommendations of the final report of the Joint Commission on Mental Illness and Health. The nurses demonstrate an understanding of this information when they identify that the report recommended an increase in what?

Accepted Answer

The final report of the Joint Commission on Mental Illness and Health, called Action for Mental Health, recommended increased numbers of community clinics supplemented by general hospital units for mental illness care. The ideas in the report shifted responsibility for mental health care to the federal, state, and local governments.

Question 2

A nurse is reviewing literature that sanctions the involvement of psychiatric-mental health nurses in the provision of holistic nursing care. Integrating knowledge of the various theories and views of mental health and illness, the nurse identifies which as most strongly linked to this holistic approach?

Accepted Answer

The American Nurses Association's Statement on Psychiatric Nursing Practice (1967) officially sanctioned a holistic approach to nursing care for the first time. The roots of this contemporary psychiatric-mental health nursing thought can be traced to Florence Nightingale's Notes on Nursing, which presented a holistic view of the patient, with the view of the patient as living within a family and community. Freud's psychoanalytic theory focused on personality development and unconscious motivations for drives. Beers' autobiography described the inhumane treatments used for mental illness, which led to the formation of a National Committee for Mental Hygiene.

Question 3

A psychiatric-mental health nurse is preparing a presentation about key events and people that influenced the development of contemporary mental health and illness care. When describing the effects of World War II, which would the nurse most likely include?

Accepted Answer

During World War II, mental illness was beginning to be seen as a problem that could happen to anyone. Many "normal" people who volunteered for service were disqualified on the grounds that they were psychologically unfit to serve. Others who had already served a tour of duty developed psychiatric and emotional problems related to their wartime experiences. The biologic understanding of mental illness continues to evolve. Deinstitutionalization and the community mental health movement occurred during the 1960s. In the early 20th century, Freud categorized mental illness as either a psychosis or neurosis.

Question 4

A nurse is presenting a discussion of the history of psychiatric-mental health nursing and its place within nursing history. Which would be most appropriate to include?

Accepted Answer

In 1882, the first training school for psychiatric nursing was established at the McLean Asylum by E. Cowles; this was also the first nursing program to admit men. Nutting emphasized psychiatric-mental health nursing role development. Unfortunately, deinstitutionalization failed. Hildegard E. Peplau was responsible for establishing the first graduate program in psychiatric-mental health nursing, in 1954. Publication of journals soon followed, beginning in the 1960s.

Question 5

When reviewing the evolution of mental health and illness care, which event is associated with mental disorders beginning to be viewed as illnesses requiring treatment?

Accepted Answer

Mental disorders began to be viewed as illnesses with the establishment of Pennsylvania Hospital, the first institution in the United States to receive those with mental disorders for treatment and cure. The Quaker establishment of asylums reflected the impetus toward moral treatment. Dorothea L. Dix advocated for the humane treatment of clients with mental illness with the creation of state hospitals. Freud believed that the primary causes of mental illnesses were psychological and a result of disturbed personality development and faulty parenting.

Question 6

A psychiatric-mental health nurse is working on a committee that is developing programs that integrate the objectives for mental health and mental disorders, as identified in Healthy People 2030. Which type of program would be least appropriate?

Accepted Answer

The objectives of Healthy People 2030 identify the need to increase the proportion of persons with co-occurring substance abuse and mental disorders receiving treatment for both disorders. Thus, single substance abuse treatment programs would be least beneficial. The objectives call for an increase in depression screening by primary care providers, an increase in the proportion of homeless adults with mental health problems who receive mental health treatment, and an increase in the proportion of persons with serious mental illness who are employed.

Question 7

The following events are important in the development of psychiatric-mental health nursing practice. Which event occurred first?

Accepted Answer

In 1920, the first psychiatric nursing text was published. In 1954, the first graduate program in psychiatric nursing was established. In 1967, the ANA published the Standards of Psychiatric-Mental Health Nursing. In 1985, the Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice was published.

Question 8

A nurse is preparing a presentation about the current status of mental health services in the United States. Which statement would the nurse include as the most reflective of this status?

Accepted Answer

Today, mental health services in the United States are inadequate and fragmented, with millions of adults and children being disabled by mental illness every year. Mental illness ranks first in terms of causing disability in the United States compared with other illnesses. Recovery from mental illness, not cure, is the current worldwide goal.

Question 9

A group of nurses are reviewing the goals identified by the New Freedom Commission on Mental Health. The nurses demonstrate understanding of this report when they identify what as a goal?

Accepted Answer

According to the New Freedom Commission on Mental Health, one goal is to ensure that mental health care is consumer and family driven. In addition, the goals address the need to understand that mental health is essential to overall health, not just that it is one part of overall health. It also emphasizes that early mental health screening, assessment, and referral to services are common practice. Thus, screening is as important as assessment and referral. Moreover, the goals address the need for disparities in mental health services to be eliminated, not just reduced.

Question 10

As part of a career day presentation to a group of nursing students, a psychiatric-mental health nurse plans to describe how this specialty developed. Which individual would the nurse describe as playing a major role in the development of specialty training programs for psychiatric nurses?

Accepted Answer

Hildegard E. Peplau developed the first graduate program in psychiatric nursing, identifying it as a specialty. Mary Adelaide Nutting emphasized nursing role development. Harriet Bailey wrote the first psychiatric nursing textbook. Linda Richards was the first trained nurse in the United States and opened the Boston City Hospital Training School for Nurses at McLean Hospital, a psychiatric facility.

Question 11

A group of students is reviewing information about mental health care after World War II. The students demonstrate an understanding of this information when they identify which action that took place as a result of the National Mental Health Act?

Accepted Answer

The National Mental Health Act created a six-member National Mental Health Advisory Council that established the National Institute of Mental Health, which was responsible for overseeing and coordinating research and training. Passage of this act did not lead to the discovery of psychopharmacology. The Hill-Burton Act, which followed the passage of the National Mental Health Act, provided federal support for hospital construction. The development of community mental health centers was the result of the Action for Mental Health, which provided the basis for the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963.

Question 12

When providing care to a client, the psychiatric-mental health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual?

Accepted Answer

Hildegard E. Peplau conceptualized nursing practice as independent of physicians and emphasized the use of self as a nursing tool. Florence Nightingale identified the need to view clients holistically, was sensitive to human emotions, and recommended interactions that today would be classified as therapeutic communication. Dorothea L. Dix crusaded for the humane treatment of clients with mental illness. Sigmund Freud developed a personal theory based on unconscious motivations for behavior.

Question 13

After teaching a group of nurses about the historical perspectives of mental health care, the presenter determines that the group has understood the information when they identify which as a common belief about mental illness during the later medieval period from 1000 to 1300?

Accepted Answer

During the medieval period, contaminated environments were believed to cause mental illness. Consequently, individuals were removed from their sick environments and placed in protected asylums. During the early Christian period, sin or demonic possession was thought to cause mental disorders. Thus, exorcisms were commonly performed. Moral treatment was the focus of care primarily during the 19th century.

Question 14

A psychiatric-mental health nurse is implementing evidence-based practice. The nurse understands that this approach is developed by doing what first?

Accepted Answer

In an evidence-based approach, first clinical questions are defined. Then evidence is discovered and analyzed. Next, the research findings are applied in a practical manner and in collaboration with the patient, and outcomes are evaluated.

Question 15

A psychiatric-mental health nurse is describing the various programs offered by the local community mental health center. When explaining how these programs work, the nurse would emphasize which concept?

Accepted Answer

In today's environment, the traditional medical model, which is viewed as autocratic and paternalistic, is being replaced by a collaborative model whereby mental health professionals work in partnership with consumers to help rebuild their lives. Consumer advocacy efforts have led to the implementation of recovery philosophy and practices.

Question 16

A psychiatric-mental health nurse wants to use an evidence-based approach to care. Which action would the nurse implement first?

Accepted Answer

When using an evidence-based approach, the nurse would first define the clinical questions, then discover and analyze the evidence, apply the research findings in a practical manner and in collaboration with the patient, and lastly evaluate the outcomes.

Question 17

A nurse is describing the concept of evidence-based practice in psychiatric-mental health nursing to a group of colleagues. Which information would the nurse include as being important? (Select all that apply.)

Accepted Answer

Evidence-based practice is based on the most relevant evidence from research or evidence-based theories, as well as expert opinion, client data, and clinical experiences. Established routines may or may not be grounded in evidence; therefore, they may be subject to change based on supporting evidence.

Question 18

A psychiatric-mental health nurse is working a booth at a local community college job fair. One of the participants comes to the booth and asks the nurse about the different types of conditions for which psychiatric-mental health nurses provide care. Which condition would the nurse most likely include in the response? (Select all that apply.)

Accepted Answer

Psychiatric nurses care for patients with a wide range of emotional problems and mental disorders. These nurses, specializing in mental health nursing, are not only experts in caring for persons with a primary diagnosis of a mental disorder but also for those with self-concept and body image issues, developmental crises, co-occurring disorders, end-of-life changes, and emotional stress related to illness, disability, or loss. It is a psychiatric nurse who is called when violence, suicide, or a disaster erupts. Issues involving non-adherence related to low health literacy would be a situation in which psychiatric-mental health nurses would be involved.

Quiz 1: Psychiatricmental Health Nursing and Evidence-Based Practice