d. Decrease the "red tape" associated with commitments so that commitments are faster
and easier
✓ B. Identifies the trend of ensuring the protection of individual civil liberties for
psychiatric clients.
Mr. Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses
to take any of his ordered medication because he believes "Jesus Christ told me I am the
prophet and must fast for a year." Your actions should be based on your knowledge of
which of the following?
a. Psychiatric clients cannot refuse treatment
b. Psychiatric clients do not always know what is good for them
c. Psychiatric clients can refuse treatment
d. Psychiatric clients cannot be trusted to make good healthcare decisions and, therefore,
the nurse's best clinical judgment should guide actions
✓ C. As with any client, psychiatric clients can refuse treatment unless a legal process
resulting in involuntary commitment or mandatory court order for treatment has
been obtained.
Which of the following statements best reflects the difference between the nurse-client (N-
C) relationship and a social relationship?
a. In the N-C relationship, the primary focus is on the client and the client's needs.
b. Goals in the N-C relationship are deliberately left vague and unspoken so that the client
can work on any issue.
c. In the N-C relationship, the nurse is solely responsible for making the relationship work.
d. In the N-C relationship, there is no place for social interaction.
A community has an unusually high incidence of depression and drug use among the teenage
population. The public health nurses decide to address this problem, in part, by modifying
the environment and strengthening the capacities of families to prevent the development of
new cases of depression and drug use. What is this is an example of?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Protective factorial prevention
✓ A. This action focuses on interventions designed to reduce the incidence of new
cases of disease.
Mrs. Kemp is voluntarily admitted to the hospital. After 24 hours, she states she wishes to
leave because "this place can't help me." The best nursing action that reflects the legal right
of this client is
a. Discharge the client
b. Explain that the client cannot leave until you can complete further assessment
c. Allow the client to leave but have her sign forms stating she is leaving against medical
advice
d. Immediately start the paperwork to commit the client and to allow you to treat her
against her wishes
✓ B. Almost every state allows for a brief for a period detainment to assess a client for
dangerousness to self or others before allowing the client to leave a hospital setting,
even if the admission was voluntary.
many characteristics that are known to be helpful in relationship-building. Which of the
following is an essential part of building a therapeutic relationship?
a. Collecting a family history
b. Like-mindedness
c. Authenticity
d. Accuracy in assessment
✓ C. Authenticity. Being genuine, honest, and respectful are essential elements in
establishing a working relationship with any client. Like-mindedness is not a part of
the therapeutic relationship. Although an important aspect of the PMHNP role,
collecting a family history and accuracy in assessment does not in and of itself
facilitate relationship building.
According to the DSM-5, which of the following is true? (Ch. 3)
a. A mental disorder is equivalent to the need for treatment.
b. Diagnostic criteria are used to inform clinical judgment.
c. Socially deviant behavior is considered a mental disorder.
d. A culturally expected response to a stressor is not a mental disorder.
✓ D. All DSM-5 disorders need to be made taking a person's culture into account. A
cultural expression of a response to grief, loss, or stress is not considered a DSM-5
diagnosis.
Mrs. French has been in individual therapy for 3 months. She has shown much growth and
improvement in her functioning and insight and is to discontinue services within the next
few weeks. In the next session, after you discuss service termination, she suddenly begins to
demonstrate the original symptoms that had brought her to treatment initially. She is now
hesitant to discharge, wants to continue services, and is displaying an increase in regressive
defense mechanisms. What is the best explanation for Ms. French's behavior?
a. An exacerbation of her symptoms related to stress
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