Test Bank for Foundations of Mental Health Care 8th Edition by Michelle Morri son-Valfre LATEST VERSION Chapter 01: The History of Mental Health Care MULTIPLE CHOICE 1. The belief of the ancient Greek philosopher Plato that the rational soul controlled the irrational soulcould be compared with the belief of the more recent psychological theorist: a. Freud. b. Pinel. c. Fisher. d. Rush. ANS: A Sigmund Freud believed that mental illness was, in part, caused by forces both within and outside the personality. Philippe Pinel advocated acceptance of mentally ill individuals as human beings in need of medical assistance. Alice Fisher was a Florence Nightingale nurse who cared for the mentally ill, and Dr. Benjamin Rush was the author of the book Diseases of the Mind . DIF: Cognitive Level: Comprehension OBJ: 2 TOP: Early Years of Mental Health KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 2. During the mid -1500s, behaviors associated with mental illness were more accurately recorded by professionals. This practice led to _ for different abnormal behaviors. a. classificat ions b. diagnosing c. treatment d. education ANS: A Classification of abnormal behaviors did not begin until this time, after the practice of more accurate recording of behaviors was begun. Diagnoses, treatment guidelines, and any education regarding mental health disorders were not available during this period. DIF: Cognitive Level: Knowledge OBJ: 3 TOP: Mental Illness During the Renaissance KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 3. During the latter part of the 18th century, psychiatry became a separate branch of medicine, and inhumane treatment was greatly diminished by the French hospital director: a. Dix. b. Beers. c. Pinel. d. Carter. ANS: C Philippe Pinel advocated acceptance of the mentally ill, as well as proper treatment. Dorothea Dix crusaded for construction of mental health hospitals. Clifford Beers wrote the book A Mind That Found Itself . President Jimmy Carter established the President’s Commission on Mental Health in 1978. DIF: Cognitive Level: Knowledge OBJ: 4 TOP: Mental Ill ness in the 18th Century KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 4. In 1841, surveyed asylums, jails, and almshouses throughout the United States, Canada, and Scotland and is credited with bringing about public awareness and reform for the care of the mentally ill. a. Sigmund Freud b. John Cade c. Florence Nightingale d. Dorothea Dix ANS: D Dorothea Dix spent 20 years surveying facilities that housed mentally ill individuals and is credited with major changes in the care of the mentally ill. Sigmund Freud introduced the concept of psychoanalysis, John Cade discovered lithium carbonate for the treatment of bipolar disorder, and Florence Nightingale trained nurses in England in the 180 0s. DIF: Cognitive Level: Knowledge OBJ: 4 TOP: Mental Illness in the 19th Century KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 5. As a direct result of Clifford Beers’ work and book, A Mind That Found Itself , the Committee for Mental Hygiene was formed in 1909 with a focus on prevention of mental illness and: a. early detection of symptoms of mental illness. b. education of caregivers. c. current treatment options. d. removing the stigma attached to mental illness. ANS: D Clifford Beers’ book reflected on his attempt at suicide followed by the deplorable care he received for the next 3 years in mental hospitals. Beers’ work and book raised the consciousness of people throughout the country regarding prevention and removal of the stigma of having a mental illness. Early detection of symptoms, education of caregivers, and current treatment options regarding mental illness were not the focus of his book, nor were they a priority for the Committee for Mental Hygiene. DIF: Cogn itive Level: Knowledge OBJ: 4 TOP: Mental Illness in the 20th Century KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 6. During the 1930s, what common treatment for schizophrenia caused clients to fall into a coma that could last as long as 50 hours? a. Electroconvulsive therapy b. Insulin therapy c. Humoral therapy d. Amphetamine therapy ANS: B Insulin therapy was believed to successfully treat schizophrenia in the early 1900s. Amphetamines were used to treat depression, and electroconvulsive therapy was used for severe depression. Humoral therapy, which originated in ancient Greece and Rome, was a belief that mental illness resulted from an imbalance of the humors of air, fire, water, and earth. DIF: Cognitive Level: Knowledge OBJ: 5 TOP: Influences of War on Mental Health Therapies KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 7. In the 1930s, what mental health disorder was electroconvulsive therapy (ECT) most often used to treat? a. Schizophrenia b. Bipolar disorder c. Severe depression d. Violent behavior ANS: C ECT was found to be an effective treatment for severe depression in the 1930s. During this period, schizophrenia was treated with insulin therapy, and violent behavior was treated with a lobotomy. In 1949, lithium carbonate was discovered as a treatment for bipolar disorder. DIF: Cognitive Level: Knowledge OBJ: 5 TOP: Influences of War on Mental Health Therapies KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 8. In the early 20th century, a frontal lobotomy was a common treatment for violent behaviors. Which description of this procedure is accurate? a. A procedure that delivers an electrical stimulus to the frontal lobes of the brain. b. A surgical procedure that drills holes in the front of the skull to drain fluid. c. A surgical procedure that severs the frontal lobes of the brain from the thalamus. d. A surgical procedure that inserts implants into the frontal lobes of the brain. ANS: C A frontal lobotomy is a surgical procedure in which the frontal lobes of the brain are severed from the thalamus. DIF: Cognitive Level: Knowledge OBJ: 5 TOP: Influences of War on Mental Health Therapies KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 9. In 1937, Congress passed the Hill -Burton Act, which was significant for the treatment of mental health because it funded: a. research on drugs for the treatment of mental health disorders. b. training of mental health professionals. c. construction of psychiatric units in facilities throughout North America. d. development of community mental health clinics. ANS: C The Hill -Burton Act provided money for the construction of psychiatric units in the United States. Research on drugs was not a part of the Hill-Burton Act. Training of mental health professionals was funded by the National Mental Health Act of 1946, and co mmunity mental health centers were not instituted until the 1960s. DIF: Cognitive Level: Knowledge OBJ: 5 | 9 TOP: Influences of War on Mental Health Therapies KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 10. The National Mental Health Act of 1946 provided a means for funding of programs that promote research on mental health and: a. development of mental health clinics in the community. b. training of mental health professionals. c. treatment for veterans suffering from mental health disorders. d. educating the public about mental illness. ANS: B The National Mental Health Act of 1946 provided much needed training for individuals who cared for patients with mental health disorders. Community mental health clinics were initiated in the 1960s, treatment for veterans was not funded by this act, and education of the public occurred later. DIF: Cognitive Level: Knowledge OBJ: 5 | 9 TOP: Influences of War on Mental Health Therapies KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 11. Which of the following best describes the disorder that was first recognized in veterans following the Korean and Vietnam Wars? a. Depression b. Bipolar disorder c. Post-traumatic stress disorder d. Paranoid schizophrenic disorder ANS: C Post-traumatic stress disorder was initially discovered in veterans who had been involved in armed conflicts. The other disorders also occur in veterans but were not first recognized in soldiers who were fighting wars. DIF: Cognitive Level: Knowledge OBJ: 5 TOP: Influences of War on Mental Health Therapies KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 12. The introduction of in the 1950s led to the deinstitutionalization of many mentally ill individuals. a. psychotherapeutic drugs b. community mental health clinics c. residential treatment centers d. state mental health facilities ANS: A Psychotherapeutic drugs allowed for better control of behaviors than did other therapies alone during the 1950s. Patients were being released from state mental health facilities as a result of psychotherapeutic drug therapy. Community mental health clinics and residential treatment centers resulted from the deinstitutionalization of patients. DIF: Cognitive Level: Knowledge OBJ: 6 TOP: Introduction of Psychotherapeutic Drugs KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 13. In 1949, an Australian physician discovered which therapy to be an effective treatment for bipolar (manic -depressive) illness? a. Insulin therapy b. Water/ice therapy c. Lithium carbonate therapy d. Electroconvulsive therapy ANS: C To this day, lithium is a treatment that is used to effectively balance the manic states and depressive states of bipolar disorder. None of the other therapies listed are effective for bipolar disorder. DIF: Cognitive Level: Knowledge OBJ: 6 TOP: Introduction of Psychotherapeuti c Drugs KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 14. In the early 1960s, a committee appointed by President John F. Kennedy recommended the development of a new approach to the way mental health care was administered, with an emphasis on the introduction of: a. psychotherapeutic drugs. b. state mental health care systems. c. community mental health centers. d. deinstitutionalization of patients. ANS: C The emergence of community mental health centers was necessary, in part because of the massive deinstitutionalization of patients from state mental health care facilities after the introduction of psychotherapeutic drugs in the 1950s. DIF: Cognitive Level: Knowledge OBJ: 7 TOP: Introduction of Psychother apeutic Drugs KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 15. The Mental Health Systems Act of 1980 was one of the most progressive mental health bills in the history of the United States, but its enactment was interrupted by the: a. election of a new president. b. appointment of a new Surgeon General. c. rapid expansion of community centers. d. National Alliance on Mental Illness (NAMI) surveys. ANS: A The election of a new president and his administration led to drastic cuts in federal funding for mental health programs. None of the other three choices were a part of the Mental Health Systems Act of 1980. DIF: Cognitive Level: Knowledge OBJ: 9 TOP: Congressional Actions KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 16. The Omnibus Budget Reform Act (OBRA) of 1987 prevented the housing of people with chronic mental illness in: a. nursing homes. b. state mental health facilities. c. residential treatment centers. d. homeless shelters. ANS: A Many mentally ill, especially elderly, people were inappropriately placed in nursing homes with personnel who were not trained to care for these people. OBRA prevented this practice. State mental health facilities, residential treatment centers, and homeless shelters were not addressed in the OBRA of 1987. DIF: Cognitive Level: Knowledge OBJ: 9 TOP: Congressional Actions KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 17. In the late 1980s, government funding for mental health care dwindled, and most insurance companies coverage for psychiatric care. a. withdrew b. increased c. decreased d. added ANS: A Unfortunately, insurance companies followed the trend of the national government to the point of actually dropping coverage for psychiatric care. DIF: Cognitive Level: Knowledge OBJ: 9 TOP: Congressional Actions KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 18. In 2006, the National Alliance on Mental Illness (NAMI) conducted a comprehensive survey and grading of state mental health care for adults and learned that the overall grade for care was: a. “A.” b. “B.” c. “C.” d. “D.” ANS: D The NAMI gave a grade of “D” to the mental health care system based on poor funding, limited availability of care, and patients’ lack of access to mental health care. DIF: Cognitive Level: Knowledge OBJ: 9 TOP: Congressional Actions KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 19. In the early 1900s, the first theory of mental illness that showed behavior could be changed is attributed to: a. Beers. b. Dix. c. Freud. d. Pinel. ANS: C Freud was the first person who succeeded in explaining human behavior in psychological terms and in demonstrating that behavior can be changed under the proper circumstances. DIF: Cognitive Level: Knowledge OBJ: 5 TOP: Psychoanalysis KEY: Nursing Process Step: Asses sment MSC: Client Needs: Psychosocial Integrity MULTIPLE RESPONSE 1. The humoral theory of disease embraced by Hippocrates required a balance of which elements? (Select all that apply. ) a. Fire b. Water c. Light d. Air e. Earth ANS: A, B, D, E Hippocrates viewed mental illness as a result of an imbalance of humors —the fundamental elements of air, fire, water, and earth. Each basic element had a related humor or part in the body. DIF: Cognitive Level: Knowledge OBJ: 2 TOP: Greece and Rome KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 2. Which aspects of adult mental health care systems did the National Alliance on Mental Illness survey focus on? ( Select all that apply. ) a. Availability of care b. Access to care c. Regulation of medications d. Increased funding ANS: A, B, D In 2006, the National Alliance on Mental Illness (NAMI) conducted the “first comprehensive survey and grading of state adult mental health care systems conducted in more than 15 years” (NAMI, 2006). Their results revealed a fragmented system with an overall grade of D. Recommendations focused on increased funding, availability of care, access to care, and greater involvement of consumers and their families. DIF: Cognitive Level : Knowledge OBJ: 9 TOP: 21st Century KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity Chapter 02: Current Mental Health Care Systems Morrison -Valfre: Foundations of Mental Health Care, 8th Edition MULTIPLE CHOICE 1. 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 Britain’s 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 OBJ: 1 TOP: Mental Health Care in Britain KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 2. 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 OBJ: 3 TOP: Outpatient Care KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 3. 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 OBJ: 5 TOP: Case Management Systems KEY: Nursing Process Step: Intervention MSC: Client Needs: Health Promotion and Maintenance 4. 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: a. once per week. b. two to four times per week. c. five to six times per week. d. seven to eight times per week. 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 client’s 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 OBJ: 5 TOP: Case Management Systems KEY: Nursing Process Step: Intervention MSC: Client Needs: Safe and Effective Care Environment 5. 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. Psychiatric nurse b. Clinical psychologist c. Psychiatrist d. Psychiatric social worker ANS: D These are the primary responsibilities of the psychiatric social worker. The psychiatric nurse’s primary responsibilities include assisting with the client’s 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 psychiatr ist is the leader of the team. DIF: Cognitive Level: Comprehension OBJ: 6 TOP: Multidisciplinary Mental Health Care Team KEY: Nursing Process Step: Intervention MSC: Client Needs: Safe and Effective Care Environment 6. It is estimated that approximately million adults in the United States experience some form of mental or emotional disorder. a. 35.5 b. 61.5 c. 28.2 d. 59 ANS: B Although exact statistics are unavailable, it is estimated that at any given time at least 61.5 million adults in the United States suffer from mental -emotional disorders. “Approximately 18.1% of American adults —about 42 million people —live with anxiety disorders” (National Alliance on Mental Illness, 2014). DIF: Cognitive Level: Knowledge OBJ: 7 TOP: Impact of Mental Illness KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 7. A male client with a diagnosis of bipolar disorder is admitted to an inpatient unit during a severe manic episo de. As a result of guidelines implemented by the Health Care Financing Administration in 1983, the client’s 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 pre-determined 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 pre-determined 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 client’s stay. DIF: Cognitive Level: Comprehension OBJ: 1 TOP: Economic Issues of Mental Illness KEY: Nursing Process Step: Assessment MSC: Client Needs: Safe and Effective Care Environment 8. 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 into the group of nearly of U.S. citizens who live below the poverty level. a. 1% b. 6% c. 12% d. 25% ANS: C Approximately 12% of Americans (or 45 million people) live below the 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 OBJ: 7 TOP: Social Issues of Mental Illness KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 9. 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: Knowledg e OBJ: 7 TOP: Social Issues of Mental Illness KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 10. 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
