Chapter 35 Seriously and Persistently Mentally Ill

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Chapter 35  Seriously and Persistently Mentally Ill

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

 

Individuals with serious and persistent mental illness (SPMI) face multiple and complex social problems that reduce their ability to maintain themselves in society. Which of the following statements is most true of deinstitutionalization?
A)
Deinstitutionalization has created a situation in which individuals with SPMI are commonly held within ER settings, instead of in the community where they belong.
B)
Deinstitutionalization is no longer a large problem due to recent federal funding initiatives for community housing for those with SPMI.
C)
Deinstitutionalization creates difficulties for families because they now have to visit their loved ones within the sterile environments of state mental institutions.
D)
Deinstitutionalization since the 1960s has caused individuals with SPMI to be discharged into community settings that were ill equipped to handle their multiple and complex needs.
Ans:
D

Feedback:

Deinstitutionalization, the process by which large numbers of psychiatric–mental health clients were discharged from public psychiatric facilities, created an influx of seriously and persistently mentally ill clients back into the community to receive outpatient care. It is a major factor in the current problems of the mentally ill.

2.
Which of the following statements is most true regarding the population of homeless individuals who are women?
A)
Women are at lower risk for homelessness due to their ability to obtain federal funding and welfare services.
B)
Women are at greater risk for homelessness because they often have children.
C)
Women who are homeless have often experienced domestic violence and have a mental illness, which renders them at high risk.
D)
Women who have children are less likely to be homeless because extended family members are more likely to offer them harbor.
Ans:
C

Feedback:

Women who are homeless have often experienced domestic violence. When mental illness is present, the combination of the illness and lack of adequate resources is a causative factor in homelessness. The history of unwanted pregnancies, STDs, and the risk of rape and violence are also common in homeless women.

3.
Which of the following statements by the nurse working with a client with SPMI best reflects a cognitive–behavioral therapy approach to caring for the client?
A)
“The impact of the death of your mother when you were 3 years old has made it difficult for you to trust women.”
B)
“I know it is difficult but you must get up and get dressed now or you will not be able to use your unit privileges for the remainder of the week.”
C)
“Sit in the chair next to me, and let’s role-play about how you should approach your daughter regarding obtaining money for your clothing.”
D)
“You have been able to shave and shower for 2 days in a row, which reflects significant progress toward your discharge goals.”
Ans:
D

Feedback:

The client with SPMI often has great difficulty feeling positive about herself or himself due to repeated failures in multiple areas of living. During cognitive–behavioral therapy, the nurse communicates respect for the client and identifies those areas in which the client has been able to function. Encouraging the client to identify positive self-statements and provide examples of positive functioning promotes self-esteem.

4.
The nurse is working with a female client who is admitted with SPMI regarding identification of her current problems. The client states, “I need to find an apartment soon, or I will be homeless again.” The nurse believes that the client’s immediate problem is her delusion that she is “a messenger from God,” which has been a theme since the client was admitted. Which of the following responses by the nurse reflects that she is taking an “empowerment education” approach to nursing care of the client?
A)
“We need to get your delusions under control first with medications before we can address any other needs.”
B)
“Remember that you can stay here in the hospital for now.”
C)
“Yes, we do need to focus on finding a home environment for you when you leave the hospital.”
D)
“We cannot deal with your living situation until you take this medication to control your thoughts.”
Ans:
C

Feedback:

Most likely, the client with SPMI has been subjected to multiple instances of rejection based on appearance and behaviors. The nurse enhances the client’s feelings of being understood through the use of active listening skills. Schofield (1998) describes empowerment education as an approach that shifts focus from the client’s illness to health and from the nurse’s perspective to the client’s perspective. The nurse focuses on the client’s priorities and goals to promote empowerment.

5.
Which of the following would be the least likely characteristic of a client who would commit suicide while incarcerated?
A)
Old age
B)
History of suicide attempts
C)
Short sentence
D)
Presence of significant mental illness
Ans:
C

Feedback:

The characteristics of individuals who commit suicide during incarceration include the presence of a significant mental illness, a history of suicide attempts, older age, a lengthy sentence, and segregated or isolated housing.

 

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