NUR 370 Exam 1 Questions and
Answers| Already Passed
What are the myths about mental illnesses? ✅mental illnesses are caused by personal
weaknesses and can be cured by personal strength; they are not real diseases; there is
no treatment; they won't affect me; these are all false
What is stigma? ✅an attribute that is deeply discrediting and reduces the bearer from
a whole and usual person to a tainted discounted one
What is the problem with stigmas? ✅people can internalize them
What is the prevalence of mental disorders? ✅lifetime prevalence is 46.4% of adults;
depression has the greatest prevalence of causing disability even compared to heart
disease; 25% of adults have a mental disorder and 68% have a medical disorder
(common to have both)
Where does funding for mental health services come from? ✅mostly paid by the state
government which is opposite for medical (which is more private); majority comes from
medicaid; substance abuse if mostly public funding
How does support help patients? ✅can promote comfort and sense of security,
lessens anxiety, and promotes engagement in treatment; allow patients to vent, use
empathy, enhance self esteem, unconditional acceptance of patient, provide safe
places, therapeutic communication, active listening
How does structure help patients? ✅helps connect behavior to consequences, control
maladaptive behaviors, have a sense of security, avoid confusion which allows for
success and enhances self esteem; plan activities, give clear time and place; have
consistent consequences, set limits
What is the continuum of mental health care? ✅continuum from institutional to
community based care; three points are structure/restrictiveness, skills orientation, and
community integration; you need more structure for acute symptoms which means more
restriction; skills tend to be more community based
What is the continuum of structure? ✅inpatient, day hospital, intensive outpatient,
outpatient, residential treatment, and ACT team
What is the community continuum? ✅inpatient, residential, outpatient, and ACT
,What are mental health service disparities? ✅minorities have less access to mental
health services, are less likely to get needed services, often receive poorer quality
mental health care, and are underrepresented in mental health research
What is deinstitutionalization? ✅from 1955-1998, 559000 inpatients were released
from psych units into the streets as a push to go towards community health care but not
enough community health centers were created to meet demands; many patients
became homeless or went into the jails
What is the role of nursing in psychiatric care? ✅purposeful use of self; assessment of
bio-social-psycho, planning with patient and families, organize care with other
specialists, promote/maintain health, milieu management, structure, safety, stabilize
patient, group therapy, psychoeducation, couseling, meds, family support, ECT
When can you use coercion? ✅when patient is in immediate danger of hurting self or
others; needs to be done in least restrictive way, cannot be used for custodial care;
there lacks a gap when a person is mentally ill and lacks an ability to decide in their own
best interests but is not dangerous
When can you use restraints? ✅Can use if imminent danger to self or others, must use
least restrictive method, after other measures have been used, must be implemented
with standard of care, and have made reasonable efforts to reduce use
What are the standards of care r/t restraints? ✅documentation of justification,
authorizing order from MD, observation of good care (constant or q15min, VS, and
extremity check q2h, hydration, toiling, and nutrition PRN)
What is the duty to warn? ✅if someone makes a personal threat that person must be
warned
What is the Americans with Disabilities Act? ✅those with mental disorders are entitled
to reasonable accommodation on job and the employer can ask only to the extant
relevant
What is voluntary medical admission? ✅no notice required to leave AMA
What is voluntary psych admission? ✅AMA requires 3 days notice in order to get court
approval if you need to stay longer
What is involuntary psych admission? ✅still retains civil commitment and can refuse
treatment unless they are incompetent or there is a court order
What is the civil commitment in michigan? ✅person has a mental illness and is a
danger to self, other, or imminent danger of significant harm because of unable to
provide for own basic needs
, What is the petition? ✅this is filled out by anyone over 18 who has knowledge that
person has mental illness and a danger; this needs to be taken to magistrates office
who can then issue custody order to get person transported to an area for evaluation
What is the 1st medical certificate? ✅after petition, has 24 hours to evaluate the
patient by physician or PhD psych; they can release patient or require further evaluation
What is the 2nd medical certificate? ✅evaluation done by psychiatrists within 72 hours
What is the court hearing? ✅must occur within 7 days of admit; patients can waive
right or defer hearing; judge can order further treatment; order lasts 60 days; patients
are often discharged before hearing takes place
What is the purpose of psychiatric advance directives? ✅Extends patient autonomy to
circumstances when patient lacks decision making capacity due to mental disorder;
includes surrogate decision makers, conditions indicating loss of DMC, and best prior
treatments
What are the cultural differences in psych care? ✅variations in type of expressed
emotion, non-verbals, privacy issues, relationships with authority, gender expression,
family roles, sexual behavior, rituals, developmental milestones, and values; may be
differences in appearance, affect, speech, and thought content; different meanings
behind diseases and response to symptoms
What should a nurse do for culturally competent care? ✅Don't assume patient's beliefs
are the same, discuss patient's beliefs about health and illness, ask about religion, world
view, and spirituality, self assessment necessary, recognize stressors, respect beliefs
and autonomy
What are patient's rights? ✅Communicate with people outside hospital, Keep personal
effects, Have religious freedom, Make purchases, Enter into contractual relationships,
Receive education, Legal representation, Privacy and confidentiality, Treatment in least
restrictive environment, Informed consent, Refuse treatment, Manage and dispose of
property, Dignity and respect, Access to medical record, 3 day intent with voluntary
admission, May file recipient rights complaint
What is therapeutic milieu? ✅a scientific structuring of environment to effect behavioral
changes and improve the psychological health and functioning
What is the aim of therapeutic milieu? ✅provide a stable and coherent social
environment that facilitates the development and implementation of an individualized
treatment plan
