Community Mental Health Nursing Group 9, 10 Mcqs

1. A nursing instructor is teaching about the Community Health Centers Act of 1963.
What
was a deterring factor to the proper implementation of this act?
1. Many perspective clients did not meet criteria for mental illness diagnostic-related groups.
2. Zoning laws discouraged the development of community mental health centers.
3. States could not match federal funds to establish community mental health centers.
4. There was not a sufficient employment pool to staff community mental health centers.
ANS: 3
Rationale: A deterring factor to the proper implementation of the Community Mental Health
Centers Act of 1963 was that states could not match federal funds to establish community
mental health centers. This act called for the construction of comprehensive community
mental health centers to offset the effect of deinstitutionalization, the closing of state
mental health hospitals.
2. A nurse is implementing care within the parameters of tertiary prevention. Which
nursing action is an example of this type of care?
1. Teaching an adolescent about pregnancy prevention
2. Teaching a client the reportable side effects of a newly prescribed neuroleptic medication
3. Teaching a client to cook meals, make a grocery list, and establish a budget
4. Teaching a client about his or her new diagnosis of bipolar disorder
ANS: 3
Rationale: The nurse who teaches a client to cook meals, make a grocery list, and establish a
budget is implementing care within the parameters of tertiary prevention. Tertiary
prevention consists of services aimed at reducing the residual effects that are associated
with severe and persistent mental illness. It is accomplished by preventing complications of
the illness and promoting rehabilitation that is directed toward achievement of maximum
functioning.
3. A nursing instructor is teaching about case management. What student statement
indicates that learning has occurred?
1. “Case management is a method used to achieve independent client care.”
2. “Case management provides coordination of services required to meet client needs.”
3. “Case management exists mainly to facilitate client admission to needed inpatient
services.”
4. “Case management is a method to facilitate physician reimbursement.”
Rationale: The instructor evaluates that learning has occurred when a student defines case
management as providing coordination of services required to meet client needs. Case
management strives to organize client care so that specific outcomes are achieved within
allotted time frames.
4. A client at the mental health clinic tells the case manager, “I can’t think about living
another day, but don’t tell anyone about the way I feel. I know you are obligated to
protect my confidentiality.” Which case manager response is most appropriate?
1. “The treatment team is composed of many specialists who are working to improve your
ability to function. Sharing this information with the team is critical to your care.”
2. “Let’s discuss steps that will resolve negative lifestyle choices that may have increased
your suicidal risk.”
3. “You seem to be preoccupied with self. You should concentrate on hope for the future.”
4. “This information is secure with me because of client confidentiality.”
ANS: 1
Rationale: The most appropriate response by the case manager is to explain that sharing the
information with the treatment team is critical to the client’s care. This case manager’s
priority is to ensure client safety and to inform others on the treatment team of the client’s
suicidal ideation.
5. When intervening with a married couple experiencing relationship discord, which
nursing action reflects an intervention at the secondary level of prevention?
1. Teaching assertiveness skills in order to meet assessed needs
2. Supplying the couple with guidelines related to marital seminar leadership
3. Teaching the couple about various methods of birth control
4. Counseling the couple related to open and honest communication skills
ANS: 4
Rationale: Counseling the couple related to open and honest communication skills is a
reflection of a nursing intervention at the secondary level of prevention. Secondary
prevention aims at minimizing symptoms and is accomplished through early identification of
problems and prompt initiation of effective treatment.
6. A school nurse provides education on drug abuse to a high school class. This nursing
action is an example of which level of preventive care?
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Primary intervention
ANS: 1
Rationale: Providing nursing education on drug abuse to a high school class is an example of
primary prevention. Primary prevention services are aimed at reducing the incidence of
mental health disorders within the population.
7. A newly admitted homeless client diagnosed with schizophrenia states, “I have been
living in a cardboard box for two weeks. Why did the government let me down?” Which is
an appropriate nursing response?
1. “Your discharge from the state hospital was done prematurely. Had you remained in the
state hospital longer, you would not be homeless.”
2. “Your premature discharge from the state hospital was not intended for patients
diagnosed with chronic schizophrenia.”
3. “Your discharge from the state hospital was based on firm principles; however, the
resources were not available to make the transition a success.”
4. “Your discharge from the state hospital was based on presumed family support, and this
was not forthcoming.”
ANS: 3
Rationale: The most accurate nursing response is to explain to the client that the resources
were not available to make transitioning out of a state hospital a success. There are several
factors that are thought to contribute to homelessness among the mentally ill:
deinstitutionalization, poverty, lack of affordable housing, lack of affordable health care,
domestic violence, and addiction disorders.
8. An instructor is teaching nursing students about the difference between partial and
inpatient hospitalization. In what way does partial hospitalization differ from traditional
inpatient hospitalization?
1. Partial hospitalization does not provide medication administration and monitoring.
2. Partial hospitalization does not use an interdisciplinary team.
3. Partial hospitalization does not offer a comprehensive treatment plan.
4. Partial hospitalization does not provide supervision 24 hours a day.
ANS: 4
Rationale: The instructor should explain that partial hospitalization does not provide
supervision 24 hours a day. Partial hospitalization programs generally offer a comprehensive
treatment plan formulated by an interdisciplinary team. They have proved to be an effective
method of preventing hospitalization.
9. When a home health nurse administers an outpatient’s injection of haloperidol
decanoate (Haldol decanoate), which level of care is the nurse providing?
1. Primary prevention level of care
2. Secondary prevention level of care
3. Tertiary prevention level of care
4. Case management level of care
ANS: 3
Rationale: When administering medication in an outpatient setting, the nurse is providing a
tertiary prevention level of care. Tertiary prevention services are aimed at reducing the
residual effects that are associated with severe and persistent mental illness. It is
accomplished by preventing complications of the illness and promoting rehabilitation that is
directed toward achievement of maximum functioning.
10. A client diagnosed with schizophrenia is hospitalized owing to an exacerbation of
psychosis related to non-adherence with antipsychotic medications. Which level of care
does the client’s hospitalization reflect?
1. Primary prevention level of care
2. Secondary prevention level of care
3. Tertiary prevention level of care
4. Case management level of care
ANS: 2
Rationale: The client’s hospitalization reflects the secondary prevention level of care.
Secondary prevention aims at minimizing symptoms and is accomplished through early
identification of problems and prompt initiation of effective treatment.
11. When attempting to provide health-care services to the homeless, what should be a
realistic concern for a nurse?
1. Most individuals that are homeless reject help.
2. Most individuals that are homeless are suspicious of anyone who offers help.
3. Most individuals that are homeless are proud and will often refuse charity.
4. Most individuals that are homeless relocate frequently.
ANS: 4
Rationale: A realistic concern in the provision of health-care services to the homeless is that
individuals who are homeless relocate frequently. Frequent relocation confounds service
delivery and interferes with providers’ efforts to ensure appropriate care.

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1. A nursing instructor is teaching about the Community Health Centers Act of 1963.

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