Chapter 12: Prevention and Mental Health Promotion Flashcards
- The nurse explains that the main goal of primary prevention is the reduction of the _____ of mental disorders.
a. severity
b. duration
c. incidence
d. prevalence
ANS: C
Primary prevention is lowering the incidence of a mental disorder or reducing the rate at which new cases of the disorder develop. Secondary prevention reduces the prevalence of a mental disorder. Tertiary prevention reduces the severity of a mental disorder and its associated disability.
- A psychiatric nurse is assessing the need for mental health services at the clinic. When estimating the number of patients with bipolar disorder in the community, the nurse places highest priority on which data-gathering technique?
a. Community forums that solicit data shared by patients and families
b. Epidemiological studies that indicate incidence and prevalence of disease
c. Use of key informants, such as local social service personnel, nurses, and physicians
d. Statistics from local public reports about race, marital status, population density, and substance abuse
ANS: B
Epidemiological studies examine the incidence (number of new cases) and prevalence (number of current existing cases) of a disease or disorder in a defined population over a specified period. The nurse who is trying to plan for services would find these data very helpful. The remaining options refer to other methods of assessing community needs, but they are not as well suited to gathering the data identified by this question.
- What is the essential difference between the nursing prevention model and the medical prevention model?
a. The medical model targets universal populations; the nursing model targets a selective population.
b. The medical model assumes that all people are at equal risk; the nursing model attempts to identify those who are more vulnerable.
c. The medical model attempts to identify the most likely cause of the disease; the nursing model stresses that mental disorders are multicausal.
d. The medical model offers a continuum of nonspecific preventive measures; the nursing model offers one specific, tested, preventive measure.
ANS: C
The primary difference is the medical model’s attempt to identify a single cause of a disease; the nursing model assumes that mental disorders result from the interplay of several risk and protective factors.
- A psychiatric nurse is responsible for providing patient-focused health education. In order to promote primary prevention of mental health problems, the nurse stresses:
a. trust.
b. resilience.
c. networking.
d. motivation.
ANS: B
The health education strategy of primary prevention in mental health involves the strengthening of individuals and groups through building of competence or resilience. The other answers do not address this particular trait.
- A nurse whose primary focus is tertiary prevention of mental disorders would focus on:
a. providing prompt treatment of an individual’s mental disorder.
b. identifying social supports to prevent the need for hospitalization.
c. funding rehabilitative activities to reduce the disability associated with mental disorders.
d. forming a preretirement counseling program staffed by professional mental health nurses.
ANS: C
The nurse’s work in tertiary prevention involves rehabilitative efforts.
- A nurse who works in community mental health identifies a minority neighborhood group as having low self-efficacy and being particularly susceptible to a number of stressors. In which phase of the nursing process did this activity take place?
a. Assessment
b. Analysis
c. Planning
d. Implementation
e. Evaluation
ANS: C
The analysis/nursing diagnosis phase of the nursing process is in use when the nurse identifies problem areas. Assessment identifies symptoms while planning and implementation involves putting solutions into the therapy plan. Evaluation reviews the outcomes of the therapy plan.
- People with low self-efficacy:
a. are often found to engage in antisocial and/or criminal behavior.
b. usually require an inordinately large percentage of the available community health resources.
c. are usually well motivated and handle stress well and typically have low vulnerability to depression.
d. give up in the face of difficulty, recover slowly from setbacks, and easily fall victim to depression.
ANS: D
Low self-efficacy negatively affects an individual’s thoughts, motivation, mood, and health. A person with low self-efficacy dwells on obstacles and personal deficiencies, and such a person is depression prone. Successful interventions for groups with low self-efficacy can be planned and implemented.
- When a community mental health nurse focuses on intervention strategies designed to increase self-efficacy among members of a minority neighborhood group, a realistic primary prevention goal would be:
a. elimination of mental illness in the community.
b. resolving social problems within the community.
c. reducing both stressors and suffering in the group.
d. reducing the incidence of depression in the group.
ANS: D
Primary prevention is aimed at reducing the incidence of mental illness. Depression is a frequent outcome of low self-efficacy. Therefore a goal of intervention to raise self-efficacy is to reduce the incidence of depression in the group.
- The identification of intervention strategies designed to increase self-efficacy among members of a minority neighborhood group would occur in which phase of the nursing process?
a. Assessment
b. Analysis
c. Planning
d. Implementation
e. Evaluation
ANS: C
Planning is the elaboration of strategies designed to achieve a specific goal.
- A nurse assessing a person who is deemed to be at high risk for mental disorders will find that, as suggested by the nursing primary prevention model, the person has:
a. fewer stressors.
b. more protective factors.
c. unusual developmental tasks.
d. inadequate coping mechanisms.
ANS: D
Factors that place a person at high risk include the presence of many stressors, fewer protective factors, and inadequate coping mechanisms. (Developmental tasks are considered universal.)
- In the event that a vaccine is developed to prevent schizophrenia, which population group would be selected to receive it first?
a. The universal population
b. The indicated population
c. The developmental population
d. The epidemiological population
ANS: B
An indicated population is one made up of high-risk individuals identified as having biological markers that indicate a predisposition for the disorder.
- Which person is most vulnerable to the development of psychiatric illness based on sociocultural factors?
a. A 16-year-old who has a parent with bipolar disorder
b. A 55-year-old who has retired with full pay from a job as a high school teacher
c. A 24-year-old who was raised by a grandparent after both parents died in a plane crash
d. A 67-year-old from a minority group who is poor and has no social support system
ANS: D
Being a minority, living in poverty, being elderly, and having no social support are sociocultural risk factors.
- To effectively use the nursing primary prevention model, it is most important for a nurse to have knowledge of:
a. personality types.
b. psychiatric medications.
c. normal growth and development.
d. the DSM-IV-TR diagnostic categories.
ANS: C
Knowledge of normal growth and development is necessary for assessing a person’s functioning and for choosing appropriate preventive nursing interventions.
- A nurse working in a community health agency wishes to implement a primary preventive program in mental health for the elderly. Which action should occur first?
a. Elaboration of specific preventive strategies
b. Identification of stressors that precipitate maladaptive responses
c. Application of selected nursing interventions to enhance adaptation
d. Determination of the effectiveness of the existing nursing activities
ANS: B
Assessment is the first phase of the nursing process.
- A psychiatric nurse is working with patients in a health education group on strategies to improve anger management. The nurse would best evaluate the effectiveness of this intervention by determining changes in a patient’s:
a. routinely used coping skills.
b. opinion about own self-worth.
c. knowledge of people and events that trigger anger.
d. underlying mental health disorder, exhibited by the symptom of anger.
ANS: A
Health education for patients with mental health disorders can include interventions to increase the coping skills of the individual or group, such as problem solving, communication skills, tolerance of stress and frustration, motivation, hope, anger management, and self-esteem. The remaining options do not relate to an increase in coping skills related to anger management.
