exam i: ch4 - treatment settings

Question 1

inability to recognize need for care

Answer 1

anosognosia

Question 2

what factors can complicate psychiatric care?

Answer 2

-misunderstanding mental illness
- apathy
- misdiagnosis

Question 3

what was the first antipsychotic med and when was it discovered

Answer 3

thorazine (chlorpromazine) in the 1950s

Question 4

which commission recommended more community-based care and when

Answer 4

carter’s commission on mental health in the 1980s

Question 5

decision that deinstitutionalized - keeping people in psychiatric hospitals was “unjustified isolation” and created community care systems instead

Answer 5

olmstead decision in 1999

Question 6

when was the affordable care act placed

Answer 6

2010

Question 7

what is the current psychiatric care system

Answer 7

outpatient and inpatient settings along a continuum of care

Question 8

serves the needs of the hard to engage, community living needs of people with serious persistent psychiatric symptoms

Answer 8

assertive community treatment (ACT)

Question 9

what are some challenges with the success of tx?

Answer 9

• housing and stability
• income and source of income
• family/support
• substance abuse history
• physical well-being

Question 10

people who use mental health services

Answer 10

consumers

Question 11

explain the role of a mental health nurse

Answer 11

• Promote optimal mental and physical well being
• Prevention of mental and behavioral distress
• Promotion of social inclusion to the mentally and behaviorally challenged person
• Care for co-occurring mental health and substance use disorders
• Care for mental health and physical disorders
• Ensure a safe and therapeutic environment
  Illness and medication management and education

Question 12

element of tx environment; primary to all other aspects

Answer 12

safety

Question 13

element of tx environment; physical environment, daily schedules + tx acitivities

Answer 13

structure

Question 14

element of tx environment; specific expectations for behavior that exist in the environment

Answer 14

norms

Question 15

element of tx environment; establishing boundaries and clarifying expectations of behavior in the millieu

Answer 15

limit-setting

Question 16

element of tx environment; allowing increasing independent behaviors in a dependent environment

Answer 16

balance

Question 17

what are the criteria for admission (4)

Answer 17

• suicidal/homicidal
• short term acute care/inability to care for self
• can be locked or unlocked
• voluntary or involuntary

Question 18

psychiatric care plan that focuses on disability

Answer 18

social security disability insurance

Question 19

psychiatric care plan that focuses on economic need

Answer 19

supplemental secruity income

Question 20

Requires insurance to provide comparable coverage for mental health, substance use disorder, and physical health care so people can get the tx they need

Answer 20

parity

Question 21

surrounds/environment, setting structures, emotional climate that is important to healing
- training ground for communication, coping skills

Answer 21

therapeutic millieu

Question 22

what is the most frequent method of inpatient suicide

Answer 22

hanging

Question 23

medical emergency where patient shows violence toward self or others (like a rapid for behavioral health)
- “code”
- escalates in predictable way
- can lead to seclusion, restraints, or medications

Answer 23

behavioral crisis

Question 24

what are the 4 national patient safety goals in behavioral health

Answer 24

• ID pt with 2 identifiers
• use meds safely
• prev infection
• ID pt at risk for harming selves/others