






























Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Community
Ask the community for help and clear up your study doubts
Discover the best universities in your country according to Docsity users
Free resources
Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors
NR 548 LATEST EXAM WITH DETAILED QUESTIONS AND ANSWERS.pdf
Typology: Exams
1 / 38
This page cannot be seen from the preview
Don't miss anything!
question-What year brought a transition towards deinstitutionalization in care for those with mental illnesses, which led to an increase in the number of psychiatric patients receiving care in the community rather than hospitals? - answer-1950s question-What Act allowed for the expansion of the PMHCNS role into community and ambulatory settings as they helped those who had been deinstitutionalized adapt (ANA, 2014). - answer-The Community Mental Health Centers Act of 1963 question-occur in a hospital, psychiatric facility or community setting. These services focus on psychiatric and substance-related emergencies. - answer-Crisis intervention and psychiatric emergency services Who the first organized training school within a hospital for the insane in 1882? - answer-Dr. Edward Cowles question-Who developed the first nurse-organized training course for psychiatric nursing at Johns Hopkins Hospital. - answer-Effie Jane Taylor question-Who recommended standards of training for psychiatric nurses, which led to improved education and standards of care? - answer-Laura Fitzsimmons
question-is a short-term treatment. It occurs in the inpatient setting providing care for acutely ill patients at risk for harming self or others or unable to meet basic needs due to impairment. The focus is crisis stabilization. - answer-Acute inpatient care question-may admit clients directly or accept transfers from acute inpatient care. They provide intermediate or long-term care for patients at chronic risk to self or others or unable to function without supervision and support due to mental disorders. They include treatment, habilitation and rehabilitation and may be public, private, or state hospitals operated through the criminal justice system. - answer-Intermediate and long-term care question-provide acute symptom management, intensive treatment, and safe housing for patients who do not require 24-hour medical management or nursing care. These programs can be free standing or step-down facilities. - answer-Partial hospitalization and intensive outpatient treatment (IOP) question-provide 24-hour care and housing for an extended period. Services include psychoeducation, vocational rehabilitation, and training for activities of daily living. - answer- Residential Services question-is provided in non-hospital community settings such as mental health clinics, homes, worksites, shelters, crisis centers, senior centers, group homes, or schools. It can also provide care in an integrative primary health care setting. - answer-Community based Care question-is a team treatment approach to provide comprehensive, community-based psychiatric treatment, rehabilitation, and support to persons with severe mental illness (SMI). It provides individualized service 24 hours a day, 7 days a week. - answer-Assertive Community Treatment (ACT)
question-The PMHNP engages in the design, implementation, management, and evaluation of programs, systems, or policies to address the mental health needs of a population at risk for developing mental health problems through prevention, health promotion, identification and reduction of risk factors, screening, and early intervention. - answer-Program, system, and policy development management question-The role involves "the assessment, diagnosis, and treatment of behavioral, cognitive, developmental, emotional, and spiritual responses of individuals, families, and significant others with co-occurring [actual or potential] physical illness(es) and/or dysfunction" (ANA, 2014, p.33). The PCLN often works as a member of an interdisciplinary consultation-liaison team. - answer-Psychiatric Consultation-Liaison Nursing (PCLN) question-The PMHNP assists other mental health clinicians to evaluate their practice, expand their skills, and meet standards for ongoing peer supervision. Clinical supervision focuses on growth and development rather than performance evaluation. Administration, Education, and Research Practice: PMHNP may serve as administrators, educators, and researchers. - answer- Clinical Supervision: question-PMHNPs provide direct comprehensive mental health services in solo or group private practice settings or through contracts with other entities. - answer-Self employment question-The PMHNP functions as part of an interdisciplinary team, providing care and treatment for clients with mental disorders, including substance use disorders and co-occurring medical disorders. Integrative care helps improve care coordination between primary care providers and behavioral health. - answer-Integrative programs(Specialty Areas)
question-The PMHNP utilizes telecommunication technology such as telephone consultation, interactive video sessions, and e-mail to deliver care and treatment to clients. Telehealth must be practiced following all applicable laws and regulations - answer-Telehealth (Specialty Areas) question-involves the intersection of psychiatric nursing and the criminal justice system. Activities may include working with victims or offenders in settings including the community, jails, prisons, and state psychiatric hospitals. "Also perform psychiatric assessments, prescribe and administer psychiatric medications, and educate correctional officers about mental health issues. Provides therapeutic services to witnesses and victims of crime - answer-Forensic Mental Health (Specialty area) question-Is a growing field. As first responders, PMHNPs provide psychological first aid and mental health clinical services in response to environmental and man-made disasters. - answer- Disaster psychiatric-mental health nursing ( Specialty Areas) question-Scenario Person A: "I can't believe you deal with these people every day. Schizophrenics would drive ME crazy!" PMHNP: "Actually, schizophrenia is a chronic treatable disease, much like diabetes or other physical illnesses. Patients who have mental illness deserve compassion and care." - answer- Respect for the individual question-Scenario The client presents to the emergency department with hallucinations and is threatening self- harm. The PMHNP signs an involuntary admission order for emergent psychiatric care.
question-Scenario The PMHNP takes time for daily meditation to improve mindfulness and ease stress. Rationale The PMHNP is committed to practicing self-care, managing stress, and maintaining supportive relationships to meet personal needs outside of therapeutic relationships. - answer-Duties of self and others question-Scenario A PMHNP discovers her colleague is diverting scheduled medications to self-medicate anxiety. The PMHNP reports the concerns to the colleagues supervisor. Rationale The PMHNP recognizes signs/symptoms of psychiatric disorders in the workplace reporting peer observations to leadership. The PMHNP helps address problems faced by colleagues that impact client safety or violate public trust, including substance abuse. - answer-Contributions to Healthcare Environments question-Scenario The PMHNP gives a presentation at a national conference on best practices in depression treatment. Rationale The PMHNP contributes to advancing the professing through practice, education, administration, and knowledge development. - answer-Advancement of the Nursing Profession
question-Scenario The PMHNP is a member of the ANA and NAMI and regularly participates in workgroups that seek to expand access to care for healthcare consumers with PMH disorders. Rationale The PMHNP promotes community, national, and international efforts to meet health needs through collaboration with other healthcare professionals to promote prevention, treatment, and recovery. - answer-Collaboration to meet health needs question-Scenario A PMHNP speaks at a school board meeting about the need develop policies to expand mental health services for underserved students. Rationale The PMHNP participates in policy development and implementation that recognizes PMH disorders as treatable and ensures that nursing care is delivered with respect to human needs and values without prejudice. - answer-Promotion of the Nursing Profession question-How mental health diagnoses affect the average life expectancy - answer-on average, people with SMI die 25 years earlier than those without these illnesses, In 2018, the American Psychiatric Association (APA), in conjunction with the American Telemedicine Association (ATA) developed: - answer-best practices for providing
question-Telepsychiatry Legal and Regulatory Considerations: Licensure requirements - answer- Licensure requirements differ from in-person practice.-Providers must hold a license to practice in the state where the client resides.-The PMHNP is responsible for following standards for the state in which they are practicing. question-Telepsychiatry Legal and Regulatory Considerations: Federal and state prescribing guidelines - answer-Federal and state prescribing guidelines differ for telepsychiatry.-The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 governs the prescribing of controlled substances via teleconferencing.• To safely prescribe, the provider must conduct an in-person medical evaluation at least once every 24 months and comply with all federal and state prescribing guidelines. question-Telepsychiatry Legal and Regulatory Considerations: Billing and Reimbursement - answer--Reimbursement varies by state and insurance provider.• Currently, 48 states provide Medicaid reimbursement for telepsychiatry services.-pt made aware of any and all financial charges that may arise from the services prior to the commencement of initial services question-Best practices for determining the appropriateness of telepsychiatry services include consideration of the following: - answer--cognitive capacity of the client-client history and medical status - geographic distance to emergency facilities - client support system question-Best practices related to special populations: Forensic and Correctional - answer-- follow applicable standards of consent in terms of client's legal status and rights - develop clear, site-specific protocols
question-Telemental health Children and Adolescents: environment - answer-should facilitate the assessment by providing an adequate room size, furniture arrangement, toys, and activities that allow the youth to engage with the accompanying parent, presenter, and provider and demonstrate age-appropriate skills question-best practices related to special populations: Children and Adolescents - answer-follow the same guidelines presented for adults•modify care based on developmental status (motor functioning, speech and language capabilities, relatedness, and relevant regulatory issues)- include family as appropriate-Providers should consider how the presenter's involvement can affect service delivery - Appropriateness for telemental care shall consider safety of the youth, the availability of supportive adults, the mental health status of those adults, and ability of the site to respond to any urgent or emergent situations. question-Best practices related to special populations: Geriatric - answer--include family as clinically appropriate-adapt care for cognitive or sensory impairment question-best practices related to special populations: Military and Veteran - answer--be familiar with federal and organizational structures and guidelines - be familiar with military cultural competence question-best practices related to special populations: Substance Use Disorder Treatment - answer-comply with federal, state, and local regulations related to prescribing controlled substances
Traditionally, the use of telehealth and tele-mental health care was designed to meet the needs of rural populations and geographic areas with identified shortages of specialty health care professionals question-Forensic Mental Health Care - answer-Any cross between the criminal justice system and psychiatric nursing can be considered forensic mental health-64% of U.S. inmates have mental health concerns or disorders-15% to 20% of inmates in jails and prisons suffer from serious mental illness
Providers shall ensure privacy so clinical discussion cannot be overheard by others outside of the room
person evaluation is a major barrier for telepsychiatry with youth and the exceptions to this requirement are narrow and do not apply to many telepsychiatry applications question-The Ryan Haight Act is relevant to the increasing trend towards: - answer-direct-to- consumer telepsychiatry as the home setting is not an approved site of service for prescribing controlled substances. question-Child & Adolescent Telepsychiatry: Developing a Virtual Therapeutic Space - answer-- starts with the rooms at both the patient's and psychiatrist's sites-rooms should be set up to establish a typical clinical experience-psychiatrist's room should be conservatively appointed both to facilitate the camera's focus and to not distract the patient-patient's room should be of appropriate size to optimally conduct a mental status examination• including observation of gross motor and fine motor skills, affect and relatedness question-Health Insurance Portability and Accountability Act (HIPAA) - answer-provides a legal framework for handling client information-HIPAA rules help protect the privacy of the client's identifiable health information while facilitating communication among providers and other entities• ensure information is available for treatment and other purposes such as insurance benefits - health professionals may be held legally liable by state and federal law for breaching confidentiality question-HIPPPA- Release of Information - answer--HIPAA guides the PMHNP in making decisions about when to share information based on their professional judgment to prevent harm• may be necessary for providers to share mental and behavioral health information to enhance treatment or ensure the health and safety of the client and others
question-Piaget's cognitive stage: Sensorimotor - answer- 0 - 2 years of age• cognitive abilities based on reflexes• children master object permanence and causality question-Cognitive Development: Piaget's cognitive stages - answer--Sensorimotor - Preoperational - Concrete Operational - Formal Operational question-Piaget's cognitive stage: Preoperational - answer- 2 - 7 years of age child can use mental representations, symbolic thought, and language • thinking is egocentric question-Piaget's cognitive stage: Concrete Operational - answer- 7 - 11 years of age child uses logical operations when thinking and solving problems thinking is concrete question-Formal Operational - answer-12 years and older• adolescent can use abstract reasoning in addition to logical operations can understand theories, hypothesize, and comprehend abstract ideas such as love and justice question-Psychosocial Development: Erikson's developmental theory - answer-individuals go through a series of eight stages of psychosocial development from birth to death - each stage, individuals must resolve a psychosocial crisis to move to the next stage• Unsuccessful resolution could impair the development of a healthy personality and sense of self, which could negatively impact mental health and relationships
question-Erikson's psychosocial stages - answer--Infancy: Trust vs. Mistrust (birth-18 months)