1. Which activity best exemplifies an important focus for a case manager? 

    C. Providing a comprehensive client social history to the treatment team

    Psychiatric case management fosters success in all aspects of community living by supporting recovery from acute symptoms, reducing recidivism, and enhancing the quality of life for the client with long-term illness. Text page: 77
  2. A client was admitted to the behavioral health unit for evaluation and diagnosis after being found wandering the streets. His personal hygiene is poor and his responses to questions are bizarre and inappropriate. The client's constitutional rights are violated when the nurse states: 

    D. "I am going to help you shower so you will not smell so bad."

    Every client has the right to be treated with dignity. This statement is demeaning.Text page: 79
  3. You are about to interview a newly admitted patient on your inpatient mental health unit. This is his first experience with psychiatric treatment. Which of the following interventions would be appropriate for this patient? Select all that apply.

    1. Discuss outpatient care options for after discharge.
    2. Anticipate and address possible increased anxiety and shame.
    3. Ensure that the individual understands his rights as a patient on your unit.
    4. Confirm his insurance coverage or other plans for payment of charges.
    5. Assess the patient for physical health needs which may have been overlooked.
    6. Carefully check all clothing and possessions for potentially dangerous items.

    (6) Assessment, particularly related to potential safety considerations, is always the highest priority for a newly admitted patient, and checking for items that might be dangerous to this or other patients is one of the first and most important nursing interventions in a new admission situation.

    (5) Mental health patients may have overlooked or inadequately treated medical conditions, and some medical conditions can masquerade or be mistaken for psychiatric conditions. Either situation could harm the patient’s health; thus a full assessment of the patient’s physical health is essential early in the admission.

    (2) Newly admitted patients, especially if they have not been in treatment previously, may have many questions and concerns about their treatment. They may also be anxious, embarrassed, or ashamed about their condition and/or being on a mental health unit. Anxiety can increase patient distress and lead to behavioral concerns such as agitation or resistance; it should be assessed and addressed early in treatment. Providing support and an opportunity to explore and address such concerns is helpful after safety and other urgent clinical elements are addressed.

    (3) Ensuring that new patients understand their rights as mental health clients is also an essential nursing duty and should occur on the day of admission (and is often done as part of the admission process itself).

    (1) Discharge planning shouldstart early, but insufficient information is available at this time to begin such planning, and other concerns take a priority immediately after admission.

    (4) Although financial considerations may be a significant and appropriate concern for the patient, this is not typically a role of the mental healthnurse, and other clinically-based concerns must be addressed (although a financial supportperson could meet with the patient about financial concerns after his immediate clinical needs are addressed, if indicated).
Card Set
Psychiatric Mental Health Nursing in Acute Care Settings