• (A) Let all mentally ill people care for themselves.
• (B) Return as many people as possible to a “normal” life.
• (C) Keep all mentally ill people in locked wards.
• (D) Close all community hospitals.

Check AnswerSolution[B]:-The main goal of deinstitutionalization was to allow as many people as possible to return to the community and lead as normal a life as they could. Not all mentally ill people would be able to do that because of the severity of their illnesses. On the other hand, not all mentally ill people had to be kept in locked units, nor do they today. Community hospitals were to be kept open, but many state hospitals closed because of the decline in census.

• (A) The Community Mental Health Centers Act
• (B) The Nurse Practice Act
• (C) The development of psychotropic medications
• (D) Electroshock therapy

Check AnswerSolution[C]:-The development of psychotropic (psychoactive) medications in the 1950s was a keystone to allowing people to return to their homes. The Community Mental Health Centers Act came about 10 years later. The Nurse Practice Act dictates the scope of practice for nurses; and electroshock therapy, now called electroconvulsant therapy,took place in hospitals.

• (A) National League for Nursing
• (B) American Nurses Association
• (C) Patient Bill of Rights
• (D) Nurse Practice Act

Check AnswerSolution[D]:-The Nurse Practice Act, which is written specifically for each state, is the set of regulations that dictates the scope of nursing practice. The NLN and the ANA are national nursing associations that set recommendations for the practice, education, and well-being of nurses. The Patient Bill of Rights is a document to protect the patient.Nurses must know the parameters of this document for ethical practice, but it does not dictate the scope of nursing practice.

• (A) Psychiatric hospitals only
• (B) Outpatient settings only
• (C) Medical-surgical hospital settings
• (D) All of the above

Check AnswerSolution[D]:-Deinstitutionalization and changes in the health-care delivery system encourage people with mental health issues to be treated in a variety of health-care settings. Nurses will care for patients with mental illnesses in all of the settings listed.

• (A) Hildegard Peplau
• (B) Linda Richards
• (C) Harriet Bailey
• (D) Dorothea Dix

Check AnswerSolution[D]:-Dorothea Dix is the only one on this list who is not a nurse.

• (A) NACE
• (B) AAPINA
• (C) PNAA
• (D) NANAINA

Check AnswerSolution[D]:-AAPINA represents Asian American and Pacific Islander nurses; PNAA represents Philippine nurses; NANAINA represents Alaska Native American Indian nurses.

• (A) Detox centers
• (B) Asylums
• (C) Outpatient clinics
• (D) Hospitals

Check AnswerSolution[B]:-Asylums were originally described as places of refuge. The meaning is much different today.

• (A) NLN
• (B) NFLPN
• (C) Hill-Burton Act
• (D) NIMH

Check AnswerSolution[D]:-The National Institute of Mental Health was established in 1946.

• (A) Mental health
• (B) Upgrading education
• (C) Clean environment
• (D) Writing care plans

Check AnswerSolution[C]:-Florence Nightingale recognized the relationship between sanitary conditions and healing.

• (A) 1950s
• (B) 1930s
• (C) 1980s
• (D) 1920s

Check AnswerSolution[A]:-Phenothiazines were the first psychotropics drugs introduced in the 1950s.

• (A) “Why did you do that, Mrs. Jones?”
• (B) “How can I help you, Mr. Thompson?”
• (C) “Can I help you, Ms. Greene?”
• (D) “Please, can I ask you a question, Mark?”

Check AnswerSolution[B]:-This option offers assistance in a way that encourages the patient to say what he or she needs. Option A used the word “why,” which has negative connotations.C is closed-ended and allows a “yes” or “no” answer. D is also closedended. Adding the “please” does not make it a correctly formatted question.

• (A) Develop a friendly, social relationship with the patient.
• (B) Develop a parental, authoritarian relationship with the patient.
• (C) Develop a helping, purposeful relationship with the patient.
• (D) Develop a cool, businesslike relationship with the patient.

Check AnswerSolution[C]:-Nurse-patient communication is purposeful and helpful. Option A would change the focus of the nurse-patient relationship and lower the chances for a successful therapeutic relationship.Sometimes nurses and patients do become friends, but this cannot get in the way of the professional relationship of the nurse to the patient. B suggests that the nurse is somehow “the boss.” Patients sometimes have that perception, but the nurse is really a “partner” in collaboration with the patient. D suggests a distance that would place the nurse too far from the patient emotionally. It would be difficult to discuss some of the intimate details the patient needs to discuss if the relationship is too distant and formal.

• (A) “Who are you talking to?”
• (B) “Please stop talking. You are disturbing the other people.”
• (C) “I saw your lips moving. Can you tell me what you are talking about?”
• (D) “Why are you talking to yourself?”

Check AnswerSolution[C]:-This option combines an observation with a closed-ended question. In this instance, it can be effective. Even with the closed-ended question, it is the best of the four choices. Option A implies playing into a hallucination and assumes that the patient intends to be talking to someone else. B is intended to quiet the patient by using guilt. Asking the patient to be quiet will discourage the patient from wanting to confide in you. D uses the word “why” without prefacing it with an observation, thus opening up the possibility of the patient’s feeling defensive.

• (A) “They are all negative.”
• (B) “Why do you want to know?”
• (C) “I think you should wait until your physician comes in.”
• (D) “I am not able to tell you right now, but I will call your physician and have her stop in to explain them to you.”

Check AnswerSolution[D]:-This option honestly tells the patient that you cannot give that information.The physician must explain the results first. Option A oversteps the boundaries of the nurse. B uses the “why” word. C gives advice, by using the

• (A) “I think you should just stay busy.”
• (B) “I wouldn’t worry about it.”
• (C) “What are your thoughts about returning to work?”
• (D) “Oh, you’ll be just fine. There are lots of people worse off than you.”

Check AnswerSolution[C]:-This puts the conversation back to the patient and allows venting of concerns. Options A and B give advice; D gives false reassurance and also belittles the patient’s concerns.

• (A) “I’d like to help you; what can I do?”
• (B) “Why don’t you like me?”
• (C) “What is the matter with you?”
• (D) “You must do this; physician’s orders!”

Check AnswerSolution[A]:-This is correct because it tells the patient the nurse is concerned yet leaves the patient responsible for stating what he or she needs at the moment. B uses the word “why,” and C has a very authoritarian tone.D is a command that is very authoritarian and even threatening.

• (A) “I will ask the dietitian to come and talk with you.”
• (B) “The dietitian will come to see you.”
• (C) “It’s the best we can do. You need to eat.”
• (D) “You’re right. The hospital food does leave much to be desired!”

Check AnswerSolution[A]:-Here, the nurse tells the patient that he or she understands the special concerns of the religion and culture of Judaism but does not make a promise that the dietitian will come, which would build false hope. Option B is incorrect because it does make that promise. C does not give any indication that compromise is possible or that the nurse is “hearing” the true concern. D is agreeing and is a block to therapeutic communication.

• (A) “I hate it when that happens!”
• (B) “What do you need to know?”
• (C) “Well, he is very busy!”
• (D) “You feel ignored by your physician?”

Check AnswerSolution[D]:-This is stating an implied thought or feeling. The nurse is checking out the fact that the patient is feeling ignored. Option A makes light of the patient’s concern to see the physician.B is not helpful for the patient and shows no sensitivity for the patient’s desire to see the physician. C is a block because it shows disapproval for the patient’s concern and sides with the physician rather than the patient.

• (A) “Ms. Smith, you are so quiet this afternoon. Is something bothering you?”
• (B) “Ms. Smith, is something bothering you?”
• (C) “Can I help you?”
• (D) “Why are you so quiet this afternoon?”

Check AnswerSolution[A]:-This option is more correct than B because it offers an observation before using a closed-ended question.B and C are simply closed-ended questions. D is an observation, but it uses “why,” which tends to leave people feeling defensive.

• (A) “Why do you say that?”
• (B) “Like nobody cares? Please try to describe the emotion you are truly �feeling.'”
• (C) “Ms. Smith, you’re wrong about that.Of course we care.”
• (D) “Ms. Smith, maybe the doctor can change the dosage of your medication.You’ll feel better.”

Check AnswerSolution[B]:-“I feel like” is not a “feeling” statement at all, but rather a thought statement. There is no emotion identified. Option B encourages the nurse and patient to explore what emotional response is being experienced by the patient in a safe environment. Options A and C are nontherapeutic techniques. Option D is nontherapeutic in many ways: changes the subject, does not reflect what the patient has said, and implies the nurse is not interested in pursuing the patient’s feelings.