Ch 4- Treatment Settings and Theraputic Programs

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Page 1
1. Which of the following factors is primarily responsible for the changes in inpatient
hospital treatment between the 1980s and the present?
A) Progress in treatment options for mentally ill persons
B) The growth of managed care
C) Less stigma associated with mental illness
D) The current use of milieu therapy
Ans: B
Feedback:
Managed care exerts cost-control measures such as recertification of admissions,
utilization review, and case managementóall of which have altered inpatient treatment
significantly. There has been some progress in treatment options for mentally ill
persons, but that is not the primary factor that has changed mental health inpatient
hospital care. There is lesser stigma associated with mental illness, but that is not the
primary factor that has changed mental health inpatient hospital care. In the 1980s, a
typical psychiatric unit emphasized milieu therapy, which required long lengths of stay
because clients with more stable conditions helped to provide structure and support for
newly admitted clients with more acute conditions.
2. The factor having the most influence on the current trend in treatment settings is the fact
in recent years,
A) funding for community programs has been inadequate.
B) laws have enabled more people to be committed to treatment.
C) state hospitals have expanded to meet the demand.
D) community programs have been fully developed to meet treatment needs.
Ans: A
Feedback:
Adequate funding has not kept pace with the need for community programs and
treatment. Commitment laws have led to deinstitutionalization. Large state hospitals
emptied as a result. Treatment in the community was intended to replace much of state
hospital inpatient care, but funding has been inadequate.
Page 2
3. A patient who has continuously experienced severe symptoms of schizoaffective
disorder for the past 17 years is experiencing an acute psychotic episode. Which level of
care is most appropriate for this patient at this time?
A) Partial hospitalization
B) Residential treatment
C) Inpatient hospital treatment
D) Clubhouse
Ans: C
Feedback:
Long-stay clients in an inpatient setting are people with severe and persistent mental
illness who continue to require acute care services despite the current emphasis on
decreased hospital stays. This population includes clients who were hospitalized before
deinstitutionalization and remain hospitalized despite efforts at community placement. It
also includes clients who have been hospitalized consistently for long periods despite
efforts to minimize their hospital stays. Partial hospitalization is designed for patients
transitioning to independent living. Residential treatment and clubhouse model provide
supervised independent living.
4. A patient with depression is admitted to an inpatient hospital unit for treatment. The
type of therapy most likely provided in this setting includes
A) leisure skills.
B) self-monitoring of treatment.
C) skills for daily living.
D) talk therapy.
Ans: D
Feedback:
A typical psychiatric unit emphasizes talk therapy, or one-on-one interactions between
residents and staff, and milieu therapy, meaning the total environment and its effect on
the client’s treatment. Partial hospitalization programs teach skills for daily living.
Clubhouse models provide patients opportunities for leisure activities and self-
monitoring of treatment.
5. Which of the following is the highest priority for admission to inpatient care?
A) Confusion or disorientation
B) Need for medication changes
C) Safety of self or others
D) Withdrawal from alcohol or other drugs
Ans: C
Feedback:
Safety is a priority; the inpatient setting provides for the safety of the client and/or
others. Confusion or disorientation, need for medication changes, and withdrawal from
alcohol or other drugs may also require inpatient care but the priority is safety.
Page 3
6. The priority of inpatient care for people with severe mental illness is
A) family issues.
B) insight into illness.
C) social skills.
D) symptom management.
Ans: D
Feedback:
Rapid assessment, stabilization of symptoms, and discharge planning are the focus of
inpatient care today. Family issues, insight into illness, and social skills would not be
priorities of care for clients with severe mental illness.
7. Discharge planning from inpatient care for people with severe mental illness must
address which of the following to be effective? Select all that apply.
A) Finding housing for the client
B) Finding a job for the client
C) Finding transportation for the client
D) Improving family support
E) Identifying ideal recreational activities
Ans: A, C
Feedback:
Clinicians help clients recognize symptoms, identify coping skills, and choose discharge
supports in the inpatient setting. People are able to remain in the community for longer
periods of time when discharge planning addresses environmental supports, housing,
transportation, and access to community support services. Finding a job for the client
may be helpful if appropriate but may not be appropriate for the individual at the time of
discharge from inpatient care. Improving family support and identifying ideal
recreational activities are desirable but not essential for successful reintegration with the
community.