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Morrison-Valfre: Foundations of Mental Health Care, 4th Edition
Test Bank
Chapter 1: The History of Mental Health Care
MULTIPLE CHOICE
1. The belief of the ancient Greek philosopher Plato that the rational soul controlled the irrational soul could be compared with the belief of the more recent psychological theorist:

a.

Freud

b.

Pinel

c.

Fisher

d.

Rush

ANS: A


Sigmund Freud believed that mental illness was, in part, caused by forces both within and outside the personality. Philippe Pinel advocated acceptance of mentally ill individuals as human beings in need of medical assistance. Alice Fisher was a Florence Nightingale nurse who cared for the mentally ill, and Dr. Benjamin Rush was the author of the book, Diseases of the Mind.

DIF: Cognitive Level: Comprehension REF: Page 5 | Page 6

OBJ: 2 TOP: Early Years of Mental Health

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


2. If a person’s behaviors interfere with daily activities, impair her judgment, or alter her perception of reality, this person is considered to be:

a.

Confused

b.

Disoriented

c.

Mentally healthy

d.

Mentally ill

ANS: D


Mentally ill individuals cannot perform activities of daily living easily, nor do they have good judgment or perceive things realistically. Confused and disoriented people differ from mentally ill people in that they typically are not oriented to who they are, where they are, or the general time frame. Mentally healthy individuals are able to perform activities of daily living, to problem solve, and to adapt to change, and they are in touch with reality.

DIF: Cognitive Level: Comprehension REF: Page 1 OBJ: 1

TOP: Mental Illness KEY: Nursing Process Step: Assessment

MSC: Client Needs: Psychosocial Integrity


3. During the mid-1500s, behaviors associated with mental illness were more accurately recorded by professionals. This practice led to ______________ for different abnormal behaviors.

a.

Classifications

b.

Diagnosing

c.

Treatment

d.

Education

ANS: A


Classification of abnormal behaviors did not begin until this time, after the practice of more accurate recording of behaviors was begun. Diagnoses, treatment guidelines, and any education regarding mental health disorders were not available during this period.

DIF: Cognitive Level: Knowledge REF: Page 3 OBJ: 3

TOP: Mental Illness During the Renaissance

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


4. During the latter part of the eighteenth century, psychiatry became a separate branch of medicine, and inhumane treatment was greatly diminished by the French hospital director:

a.

Dix

b.

Beers

c.

Pinel

d.

Carter

ANS: C


Philippe Pinel advocated acceptance of the mentally ill, as well as proper treatment. Dorothea Dix crusaded for construction of mental health hospitals. Clifford Beers wrote the book, A Mind That Found Itself. President Jimmy Carter established the President’s Commission on Mental Health in 1978.

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 4

TOP: Mental Illness in the Eighteenth Century

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


5. In 1841, _______________ surveyed asylums, jails, and almshouses throughout the United States, Canada, and Scotland and is credited with bringing about public awareness and reform for the care of the mentally ill.

a.

Sigmund Freud

b.

John Cade

c.

Florence Nightingale

d.

Dorothea Dix

ANS: D


Dorothea Dix spent 20 years surveying facilities that housed mentally ill individuals and is credited with major changes in the care of the mentally ill. Sigmund Freud introduced the concept of psychoanalysis, John Cade discovered lithium carbonate for the treatment of bipolar disorder, and Florence Nightingale trained nurses in England in the 1800s.

DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 4

TOP: Mental Illness in the Nineteenth Century

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


6. As a direct result of Clifford Beers’ work and book, A Mind That Found Itself, the Committee for Mental Hygiene was formed in 1909 with a focus on prevention of mental illness and:

a.

Early detection of symptoms of mental illness

b.

Education of caregivers

c.

Current treatment options

d.

Removing the stigma attached to mental illness

ANS: D


Clifford Beers’ book reflected on his attempt at suicide followed by the deplorable care he received for the next 3 years in mental hospitals. Beers’ work and book raised the consciousness of people throughout the country regarding prevention and removal of the stigma of having a mental illness. Early detection of symptoms, education of caregivers, and current treatment options regarding mental illness were not the focus of his book, nor were they a priority for the Committee for Mental Hygiene.

DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 4

TOP: Mental Illness in the Twentieth Century

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


7. In the early 1900s, the neurophysiologist Sigmund Freud is credited with introducing which concept?

a.

Psychoanalysis

b.

Insanity

c.

Lunacy

d.

Mental illness

ANS: A


Psychoanalysis is the observation of and theory behind how mental illness occurs. Insanity, lunacy, and mental illness are terms that are considered synonyms.

DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 5

TOP: Mental Illness in the Twentieth Century

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


8. During the 1930s, what common treatment for schizophrenia caused clients to fall into a coma that could last as long as 50 hours?

a.

Electroconvulsive therapy

b.

Insulin therapy

c.

Humoral therapy

d.

Amphetamine therapy

ANS: B


Insulin therapy was believed to successfully treat schizophrenia in the early 1900s. Amphetamines were used to treat depression, and electroconvulsive therapy was used for severe depression. Humoral therapy, which originated in ancient Greece and Rome, was a belief that mental illness resulted from an imbalance of the humors of air, fire, water, and earth.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


9. In the 1930s, what mental health disorder was electroconvulsive therapy (ECT) most often used to treat?

a.

Schizophrenia

b.

Bipolar disorder

c.

Severe depression

d.

Violent behavior

ANS: C


ECT was found to be an effective treatment for severe depression in the 1930s. During this period, schizophrenia was treated with insulin therapy, and violent behavior was treated with a lobotomy. In 1949, lithium carbonate was discovered as a treatment for bipolar disorder.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


10. In the early twentieth century, a frontal lobotomy was a common treatment for violent behaviors. Which description of this procedure is accurate?

a.

A procedure that delivers an electrical stimulus to the frontal lobes of the brain

b.

A surgical procedure that drills holes in the front of the skull to drain fluid

c.

A surgical procedure that severs the frontal lobes of the brain from the thalamus

d.

A surgical procedure that inserts implants into the frontal lobes of the brain

ANS: C


A frontal lobotomy is a surgical procedure in which the frontal lobes of the brain are severed from the thalamus.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


11. Which class of drugs was introduced in the 1930s for the treatment of depression?

a.

SSRIs

b.

Tricyclic antidepressants

c.

MAOIs

d.

Amphetamines

ANS: D


In the 1930s, amphetamines were found to boost the spirits of depressed people. SSRIs, tricyclic antidepressants, and MAOIs are antidepressant agents, but they were not discovered until much later.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


12. In 1937, Congress passed the Hill-Burton Act, which was significant for the treatment of mental health because it funded:

a.

Research on drugs for the treatment of mental health disorders

b.

Training of mental health professionals

c.

Construction of psychiatric units in facilities throughout North America

d.

Development of community mental health clinics

ANS: C


The Hill-Burton Act provided money for the construction of psychiatric units in the United States. Research on drugs was not a part of the Hill-Burton Act. Training of mental health professionals was funded by the National Mental Health Act of 1946, and community mental health centers were not instituted until the 1960s.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5 | 9

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


13. The National Mental Health Act of 1946 provided a means for funding of programs that promote research on mental health and:

a.

Development of mental health clinics in the community

b.

Training of mental health professionals

c.

Treatment for veterans suffering from mental health disorders

d.

Educating the public about mental illness

ANS: B


The National Mental Health Act of 1946 provided much needed training for individuals who cared for patients with mental health disorders. Community mental health clinics were initiated in the 1960s, treatment for veterans was not funded by this act, and education of the public occurred later.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5 | 9

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


14. Which of the following best describes the disorder that was first recognized in veterans following the Korean and Vietnam Wars?

a.

Depression

b.

Bipolar disorder

c.

Posttraumatic stress disorder

d.

Paranoid schizophrenic disorder

ANS: C


Posttraumatic stress disorder was initially discovered in veterans who had been involved in armed conflicts. The other disorders also occur in veterans but were not first recognized in soldiers who were fighting wars.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5

TOP: Influences of War on Mental Health Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


15. The introduction of ___________ in the 1950s led to the deinstitutionalization of many mentally ill individuals.

a.

Psychotherapeutic drugs

b.

Community mental health clinics

c.

Residential treatment centers

d.

State mental health facilities

ANS: A


Psychotherapeutic drugs allowed for better control of behaviors than did other therapies alone during the 1950s. Patients were being released from state mental health facilities as a result of psychotherapeutic drug therapy, and community mental health clinics and residential treatment centers resulted from the deinstitutionalization of patients.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 6

TOP: Introduction of Psychotherapeutic Drugs

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


16. In 1949, an Australian physician discovered which therapy to be an effective treatment for bipolar (manic-depressive) illness?

a.

Insulin therapy

b.

Water/ice therapy

c.

Lithium carbonate therapy

d.

Electroconvulsive therapy

ANS: C


To this day, lithium is a treatment that is used to effectively balance the manic states and depressive states of bipolar disorder. None of the other therapies listed are effective for bipolar disorder.

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 6

TOP: Introduction of Psychotherapeutic Drugs

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


17. In the early 1960s, a committee appointed by President John F. Kennedy recommended the development of a new approach to the way mental health care was administered, with an emphasis on the introduction of:

a.

Psychotherapeutic drugs

b.

State mental health care systems

c.

Community mental health centers

d.

Deinstitutionalization of patients

ANS: C


The emergence of community mental health centers was necessary, in part because of the massive deinstitutionalization of patients from state mental health care facilities after the introduction of psychotherapeutic drugs in the 1950s.

DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 7

TOP: Introduction of Psychotherapeutic Drugs

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity


18. The Mental Health Systems Act of 1980 was one of the most progressive mental health bills in the history of the United States, but its enactment was interrupted by the:

a.

Election of a new president

b.

Appointment of a new Surgeon General

c.

Rapid expansion of community centers

d.

National Alliance for Mental Illness (NAMI) surveys

ANS: A


The election of a new president and his administration led to drastic cuts in federal funding for mental health programs. None of the other three choices were a part of the Mental Health Systems Act of 1980.

DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9

TOP: Congressional Actions KEY: Nursing Process Step: Assessment

MSC: Client Needs: Psychosocial Integrity


19. The Omnibus Budget Reform Act (OBRA) of 1987 prevented the housing of people with chronic mental illness in:

a.

Nursing homes

b.

State mental health facilities

c.

Residential treatment centers

d.

Homeless shelters

ANS: A


Many mentally ill, especially elderly, people were inappropriately placed in nursing homes with personnel who were not trained to care for these people. OBRA prevented this practice. State mental health facilities, residential treatment centers, and homeless shelters were not addressed in the OBRA of 1987.

DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9

TOP: Congressional Actions KEY: Nursing Process Step: Assessment

MSC: Client Needs: Psychosocial Integrity


20. In the late 1980s, government funding for mental health care dwindled, and most insurance companies __________ coverage for psychiatric care.

a.

Withdrew

b.

Increased

c.

Decreased

d.

Added

ANS: A


Unfortunately, insurance companies followed the trend of the national government to the point of actually dropping coverage for psychiatric care.

DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9

TOP: Congressional Actions KEY: Nursing Process Step: Assessment

MSC: Client Needs: Psychosocial Integrity


21. In 2006, the National Alliance on Mental Illness (NAMI) conducted a comprehensive survey and grading of state mental health care for adults and learned that the overall grade for care was:

a.

“A”

b.

“B”

c.

“C”

d.

“D”

ANS: D


The NAMI gave a grade of “D” to the mental health care system based on poor funding, limited availability of care, and patients’ lack of access to mental health care.

DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9

TOP: Congressional Actions KEY: Nursing Process Step: Assessment

MSC: Client Needs: Psychosocial Integrity


22. During the Dark Ages, demonical exorcisms were performed as a result of the belief that mental illness was punishment for sins, the result of witchcraft, or caused by:

a.

Imbalance of fundamental elements

b.

Possession by the devil

c.

Rational soul controlling the irrational soul

d.

Chemical imbalances within the body

ANS: B


The belief that mental illness occurred as the result of possession by the devil accounted for the need for demonical exorcisms during the Middle Ages. Theories on an imbalance of fundamental elements and beliefs involving the rational and irrational soul were popular in ancient Greece and Rome. Chemical imbalance was determined to be a cause of some mental illness in more recent times.

DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 2 | 3

TOP: Mental Illness in the Dark Ages KEY: Nursing Process Step: Assessment

MSC: Client Needs: Psychosocial Integrity





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