Chapter 1. History of Mental Health Nursing

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	The act of developing a clean environment is a factor in providing effective health care as demonstrated by:
1.	Nightingale.	
2.	Benner.	
3.	Swanson.	
4.	King.	

____	2.	What is the name of the publication written by Florence Nightingale?
1.	Nursing Sanitation Notes	
2.	Nursing 101	
3.	Notes on Nursing	
4.	Nursing Notes	

____	3.	A long-term goal for inpatient mental health treatment is generally to:
1.	Return the patient to the community.	
2.	Locate a facility for long-term care.	
3.	Be arrested and placed in prison.	
4.	Be completely cured of the disorder.	

____	4.	The mentally ill were once housed in mental institutions known as:
1.	Hospitals.	
2.	Long-term care facilities.	
3.	Asylums.	
4.	Free-standing treatment centers.	

____	5.	Which nursing theorists promoted the interpersonal theory between the nurse and the patient?
1.	Hildegard Peplau	
2.	Hattie Bessent	
3.	Mary Mahoney	
4.	Linda Richards	

Completion
Complete each statement.

	6.	The first psychiatric program of study was established by which nursing leader? ______ _______ _________

	7.	Which nurse theorist was the first American-trained nurse credited with teaching how to provide care for people with mental illness? ___________ ____________

	8.	The greatest advance in the early years of mental health care was the introduction of ___________________.

	9.	The legislation that provided funding for improving the care of the mentally ill is known as the National Mental Health Act of what year? ______.

	10.	One of the goals of the American Nurses association (ANA) is to promote ________________ of nursing care in the United States.

	11.	______________ ____________ has always been called the “founder of nursing.”

	12.	A schoolteacher by the name of _____________ _________helped established asylums and psychiatric hospitals for the mentally ill.

	13.	The first psychotropic drug category was known as ____________________.

	14.	The first major federal law to address mental illness was called the _____-_______ Act.

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	15.	What trends contributed to the deinstitutionalization of mental health facilities to outpatient care (select all that apply)?
1.	Cost of the facilities	
2.	The increased use of phenothiazines	
3.	Staff cost	
4.	Establishment of outpatient clinics	
5.	Development of the Patient Bill of Rights	

Chapter 1. History of Mental Health Nursing
Answer Section

MULTIPLE CHOICE

	1.	ANS:	1
Page: 2
Integrated Processes: Teaching/Learning
Content Area: Community Health
Cognitive Level: Application
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Chapter 1: History of Mental Health Nursing; The Trailblazers; Florence Nightingale 
	Feedback	
1	The relationship between sanitary conditions and healing became known and accepted due to Nightingale’s observations and diligence. Her commitment to improved outcomes at a military hospital was directly related to introducing sanitation methods.	
2	Benner did not emphasize developing a clean environment as a factor in providing effective health care.	
3	Swanson did not emphasize developing a clean environment as a factor in providing effective health care.	
4	King did not emphasize developing a clean environment as a factor in providing effective health care.	

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Florence Nightingale

	2.	ANS:	3
Page: 3
Integrated Processes: Teaching/Learning
Content Area: Nursing Trends
Cognitive Level: Knowledge
Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Chapter 1: History of Mental Health Nursing; The Trailblazers; Florence Nightingale 
	Feedback	
1	Although Florence Nightingale did write a book on the relationship of sanitary techniques to medical facilities, it was called Notes on Hospitals, not Nursing Sanitation Notes. 	
2	Florence Nightingale did not write Nursing 101.	
3	Florence Nightingale wrote the book Notes on Nursing, which was the most respected nursing textbook of its day.	
4	Florence Nightingale did not write Nursing Notes.	

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Florence Nightingale

	3.	ANS:	1
Page: 8
Integrated Processes: Nursing Process: Planning
Content Area: Mental Health
Cognitive Level: Comprehension
Client Need: Safe and Effective Care Environment: Coordinated Care
Chapter 1: History of Mental Health Nursing; The Breakthroughs
	Feedback	
1	People who had formerly required long hospital stays were now able to leave the institutions and return to their communities due to appropriate medications and deinstitutionalization.	
2	Locating a facility for long-term care is not a long-term goal for inpatient mental health treatment. 	
3	Being arrested and placed in prison is not a long-term goal for inpatient mental health treatment.	
4	The long-term goal is not to be completely cured of the disorder but control unwanted behaviors. 	

PTS:	1	REF:	Chapter 1: History of Mental Health Nursing; The Breakthroughs

	4.	ANS:	3
Page: 7
Integrated Processes: Teaching/Learning
Content Area: Mental Health
Cognitive Level: Comprehension
Client Need: Psychosocial Integrity: Therapeutic Environment
Chapter 1: History of Mental Health Nursing; The Facilities; Asylums
	Feedback	
1	Hospitals are not mental institutions but can handle patients with psychological needs according to the size of the hospital and its resources.	
2	Long-term care facilities are not mental institutions.	
3	Early on, these special facilities were called asylums, which Webster’s online dictionary defines as “an institution for the care of the needy or sick and especially of the insane.”	
4	Free-standing treatment centers are not mental institutions but can handle patients that need detoxification (detox centers) or help managing a crisis (crisis centers). 	

PTS:	1	REF:	Chapter 1: History of Mental Health Nursing; The Facilities; Asylums

	5.	ANS:	1
Page: 5
Integrated Processes: Communication and Documentation
Content Area: Nursing Trends
Cognitive Level: Knowledge
Client Need: Safe and Effective Care Environment: Coordinated Care
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization
	Feedback	
1	In her book Interpersonal Relations in Nursing (1952), Peplau brought together interpersonal theories from psychiatry and melded them with theories of nursing and communication.	
2	Dr. Hattie Bessent is credited with the development and directorship of a grant that researched minority nurses who were choosing to upgrade to master’s and doctorate levels of practice. 	
3	Mary Mahoney is considered to be America’s first African American professional nurse.	
4	Linda Richards worked to upgrade nursing education, opened a nursing school, and taught the care of the mentally ill.	

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Hildegard Peplau

COMPLETION

	6.	ANS:	
Effie Jane Taylor
Page: 4
Rationale: In 1913, the first psychiatric program for nurses was established by Effie Jane Taylor. Ms. Taylor also believed in patient-centered care.
Integrated Processes: Teaching/Learning
Content Level: Nursing Trends
Cognitive Level: Knowledge
Client Need: Psychosocial Integrity: Mental Health Concepts
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Effie Jane Taylor

	7.	ANS:	
Linda Richards
Page: 4
Rationale: Linda Richards wanted to upgrade the nursing education field and opened the Boston City Hospital Training School for Nurses to teach the specialty of caring for the mentally ill.
Integrated Processes: Teaching/Learning
Content Area: Nursing Trends
Cognitive Level: Knowledge
Client Need: Psychosocial Integrity: Mental Health Concepts
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Linda Richards

	8.	ANS:	
phenothiazines
Page: 7
Rationale: With the discovery of phenothiazines, people living with mental disorders could control unwanted behaviors (to a degree) and were able to function more independently. 
Integrated Processes: Teaching/Learning
Content Area: Mental Health: Pharmacology
Cognitive Level: Knowledge
Client Need: Physiological Integrity: Pharmacological Therapies; Expected Actions/Outcomes
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Breakthroughs; Psychotropic Medications

	9.	ANS:	
1946
Page: 10
Rationale: The National Mental Health Act of 1946 provided money for training nurses and several other disciplines to improve treatment for the mentally ill.
Integrated Processes: Teaching/Learning
Content Area: Mental Health: Treatment
Cognitive Level: Knowledge
Client Need: Psychosocial Integrity: Mental Health Concepts
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Law; The National Mental Health Act of 1946

	10.	ANS:	
standardization
Page: 8
Rationale: The ANA has developed standards for a number of different nursing practices areas in the United States, including psychiatric nursing. 
Integrated Processes: Teaching/Learning
Content Area: Nursing Trends
Cognitive Level: Knowledge
Client Need: Safe and Effective Care Management: Coordinated Care: Establishing Priorities
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Breakthroughs; Organizations for Mental-Health Nurses and Others

	11.	ANS:	
Florence Nightingale
Page: 2
Rationale: Florence Nightingale has been called the founder of nursing based upon her numerous contributions to the nursing profession. 
Integrated Processes: Teaching/Learning
Content Area: Nursing Trends
Cognitive Level: Knowledge
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Florence Nightingale

	12.	ANS:	
Dorothea Dix
Page: 3
Rationale: Dorothea Dix was not a nurse but was concerned about the treatment of the mentally ill and prisoners. Because of her efforts, 32 states developed asylums or “psychiatric hospitals” to care for the mentally ill that treated patients humanely.
Integrated Processes: Teaching/Learning
Content Area: Nursing Trends
Cognitive Level: Knowledge
Client Need: Safe and Effective Care Environment: Coordinated Care: Advocacy
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	REF:	Chapter 1: History of Mental Health Nursing; The Trailblazers; Dorothea Dix

	13.	ANS:	
phenothiazines
Page: 7
Rationale: In 1955, a group of psychotropic medications called phenothiazines was discovered to have the effect of calming and tranquilizing people. 
Integrated Processes: Teaching/Learning
Content Area: Mental Health: Pharmacology
Cognitive Level: Knowledge
Client Need: Physiological Integrity: Pharmacological Therapies: Expected Actions/Outcomes
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Breakthroughs; Psychotropic Medications

	14.	ANS:	
Hill-Burton
Page: 10
Rationale: The Hill-Burton Act of 1946 provided much needed funding to build psychiatric units in hospitals and was the first major federal law to address mental illness. 
Integrated Processes: Teaching/Learning
Content Area: Mental Health: Legal
Cognitive Level: Knowledge
Client Need: Safe and Effective Care Environment: Coordinated Care
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

PTS:	1	REF:	Chapter 1: History of Mental Health Nursing; The Law; Hill-Burton Act

MULTIPLE RESPONSE

	15.	ANS:	1, 2, 3, 4
Page: 8
Integrated Processes: Teaching/Learning
Content Area: Mental Health
Cognitive Level: Synthesis
Client Need: Safe and Effective Care Environment: Coordinated Care: Advocacy
Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization

	Feedback	
1.	Correct. It became costly to run these large buildings even though the patient population was declining.	
2.	Correct. Phenothiazines were so effective that state hospitals saw a large decline in population.	
3.	Correct. It became costly to continue to employ staff even though the patient population was declining.	
4.	Correct. Other facilities, such as outpatient clinics, dedicated to the care and treatment of people with mental illness caused a decline in state hospitals’ patient population. 	
5.	Incorrect. The Patient Bill of Rights provides “vulnerable” people with certain rights.	

PTS:	1	
REF:	Chapter 1: History of Mental Health Nursing; The Breakthroughs; Deinstitutionalization