A patient with schizophrenia lives in the community. On a home ...

[stephzh]

A patient with schizophrenia lives in the community. On a home visit, the community psychiatric nurse case manager learns that the patient:
 
   Will begin attending an activities group at the mental health outreach center.
   Is worried about being able to pay for the therapy.
   Does not know how to get from home to the outreach center.
   Has an appointment to have blood work at the same time the activities group meets.
   Wants to attend services at a church that is a half mile from the patient's home.
   Which task(s) would be part of the role of a community mental health nurse? (Select all that apply.)
  a. Rearranging conflicting care appointments
  b. Negotiating the cost of therapy for the patient
  c. Arranging transportation to the outreach center
  d. Accompanying the patient to church services weekly
  e. Monitoring to ensure the patient's basic needs are met

Question 2

Typical central nervous system responses when an individual has drunk five or more alcoholic beverages or has a blood alcohol content of 0.20 within a 4-hour period include:
 
  a. Thought, restraint, reaction time, and judgment are slowed, and the individual usually is more at ease socially
  b. The entire motor area of the brain is depressed; individual is staggering, easily angered, and emotional and feels fatigued
  c. Comatose, medullary area of the brain is severely depressed, and respiratory failure can result in death
  d. Confused, unresponsive to most external stimuli; loss of ability to control involuntary responses and decreased vital signs

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Answer to Question 1

A, C, E
The correct answers reflect the coordinating role of the community psychiatric nurse case manager. Negotiating the cost of therapy and accompanying the patient to church services are interventions the nurse would not be expected to undertake. The patient can walk to the church services; the nurse can provide encouragement.

Answer to Question 2

B
These responses can vary somewhat among individuals. Slowed reaction time usually is seen with one or two drinks, or with a blood alcohol content of 0.05; a comatose state occurs with seven or more drinks or 0.40 to 0.50 blood alcohol content; and confusion and unresponsiveness to most external stimuli occur with six to seven drinks or a blood alcohol content of 0.30.