Chapter 41: Caring for Persons Who Are Experiencing Homelessness and Mental Illness

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Apply

Integrated Process: Nursing Process

Objective: 3

Page and Header: 809, Chronic Homelessness

1. The nurse is working in a shelter for homeless men. When planning the care for these clients, the nurse integrates understanding that men who have been homeless for a long period of time often feel a sense of which assessment finding?

A) Depersonalization

B) Strong coping skills

C) Self-efficacy

D) Fear of failure

Page and Header: 809, Homelessness and Hope

2. A nurse is presenting a talk on homelessness and its effect on individuals. The nurse describes the resiliency and hope of homeless individuals based on which factor?

A) Strong community supports

B) Available family resources

C) Coping with extreme stressors

D) Local governmental intervention

Page and Header: 806, Introduction

3. The nurse is caring for a homeless client who has been seen in the mobile clinic every week for the past month because of a foot infection. Which nursing diagnosis would the nurse most likely identify as the priority?

A) Social Isolation related to homelessness

B) Ineffective Health Maintenance related to homelessness

C) Chronic Low Self-Esteem related to foot disorder and homelessness

D) Imbalanced Nutrition, less than body requirements, related to poor eating

Page and Header: 807, Epidemiology

4. A new graduate nurse is considering taking a job that focuses on meeting the mental health needs of homeless populations. During the pre-employment interview, the graduate nurse asks the interviewer what characteristics are common in this population. Which response by the interviewer would be most likely?

A) “Most of them have very little education and, consequently, they work in menial jobs—when they can get them.”

B) “They come from a variety of backgrounds, and they often experience chronic illness and are unemployed.”

C) “They have often squandered their financial resources, and most are from poorer rural and urban backgrounds.”

D) “Most are frail elderly people, and many are mentally ill. However, very few are addicts or alcoholics.”

Page and Header: 811, Evidence-Based Nursing Care for Person with a Mental Illness Who is Experiencing Homelessness

5. A nurse is assessing a 49-year-old homeless client. The nurse fashions the assessment process based on the understanding that the client would most likely demonstrate which behavior?

A) Cooperation and talkativeness to share ideas

B) Agreement to allow a complete physical examination

C) Desire for in-depth discussion of the condition

D) Resistance and caution about the interaction

Page and Header: 814, Overcoming Barriers to Care; 815, NCLEX Note

6. A nurse has formulated several nursing diagnoses for a homeless client after a thorough nursing assessment. Which diagnoses would the nurse determine as the priority?

A) Anxiety

B) Powerlessness

C) Imbalanced nutrition

D) Impaired social interaction

Page and Header: 815, Improving Quality of Life

7. The nurse is helping a homeless 56-year-old client develop a plan for care after discharge. Which action will be most appropriate to take to support a successful transition?

A) Contact the client’s daughter as a possible source of support after the client’s discharge.

B) Contact the client’s parents as a possible source of support after the client’s discharge.

C) Provide the client with a three-ring binder full of resources that will promote independent living.

D) Provide the client with telephone numbers of various local health care insurance companies.

Page and Header: 814, Overcoming Barriers to Care

8. A nursing instructor is preparing an education plan for a group of nursing students who will be working with homeless populations. As part of the class, the instructor will be including information about barriers to successful treatment of homeless clients who are mentally ill. Which reason would the instructor include as contributing to lack of compliance with psychotropic medications?

A) Mistrust of medical personnel

B) Lack of proper medication storage

C) Chemical dependence on prescription medications

D) Lack of motivation and literacy skills

Page and Header: 815, Emergency Services

9. A nurse is working for a mobile homeless treatment program. Which method would the nurse most likely use to provide follow-up care to clients?

A) Seeing them by appointment at a clinic office

B) Riding a bicycle to wherever the client happens to be

C) Meeting the client in a public place easily accessible by taxi

D) Using the telephone to determine how well the clients are doing

Page and Header: 816, Housing Resources

10. A nurse is providing an in-service education class on caring for homeless populations. When explaining the difference between the care provided by Safe Havens and Shelter Plus Care, which statement would the nurse include?

A) “Shelter Plus Care offers more services to a larger population than does Safe Havens.”

B) “Safe Havens provides shelter for as many as 100 people at a time.”

C) “Safe Havens provides traditional support services as well as short-term housing.”

D) “Shelter Plus Care offers a variety of supportive services in addition to long-term housing.”

Page and Header: Page: 816, Housing Resources

11. After describing the various legislative efforts to address the issue of homelessness in the United States, a nursing instructor determines that the education was successful when the students identify which legislation as addressing the need for a continuum of care approach?

A) Bringing Home America Act

B) Affordable Care Act

C) American Recovery and Reinvestment Act

D) McKinney–Vento Homeless Assistance Act

Page and Header: 808, The Experience of Being Homeless

12. A nurse working in an emergency homeless shelter is interviewing a woman who has just arrived with her two small children. When assessing this client, the nurse would expect the woman to report which reason for seeking shelter?

A) Substance abuse

B) Domestic violence

C) Unemployment

D) Imprisonment

Page and Header: 811, Mental Health Nursing Assessment

13. A nurse is developing a plan of care for a client who is homeless. Which action would the nurse take first?

A) Refer the client to social services to access necessary benefits.

B) Provide the client with a list of facilities that are safe.

C) Discuss how the client can maintain privacy.

D) Stabilize the client’s physical health status.

Page and Header: 813, Therapeutic Relationship; 814, Box 41.8

14. A group of nurses is in a discussion about the homeless population in their community as well as means for developing appropriate programs for this group. Which statement by one of the members indicates a need for the group to address the nurse’s stereotypical thinking?

A) “Homeless individuals must be creative in figuring out ways to survive.”

B) “People who are homeless come from all walks of life.”

C) “If the person lives on the street, he or she will not accept services.”

D) “Most people are homeless for a relatively short period of time.”

Page and Header: 813, Therapeutic Relationship

15. Before caring for homeless clients, nurses need to examine their own myths and feelings about homelessness. What is this type of reflection called?

A) Nursing care

B) Caring behaviors

C) Personal identity

D) Self-awareness

Page and Header: 806, Homelessness and Mental Illness

16. A nurse completed a health history on a homeless client who was sexually assaulted in a shelter. What is the priority nursing diagnosis for the client?

A) Impaired dentition

B) Fatigue

C) Anxiety

D) Impaired verbal communication

Page and Header: 806, Homelessness and Mental Illness; 807, Box 41.1

17. A psychiatric–mental health nurse is preparing a class for a group of staff nurses on individuals who are homeless and mentally ill. When describing the characteristics of this population, which finding would the nurse most likely include? Select all that apply.

A) Individuals usually receive psychiatric care in outpatient units.

B) Their physical health is likely to be worse than that of other homeless individuals.

C) Most of these individuals have easy access to disability or other types of benefits.

D) These individuals typically are more often involved with the legal system than other homeless people.

E) An individual with a mental illness has a greater risk than others of becoming homeless.

Page and Header: 808, Risk Factors

18. The nurse is developing a plan of care for a client who has been admitted to the inpatient unit after being brought to the emergency department by law enforcement. Assessment in the emergency department reveals that the client is homeless and has been diagnosed with posttraumatic stress syndrome. The client also has a history of substance abuse. When reviewing the client’s medical record, which factor would the nurse identify as contributing to the client’s homelessness? Select all that apply.

A) Diagnosis of posttraumatic stress syndrome

B) Involved participation of family members

C) Part-time employment as a custodian

D) History of substance abuse

E) Recent loss of public assistance support

Page and Header: 817, Integrated Services

19. A client who is homeless and mentally ill is being discharged to an Assertive Community Treatment (ACT) program. The nurse interprets discharge as including which services? Select all that apply.

A) Substance abuse management

B) Medication monitoring

C) Counseling

D) Living skills classes

E) Shelter for one night

Page and Header: 808, The Experience of Being Homeless

20. A nurse is completing an admission assessment of a client admitted for an infection. The client states that the client lives in a homeless shelter. What additional assessments should the nurse complete on the client? Select all that apply.

A) Nutrition

B) Mental illness

C) Substance abuse

D) Medication intake

E) Vision