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NR607 Final Exam with correct answers
The |PMHNP |(Psychiatric |Mental |Health |Nurse |Practitioner) |is |providing |care |to |a |29-year-old |client | who |presents |with |persistent |sadness |and |hopelessness |for |the |last |two |months. |She |is |having | difficulty |sleeping |and |has |a |decreased |appetite. |This |is |the |patient's |first |contact |with |with |the | healthcare |system |about |her |concerns. PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx Community-Based |Care Self-Employment Psychotherapy |- |CORRECT |ANSWER-Primary |Care Rationale: |This |is |the |client's |initial |contact |with |the |healthcare |system |about |her |concerns The |client |has |experienced |depressive |symptoms. |The |PMHNP |prescribes |a |selective |serotonin | reuptake |inhibitor |(SSRI). PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention
Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx Community-Based |Care Self-Employment Psychotherapy |- |CORRECT |ANSWER-Pharmacologic |Intervention Rationale: |The |PMHNP |is |prescribing |psychopharmacotherapy |for |the |client The |PMHNP |provides |the |client |with |some |mindfulness |techniques |to |try |at |home. PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx Community-Based |Care Self-Employment Psychotherapy |- |CORRECT |ANSWER-Psychotherapy Rationale: |The |PMHNP |is |utilizing |a |psychotherapeutic |approach |to |help |the |client |gain |insight Two |weeks |after |starting |on |the |SSRI, |the |client |begins |to |experience |suicidal |ideations |and |develops | a |plan |to |kill |herself. |A |friend |brings |the |client |to |the |emergency |room. |The |PMHNP |meets |the |client | at |the |emergency |room |and |collaborates |with |the |physician |to |coordinate |care. PMHNP |role: Acute |PMHNP |Care Telehealth
PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx Community-Based |Care Self-Employment Psychotherapy |- |CORRECT |ANSWER-Partial |Hospitalization/Intensive |Outpatient |Treatment Rationale: |Partial |Hospitalization/Intensive |Outpatient |Treatment |occurs |when |a |client |receives | intensive |therapy |on |an |outpatient |basis, |often |used |when |a |client |do |not |require |24-hour |care |but | still |require |intense |treatment. The |PMHNP |serves |as |the |point |of |contact |person, |coordinating |the |treatment |team, |which |consists | of |the |PMHNP, |a |social |worker, |and |possibly |a |psychologist |and |psychiatrist. PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx Community-Based |Care Self-Employment Psychotherapy |- |CORRECT |ANSWER-Case |Management
Rationale: |Case |management |involves |oversight |and/or |coordination |of |care. Over |the |course |of | 2 |months, |the |client's |condition |improves. |She |is |discharged |from |intensive | outpatient |treatment |and |begins |weekly |appointments |with |the |PMHNP |at |the |PMHNP's |clinic. PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx Community-Based |Care Self-Employment Psychotherapy |- |CORRECT |ANSWER-Community-Based |Care Rationale: |Community-based |care |is |provided |in |a |non-hospital |community |setting. A |global |pandemic |limits |face-to-face |mental |health |visits, |the |PMHNP |determines |that |the |patient | requires |ongoing |mental |health |treatment. |The |PMHNP |arranges |to |meet |with |the |client |via |weekly | interactive |video |sessions. PMHNP |role: Acute |PMHNP |Care Telehealth Case |Management Primary |Care Pharmacologic |Intervention Crisis |Intervention Partial |Hospitalization/Intensive |Outpatient |Tx
How |the |PMHNP |does |Code |of |Ethics: |Respect |for |the |Individual |- |CORRECT |ANSWER--approaches | professional |relationships |with |compassion, |caring, |& |respect, |acknowledging |the |dignity |& |worth |of | each |individual. -helps |instill |hope |& |empowers |those |with |PMH |disorders. -affirms |the |worth |& |dignity |of |those |with |PMH |disorders |by |advocating |to |overcome |(-) |stigmas | towards |PMH |diagnoses |to |ensure |access |to |care. How |the |PMHNP |does |Code |of |Ethics: |Commitment |to |the |Healthcare |Consumer |- |CORRECT | ANSWER--recognizes |& |addresses |personal |attitudes |& |behaviors |that |could |interfere |with |meeting | ethical |guidelines |for |care. -maintains |proper |boundaries. participates |in |self, |peer, |& |supervisory |oversight |of |clinical |skills |& |practice. -recognizes |that |those |with |brain-based |mental |health |disorders |may |have |maladaptive |coping | behaviors, |which |impact |the |individual, |family, |& |society.
- |Maladaptive |behavior |may |continue |in |spite |of |(-) |consequences. |
- |Behavioral |change |may |involve |setbacks. -is |aware |of |the |need |to |balance |human |rights |with |safety, |including |coercive |measures |or |forced |tx | when |individuals |are |unable |to |maintain |their |own |safety. How |the |PMHNP |does |Code |of |Ethics: |Advocacy |for |the |Healthcare |Consumer |- |CORRECT |ANSWER-- strives |to |protect |the |rights, |health, |& |safety |of |clients. -maintains |confidentiality |according |to |HIPAA |requirements |& |professional |boundaries |in |all | interactions -recognizes |the |power |differential |in |the |therapeutic |relationship |& |understands |that |any |sort |of | sexual |activity |or |intimacies |with |current |clients, |their |close |family |members, |guardians, |or |significant | others |is |unethical. How |the |PMHNP |does |Code |of |Ethics: |Responsibility |and |Accountability |for |Practice |- |CORRECT | ANSWER--must |be |responsible |& |accountable |for |their |own |practice. -must |be |able |to |articulate |competencies |& |be |aware |of |scope |of |practice |professional |standards | guiding |their |own |practice. -must |understand |the |scope |of |other |team |members' |practice |in |order |to |delegate |appropriately. How |the |PMHNP |does |Code |of |Ethics: |Duties |to |Self |and |Others |- |CORRECT |ANSWER--owes |the |same | duties |to |self |as |to |others. -accords |moral |worth |& |dignity |to |oneself |& |others, |including |colleagues. -is |committed |to |practicing |self-care, |managing |stress, |& |maintaining |supportive |relationships |to |meet |personal |needs |outside |of |therapeutic |relationships.
-identifies |& |addresses |moral |distress. How |the |PMHNP |does |Code |of |Ethics: |Contributions |to |Healthcare |Environments |- |CORRECT | ANSWER--helps |maintain |& |improve |healthcare |environments |and |conditions |of |employment. -recognizes |signs |& |symptoms |of |psychiatric |disorders |in |the |workplace |& |reports |peer |observations | or |concerns |to |leadership. -helps |address |problems |faced |by |colleagues |that |may |impact |patient |safety |or |violate |public |trust, | including |substance |abuse. How |the |PMHNP |does |Code |of |Ethics: |Advancement |of |the |Nursing |Profession |- |CORRECT |ANSWER-- contributes |to |advancing |the |professing |through |practice, |education, |administration, |& |knowledge | development. -maintains |knowledge |of |& |apply |evidence-based |practice |guidelines, |including |risk |assessment |& | management. -participates |in |continuous |quality |improvement. -pursues |continuing |education. How |the |PMHNP |does |Code |of |Ethics: |Collaboration |to |Meet |Health |Needs |- |CORRECT |ANSWER-- promotes |community, |national, |& |international |efforts |to |meet |health |needs |through |collaboration | with |other |healthcare |professionals. -engages |in |partnerships |with |other |specialty |nurses, |government |agencies, |professional |nursing | organizations, |& |mental |health |organizations |to |promote |prevention, |treatment, |& |recovery. How |the |PMHNP |does |Code |of |Ethics: |Promotion |of |the |Nursing |Profession |- |CORRECT |ANSWER-- advocates |for |environments |that |respect |human |rights, |customs, |& |spiritual |beliefs |of |individuals, | families, |& |communities. -engages |in |interactions |& |collaborations |to |articulate |nursing |values |& |maintain |the |integrity |of |the | profession. -participates |in |policy |development |& |implementation |that |recognizes |PMH |disorders |as |treatable |& | ensures |that |nursing |care |is |delivered |with |respect |to |human |needs |& |values |without |prejudice. Person |A: |"I |can't |believe |you |deal |with |these |people |every |day. |Schizophrenics |would |drive |ME | crazy!" PMHNP: |"Actually, |schizophrenia |is |a |chronic |treatable |disease, |much |like |diabetes |or |other |physical | illnesses. |Patients |who |have |mental |illness |deserve |compassion |and |care." How |the |PMHNP |applied |ethical |principles: -Respect |for |the |Individual -Commitment |to |the |Healthcare |Consumer
-Respect |for |the |Individual -Commitment |to |the |Healthcare |Consumer -Advocacy |for |the |Healthcare |Consumer -Responsibility |and |Accountability |for |Practice -Duties |to |Self |and |Others -Contributions |to |Healthcare |Environments -Advancement |of |the |Nursing |Profession -Collaboration |to |Meet |Health |Needs -Promotion |of |the |Nursing |Profession |- |CORRECT |ANSWER-Advocacy |for |the |Healthcare |Consumer Rationale: |This |is |an |unethical |scenario. |The |PMHNP |recognizes |the |power |differential |in |the | therapeutic |relationship |and |understands |that |any |sort |of |sexual |activity |or |intimacies |with |current | clients, |their |close |family |members, |guardians, |or |significant |others |is |unethical. The |PMHNP |has |overbooked |her |sessions |today, |so |she |asks |the |registered |nurse |(RN) |who |works |in | her |office |to |conduct |one |of |her |phone |therapy |sessions |today. How |the |PMHNP |applied |ethical |principles: -Respect |for |the |Individual -Commitment |to |the |Healthcare |Consumer -Advocacy |for |the |Healthcare |Consumer -Responsibility |and |Accountability |for |Practice -Duties |to |Self |and |Others -Contributions |to |Healthcare |Environments -Advancement |of |the |Nursing |Profession -Collaboration |to |Meet |Health |Needs -Promotion |of |the |Nursing |Profession |- |CORRECT |ANSWER-Responsibility |and |Accountability |for | Practice
Rationale: |This |is |an |unethical |scenario. |The |PMHNP |must |understand |the |scope |of |other |team | members' |practice |in |order |to |delegate |appropriately. |Conducting |a |counseling |session |is |outside |of | the |RN's |scope |of |practice. The |PMHNP |takes |time |for |daily |meditation |to |improve |mindfulness |and |ease |stress. How |the |PMHNP |applied |ethical |principles: -Respect |for |the |Individual -Commitment |to |the |Healthcare |Consumer -Advocacy |for |the |Healthcare |Consumer -Responsibility |and |Accountability |for |Practice -Duties |to |Self |and |Others -Contributions |to |Healthcare |Environments -Advancement |of |the |Nursing |Profession -Collaboration |to |Meet |Health |Needs -Promotion |of |the |Nursing |Profession |- |CORRECT |ANSWER-Duties |to |Self |and |Others Rationale: |The |PMHNP |is |committed |to |practicing |self-care, |managing |stress, |and |maintaining | supportive |relationships |to |meet |personal |needs |outside |of |therapeutic |relationships. A |PMHNP |discovers |her |colleague |is |diverting |scheduled |medications |to |self-medicate |anxiety. |The | PMHNP |reports |the |concerns |to |the |colleagues |supervisor. How |the |PMHNP |applied |ethical |principles: -Respect |for |the |Individual -Commitment |to |the |Healthcare |Consumer -Advocacy |for |the |Healthcare |Consumer -Responsibility |and |Accountability |for |Practice -Duties |to |Self |and |Others -Contributions |to |Healthcare |Environments -Advancement |of |the |Nursing |Profession -Collaboration |to |Meet |Health |Needs
-Contributions |to |Healthcare |Environments -Advancement |of |the |Nursing |Profession -Collaboration |to |Meet |Health |Needs -Promotion |of |the |Nursing |Profession |- |CORRECT |ANSWER-Collaboration |to |meet |health |needs Rationale: |The |PMHNP |promotes |community, |national, |and |international |efforts |to |meet |health |needs |through |collaboration |with |other |healthcare |professionals |to |promote |prevention, |treatment, |and | recovery. A |PMHNP |speaks |at |a |school |board |meeting |about |the |need |develop |policies |to |expand |mental | health |services |for |underserved |students. How |the |PMHNP |applied |ethical |principles: -Respect |for |the |Individual -Commitment |to |the |Healthcare |Consumer -Advocacy |for |the |Healthcare |Consumer -Responsibility |and |Accountability |for |Practice -Duties |to |Self |and |Others -Contributions |to |Healthcare |Environments -Advancement |of |the |Nursing |Profession -Collaboration |to |Meet |Health |Needs -Promotion |of |the |Nursing |Profession |- |CORRECT |ANSWER-Promotion |of |the |Nursing |Profession Rationale: |The |PMHNP |participates |in |policy |development |and |implementation |that |recognizes |PMH | disorders |as |treatable |and |ensures |that |nursing |care |is |delivered |with |respect |to |human |needs |and | values |without |prejudice. Informed |Consent |- |CORRECT |ANSWER--for |care |& |tx |is |a |fundamental |ethical |& |legal |principle |that | respects |the |client's |autonomy |in |medical |decision-making. -Clients |have |the |right |to |receive |information |& |ask |Qs |about |recommended |txs |to |make |decisions | about |their |care |that |are |consistent |with |their |beliefs, |values, |& |tx |goals -The |Joint |Commission |requires |providers |to |conduct |informed |consent |discussions
steps |required |to |obtain |informed |consent, |according |to |the |American |Medical |Association |- |CORRECT |ANSWER--Assess |client |ability |to |understand |medical |info. |& |tx |options |& |to |make |a |voluntary | decision. -Present |relevant |info. |with |accuracy |& |sensitivity. |Include:
- |diagnosis
- |nature |& |purpose |of |tx |options
- |benefits, |risks, |& |burdens |of |all |tx |options, |including |forgoing |tx -Document |informed |consent |conversation |in |the |medical |record, |including |all |consent |forms. exceptions |to |informed |consent |- |CORRECT |ANSWER--incapacitation -situations |involving |life-threatening |emergencies |in |which |there |is |no |time |for |informed |consent -client's |voluntary |waiver |of |informed |consent -When |a |client |is |incapable |of |informed |consent |due |to |the |nature |or |severity |of |their |mental |illness
- |PMHNP |must |determine |if |a |client |has |the |capacity |to |make |medical |decisions steps |in |evaluating |a |client's |capacity |for |decision-making. |- |CORRECT |ANSWER-1. |Assess |for | communication |barriers: |language, |hearing |or |vision |impairments, |dysarthria
- |Evaluate |for |reversible |causes |of |incapacity: |infection, |medications |or |other |substances, |acute | neurologic |& |psychiatric |disorders
- |Identify |values |& |cultural |influences |that |may |impact |client |decision |making
- |Ask |questions: |determine |the |client's |ability |to |understand |the |tx |& |how |tx |applies |to |their | situation.
- |Identify |a |surrogate |if |needed: |healthcare |advance |directive, |medical |power |of |attorney, |spouse, | adult |children, |other |close |relatives
- |Document formal |assessment |tool |to |assist |in |determining |capacity |- |CORRECT |ANSWER-Aid |To |Capacity | Evaluation |(ACE) Practice |Settings |for |complex |mental |health |care |- |CORRECT |ANSWER--mental |health |settings -primary |care -pediatrics -family |and |internal |medicine -home |health |care -hospitals
document |refusal |of |treatment initiate |treatment |without |informed |consent |- |CORRECT |ANSWER-provide |additional |education Rationale: |The |client |should |receive |education |about |the |risks, |benefits, |and |appropriateness |of | pharmacological |treatment. |If, |after |receiving |education, |the |client |still |refuses |medication |therapy, |it | is |important |to |document |the |education |provided |and |the |client's |refusal |of |treatment. Kevin |is |a |48-year-old |with |a |20-year |history |of |schizophrenia. |He |has |decided |to |stop | pharmacological |treatment |due |to |the |intolerable |adverse |effects |of |his |medications. |Kevin |and |the | provider |have |discussed |the |benefits |and |drawbacks |of |ceasing |treatment, |and |he |has |agreed |to | weekly |telephone |check-ins |to |ensure |his |well-being. Which |of |the |following |is |the |most |appropriate |action? provide |additional |education document |refusal |of |treatment initiate |treatment |without |informed |consent |- |CORRECT |ANSWER-document |refusal |of |treatment Rationale: |The |client |has |the |capacity |to |consent, |and |the |situation |is |not |emergent. |The |ethic |of | autonomy |provides |for |the |client |to |refuse |treatment. Ashlei |is |a |19-year-old |who |presents |to |the |clinic |with |severe |anxiety |symptoms. |As |the |PMHNP | begins |reviewing |treatment |options, |Ashlei |interrupts |and |states, |"Hearing |about |these |medications | increases |my |anxiety. |Please |prescribe |what |you |think |is |best |for |me, |and |I |will |take |it." Which |of |the |following |is |the |most |appropriate |action? provide |additional |education document |refusal |of |treatment initiate |treatment |without |informed |consent |- |CORRECT |ANSWER-initiate |treatment |without |informed |consent Rationale: |Clients |may |choose |to |waive |their |right |to |informed |consent. |The |PMHNP |should |clearly | document |the |client's |waiver. Geoff |is |a |32-year-old |who |presents |to |the |clinic |with |anhedonia, |fatigue, |feelings |of |worthlessness, | and |a |lack |of |focus. |He |admits |to |thinking |about |death |but |denies |suicidal |ideations |or |a |plan. |He |has
|been |taking |sertraline | 50 |mg |daily |and |wishes |to |stop |taking |the |medication |as |it |does |not |seem |to | be |helping. Which |of |the |following |is |the |most |appropriate |action? provide |additional |education document |refusal |of |treatment initiate |treatment |without |informed |consent |- |CORRECT |ANSWER-provide |additional |education Rationale: |The |client |has |the |capacity |to |provide |consent |and |the |situation |is |not |emergent; |however, |the |client |should |receive |education |about |the |risks, |benefits, |and |appropriateness |of |pharmacological |treatment. |At |this |time, |the |dose |should |be |increased |to |achieve |efficacy. |If, |after |receiving | education, |the |client |still |refuses |medication |therapy, |the |PMHNP |should |document |the |education | provided |and |the |client's |refusal |of |treatment. Fritz |is |a |25-year-old |who |has |been |brought |to |the |emergency |department |by |the |police |after | threatening |a |server |at |a |restaurant. |The |PMHNP |on |call |has |treated |Fritz |for |schizophrenia |in |the | past. |He |has |a |history |of |poor |treatment |adherence. |While |in |the |emergency |department, |he |admits | to |auditory |hallucinations. |He |becomes |agitated |and |begins |throwing |items |around |the |examination | room. Which |of |the |following |is |the |most |appropriate |action? provide |additional |education document |refusal |of |treatment initiate |treatment |without |informed |consent |- |CORRECT |ANSWER-initiate |treatment |without |informed |consent Rationale: |The |client |does |not |have |the |capacity |to |provide |consent |at |this |time |due |to |active | hallucinations |and |agitation. |For |the |safety |of |the |client |and |staff, |treatment |should |be |initiated | without |obtaining |informed |consent. Acute |inpatient |care |- |CORRECT |ANSWER-short-term |treatment |to |provide |care |for |acutely |ill |clients | who |are |unable |to |meet |basic |needs |due |to |a |mental |health |condition |or |are |at |risk |of |harming | themselves |or |others -focus |is |crisis |stabilization -may |be |voluntary |or |involuntary
no varies |according |to |state |legislation |- |CORRECT |ANSWER-no Rationale: |Keith |does |not |meet |the |criteria |for |an |emergency |psychiatric |hold. |Although |he |is | experiencing |active |delusions, |his |behavior |does |not |threaten |the |safety |of |himself |or |others. | Education, |resources, |and |a |plan |for |follow-up |care |should |be |established. Dakota |is |a |24-year-old |who |presents |to |the |emergency |department |with |his |sister. |He |endorses | taking |a |"handful" |of |pills |after |a |fight |with |his |boyfriend. |He |states |that |he |regrets |taking |the |pills, | and |he |does |not |want |to |end |his |life. |He |denies |active |suicidal |ideations |or |a |plan. |Dakota |plans |to | stay |with |his |sister |for |the |next |few |days. Does |Dakota |require |an |emergency |psychiatric |hold? yes no varies |according |to |state |legislation |- |CORRECT |ANSWER-no Rationale: |Dakota |does |not |meet |the |criteria |for |an |emergency |psychiatric |hold. |He |does |not |have | active |thoughts |of |killing |himself. |He |should |be |provided |with |resources |for |follow-up |as |well |as | information |for |the |National |Suicide |Prevention |Lifeline. Rudy |is |a |42-year-old |who |was |brought |to |the |emergency |department |by |his |social |worker. |He |was | lethargic |and |disoriented |when |she |found |him |at |his |"regular" |spot |in |an |encampment |of |unhoused | individuals. |Rudy |was |admitted |for |dehydration |and |his |labs |indicated |severe |malnutrition. |Rudy |has |a |history |of |schizophrenia |with |poor |treatment |adherence. |He |has |no |family |in |the |area |and |has |been | living |without |housing |for |several |years; |his |social |worker |endorsed |that |before |this |point, |he |had | appeared |healthy |and |had |utilized |available |services |for |meals. |Once |medically |stable, |Rudy |stated | that |he |did |not |remember |where |to |get |food, |and |he |was |not |sure |how |he |got |so |sick. |He |does |not | wish |to |remain |in |the |hospital. Does |Rudy |require |an |emergency |psychiatric |hold? yes no varies |according |to |state |legislation |- |CORRECT |ANSWER-varies |according |to |state |legislation
Rationale: |Rudy |meets |the |criteria |for |a |psychiatric |hold |in |most |states. |He |has |a |history |of |mental | illness |with |poor |treatment |adherence, |has |no |family |support, |and |has |been |unable |to |care |for | himself; |he |meets |the |criteria |for |a |gravely |disabled |individual |and |may |be |detained |involuntarily |for | further |evaluation. Nnenna |is |a |22-year-old |who |was |brought |to |the |emergency |department |by |the |police |after |a |car | crash. |The |police |officers |state |that |Nnenna |was |crying |and |repeating, |"just |let |me |die" |and |the | officers |were |concerned |for |her |mental |wellbeing. |Nnenna's |blood |alcohol |content |is |0.12 |g/mL. |Upon |interview, |Nnenna |has |gross |motor |impairment |and |impaired |judgment. |She |denies |suicidal | ideations, |but |she |states |it |might |be |better |for |her |to |just |die |because |her |parents |are |going |to |be |so |upset |after |they |find |out |about |the |accident. |Nnenna's |boyfriend |met |her |in |the |emergency | department |and |reported |that |she |frequently |drinks |excessive |amounts |of |alcohol. |He |plans |to |stay | with |her |in |her |apartment |overnight |if |she |is |released. Does |Nnenna |require |an |emergency |psychiatric |hold? yes no varies |according |to |state |legislation |- |CORRECT |ANSWER-varies |according |to |state |legislation Rationale: |Nnenna |meets |the |criteria |for |a |psychiatric |hold |in |some |states. |She |is |legally |impaired |due |to |alcohol |consumption, |and |her |boyfriend |reports |that |she |frequently |drinks |excessive |amounts |of | alcohol. |She |also |crashed |her |vehicle |and |states |that |she |wants |to |die. Miguel |is |a |64-year-old |who |was |arrested |at |a |nearby |supermarket |after |pulling |a |knife |out |of |his | jacket |pocket |and |threatening |an |employee |who |refused |to |allow |him |to |enter |without |a |mask. |After | finding |a |prescription |bottle |for |lithium |in |his |belongings, |police |requested |a |psychiatric |evaluation |to | determine |if |he |should |be |transferred |to |a |psychiatric |facility. |During |the |interview, |Miguel |is |alert, | oriented, |and |calm. |He |appears |focused |and |his |speech |is |measured |and |clear. |He |states |that |he |has | been |living |with |bipolar | 2 |disorder |for |about | 30 |years, |takes |his |medications |regularly, |and |sees |a | mental |health |professional |every |month. Does |Miguel |require |an |emergency |psychiatric |hold? yes no varies |according |to |state |legislation |- |CORRECT |ANSWER-no
