Chapter 02: Historical Issues
1. A person says, “Now that many state hospitals are closed, patients with psychiatric problems
are free in our community. It is not safe for me.” The nurse’s reply should be based on
a. depressed patients are nonviolent.
b. state hospitals are no longer needed.
c. major depression is very prevalent.
d. bizarre behavior is viewed as sensational.
Four of the top medical disorders causing disability are psychiatric disorders (i.e., major
depression, schizophrenia, bipolar disorder, and alcohol abuse). The other options are not true
DIF: Cognitive level: Understanding REF: p. 9
TOP: Nursing process: Implementation MSC: NCLEX: Psychosocial Integrity
2. Select the most accurate characterization of treatment of the mentally ill prior to the Period of
a. Large asylums provided custodial care.
b. Care for the mentally ill was more compassionate.
c. Care focused on reducing stress and meeting basic human needs.
d. Patients were banished from communities or displayed for public amusement.
In the 1700s it was common practice for caretakers to display mentally ill patients for the
amusement of the paying public. The creation of large asylums took place during the Period
of Enlightenment. Mental illness was first studied during the Period of Scientific Study.
Dealing with stress and meeting basic needs are concerns of the modern era.
DIF: Cognitive level: Understanding REF: p. 10
TOP: Nursing process: Assessment MSC: NCLEX: Safe, Effective Care Environment
3. What concerns were shared by society during both the Period of Enlightenment and the Period
of Community Mental Health?
a. Moving patients out of asylums
b. Studying brain structure and function
c. Meeting basic human needs humanely
d. Providing medication to control symptoms
The use of asylums signaled concern for meeting basic needs of the mentally ill, who in
earlier times often wandered the countryside. With deinstitutionalization, many patients who
were poorly equipped to provide for their own needs were returned to the community. The
current system must now concern itself with ensuring that patients have such basic needs as
food, shelter, and clothing. Studying brain structure and function is more a concern of modern
times, as is the provision of medication.