Solutions
A newly admitted patient is withdrawn and does not seek out
interaction with staff or patients. Nursing interventions should
focus on which element of the treatment environment?
a. Norms
b. Safety
c. Structure
d. Limit-setting Correct Answers C
Structure refers to the physical environment, regulations, and
daily schedule of classes and groups provided. The unit
activities will provide an opportunity for the nurse to interface
with the patient to develop a trusting relationship. The other
treatment environment elements are important but are of lower
priority for this patient.
A nurse plans ways to promote patient safety and security. A
proactive approach would include which intervention?
a. Restricting psychotic patients' rights
b. Enforcing consequences of limit-setting
c. Setting limits when a patient acts out aggressively
d. Clearly communicating expectations for patients' behavior
Correct Answers D
Proactive is the key word in this question. Communicating clear
rules for expected behavior from the beginning reinforces norms
and structure, and encourages self-responsibility. The other
options are reactive.
, A patient demonstrating manic behaviors gathered other patients
in the dayroom and gave a sales talk, pressuring others to
purchase shares of stock in a gold mine. Which element of a
therapeutic environment is jeopardized?
a. Connection
b. Exploration
c. Structure
d. Balance Correct Answers D
The patient is violating the rights of others by being allowed to
give unsolicited discourses and exert pressure on others. Balance
is lacking when patients are not protected from the symptom
expression of other patients.
A patient has been bumping and pushing other patients. The
nurse carefully explains to the patient that such behavior is
unacceptable. The nurse has provided what characteristic of a
therapeutic environment?
a. Balance
b. Limit-setting
c. Personal control
d. Environmental modification Correct Answers B
Limit-setting provides a patient with a clear explanation of the
acceptability or unacceptability of a behavior. Limit-setting
reinforces norms and encourages the milieu concept of
responsibility for self. The other options are not applicable.
A psychiatric facility is "accredited by JCAHO." Which asset
would be expected?
a. A 4:1 patient-to-staff ratio