MULTIPLE CHOICE
1. Which nursing action is a reflection of Hildegard Peplaus theoretic framework
regarding psychiatric mental health nursing?
a. Basing patient outcomes on expected instinctual responses
b. Discussing a patients feelings regarding parents and siblings
c. Providing the patient with clean clothes and wholesome
food
d. Centering professional practice in a state run psychiatric facility
ANS: B
Peplaus pioneering endeavors and contributions were largely influenced by interpersonal
psychotherapy. She believed that disorders evolved in the social context of interpersonal
interactions. (i.e., what went on between people). Instinctual responses are more related to
intrapersonal interactions. Florence Nightingale was instrumental in the holistic approach to
nursing care, whereas Linda Richards practice was centered on institutional care of the mental
ill.
2. The nurse is attempting to provide a safe environment for a patient at great risk for self-
harm. Which intervention shows an understanding of evidence-based practice (EBP)?
a. Using physical restraints only after all other options have been
proven ineffective
b. Referring to the facilitys policies manual for guidelines for applying
physical restraints
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c. Collecting data regarding the short-term effects of using physical restraints on an
aggressive patient
, d. Requiring constant monitoring of a patient whose inability to self-regulate anger
has required the use of physical restraints
ANS: B
Health care systems are participating in the shift in nursing practice by encouraging research in
their facilities and by implementing interventions that increase nurses knowledge about EBP.
Nurses are participating to make evidence-based nursing practices available for their use, and
they are helping to determine the outcomes that will benefit patients. The remaining options are
examples of long-standing practice related to the use of physical restraints.
MSC: NCLEX: Safe, Effective Care Environment, Psychosocial Integrity
3. Which statement by the patient reflects patient education that was based on the concept of
integrated patient care?
a. I know Im anxious when I get a tension headache.
b. My anxiety is a result of stressors I dont cope well with.
c. Medication has helped me tremendously with anxiety control.
d. Anxiety runs in my family; my entire family is trying to deal with it.
ANS: A
Integrated patient care is the recognition of the interplay between physical and mental health. In
integrated care, these disorders are not treated as separate illnesses; rather, they are treated
together. The remaining options make no mention of a relationship between mental and physical
illness.
4. The nurse demonstrates objective patient care when:
a. Being sympathetic to the patients recent loss of a spouse
b. Protecting the anxious patient by eliminating stressors in the milieu
, c. Responding to the patient by stating, I know exactly how you feel.
d. Facilitating the patients exploration of various stress reduction techniques
ANS: D
The nurse demonstrates objectivity by helping the patient to process and organize thoughts that
are directed toward the solving of his or her own problems. With sympathy, the nurse loses
objectivity and moves into his or her own personal feelings. Removing all stress does not allow
the patient to develop necessary coping skills.
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Management of Care, Psychosocial Integrity
5. Which nursing intervention would be appropriately addressed during the orientation phase of
the nursepatient relationship?
a. Self reflection by the nurse regarding personal biases and prejudices regarding
the patient
b. Patient works at prioritizing personal needs and develops realistic expected
outcomes
c. Establishing the contract between the nurse and the patient regarding mutual
needs and expectations
d. Patient commits to the reinforcement of positive personal characteristics while
working on problems and concerns
ANS: C
A contract or agreement is established during the orientation phase of the relationship. The
contract defines limits and expectations of both the patient and the nurse. Self Reflection occurs
during the pre-orientation phase while the remaining options are addressed during the working
phase of the relationship.
MSC: NCLEX: Safe, Effective Care Environment: Management of Care, Psychosocial Integrity
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