A 16-year-old girl is admitted for her first psychotic break. Her parents feel
very guilty. What is your best nursing response?
A. No one really knows the cause of schizophrenia. It is not your fault and
is not due to anything you did in the past. It is important to understand this,
to support your daughter, and to find support for yourselves.
B. Does anyone in your family have schizophrenia, as this disease is known
to be genetic?
C. You may feel bad now, but there are so many other bad things out there,
such as cancer and paralysis.
D. Let me share with you some websites to help you deal with your guilt.
A. No one really knows the cause of schizophrenia. It is not your fault and
is not due to anything you did in the past. It is important to understand this,
to support your daughter, and to find support for yourselves.
Reason: Schizophrenia has a multifocal origin and its cause may include a
genetic component. Support is needed for both patients and caregivers.
A 21-year-old patient has a diagnosis of schizophrenia and is stuporous, yet
exhibits sudden, excessive motor activity with repetitive sit-ups. What is
this behavior called?
A. Delusional.
B. Hallucinogenic.
C. Paranoid.
D. Catatonic.
D. Catatonic.
Reason: Catatonic schizophrenia occurs suddenly and includes motor
immobility or excessive motor activity.
,A 22-year-old female is admitted to the unit following a suicide attempt.
She has a 2-week history of depression as well as a history of abusing
multiple substances and anorexia nervosa. What is your first nursing
priority?
A. Socialization.
B. Contracting for eating behavior.
C. Safety.
D. Administering the Beck depression scale.
C. Safety.
Reason: Safety is the major principle underlying psychiatric nursing.
A 22-year-old female was admitted to the mental health unit with major
depression and suicidal ideation. She has a history of cutting her wrists
intermittently throughout the last 2 years. On days 1 and 2, the patient stays
in her room and eats only 20% of her meals. On day 3, she eats 80% of her
meals and is talking to others in group. The nurse should consider that the
patient is
A. Showing improvement.
B. Highly suicidal.
C. Exhibiting mood swings.
D. In need of electroshock therapy.
A. Showing improvement.
Reason: The patient improvement is based on increased socialization and
increased appetite.
, A 35-year-old male patient has been brought to your hospital unit after
making a suicide attempt at his workplace. Which of the following
interventions can you legally implement?
A. Call the patient's girlfriend and inform her of his admission and visiting
hours.
B. Physically search the patient for weapons and harmful materials.
C. Call the patient's boss at work and report him as in need of extended
medical leave.
D. Place the patient in four-point restraints and begin an IV for sedation.
B. Physically search the patient for weapons and harmful materials.
Reason: A suicide attempt is a serious and self-destructive behavior that
demands searching for weapons and harmful materials to increase safety.
A 48-year-old Hispanic woman is seen by a psychiatric clinical nurse
specialist after receiving a call by her son. According to the son, since his
father's death 7 months ago, his mother has lost 30 pounds and can't sleep.
During her initial visit, the patient states, 'My husband talks to me in his
visits, but his words make no sense to me. I don't understand what he wants
me to do.' What is an appropriate nursing diagnosis?
A. Ineffective denial.
B. Bipolar mood disorder.
C. Hyper-religiosity.
D. Grieving.
D. Grieving.
Reason: Grieving may be characterized by weight loss, sleep disturbances,
and messages from beyond.
very guilty. What is your best nursing response?
A. No one really knows the cause of schizophrenia. It is not your fault and
is not due to anything you did in the past. It is important to understand this,
to support your daughter, and to find support for yourselves.
B. Does anyone in your family have schizophrenia, as this disease is known
to be genetic?
C. You may feel bad now, but there are so many other bad things out there,
such as cancer and paralysis.
D. Let me share with you some websites to help you deal with your guilt.
A. No one really knows the cause of schizophrenia. It is not your fault and
is not due to anything you did in the past. It is important to understand this,
to support your daughter, and to find support for yourselves.
Reason: Schizophrenia has a multifocal origin and its cause may include a
genetic component. Support is needed for both patients and caregivers.
A 21-year-old patient has a diagnosis of schizophrenia and is stuporous, yet
exhibits sudden, excessive motor activity with repetitive sit-ups. What is
this behavior called?
A. Delusional.
B. Hallucinogenic.
C. Paranoid.
D. Catatonic.
D. Catatonic.
Reason: Catatonic schizophrenia occurs suddenly and includes motor
immobility or excessive motor activity.
,A 22-year-old female is admitted to the unit following a suicide attempt.
She has a 2-week history of depression as well as a history of abusing
multiple substances and anorexia nervosa. What is your first nursing
priority?
A. Socialization.
B. Contracting for eating behavior.
C. Safety.
D. Administering the Beck depression scale.
C. Safety.
Reason: Safety is the major principle underlying psychiatric nursing.
A 22-year-old female was admitted to the mental health unit with major
depression and suicidal ideation. She has a history of cutting her wrists
intermittently throughout the last 2 years. On days 1 and 2, the patient stays
in her room and eats only 20% of her meals. On day 3, she eats 80% of her
meals and is talking to others in group. The nurse should consider that the
patient is
A. Showing improvement.
B. Highly suicidal.
C. Exhibiting mood swings.
D. In need of electroshock therapy.
A. Showing improvement.
Reason: The patient improvement is based on increased socialization and
increased appetite.
, A 35-year-old male patient has been brought to your hospital unit after
making a suicide attempt at his workplace. Which of the following
interventions can you legally implement?
A. Call the patient's girlfriend and inform her of his admission and visiting
hours.
B. Physically search the patient for weapons and harmful materials.
C. Call the patient's boss at work and report him as in need of extended
medical leave.
D. Place the patient in four-point restraints and begin an IV for sedation.
B. Physically search the patient for weapons and harmful materials.
Reason: A suicide attempt is a serious and self-destructive behavior that
demands searching for weapons and harmful materials to increase safety.
A 48-year-old Hispanic woman is seen by a psychiatric clinical nurse
specialist after receiving a call by her son. According to the son, since his
father's death 7 months ago, his mother has lost 30 pounds and can't sleep.
During her initial visit, the patient states, 'My husband talks to me in his
visits, but his words make no sense to me. I don't understand what he wants
me to do.' What is an appropriate nursing diagnosis?
A. Ineffective denial.
B. Bipolar mood disorder.
C. Hyper-religiosity.
D. Grieving.
D. Grieving.
Reason: Grieving may be characterized by weight loss, sleep disturbances,
and messages from beyond.
