NR 606 Diagnosis & Management in Psychiatric Mental Health

NR 606 Diagnosis & Management in Psychiatric Mental Health What best describes the role of the psychiatric social worker as a member of the interdisciplinary treatment team? 1) Provides ongoing assessment of client's mental and physical condition 2) Functions under the supervision of the psychiatric nurse 3) Conducts individual, group, and family therapy 4) Writes orders for admission, medical treatments, and discharge of the patient - 3 1 & 4 is for psychiatric nurse 2 mental health technician Which of the following nursing interventions are appropriate when caring for a suicidal client? Select all that apply. 1) Initiate suicide precautions and provide a hazard-free environment. 2) Encourage the client to talk about his or her emotional pain. 3) Help the client identify areas of life that are within his or her control. 4) Provide the client with ample privacy. 5) Allow the client to isolate self. - 1,2,3 The nurse is interacting with a patient who says he has never been able to rely on anyone because "People will always disappoint you." The nurse makes an effort to be very consistent in scheduling appointments and arriving on time. Which of the following psychological tasks, identified by Peplau, is the nurse trying to assist the patient to complete? 1) Learning to delay satisfaction 2) Learning to count on others 3) Developing skills in participation 4) Identifying oneself - 2 The task of learning to count on others is rooted in the individual's comfort level that his needs will be nurtured and met. In this example, the nurse is assuming the role of surrogate mother by fulfilling the needs of the patient, with the hope that as he begins to recognize that he can count on others, his growth and maturity will be facilitated. Paul, a nurse who is working in a hospital psychiatric unit, has been asked to meet with his nurse manager to discuss concerns around patient confidentiality. Which of these behaviors by Paul are breaches of patient confidentiality? Select all that apply. 1) Paul was telling a nurse from another unit that a patient was admitted to the psychiatric unit who they both know socially. 2) Paul reveals to a patient's girlfriend, who is on the unit to visit him, that the patient threatened to kill her if he got the chance. 3) Paul, the nurse in charge of a specific patient, reviewed the chart when the psychiatrist asked for admission history information, even though this patient is also one of his neighbors. 4) Paul told a nurse during shift report that a particular patient was thinking of taking an overdose, even though the patient asked that this information remain confidential. 5) Paul saw a former patient dining with fr - 1, 5 A nursing instructor is teaching about suicide risk statistics. Which statement by the student nurse indicates that learning has occurred? 1) "Males of very high socioeconomic status are predisposed to suicide." 2) "Females of Asian-American ethnicity are predisposed to suicide." 3) The majority of people who commit suicide do not have a diagnosable mental illness. 4) People of the Roman Catholic faith have higher suicide rates than rates among Protestants and Jews. - 1 Males are more likely to commit suicide than are females. Individuals of very high and very low socioeconomic status are more likely to commit suicide than are middle-class individuals. A client is experiencing a crisis. The client states, "I can no longer function." The nurse directs the client to a quiet environment, but the client does not respond to the instruction. How would the nurse interpret this client's behavior? 1) The client is experiencing a physical disorder. 2) The client is suicidal. 3) The client is experiencing episodic catatonia. 4) The client is experiencing a decrease in perceptual fields. - 4 A decrease in perceptual fields is a symptom of severe anxiety, which can occur during crisis. This client is not able to "hear" or "follow" the directions provided by the nurse, which indicates a decrease in perceptual fields. A group of nursing students decide to engage a group of patients in a card game. What assumption about the therapeutic community justifies this activity? 1) The client owns his or her own environment. 2) Restrictions and punishments are to be avoided. 3) Every interaction is an opportunity for therapeutic intervention. 4) This activity is strictly social and is not justifiable in a therapeutic milieu. - 3 A client diagnosed with generalized anxiety disorder complains to the nurse that he only gets about four hours of sleep because as soon as he gets into bed, he starts thinking of things that upset him. Which of the following nurse responses is an example of formulating a plan of action? 1) "What time do you usually go to bed?" 2) "Tell me more about the things that upset you." 3) "I notice you become tearful whenever we talk about this." 4) "What could you do prior to going to bed that might promote relaxation?" - 4 By encouraging the client to begin thinking about how to problem-solve, the nurse is assisting the patient to formulate a plan of action. A nurse educator is conducting a class on stress management. One of the participants asks, "Why is stress reduction so important? I've always thought stress was a good thing." Which of these responses by the nurse is supported by evidence? 1) There appears to be a causal link between stress and illness. 2) Certain life events are stressful for everyone. 3) Stress is a good thing, but chronic stress initiates the "fight or flight" syndrome. 4) Stress reduction is the first step in learning how to remove all stressful events from one's life. - 1 A state's nurse practice act is an example of which type of law? 1) Common law derived from decisions made in previous cases 2) Criminal law used to protect the public welfare 3) Civil law used to protect private and property rights 4) Statutory law enacted by a legislative body - 4 Which individual is at lowest risk for suicide? 1) A single 65-year-old male dentist 2) A married middle-class woman 3) A male teenager who hunts 4) A 70-year-old Caucasian woman whose father committed suicide - 2 A married middle-class woman has the lowest risk for suicide. Single, divorced, and widowed individuals are at higher risk than are married persons. Individuals in the highest and lowest socioeconomic classes are at higher risk than are those in the middle class. Males are at higher risk than are females.