When a nurse is working with a patient who suicidal ideation the
nurse must do the following: Correct Answers assume an
authoritarian role for safety
Rationale:
The nurse assumes an authoritative role to help clients stay safe.
In this crisis situation, clients see few or no alternatives to
resolve their problems. p. 329 Videbeck
No-suicide or no-self-harm contracts have been used with
suicidal clients. In such contracts, clients agree to keep
themselves safe and to notify staff at the first impulse to harm
themselves (at home, clients agree to notify their caregivers; the
contract must identify backup people in case caregivers are
unavailable). These contracts, however, are not a guarantee of
safety, and their use has been sharply criticized. At no time
should a nurse assume that a client is safe based on a single
statement by the client. Rather a complete assessment and a
thorough discussion with the client are more reliable. Shifting
the focus to "safety planning," that is, managing or mitigating
suicidal risk, is a more effective intervention strategy
When considering a diagnosis of somatic symptom disorder,
which information, among the four types listed below, is least
likely to require detailed assessment by the nurse?
a. Patient's level of ability to voluntarily control symptoms
b. Results of the patient's diagnostic laboratory tests
c. Patient's limitations in carrying out activities of daily living
d. Patient's potential for violent behavior Correct Answers c
,Which sign or symptom would be least likely to occur for a
patient with hypochondriasis?
a.Impairment in occupational functioning
b.Repetitive, time-consuming rituals
c.Misinterpretation of physical sensations
d.Loss of interest in formerly pleasurable activities Correct
Answers a, b, c
Major depression lasts at least ------- with anhedonia,
disturbances in sleep and appetite. Correct Answers 2 weeks
Rationale:
A major depressive episode lasts at least 2 weeks, during which
the person experiences a depressed mood or loss of pleasure in
nearly all activities. Symptoms include changes in eating habits,
resulting in unplanned weight gain or loss; hypersomnia or
insomnia; impaired concentration, decision-making or problem-
solving abilities; inability to cope with daily life; feelings of
worthlessness, hopelessness, guilt, or despair; thoughts of death
and/or suicide; overwhelming fatigue; and rumination with
pessimistic thinking with no hope of improvement. These
symptoms result in significant distress or impairment of social,
occupational, or other important areas of functioning.
Mr. R. presents with a history of having assumed a new identity
in a distant locale. He has no recollection of his former identity.
Which DSM-IV-TR diagnosis can the nurse expect the
psychiatrist to make?
a. Hypochondriasis
b. Conversion disorder
, c. Dissociative fugue
d. Depersonalization disorder Correct Answers c
Nurse S is developing outcome criteria with her patient, who has
a nursing diagnosis of Ineffective coping. The diagnosis is
related to the patient's dependence on pain relievers to treat
chronic pain of psychological origin. Which of the following are
appropriate outcome criteria?
a. Patient will resume performance of work role behaviors.
b. Patient will identify ineffective coping patterns.
c. Patient will make realistic appraisal of strengths and
weaknesses.
d. Patient will make realistic appraisal of family's capacity to be
involved in decision making. Correct Answers a, b, c
Nurses working with patients with somatization and dissociative
disorders can expect that these patients will fit on the continuum
of psychobiological disorders at the:
a. mild level.
b. moderate to severe level.
c. severe to the psychotic level.
d. They do not belong on the continuum, because anxiety has
been reduced by ego defense mechanisms. Correct Answers a,
b, d
Antisocial Correct Answers Disregard rights of others, rules
and law