Nokea
A psychiatric-mental health nurse determines that a patient is competent when he is able to do which of the following?
- A. Speak coherent English.
- B. Communicate his or her choices.
- C. Write a `living will.
- D. Comply with the medical regimen.
Correct Answer: B
Rationale: The correct answer is B because competency involves the ability to communicate one's choices. Competency is determined by the patient's capacity to understand information, make reasoned decisions, and communicate preferences. This enables the patient to actively participate in their healthcare decisions. Choices A, C, and D are incorrect because speaking coherent English, writing a living will, and complying with a medical regimen do not solely demonstrate competency in decision-making and communication of choices. These actions may be important but do not encompass the full scope of competency in the context of psychiatric-mental health nursing.
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A nurse is demonstrating behaviors that the treatment team is attempting to get the patient to develop. The nurse is integrating which theory?
- A. Erikson’s model of psychosocial development
- B. Albert Bandura’s social cognitive theory
- C. Skinner’s operant conditioning
- D. Freud’s psychoanalytic model
Correct Answer: B
Rationale: The correct answer is B: Albert Bandura's social cognitive theory. The nurse is integrating this theory by demonstrating behaviors for the patient to develop through observational learning and modeling. Bandura's theory emphasizes that individuals learn by observing others and imitating their behaviors. The treatment team is likely using this approach to encourage the patient to adopt positive behaviors by showcasing them through the nurse's actions.
Incorrect Choices:
A: Erikson’s model of psychosocial development - This theory focuses on stages of psychosocial development and identity formation, not on observational learning or modeling.
C: Skinner’s operant conditioning - This theory revolves around reinforcement and punishment to shape behavior, which is different from the observational learning emphasized in the scenario.
D: Freud’s psychoanalytic model - This theory is based on unconscious processes and early childhood experiences, not on observational learning and modeling as seen in the nurse's behavior.
A nurse is preparing to administer an as-needed (PRN) medication. Which of the following would the nurse need to keep in mind when documenting administration?
- A. It requires a separate entry that includes reason for administration, dosage, route, and response to the medication the first time it is administered to a patient.
- B. It requires a separate entry that includes reason for administration, dosage, route, and response to the medication every time it is administered to a patient.
- C. It requires a separate entry that includes reason for administration, dosage, and route the first time it is administered to a patient.
- D. It requires a separate entry that includes reason for administration, dosage, and route every time it is administered to a patient.
Correct Answer: B
Rationale: The correct answer is B because when documenting administration of PRN medication, the nurse must include the reason for administration, dosage, route, and response every time it is given. This ensures comprehensive documentation for monitoring the patient's response to the medication and helps in evaluating the effectiveness of the treatment. Option A is incorrect because documenting the response is necessary each time, not just the first time. Option C is incorrect as it does not include documenting the response, which is crucial for assessing the medication's effectiveness. Option D is also incorrect as it excludes documenting the response, which is essential for evaluating the patient's progress.
A nursing instructor is preparing a class about rural cultures and the influence on mental health problems. Which of the following would the instructor include as impacting the use of mental health services for this group? Select all that apply.
- A. Limited access to care
- B. Lack of available resources
- C. Geographical similarities
- D. Diverse cultural groups
Correct Answer: A
Rationale: The correct answer is A: Limited access to care. Rural cultures often face barriers such as distance to healthcare facilities, shortage of mental health professionals, and lack of transportation. This limits their ability to access mental health services. Choice B is incorrect as lack of resources usually refers to financial resources, not necessarily availability of mental health services. Choice C is incorrect as geographical similarities do not directly impact the use of mental health services. Choice D is incorrect as diverse cultural groups may actually contribute to a greater awareness and acceptance of mental health services within rural cultures.
A nursing instructor has prepared a lecture about the scope and standards of practice of psychiatric nurses. The instructor determines that the teaching was effective when the students identify which of the following as common to both basic and advanced level practice?
- A. Case management
- B. Program development
- C. Clinical supervision
- D. Community interventions
Correct Answer: A
Rationale: The correct answer is A: Case management. This is common to both basic and advanced level practice for psychiatric nurses because it involves coordinating care, advocating for patients, and ensuring continuity of services. Basic level nurses may handle simpler cases, while advanced level nurses may manage more complex cases.
Choice B: Program development may be more common in advanced practice where nurses may be involved in creating new programs or services.
Choice C: Clinical supervision is typically a responsibility of advanced practice nurses who oversee and guide other staff members.
Choice D: Community interventions may also be more common in advanced practice where nurses may lead community-based initiatives.
A psychiatric-mental health nurse is documenting information in a patient’s medical record. Which of the following would be least likely to increase the nurse’s legal liability?
- A. `Patient reported that he was feeling better today than yesterday.
- B. `Administered haloperidol 10 mg IM stat as ordered for agitation.
- C. `Patient was talking with another staff member and started screaming.
- D. `Applied restraints to all four patient extremities.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Patient's self-report of feeling better is subjective and reflects the patient's perception, not the nurse's actions or decisions.
2. This documentation does not involve any direct intervention or action by the nurse, hence reducing legal liability.
3. It reflects positive progress in the patient's condition, which is generally a favorable indicator in psychiatric care.
4. It does not raise concerns about potential adverse outcomes or deviations from standard practice.
Summary:
- Choice A is least likely to increase legal liability as it is a subjective report by the patient.
- Choices B, C, and D involve direct actions or interventions by the nurse that could have legal implications and potential risks to patient safety.