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A bill introduced in Congress would reduce funding for the care of people diagnosed with mental illnesses. A group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled?
- A. Advocacy
- B. Attending
- C. Recovery
- D. Evidence-based practice
Correct Answer: A
Rationale: An advocate defends or asserts another's cause, particularly when the other person lacks the ability to do that for him or herself. Examples of individual advocacy include helping patients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the individuals with mental illness; the letter-writing campaign advocates for that cause on behalf of patients who are unable to articulate their own needs.
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In the shift-change report, an off-going nurse criticizes a patient who wears extremely heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
- A. This is a psychiatric hospital, so we expect our patients to behave bizarrely.
- B. Let's all show acceptance of this patient by wearing lots of makeup too.
- C. Your comments are inconsiderate and inappropriate. Keep the report objective.
- D. Our patients need our help to learn behaviors that will help them get along in society.
Correct Answer: D
Rationale: Accepting patients' needs for self-expression and seeking to teach skills that will contribute to their well-being demonstrate respect and are important parts of advocacy. The on-coming nurse needs to take action to prevent prejudice against the patient. Humor can be appropriate within the privacy of a shift report but not at the expense of respect for patients. Judging the off-going nurse in a critical way will create conflict.
Which outcome, focused on recovery, would be expected in the plan of care for a patient living in the community and diagnosed with serious and persistent mental illness? Within 3 months, the patient will demonstrate what behavior?
- A. Denying suicidal ideation
- B. Reporting a sense of well-being
- C. Taking medications as prescribed
- D. Attending clinic appointments on time
Correct Answer: B
Rationale: Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving role performance. The goal of recovery is to empower the individual with mental illness to achieve a sense of meaning and satisfaction in life and to function at the highest possible level of wellness. The incorrect options focus on the classic medical model rather than recovery.
A nurse consistently strives to demonstrate caring behaviors during interactions with patients. Which reaction reported by a patient indicates this nurse is most effective?
- A. Feeling less distrustful of others
- B. Sensing a connection with others
- C. Experiencing only minimal uneasiness about the future
- D. Being somewhat encouraged with efforts to improve
Correct Answer: B
Rationale: A patient is likely to respond most to caring with a sense of connectedness with others. The absence of caring can make patients feel some degree of distrustful, disconnection, unease, and discouragement.
A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurse's most caring comment.
- A. Let's discuss healthy means of coping when you have suicidal feelings.
- B. I understand why you're so depressed. When I got divorced, I was devastated too.
- C. You should forget about your marriage and move on with your life.
- D. How did you get so depressed that hospitalization was necessary?
Correct Answer: A
Rationale: The nurse's communication should evidence caring and a commitment to work with the patient. This commitment lets the patient know the nurse will help. Probing and advice are not helpful for therapeutic interventions.
Which research evidence would most influence a group of nurses to change their practice?
- A. Expert committee report of recommendations for practice
- B. Systematic review of randomized controlled trials
- C. Nonexperimental descriptive study
- D. Critical pathway
Correct Answer: B
Rationale: Research findings are graded using a hierarchy of evidence. A systematic review of randomized controlled trials is level A and provides the strongest evidence for changing practice. Expert committee recommendations and descriptive studies lend less powerful and influential evidence. A critical pathway is not evidence; it incorporates research findings after they have been analyzed.