Nokea
A group of students are reviewing the multiaxial diagnostic system of the DSM-IV- TR. The students demonstrate understanding of the axes when they identify that each axis represents which of the following?
- A. An evidence-based research finding
- B. An experimental design to guide care
- C. A domain of information
- D. A laboratory test finding
Correct Answer: C
Rationale: The correct answer is C: A domain of information. The multiaxial diagnostic system of the DSM-IV-TR includes five axes, each representing a different domain of information about an individual's mental health. Axis I is for clinical disorders, Axis II is for personality disorders and intellectual disabilities, Axis III is for general medical conditions, Axis IV is for psychosocial and environmental stressors, and Axis V is for global assessment of functioning. Therefore, each axis represents a distinct category or domain of information rather than an evidence-based research finding (A), an experimental design (B), or a laboratory test finding (D). The axes serve to provide a comprehensive and holistic assessment of an individual's mental health status.
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A psychiatric-mental health nurse is providing care for a patient with a mental disorder. The patient is participating in the decision-making process. The nurse interprets this as which component of recovery?
- A. Self-direction
- B. Empowerment
- C. Person-centered
- D. Holistic
Correct Answer: A
Rationale: The correct answer is A: Self-direction. In the context of recovery, self-direction refers to the patient's ability to actively participate in decisions regarding their care and treatment. By involving the patient in the decision-making process, the nurse is promoting the patient's autonomy and self-determination, which are key components of recovery in mental health. This approach empowers the patient to take control of their own recovery journey and promotes a sense of ownership over their treatment plan.
Summary of other choices:
B: Empowerment - While empowerment is related to self-direction, it focuses more on giving the patient the tools and resources to make informed decisions rather than actively involving them in the decision-making process.
C: Person-centered - This choice emphasizes tailoring care to the individual's unique needs and preferences, which is important in recovery but not specifically related to the patient's active participation in decision-making.
D: Holistic - This choice pertains to considering all aspects of the patient's well-being, including physical,
A psychiatric-mental health nurse is working on an inpatient unit that uses a privilege system. The nurse understands that this intervention integrates which group of theories?
- A. Behavioral
- B. Developmental
- C. Humanistic
- D. Cognitive
Correct Answer: A
Rationale: The correct answer is A: Behavioral. Privilege systems involve using reinforcement and consequences to modify behavior, which aligns with behavioral theories. Behavioral theories focus on observable behaviors and how they are influenced by the environment. Developmental theories focus on growth and maturation over time, humanistic theories emphasize self-actualization and personal growth, while cognitive theories focus on mental processes like perception and problem-solving. Therefore, the other choices are incorrect as they do not directly relate to the use of reinforcement and consequences in modifying behavior as seen in privilege systems.
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.
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.
A psychiatric-mental health nurse is providing care to a patient who has recently emigrated to the United States from Eastern Europe. Which of the following would be least effective in providing culturally competent care?
- A. Demonstrating a genuine interest in the patient
- B. Avoiding assumptions about the patient’s culture
- C. Speaking to the patient in his native language.
- D. Acquiring information about the patient’s country
Correct Answer: C
Rationale: The correct answer is C because speaking to the patient in his native language may not always guarantee effective communication. The patient may have acculturated to English and prefer to communicate in English. It is important to assess the patient's language preference first. Demonstrating genuine interest (A) is important for building trust. Avoiding assumptions (B) helps prevent stereotyping. Acquiring information about the patient's country (D) can enhance understanding of the patient's background.