A nurse is performing a biopsychosocial assessment of a patient with depression. Which of the following would the nurse assess as part of the psychological domain? Select all that apply.
- A. Abstract reasoning
- B. Medication use
- C. Mood
- D. Orientation
- E. Self-care
Correct Answer: A,C,D
Rationale: The psychological domain includes cognitive and emotional functions such as abstract reasoning (A), mood (C), and orientation (D). Medication use (B) is part of the biological domain, and self-care (E) relates to the social or functional domain.
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The nurse is determining the success of a patient?s plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time?
- A. On the day of discharge
- B. During the assessment process
- C. At the initial interview
- D. With goal-setting process
Correct Answer: D
Rationale: Outcome indicators are specific, measurable criteria established during the goal-setting process in the nursing plan of care. This occurs after assessment and diagnosis, aligning interventions with desired outcomes. Discharge, assessment, and initial interviews precede or inform goal-setting.
The nurse is reviewing the drawing that a patient completed as a self-portrait. The nurse observes that the drawing lacks arms and feet. The nurse interprets this as indicating which of the following? Select all that apply.
- A. Low self-esteem
- B. Powerlessness
- C. Insecurity
- D. Inadequacy
Correct Answer: A,B,C,D
Rationale: In psychiatric art assessment, missing body parts like arms and feet can indicate low self-esteem (A), powerlessness (B), insecurity (C), and inadequacy (D), reflecting feelings of incompleteness or diminished self-worth. All apply based on standard interpretations.
A home health nurse is making a home visit to a psychiatric patient who was recently discharged from a mental health unit. During the visit, the nurse plans on clarifying when she will return for the next home visit. During which stage would the nurse discuss the next home visit with the patient?
- A. Closure stage
- B. Service implementation
- C. Greeting stage
- D. Focus establishment
Correct Answer: A
Rationale: Discussing the next visit occurs during the closure stage, as it involves wrapping up the current interaction and planning future contact. Service implementation involves care delivery, greeting establishes rapport, and focus establishment sets the session?s purpose.
A patient was admitted to the hospital after a suicide attempt made after his daughter was killed in an automobile accident during which he had been driving and survived with only minor injuries. Even though the accident was unavoidable, he feels responsible. During the assessment interview, the patient begins to describe the last conversation he had with his daughter before he lost control of the automobile. As he speaks about his daughter, his voice trembles, and a silent tear rolls down his face. He makes a visible attempt to straighten up and smiles superficially at the nurse, stating, 'I?ll get over this. I just need to keep a stiff upper lip. I think all I need to do is stay overnight. I?ll be as good as new by tomorrow.' Which response by the nurse would be most appropriate?
- A. Tell me about your daughter. How would you describe the relationship you had with her?
- B. I?m sure you are right; a good night?s rest should make a big difference.
- C. As good as new?
- D. You made a serious attempt on your life; you will not be ready go home by tomorrow.
Correct Answer: C
Rationale: The patient?s statement reflects minimization or denial of his emotional distress and suicide attempt. Using reflection, 'As good as new?' prompts the patient to explore his feelings further without judgment. Option A shifts focus prematurely, option B reinforces denial, and option D is confrontational, potentially shutting down communication.
A patient is engaged in bibliotherapy and begins to express his feelings because he closely associates his experience with that provided by the reading material. The nurse interprets this as which of the following?
- A. Insight
- B. Catharsis
- C. Anxiety reduction
- D. Problem solving
Correct Answer: B
Rationale: Bibliotherapy involves emotional release through relating to reading material. The patient?s expression of feelings indicates catharsis, the release of pent-up emotions. Insight involves understanding, anxiety reduction is a secondary effect, and problem-solving involves action planning.
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