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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: Case management is a core function in psychiatric nursing, common to both basic and advanced practice levels, as it involves coordinating care to meet patient needs. Program development, clinical supervision, and community interventions are typically advanced practice functions, requiring specialized skills or leadership roles.
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A 22-year-old patient with schizophrenia is refusing his antipsychotic medication. He states, 'I don?t like the dopey way it makes me feel. I feel like I?m walking under water when I take it.' The nurse explains to him, 'Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better.' This conversation reflects a conflict between which two types of ethical principles?
- A. Autonomy and justice
- B. Paternalism and veracity
- C. Justice and nonmaleficence
- D. Autonomy and beneficence
Correct Answer: D
Rationale: The patient?s refusal of medication reflects autonomy (self-determination), while the nurse?s insistence on medication to improve symptoms reflects beneficence (acting for the patient?s benefit). This creates an ethical conflict, as the nurse?s approach prioritizes the patient?s well-being over their right to choose. The other options do not accurately capture this dynamic: justice involves fairness, paternalism involves overriding autonomy, veracity involves truthfulness, and nonmaleficence involves avoiding harm.
In a postclinical conference, a group of students are engaged in a discussion with their instructor. The instructor repeatedly has the students analyze and evaluate the nursing interventions implemented throughout the clinical experience. The students are engaged in which of the following?
- A. Therapeutic use of self
- B. Critical thinking
- C. Interdisciplinary care
- D. Planning care
Correct Answer: B
Rationale: Critical thinking involves analyzing and evaluating information to make reasoned judgments. The instructor?s focus on having students analyze and evaluate nursing interventions aligns with this process, as it encourages reflective and evidence-based reasoning. Therapeutic use of self involves personal engagement with patients, interdisciplinary care involves collaboration with other professionals, and planning care is a specific phase of the nursing process, none of which fit as well.
When applying the biopsychosocial model to client care, the nurse integrates the psychological domain when involved with which of the following?
- A. Behavior therapy
- B. Family support
- C. Nutritional therapy
- D. Sleep hygiene measures
Correct Answer: A
Rationale: The biopsychosocial model integrates biological, psychological, and social domains. The psychological domain focuses on mental processes, emotions, and behaviors. Behavior therapy directly addresses psychological aspects by modifying maladaptive behaviors and thought patterns, making it the correct choice. Family support relates to the social domain, while nutritional therapy and sleep hygiene measures primarily address the biological domain.
A psychiatric-mental health nurse is providing care to patients with a mental illness and is investigating factors related to the patient safety, delivery of care services, and cost effectiveness. The nurse is involved with which area of professional performance?
- A. Education
- B. Quality of practice
- C. Resource utilization
- D. Collaboration
Correct Answer: B
Rationale: Investigating patient safety, care delivery, and cost-effectiveness aligns with the quality of practice, a professional performance standard focused on improving care outcomes and efficiency. Education involves knowledge development, resource utilization focuses on efficient use of resources, and collaboration involves working with others, none of which fit as directly.
The plan of care for a patient with schizophrenia identifies the following outcomes. Which of the following would the nurse identify as addressing the biologic domain? Select all that apply.
- A. Improving problem-solving skills
- B. Promoting economic stability
- C. Minimizing adverse effects of drug therapy
- D. Improving nutritional status
- E. Providing family education
Correct Answer: C,D
Rationale: The biologic domain focuses on physical health and bodily functions. Minimizing adverse effects of drug therapy (C) addresses medication-related physical outcomes, and improving nutritional status (D) focuses on physical health through diet. Improving problem-solving skills is psychological, promoting economic stability is social, and providing family education is social.