Test Bank for Psychiatric Nursing: Contemporary Practice - The Psychiatric-Mental Health Nursing Process

Test Bank for Psychiatric Nursing: Contemporary Practice - The Psychiatric-Mental Health Nursing Process Related

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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.

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After teaching a group of nursing students about milieu therapy, the instructor determines that additional teaching is needed when the students identify which of the following as a key concept of milieu therapy?

  • A. Structure interaction
  • B. Open communication
  • C. Validation
  • D. De-escalation
Correct Answer: D

Rationale: Milieu therapy emphasizes a therapeutic environment with structured interaction (A), open communication (B), and validation (C) to promote healing. De-escalation (D) is a specific intervention, not a core concept of milieu therapy, indicating a need for further review.

A nurse is assisting a patient in using simple relaxation techniques. Which of the following would the nurse do first?

  • A. Have the patient assume a relaxed position.
  • B. Advise the patient to let the sensations happen.
  • C. Ensure a quiet, nondisrupting environment.
  • D. Instruct the patient to take an initial slow, deep breath.
Correct Answer: C

Rationale: Ensuring a quiet, nondisrupting environment is the first step in relaxation techniques, as it creates optimal conditions for relaxation. Positioning, allowing sensations, and deep breathing follow to facilitate the process.

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 patient was brought to the emergency department for an injury he received while working as a migrant worker. It soon becomes evident that the patient cannot speak English. A nurse on duty offers to find an interpreter so the patient can communicate with the medical staff. The nurse?s offer is an example of which type of nursing intervention?

  • A. Milieu therapy
  • B. Conflict resolution
  • C. Cultural brokering
  • D. Structured interaction
Correct Answer: C

Rationale: Cultural brokering involves facilitating communication and understanding between individuals of different cultural or linguistic backgrounds, such as securing an interpreter for a non-English-speaking patient. Milieu therapy manages the therapeutic environment, conflict resolution addresses disputes, and structured interaction is less specific.

After assessing a patient, the nurse noted the following: he was tearful, he tried to kill himself before coming into the hospital, he had no immediate plan for another suicide attempt, he was unable to concentrate, and he reported having trouble sleeping and having little or no appetite. The nurse also noted that the patient?s appearance was unkempt, that he spoke in a low monotone, and that he was unable to establish and maintain eye contact. Based on this information, which nursing diagnoses would be the most appropriate?

  • A. Ineffective Role Performance
  • B. Risk for Infection
  • C. Risk for Suicide
  • D. Risk for Self-Mutilation
Correct Answer: C

Rationale: The patient?s recent suicide attempt, tearfulness, and depressive symptoms (poor concentration, sleep issues, low appetite, unkempt appearance) indicate a high risk for suicide, making 'Risk for Suicide' the most appropriate diagnosis. Ineffective Role Performance is less immediate, and there?s no evidence for infection or self-mutilation risk.

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