Nokea
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.
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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.
Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome?
- A. Discusses feelings about not being able to fall asleep
- B. Reports feeling rested on awakening in the morning within 3 days
- C. Requests sleeping medication each night before bedtime
- D. Is able to sleep for short intervals throughout the night
Correct Answer: B
Rationale: The goal of teaching relaxation techniques is to improve sleep quality. 'Reports feeling rested on awakening in the morning within 3 days' directly indicates effective sleep, aligning with the intervention?s purpose. Discussing feelings, requesting medication, or short sleep intervals do not confirm improved sleep quality.
The nurse is reviewing the assessment data of a patient diagnosed with a mental illness. The patient is to be prescribed medication to treat the illness. The nurse would identify changes in which laboratory values as being the least significant?
- A. Hemoglobin
- B. Alanine aminotransferase (ALT)
- C. Blood urea nitrogen (BUN) level
- D. Serum creatinine
Correct Answer: A
Rationale: Hemoglobin levels, related to oxygen-carrying capacity, are less directly relevant to psychiatric medication management compared to liver function (ALT) and kidney function (BUN, creatinine), which affect drug metabolism and excretion. Abnormal hemoglobin may indicate anemia but is less critical for psychotropic drugs.
Which of the following questions would be most helpful in beginning an initial assessment interview for a patient who has just been admitted to a psychiatric inpatient unit?
- A. Have you had any previous psychiatric admissions?
- B. What brings you into the hospital today?
- C. Have you had any thoughts about trying to harm yourself?
- D. How would you describe your relationship with your spouse?
Correct Answer: B
Rationale: The initial assessment interview aims to establish rapport and understand the patient?s primary reason for admission. Asking 'What brings you into the hospital today?' is open-ended, patient-centered, and elicits the patient?s perception of their problem, setting the stage for further assessment. Previous admissions, suicidal thoughts, and relationships are important but secondary to understanding the current reason for admission.
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.