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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.
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When applying the biopsychosocial model for a patient with a mental health problem, the nurse addresses the psychological domain when assessing which of the following?
- A. Sleep patterns
- B. Feelings
- C. Family functioning
- D. Cultural groups
Correct Answer: B
Rationale: The correct answer is B: Feelings. In the biopsychosocial model, the psychological domain focuses on the individual's emotions, thoughts, and behaviors. Assessing feelings allows the nurse to understand the patient's mental and emotional state, which is crucial in mental health care. Sleep patterns (A) fall under the biological domain, family functioning (C) falls under the social domain, and cultural groups (D) relate to the social and cultural aspects, not specifically the psychological domain. By assessing feelings, the nurse can gain insight into the patient's mental health and tailor interventions accordingly.
A nursing instructor is preparing a class about rural cultures and the influence on mental health problems. Which of the following would the instructor include as impacting the use of mental health services for this group? Select all that apply.
- A. Limited access to care
- B. Lack of available resources
- C. Geographical similarities
- D. Diverse cultural groups
Correct Answer: A
Rationale: The correct answer is A: Limited access to care. Rural cultures often face barriers such as distance to healthcare facilities, shortage of mental health professionals, and lack of transportation. This limits their ability to access mental health services. Choice B is incorrect as lack of resources usually refers to financial resources, not necessarily availability of mental health services. Choice C is incorrect as geographical similarities do not directly impact the use of mental health services. Choice D is incorrect as diverse cultural groups may actually contribute to a greater awareness and acceptance of mental health services within rural cultures.
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.
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 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: The correct answer is A: Case management. This is common to both basic and advanced level practice for psychiatric nurses because it involves coordinating care, advocating for patients, and ensuring continuity of services. Basic level nurses may handle simpler cases, while advanced level nurses may manage more complex cases.
Choice B: Program development may be more common in advanced practice where nurses may be involved in creating new programs or services.
Choice C: Clinical supervision is typically a responsibility of advanced practice nurses who oversee and guide other staff members.
Choice D: Community interventions may also be more common in advanced practice where nurses may lead community-based initiatives.