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A staff nurse on a psychiatric unit knows that patients often have trouble sleeping because of their psychiatric conditions. Which of the following would reflect a psychiatric nursing intervention to appropriately address this problem?
- A. Limiting amounts of evening snacks and beverages
- B. Involving patients in a volleyball game immediately before bedtime
- C. Enforcing the rule that all patients be in bed with lights out by 10:30 PM
- D. Encouraging patients to take short naps in the afternoons
Correct Answer: A
Rationale: Correct Answer: A: Limiting amounts of evening snacks and beverages
Rationale:
1. Limiting evening snacks and beverages can help regulate patients' sleep patterns by reducing stimulants that may interfere with sleep.
2. Nutrition plays a role in sleep quality, and avoiding heavy meals close to bedtime can promote better sleep.
3. This intervention addresses a common issue in psychiatric patients without imposing strict rules or physical activity.
4. It focuses on a holistic approach to improving sleep quality by considering dietary factors.
Summary:
B: Involving patients in a volleyball game immediately before bedtime - This choice is incorrect as vigorous physical activity before bedtime can be stimulating and may disrupt sleep.
C: Enforcing the rule that all patients be in bed with lights out by 10:30 PM - This choice is incorrect as it is too rigid and may not address the underlying causes of sleep disturbances.
D: Encouraging patients to take short naps in the afternoons - This choice is incorrect as daytime
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The nurse is caring for a patient who has been under severe stress while caring for her elderly mother who is in the advanced stages of Alzheimer's disease. The nurse explains that the patient is adapting to the stress she is experiencing because of which of the following?
- A. Ability to survive in the midst of severe stress
- B. Acceptance of others'help in caring for her mother
- C. Success at being able to solve problems
- D. Capability in setting reasonable personal goals
Correct Answer: A
Rationale: Correct Answer: A: Ability to survive in the midst of severe stress
Rationale:
1. The patient is under severe stress due to caring for her mother with Alzheimer's disease.
2. Adaptation to stress involves the ability to survive and cope with challenging situations.
3. Surviving severe stress indicates the patient's resilience and ability to endure difficult circumstances.
4. This choice best reflects the patient's capacity to manage and withstand the stress she is facing.
Summary:
B: Acceptance of others' help in caring for her mother - This choice focuses on receiving help from others, which may not directly relate to the patient's ability to adapt to stress.
C: Success at being able to solve problems - While problem-solving skills are valuable, adaptation to stress goes beyond just solving problems.
D: Capability in setting reasonable personal goals - Setting goals is important but may not directly address the patient's adaptation to severe stress.
A person who has been unable to leave home for more than a week because of severe anxiety says, "I know it does not make sense, but I just can't bring myself to leave my apartment alone." Which nursing intervention is appropriate?
- A. Help the person use online video calls to provide interaction with others.
- B. Advise the person to accept the situation and use a companion.
- C. Ask the person to explain why the fear is so disabling.
- D. Teach the person to use positive self-talk techniques.
Correct Answer: D
Rationale: The correct answer is D, teaching the person to use positive self-talk techniques. This intervention is appropriate because it addresses the cognitive aspect of anxiety. By teaching the person to challenge negative thoughts and replace them with positive affirmations, they can gradually overcome their fear and build confidence in leaving the apartment. Online video calls (A) may provide temporary relief but do not address the root cause of the anxiety. Advising the person to use a companion (B) may enable avoidance of the problem rather than actively working on overcoming it. Asking the person to explain their fear (C) may not be helpful if they are already aware that it is irrational. Positive self-talk techniques empower the individual to change their mindset and behavior effectively.
While leading a group, a nurse leader says to a patient, 'This is the fourth time that you've changed the subject when we have talked about child abuse. Is something going on?' The nurse is using which technique?
- A. Support
- B. Confrontation
- C. Summarizing
- D. Clarification
Correct Answer: B
Rationale: The correct answer is B: Confrontation. In this scenario, the nurse leader directly addresses the patient's behavior of changing the subject, which is a key aspect of confrontation technique. Confrontation is used to address discrepancies or inconsistencies in a nonjudgmental manner to promote self-awareness and insight. This technique encourages the patient to explore their thoughts and behaviors.
Incorrect Choices:
A: Support - Support involves providing empathy, understanding, and validation to the patient. The nurse in the scenario is not offering support, but rather challenging the patient's behavior.
C: Summarizing - Summarizing involves restating key points to ensure understanding and facilitate communication. The nurse's statement does not summarize but rather confronts the patient's behavior.
D: Clarification - Clarification is used to ensure mutual understanding by seeking clarification on unclear statements. The nurse's statement is not seeking clarification but rather addressing a specific behavior pattern.
The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder?
- A. Providing the child with nonverbal activities
- B. Initiating conversations with the child frequently
- C. Stopping the child's conversation if stuttering begins
- D. Asking the physician for medication to improve the child's speech
Correct Answer: B
Rationale: The correct answer is B: Initiating conversations with the child frequently. This is important as it helps the child practice communication skills and improves their confidence. By engaging in regular conversations, the child gets more opportunities to develop their speech and language abilities. Option A is incorrect as solely focusing on nonverbal activities may neglect the child's speech development. Option C is incorrect as stopping the child's conversation when stuttering begins can lead to frustration and hinder progress. Option D is incorrect as medication is not typically the primary treatment for communication disorders in children.
When describing the relapse cycle to a group of families of clients experiencing co-occurring disorders, which of the following would the nurse identify as occurring first?
- A. Hospitalization
- B. Decompensation
- C. Stabilization
- D. Discharge
Correct Answer: B
Rationale: The correct answer is B: Decompensation. In the relapse cycle of co-occurring disorders, decompensation typically occurs first. Decompensation refers to a deterioration in mental health symptoms or functioning. This phase often precedes hospitalization, stabilization, and discharge. It signifies a worsening of symptoms and coping mechanisms, leading to a need for increased support and intervention. Hospitalization (choice A), stabilization (choice C), and discharge (choice D) usually occur after decompensation as steps in the treatment process to address the relapse.