Nokea
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: Limiting evening snacks and beverages, especially those with caffeine, promotes sleep hygiene by reducing stimulants and bladder disturbances, addressing sleep issues common in psychiatric conditions. Volleyball before bed may increase arousal, enforcing bedtime is rigid and non-therapeutic, and naps can disrupt nighttime sleep.
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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.
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.
During assessment, the nurse asks a patient to explain what the following means: 'A penny saved is a penny earned.' The nurse is assessing which of the following?
- A. Affect
- B. Attention
- C. Concentration
- D. Abstract reasoning
Correct Answer: D
Rationale: Interpreting proverbs like 'A penny saved is a penny earned' requires abstract reasoning, the ability to understand and analyze abstract concepts. Affect involves emotional expression, attention is focus, and concentration is sustained mental effort.
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.
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.