Nokea
Johnny is twelve-year-old boy who has had an increase in aggressive behaviors, picking fights with other students at his school. Johnny's mother calls his doctor's office to ask if there is medication to help decrease these behaviors. After gathering more information about the recent increase in Johnny's outbursts, what is the best response from the nurse?
- A. Allow more freedom at home as that may be adding to his outbursts.'
- B. Medication may not be indicated right away; there are other options.'
- C. Tell Johnny that his behavior is unacceptable.'
- D. Allow Johnny to skip school if he is having a difficult time being there.'
Correct Answer: B
Rationale: The correct answer is B: Medication may not be indicated right away; there are other options.
Rationale:
1. Medication should not be the first line of intervention for behavior issues in children.
2. It is important to explore other options such as therapy, counseling, behavior modification techniques.
3. Understanding the root cause of Johnny's behavior is crucial before considering medication.
4. Rushing into medication without exploring other avenues may not address the underlying issues.
Summary:
A: Allowing more freedom at home could potentially worsen Johnny's behavior by reinforcing the negative actions.
C: Telling Johnny his behavior is unacceptable without addressing the underlying cause may not effectively reduce his aggression.
D: Allowing Johnny to skip school is not a solution; addressing the behavior and providing appropriate support is essential.
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Taylor, a psychiatric registered nurse, orients Regina, a patient with anorexia nervosa, to the room where she will be assigned during her stay. After getting Regina settled, the nurse informs Regina:
- A. I need to go through the belongings you have brought with you.
- B. You can use the scale in the back room when you need to.
- C. You will be eating five times a day here.
- D. The daily structure is based around your desire to eat.
Correct Answer: A
Rationale: The correct answer is A because as a psychiatric nurse, it is important to ensure the safety of the patient, especially those with anorexia nervosa who may have harmful items in their belongings. Going through the patient's belongings allows the nurse to assess and remove any potential risks. This action aligns with the duty of care and ensures the patient's well-being.
Choice B is incorrect because using a scale can trigger anxiety and reinforce unhealthy behaviors related to weight monitoring in patients with anorexia nervosa. Choice C is incorrect as stating a specific number of meals may not be suitable for every individual and could create unnecessary pressure on the patient. Choice D is incorrect because the structure of care should be based on evidence-based practices and clinical guidelines, not solely on the patient’s desire to eat.
A client on a psychiatric unit is telling the nurse about anger toward the airline after losing an only child in a plane crash. In which situation is the nurse demonstrating active listening?
- A. Agreeing with the client.
- B. Repeating everything that the client says to clarify.
- C. Assuming a relaxed posture and leaning toward the client.
- D. Expressing sorrow and sadness regarding the client's loss.
Correct Answer: C
Rationale: The correct answer is C because assuming a relaxed posture and leaning toward the client demonstrates active listening by showing empathy and interest in what the client is saying. This nonverbal behavior encourages the client to continue expressing their feelings.
A: Agreeing with the client can shut down communication and invalidate the client's emotions.
B: Repeating everything the client says may come across as robotic and not conducive to building rapport.
D: Expressing sorrow and sadness, while empathetic, may shift the focus from the client to the nurse's emotions.
In summary, actively listening involves nonverbal cues that show understanding and support without interjecting personal opinions or emotions.
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.
In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states,"The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted?
- A. Long-term, inpatient facility.
- B. Day treatment.
- C. Short-term, inpatient, locked unit.
- D. Psychiatric case management.
Correct Answer: C
Rationale: The correct answer is C: Short-term, inpatient, locked unit. This setting is appropriate because the client is exhibiting acute symptoms of aggression and auditory hallucinations, indicating a need for close monitoring and safety precautions in a secure environment. Long-term inpatient facility (choice A) is not suitable for acute episodes. Day treatment (choice B) may not provide the level of supervision needed. Psychiatric case management (choice D) focuses on community-based care, not acute inpatient care. Therefore, choice C is the most appropriate for managing the client's current symptoms.
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.