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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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
A psychotherapist works with an anxious, dependent patient. Which strategy is most consistent with psychoanalytic psychotherapy?
- A. Identifying the patient's strengths and assets
- B. Praising the patient for describing feelings of isolation
- C. Focusing on feelings developed by the patient toward the therapist
- D. Providing psychoeducation and emphasizing medication adherence
Correct Answer: C
Rationale: The correct answer is C because focusing on the patient's feelings developed towards the therapist is consistent with psychoanalytic therapy. This approach allows the therapist to explore transference and countertransference dynamics, which are central in understanding the patient's inner conflicts and relational patterns. By addressing these feelings, the therapist can help the patient gain insight into unresolved issues from their past that are influencing their current behavior.
Choice A is incorrect because while it can be beneficial in therapy, it is more aligned with a strengths-based or humanistic approach rather than psychoanalytic therapy. Choice B is also incorrect because praising the patient for describing feelings of isolation does not directly address the deeper unconscious processes that psychoanalytic therapy aims to explore. Choice D is incorrect because providing psychoeducation and emphasizing medication adherence are more commonly associated with cognitive-behavioral or medication-focused therapies, rather than psychoanalytic therapy.
A psychiatric-mental health nurse is working with a patient who is being treated for depression. Which patient statement would indicate that her spirituality is intact?
- A. My church friends came to visit me this past Sunday afternoon.'
- B. Nothing will ever be the same again; my life is not worth living.'
- C. I know I am as well off as I can be under the circumstances.'
- D. I know God must be punishing me for all my sins.'
Correct Answer: C
Rationale: The correct answer is C because the patient's statement reflects a sense of acceptance and inner peace despite challenging circumstances, indicating a belief in a higher power or spirituality. This indicates that her spirituality is intact.
Choice A implies social support but does not necessarily indicate spirituality. Choice B expresses hopelessness and suicidal ideation, which are not indicative of intact spirituality. Choice D reflects feelings of guilt and punishment, which do not align with a sense of spiritual well-being.
A client has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following?
- A. Expressions of concern about psychological problems
- B. Indications that parents were always in 'good health'
- C. Reports of the same symptoms repeatedly
- D. Evidence of a need for social support from her friends
Correct Answer: C
Rationale: The correct answer is C: Reports of the same symptoms repeatedly. In complex somatic symptom disorder, individuals often report persistent physical symptoms with no clear medical explanation. By repeatedly reporting the same symptoms, the client demonstrates a key characteristic of this disorder. Choices A, B, and D do not directly align with the diagnostic criteria for complex somatic symptom disorder. Expressions of concern about psychological problems (A) could indicate other mental health conditions. Indications that parents were always in 'good health' (B) and evidence of a need for social support from friends (D) are not specific to complex somatic symptom disorder.
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.