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The nurse is leading a crisis intervention group comprising high school students who have experienced the recent death of a classmate who committed suicide. The students are experiencing disbelief as they review the details of the suicide. Which should be the initial therapeutic action by the nurse?
- A. Ask how the students recovered from a death event in the past.
- B. Reinforce the students' ability to work through this death event.
- C. Inquire about the students' perception of their classmate's suicide.
- D. Reinforce the students' sense of growth through this death experience.
Correct Answer: C
Rationale: It is essential to determine the students' views. Inquiring about the students' perception of the suicide will specifically identify the appraisal of the suicide and the meaning of the perception. Although option 1 is exploratory, it does not address the 'here-and-now' appraisal in terms of the classmate's suicide. Although the nurse is interested in how students have coped in the past, this inquiry should not be the most immediate assessment. Options 2 and 4 are attempts to foster students' self-esteem. Such an approach is premature at this point.
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A client with the diagnosis of mania is placed in a seclusion room after an outburst of violent behavior that involved a physical assault on another client. Which intervention should the nurse include in the plan of care before seclusion?
- A. Ask the client if she understands why the seclusion is necessary.
- B. Remain silent because verbal interaction would be too stimulating.
- C. Tell the client that she will be allowed to come out when she can behave.
- D. Inform the client that she is being secluded to help regain her self-control.
Correct Answer: D
Rationale: Seclusion is a process in which a client is placed alone in a specially designed room for protection and close supervision. This client is removed to a nonstimulating environment as a result of her behavior. Options 1, 2, and 3 are nontherapeutic actions. Additionally, option 2 implies punishment. It is best to directly inform the client of the purpose of the seclusion.
An older client is brought to the emergency department by a family member with whom the client lives. The nurse observes that the client has poor hygiene, contractures, and pressure ulcers on the sacrum, the scapula, and the heels. Based on the nurse's assessment data, the client is suspected of which form of victimization?
- A. Sexual abuse
- B. Physical abuse
- C. Emotional abuse
- D. Psychological abuse
Correct Answer: B
Rationale: Victimization in a family can take many forms. When analyzing a specific client situation, it is important to understand which form of abuse is being considered. Physical abuse can take the form of battering (hitting, slapping, striking), or it can be more subtle, such as neglect (the failure to meet basic needs). Sexual abuse can involve unwanted sexual remarks, sexual advances, and physical sexual acts. Emotional and psychological abuse can involve inflicting verbal statements that cause mental anguish or alienation of the victim.
The nurse is admitting a client with schizophrenia. The client is extremely socially withdrawn, is unable to perform activities of daily living, has an inappropriate affect, and has grimacing mannerisms. The nurse understands that this client is experiencing which type of schizophrenia?
- A. residual schizophrenia
- B. paranoid schizophrenia
- C. catatonic schizophrenia
- D. disorganized schizophrenia
- E. undifferentiated schizophrenia
Correct Answer: D
Rationale: Disorganized schizophrenia is characterized by inappropriate affect, social withdrawal, grimacing, and impaired daily functioning.
The nurse is admitting a client with schizophrenia. The client is extremely socially withdrawn, is unable to perform activities of daily living, has an inappropriate affect, and has grimacing mannerisms. The nurse understands that this client is experiencing which type of schizophrenia?
- A. residual schizophrenia
- B. paranoid schizophrenia
- C. catatonic schizophrenia
- D. disorganized schizophrenia
- E. undifferentiated schizophrenia
Correct Answer: D
Rationale: Disorganized schizophrenia is characterized by social withdrawal, inappropriate affect, grimacing, and impaired daily functioning. Residual (A) involves milder symptoms, paranoid (B) involves delusions, catatonic (C) involves motor issues, and undifferentiated (E) lacks specific features.
A nurse on the mental health unit is preparing a presentation on suicide for a group of student nurses. Which information would be included in this presentation? Select all that apply.
- A. Chronic pain or serious, disabling illness has little to no effect on suicide risk.
- B. Hispanic Americans attempt suicide at a greater rate than whites or African Americans.
- C. Suicide risk declines sharply once antidepressant medication has been taken for a few weeks.
- D. White males over the age of 80 are at the greatest risk among all age, race, and gender groups.
- E. Threatened suicide and/or gestures should be taken seriously and handled by trained professionals.
Correct Answer: D,E
Rationale: Chronic pain and serious illness increase suicide risk, making A incorrect. Data shows Hispanic Americans have lower suicide rates than whites, making B incorrect. Antidepressants may initially increase risk, making C incorrect. White males over 80 have the highest suicide rates, and all threats should be taken seriously, making D and E correct.