Nokea
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.
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Which of the following questions would be most helpful in beginning an initial assessment interview for a patient who has just been admitted to a psychiatric inpatient unit?
- A. Have you had any previous psychiatric admissions?
- B. What brings you into the hospital today?
- C. Have you had any thoughts about trying to harm yourself?
- D. How would you describe your relationship with your spouse?
Correct Answer: B
Rationale: The initial assessment interview aims to establish rapport and understand the patient?s primary reason for admission. Asking 'What brings you into the hospital today?' is open-ended, patient-centered, and elicits the patient?s perception of their problem, setting the stage for further assessment. Previous admissions, suicidal thoughts, and relationships are important but secondary to understanding the current reason for admission.
A home health nurse is making a home visit to a psychiatric patient who was recently discharged from a mental health unit. During the visit, the nurse plans on clarifying when she will return for the next home visit. During which stage would the nurse discuss the next home visit with the patient?
- A. Closure stage
- B. Service implementation
- C. Greeting stage
- D. Focus establishment
Correct Answer: A
Rationale: Discussing the next visit occurs during the closure stage, as it involves wrapping up the current interaction and planning future contact. Service implementation involves care delivery, greeting establishes rapport, and focus establishment sets the session?s purpose.
Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome?
- A. Discusses feelings about not being able to fall asleep
- B. Reports feeling rested on awakening in the morning within 3 days
- C. Requests sleeping medication each night before bedtime
- D. Is able to sleep for short intervals throughout the night
Correct Answer: B
Rationale: The goal of teaching relaxation techniques is to improve sleep quality. 'Reports feeling rested on awakening in the morning within 3 days' directly indicates effective sleep, aligning with the intervention?s purpose. Discussing feelings, requesting medication, or short sleep intervals do not confirm improved sleep quality.
A group of nursing students are reviewing information about counseling interventions. The students demonstrate a need for additional review when they identify counseling interventions as involving which of the following?
- A. Specific, time-limited intervention
- B. Focus on coping improvement
- C. Goal of regaining functional abilities
- D. Prevention of disability
Correct Answer: A
Rationale: Counseling interventions focus on improving coping (B), regaining function (C), and preventing disability (D), but they are not always specific or time-limited (A), as they may be ongoing or flexible. Identifying A as a key feature indicates misunderstanding.
The nurse is reviewing the drawing that a patient completed as a self-portrait. The nurse observes that the drawing lacks arms and feet. The nurse interprets this as indicating which of the following? Select all that apply.
- A. Low self-esteem
- B. Powerlessness
- C. Insecurity
- D. Inadequacy
Correct Answer: A,B,C,D
Rationale: In psychiatric art assessment, missing body parts like arms and feet can indicate low self-esteem (A), powerlessness (B), insecurity (C), and inadequacy (D), reflecting feelings of incompleteness or diminished self-worth. All apply based on standard interpretations.