Nokea
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.
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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.
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.
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.
The nurse is determining the success of a patient?s plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time?
- A. On the day of discharge
- B. During the assessment process
- C. At the initial interview
- D. With goal-setting process
Correct Answer: D
Rationale: Outcome indicators are specific, measurable criteria established during the goal-setting process in the nursing plan of care. This occurs after assessment and diagnosis, aligning interventions with desired outcomes. Discharge, assessment, and initial interviews precede or inform goal-setting.
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.