Nokea
The nursing instructor is conducting a preconference with a group of nursing students on a psychiatric unit. Which statement made by a student reflects the greatest barrier to being able to provide professional care to the client who is suicidal?
- A. I just don't understand why anyone would want to kill themselves.
- B. I think suicide is wrong and selfish.
- C. I get frustrated when my client negates all the positives I try to point out.
- D. I can see how much my client is hurting inside.
Correct Answer: B
Rationale: Viewing suicide as wrong and selfish reflects a judgmental attitude, which can hinder empathetic and effective care.
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A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which nursing diagnosis has the highest priority?
- A. Hopelessness related to recent divorce.
- B. Ineffective coping related to inadequate stress management.
- C. Spiritual distress related to conflicting thoughts about suicide and sin.
- D. Risk for suicide related to a highly lethal plan.
Correct Answer: D
Rationale: The risk for suicide with a lethal plan is the highest priority, as safety is paramount in this situation.
A client asks the nurse why he has to go to therapy and cannot just take his prescribed antidepressant medication. Which would be the most therapeutic nursing intervention?
- A. Stating, 'The effects of medications will not last forever. You will need to eventually learn to function without them.'
- B. Stating, 'Medications help your brain function better, but the therapy helps you achieve lasting behavior change.'
- C. Stating, 'Both are recommended. Since your insurance covers both, that is the best plan for you.'
- D. Asking, 'Do you have reservations about going to therapy?'
Correct Answer: B
Rationale: Therapy complements medication by fostering lasting behavioral changes, addressing underlying issues.
At 1 AM, the client with mania rushes to the nurses' station and demands that the psychiatrist come to the unit now to write an order for a pass to go home. What would be the nurse's most therapeutic response?
- A. Go to the day room and wait while I call your psychiatrist.
- B. Don't be unreasonable. I can't call the psychiatrist at this time of night.
- C. I can't call the psychiatrist now, but you and I can talk about your request for a pass.
- D. You must really be upset to want a pass immediately; I'll give you some medication.
Correct Answer: C
Rationale: This response sets limits on an unreasonable demand while opening a dialogue to address the client's needs.
A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm?
- A. Immediately after a family visit
- B. On the anniversary of significant life events in the client's life
- C. During the first few days after admission
- D. Approximately 2 weeks after starting antidepressant medication
Correct Answer: D
Rationale: The risk of self-harm increases about 2 weeks after starting antidepressants, as energy improves before mood stabilizes.
A client with mania is demonstrating hypersexual behavior by blowing kisses to other clients, making suggestive remarks, and removing some articles of clothing. Which nursing intervention would be most appropriate at this time?
- A. Redirect the client to appropriate behavior.
- B. Place the client in seclusion for his or her own protection.
- C. Ignore the behavior to avoid reinforcing it.
- D. Tell the client that the behaviors have to stop right now.
Correct Answer: A
Rationale: Redirecting to appropriate behavior is effective and non-confrontational, preventing escalation of manic behavior.