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When applying the biopsychosocial model for a patient with a mental health problem, the nurse addresses the psychological domain when assessing which of the following?
- A. Sleep patterns
- B. Feelings
- C. Family functioning
- D. Cultural groups
Correct Answer: B
Rationale: The correct answer is B: Feelings. In the biopsychosocial model, the psychological domain focuses on the individual's emotions, thoughts, and behaviors. Assessing feelings allows the nurse to understand the patient's mental and emotional state, which is crucial in mental health care. Sleep patterns (A) fall under the biological domain, family functioning (C) falls under the social domain, and cultural groups (D) relate to the social and cultural aspects, not specifically the psychological domain. By assessing feelings, the nurse can gain insight into the patient's mental health and tailor interventions accordingly.
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A psychiatric-mental health nurse determines that a patient is competent when he is able to do which of the following?
- A. Speak coherent English.
- B. Communicate his or her choices.
- C. Write a `living will.
- D. Comply with the medical regimen.
Correct Answer: B
Rationale: The correct answer is B because competency involves the ability to communicate one's choices. Competency is determined by the patient's capacity to understand information, make reasoned decisions, and communicate preferences. This enables the patient to actively participate in their healthcare decisions. Choices A, C, and D are incorrect because speaking coherent English, writing a living will, and complying with a medical regimen do not solely demonstrate competency in decision-making and communication of choices. These actions may be important but do not encompass the full scope of competency in the context of psychiatric-mental health nursing.
A psychiatric-mental health nurse is documenting information in a patient’s medical record. Which of the following would be least likely to increase the nurse’s legal liability?
- A. `Patient reported that he was feeling better today than yesterday.
- B. `Administered haloperidol 10 mg IM stat as ordered for agitation.
- C. `Patient was talking with another staff member and started screaming.
- D. `Applied restraints to all four patient extremities.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Patient's self-report of feeling better is subjective and reflects the patient's perception, not the nurse's actions or decisions.
2. This documentation does not involve any direct intervention or action by the nurse, hence reducing legal liability.
3. It reflects positive progress in the patient's condition, which is generally a favorable indicator in psychiatric care.
4. It does not raise concerns about potential adverse outcomes or deviations from standard practice.
Summary:
- Choice A is least likely to increase legal liability as it is a subjective report by the patient.
- Choices B, C, and D involve direct actions or interventions by the nurse that could have legal implications and potential risks to patient safety.
A nurse is demonstrating behaviors that the treatment team is attempting to get the patient to develop. The nurse is integrating which theory?
- A. Erikson’s model of psychosocial development
- B. Albert Bandura’s social cognitive theory
- C. Skinner’s operant conditioning
- D. Freud’s psychoanalytic model
Correct Answer: B
Rationale: The correct answer is B: Albert Bandura's social cognitive theory. The nurse is integrating this theory by demonstrating behaviors for the patient to develop through observational learning and modeling. Bandura's theory emphasizes that individuals learn by observing others and imitating their behaviors. The treatment team is likely using this approach to encourage the patient to adopt positive behaviors by showcasing them through the nurse's actions.
Incorrect Choices:
A: Erikson’s model of psychosocial development - This theory focuses on stages of psychosocial development and identity formation, not on observational learning or modeling.
C: Skinner’s operant conditioning - This theory revolves around reinforcement and punishment to shape behavior, which is different from the observational learning emphasized in the scenario.
D: Freud’s psychoanalytic model - This theory is based on unconscious processes and early childhood experiences, not on observational learning and modeling as seen in the nurse's behavior.
A psychiatric-mental health nurse is providing care to a patient who has recently emigrated to the United States from Eastern Europe. Which of the following would be least effective in providing culturally competent care?
- A. Demonstrating a genuine interest in the patient
- B. Avoiding assumptions about the patient’s culture
- C. Speaking to the patient in his native language.
- D. Acquiring information about the patient’s country
Correct Answer: C
Rationale: The correct answer is C because speaking to the patient in his native language may not always guarantee effective communication. The patient may have acculturated to English and prefer to communicate in English. It is important to assess the patient's language preference first. Demonstrating genuine interest (A) is important for building trust. Avoiding assumptions (B) helps prevent stereotyping. Acquiring information about the patient's country (D) can enhance understanding of the patient's background.
A group of students are reviewing the multiaxial diagnostic system of the DSM-IV- TR. The students demonstrate understanding of the axes when they identify that each axis represents which of the following?
- A. An evidence-based research finding
- B. An experimental design to guide care
- C. A domain of information
- D. A laboratory test finding
Correct Answer: C
Rationale: The correct answer is C: A domain of information. The multiaxial diagnostic system of the DSM-IV-TR includes five axes, each representing a different domain of information about an individual's mental health. Axis I is for clinical disorders, Axis II is for personality disorders and intellectual disabilities, Axis III is for general medical conditions, Axis IV is for psychosocial and environmental stressors, and Axis V is for global assessment of functioning. Therefore, each axis represents a distinct category or domain of information rather than an evidence-based research finding (A), an experimental design (B), or a laboratory test finding (D). The axes serve to provide a comprehensive and holistic assessment of an individual's mental health status.