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When preparing for the first clinical experience with patients on a forensic unit at a psychiatric hospital, the nursing instructor discusses students' beliefs and fears surrounding forensic patients. The primary reason for discussing personal beliefs is to
- A. practice reflective communication skills in a role-play situation.
- B. assign the most compatible patients to the students.
- C. assess the appropriateness of the setting for implementing nursing skills.
- D. become aware of possible barriers to developing therapeutic relationships.
Correct Answer: D
Rationale: Self-awareness allows the nurse to observe, pay attention to, and understand the subtle responses and reactions of clients when interacting with them. Nurses are responsible for caring for patients in all settings and build therapeutic relationship skills regardless of personal beliefs.
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A nurse is questioning whether it is ethical to seclude a client because of loud and intrusive behavior on the unit. What is the ethical principle that will best guide the decision on appropriate use of seclusion?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Veracity
Correct Answer: A
Rationale: Autonomy refers to the person's right to self-determination and independence. Beneficence refers to one's duty to benefit or to promote good for others. Justice refers to fairness, that is, treating all people fairly and equally without regard for social or economic status, race, sex, marital status, religion, ethnicity, or cultural beliefs. Veracity is the duty to be honest or truthful.
After formulating the nursing diagnoses for a new patient, what is a nurse's next action?
- A. Designing interventions to include in the plan of care
- B. Determining the goals and outcome criteria
- C. Implementing the nursing plan of care
- D. Completing the spiritual assessment
Correct Answer: B
Rationale: The third step of the nursing process is planning and outcome identification. Outcomes cannot be determined until the nursing assessment is complete and nursing diagnoses have been formulated.
The creation of asylums during the 1800s was meant to
- A. improve treatment of mental disorders.
- B. provide food and shelter for the mentally ill.
- C. punish people with mental illness who were believed to be possessed.
- D. remove dangerous people with mental illness from the community.
Correct Answer: B
Rationale: The asylum was meant to be a safe haven with food, shelter, and humane treatment for the mentally ill. Asylums were not used to improve treatment of mental disorders or to punish mentally ill people who were believed to be possessed. The asylum was not created to remove the dangerously mentally ill from the community.
A patient in a detoxification unit asks, "What good it will do to go to Alcoholics Anonymous and talk to other people with the same problem?" The nurse's best response would be to explain that self-help groups such as AA provide opportunities for
- A. newly discharged alcoholics to learn about the disease of alcoholism.
- B. people with common problems to share their experiences with alcoholism and recovery.
- C. patients with alcoholism to receive insight-oriented treatment about the etiology of their disease.
- D. professional counselors to provide guidance to individuals recovering from alcoholism.
Correct Answer: B
Rationale: The patient needs basic information about the purpose of a self-help group. The basis of self-help groups is sharing by individuals with similar problems. Self-help is based on the belief that an individual with a problem can be truly understood and helped only by others who have the same problem. The other options fail to address this or provide incorrect information.
A patient asks the nurse what she should do about her 'cheating' husband. The nurse replies, 'You should divorce him. You deserve better than that.' The nurse used which communication technique?
- A. Giving information
- B. Verbalizing the implied
- C. Giving advice
- D. Agreeing
Correct Answer: C
Rationale: Giving advice tells the client what to do, which is nontherapeutic as it assumes the nurse knows best. Information provides facts, verbalizing the implied clarifies hints, and agreeing aligns with the client, but C overrides client autonomy.