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Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?
- A. The adolescent gives away a DVD player and a cherished autographed picture of a performer.
- B. The adolescent runs out of group therapy, swearing at the group leader, and then goes to her room.
- C. The adolescent becomes angry while speaking on the phone and slams down the receiver.
- D. The adolescent gets angry with her roommate when the roommate borrows her clothes without asking.
Correct Answer: A
Rationale: The correct answer is A because giving away cherished possessions can be a sign of preparing for suicide. This behavior may indicate a lack of concern for material possessions due to a belief that they won't be needed in the future. Choice B shows anger and isolation, not necessarily suicidal ideation. Choice C demonstrates anger but no indication of suicidal thoughts. Choice D shows anger towards the roommate, not self-harm intentions.
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Which of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?
- A. Atypical antipsychotic drugs
- B. First-generation antipsychotic drugs
- C. Third-generation antipsychotic drugs
- D. Dopamine system stabilizers
Correct Answer: B
Rationale: The correct answer is B: First-generation antipsychotic drugs. These medications primarily block dopamine receptors in the brain, leading to extrapyramidal effects such as dystonia, akathisia, parkinsonism, and tardive dyskinesia. These side effects are less common with atypical antipsychotic drugs (choice A) due to their different receptor profiles. Third-generation antipsychotic drugs (choice C) and dopamine system stabilizers (choice D) are newer classes of medications with reduced extrapyramidal effects compared to first-generation drugs. Therefore, the most likely culprit for producing extrapyramidal effects among the options provided is the first-generation antipsychotic drugs.
A nurse is caring for a dying client whose family wants to be with him in the operating suite. The surgeon, however, does not allow families to be present during surgery. The nurse recognizes this as an ethical dilemma. What is the initial step of the nurse when managing this situation?
- A. Contact the physician to amend the order for the client
- B. Document an account of the situation to ensure adequate coverage of details
- C. Consult with the medical ethics committee to determine a safe and workable solution
- D. Speak with the chief nursing officer to change the policy governing this situation
Correct Answer: A
Rationale: The correct initial step is to choose option A: Contact the physician to amend the order for the client. This is the most appropriate action because the conflict arises from the surgeon's policy, which can potentially be changed with physician involvement. By discussing the situation with the physician, the nurse can advocate for the family's wishes and potentially negotiate a compromise. This step prioritizes the client's and family's needs while also respecting the surgeon's authority. Options B, C, and D are not the initial steps because they involve escalating the situation before attempting direct communication with the physician, which can be seen as bypassing the appropriate chain of command.
A patient diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided by the center includes
- A. Medical management of symptoms
- B. Daily psychotherapy
- C. Constant staff supervision
- D. Psychological stabilization
Correct Answer: A
Rationale: The correct answer is A: Medical management of symptoms. In mild anxiety disorders, medication like SSRIs or benzodiazepines are commonly used to alleviate symptoms. Psychotherapy may be helpful but is not daily. Constant staff supervision is not necessary for mild cases. Psychological stabilization is too broad and not specific to treatment.
Which example best describes the concept of beneficence?
- A. A nurse provides pain medication for a client in the recovery room who is experiencing pain
- B. A client has an advanced directive in place stating that he does not want intubation if he needs CPR
- C. At the request of the client, a nurse does not inform the family about his cancer diagnosis
- D. A nurse withholds narcotic medication for a client in pain, knowing that he is currently disoriented
Correct Answer: A
Rationale: The correct answer is A because beneficence refers to the ethical principle of doing good and promoting the well-being of the patient. Providing pain medication to a client in the recovery room aligns with this principle as it aims to alleviate suffering and improve the client's comfort. This action demonstrates a commitment to the client's best interests and upholds the duty of care.
Choice B is incorrect because it relates to autonomy, where the client's wishes regarding medical treatment are respected. Choice C is incorrect as it violates the principle of veracity by withholding important information from the family. Choice D is incorrect as it goes against beneficence by not addressing the client's pain adequately.
A nurse is using active listening as a form of therapeutic communication when:
- A. She uses humor to put the client at ease in a situation
- B. She restates what the client said in slightly different words
- C. She uses eye contact and maintains an open stance while the client is talking
- D. She provides personal information to show the client she can relate to him
Correct Answer: C
Rationale: The correct answer is C because using eye contact and maintaining an open stance while the client is talking demonstrates active listening. Eye contact shows attentiveness and respect, while an open stance conveys empathy and receptiveness. This non-verbal communication encourages the client to feel heard and understood, fostering a therapeutic relationship.
Choice A is incorrect because using humor may not always align with the client's feelings or be perceived as appropriate. Choice B is incorrect as restating what the client said is a form of paraphrasing, not active listening. Choice D is incorrect because providing personal information can shift the focus away from the client's needs and may breach professional boundaries.