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Which complaint is representative of anxiety in a 6-year-old child?
- A. I worry that my dad will get hurt at work.
- B. I get a stomach ache when it's my weekend at my dad's house.
- C. I can't sleep when I stay at Grandma's because I worry about my mom.
- D. I'm not going to sports camp because I don't like being away from my friends.
Correct Answer: B
Rationale: Children often express anxiety through physical complaints like stomachaches, especially in situations that cause distress or discomfort, such as visiting a noncustodial parent.
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The community health nurse is visiting a patient diagnosed with dysfunctional grieving since the death of his wife and child over a year ago. Which actions should the nurse implement first?
- A. Promote interaction with others.
- B. Assess risk of self-directed violence.
- C. Facilitate expression of feelings related to the loss.
Correct Answer: B
Rationale: Assessing the risk of self-directed violence is the priority when dealing with a patient diagnosed with dysfunctional grieving. Individuals experiencing complicated grief may be at an increased risk for self-harm or suicidal ideation. By assessing the risk of self-directed violence first, the nurse can ensure the patient's safety and provide appropriate interventions if necessary. Once the risk is assessed and managed, the nurse can then proceed with other interventions such as promoting interaction with others and facilitating the expression of feelings related to the loss.
A patient asks the nurse manager to help resolve a situation between her and another patient. Which action would best support the patient’s feelings of safety when experimenting with new ways of being?
- A. Encouraging the patient to report the incident to the other patient’s physician
- B. Intervening on the patient’s behalf and sorting out the incident with the other patient
- C. Suggesting that the patient ignore the situation since the other patient was probably not aware of her behavior
- D. Offering to be present and help the patient discusses her feelings about the incident with the other patient
Correct Answer: D
Rationale: Offering to be present and help the patient discuss her feelings about the incident with the other patient would best support the patient’s feelings of safety when experimenting with new ways of being. This option encourages open communication between the two patients in a safe and mediated environment. It allows the patient to express her feelings assertively while feeling supported by the nurse manager. Mediation can help both patients understand each other's perspectives, resolve conflicts, and potentially prevent similar incidents in the future. Ultimately, this approach empowers the patient to address the situation directly while providing a sense of safety and support.
A patient is in a smoking cessation program that encourages self-control therapy interventions. Which intervention would the nurse suggest?
- A. Limiting smoking to certain times of the day
- B. Keeping a behavioral diary that tracks when the patient smokes
- C. Identifying factors that encouraged the patient to start smoking
- D. Making plans to spend money saved when smoking stops
Correct Answer: B
Rationale: Self-control therapy emphasizes self-monitoring to identify triggers and patterns, enabling the patient to implement strategies for behavioral change.
A novice mental health nurse shares that, “I’ll never get used to playing cards or other games with patients. It seems like a poor use of scarce nursing time.” The best response for the nurse’s mentor would be:
- A. “Perhaps you’ll want to rethink your transfer to this unit if you’re really uncomfortable.”
- B. “Your comments make a point about scarce resources. I’ll ask the treatment team to review our position on activities.”
- C. “Activity co-leadership puts us in a position to help patients develop social skills and support them as they take small risks.”
- D. “Managed care has cost us activities therapists. Activities are
Correct Answer: C
Rationale: The best response for the nurse’s mentor would be to highlight the importance of activities in mental health nursing. Participating in activities such as playing cards or games with patients is not just about passing time, but it also serves a therapeutic purpose. Engaging in activities helps patients to develop social skills, build relationships, and take small risks in a safe environment. As mental health nurses, it is crucial to understand that these activities are not a waste of time but rather an essential part of the therapeutic process. By participating in activities with patients, nurses can actively support their mental well-being and contribute to their overall treatment and recovery.
Which strategy will the nurse include in the plan of care for a 6-year-old child for whom operant conditioning has been recommended?
- A. Periodically asking the child to attempt increasingly difficult puzzles
- B. Consistently offering praiseace their dirty dishes in the sink
- C. Expecting the child to rinse and place their dirty dishes in the sink
- D. Conditioning the child to expect punishment when misbehaving
Correct Answer: B
Rationale: Operant conditioning, based on Skinner’s theory, involves reinforcing desired behaviors. Positive reinforcement (praise) encourages repetition of the behavior.