Nurse in Psychiatry Test Bank

Nurse in Psychiatry Test Bank Related

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Which patient would the nurse determine to be at highest risk for dysfunctional grief? The patient:

  • A. Whose 16-year-old daughter was raped and killed while going on an errand for the patient
  • B. Whose 86-year-old mother, with whom she has shared her home, died after a long illness.
  • C. Who attended a support group and had been assisted by hospice to care for her terminally
  • D. Who attended a bereavement group, where she learned to express feelings after the deaths of her twin daughters
Correct Answer: A

Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions.

Summary:
Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is

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What is the priority nursing diagnosis for a catatonic patient?

  • A. Ineffective coping
  • B. Impaired physical mobility
  • C. Risk for deficient fluid volume
  • D. Impaired social interaction
Correct Answer: C

Rationale: The priority nursing diagnosis for a catatonic patient is Risk for deficient fluid volume (C) because catatonic patients are at risk for dehydration due to decreased fluid intake or inability to meet fluid needs. This diagnosis takes precedence over others as dehydration can lead to serious complications. Ineffective coping (A) may be secondary to the catatonic state but addressing fluid volume is more urgent. Impaired physical mobility (B) and Impaired social interaction (D) are important but not as critical as addressing the risk of dehydration in a catatonic patient.

Which patient would the group co-leaders determine is demonstrating Yalom’s therapeutic factor termed universality?

  • A. Patient A, who states he realizes he is not the only person who has a problem with loneliness
  • B. Patient B, who displays dysfunctional interaction patterns learned in his family of origin
  • C. Patient C, who states he finally feels a strong sense of belonging
  • D. Patient D, who openly expresses his anger about his work
Correct Answer: A

Rationale: The correct answer is A because universality in Yalom's therapeutic factors refers to the recognition that one is not alone in their struggles. Patient A demonstrates this by acknowledging that others also face loneliness, fostering a sense of commonality and reducing feelings of isolation. In contrast, patient B's dysfunctional patterns do not relate to universality. Patient C's sense of belonging is related to group cohesion, not universality. Patient D's anger expression is not directly linked to recognizing shared experiences.

To plan care for a patient with a psychiatric disorder, the nurse keeps in mind that the primary nursing role related to therapeutic activities is:

  • A. Assisting the patient in accomplishing the activity
  • B. Ensuring that the patient will comply with the rules of the activity
  • C. Ensuring that the patient can accomplish the activity in a timely manner
  • D. Directing and controlling the activities to minimize patient anxiety and confusion
Correct Answer: A

Rationale: Rationale: The correct answer is A: Assisting the patient in accomplishing the activity. This is because the primary nursing role related to therapeutic activities is to support and facilitate the patient in engaging in the activity independently. By assisting the patient, the nurse promotes autonomy and empowerment, which are essential for therapeutic outcomes.

Summary:
- B: Ensuring that the patient will comply with the rules of the activity is incorrect as it focuses on compliance rather than empowering the patient.
- C: Ensuring that the patient can accomplish the activity in a timely manner is incorrect as the focus should be on the patient's ability to engage in the activity, not just the speed.
- D: Directing and controlling the activities to minimize patient anxiety and confusion is incorrect as it doesn't promote the patient's independence and may reinforce dependency.

When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?

  • A. Evidence of spasticity or flaccidity
  • B. Medications the patient has recently taken.
  • C. Level of preoccupation with somatic symptoms
  • D. The patient’s level of motor activity
Correct Answer: B

Rationale: The correct answer is B: Medications the patient has recently taken. This is crucial because certain medications can cause delirium in elderly patients. Step 1: Evaluate recent medication history. Step 2: Identify medications known to cause delirium. Step 3: Determine if the patient has taken any of these medications. Other choices are incorrect because: A: Evidence of spasticity or flaccidity is more related to neuromuscular conditions. C: Level of preoccupation with somatic symptoms is not specific to delirium assessment. D: The patient’s level of motor activity is not a key factor in distinguishing delirium from other problems.

Which response by the nurse would best assist a patient in de-escalating aggressive behavior?

  • A. "Tell me what’s going on."
  • B. "Why are you getting so upset?"
  • C. "If you throw something, you will be restrained."
  • D. "It’s time for group therapy. You can talk there."
Correct Answer: A

Rationale: The correct answer is A because it demonstrates active listening and shows empathy towards the patient, which can help them feel heard and understood. By inviting the patient to express their feelings and concerns, the nurse can help de-escalate the situation by addressing the underlying issues.

Choice B is incorrect because it may come across as confrontational and could further provoke the patient's aggression. Choice C is also incorrect as it threatens the patient with consequences, which can escalate the situation. Choice D is not appropriate as it distracts from addressing the current issue of aggression and may not be well-received by the patient in that moment.

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