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Which statement demonstrates the effective implementation of evidence-based practice guidelines?
- A. A nurse explains that, 'Negative responses to suicidal ideation assessments are documented on each client diagnosed with depression at least once a shift.'
- B. A family member states that, 'My mother has been introduced to an antipsychotic medication that has significantly decreased her paranoia.'
- C. A nursing assistant's comment that, 'Working here is a very rewarding job since I can help those who are really in need.'
- D. A client reports, 'I'm so happy I was admitted to this mental health unit because they really care about me here.'
Correct Answer: A
Rationale: The correct answer is A because it demonstrates the systematic and consistent implementation of evidence-based practice guidelines in documenting negative responses to suicidal ideation assessments for clients diagnosed with depression. This approach ensures that crucial information is captured regularly, aiding in monitoring and managing the clients' mental health effectively.
Choice B focuses on the outcome of a specific treatment but does not directly address the implementation of evidence-based practice guidelines. Choice C expresses personal satisfaction rather than adherence to guidelines. Choice D reflects the client's subjective opinion and does not provide evidence of following specific guidelines. Thus, A is the correct choice as it directly relates to evidence-based practice implementation.
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A survivor of physical spousal abuse was treated in the emergency department for a broken wrist. This patient said, Ive considered leaving, but I made a vow and I must keep it no matter what happens. Which outcome should be met before discharge? The patient will:
- A. facilitate counseling for the abuser.
- B. name two community resources for help.
- C. demonstrate insight into the abusive relationship.
- D. reexamine cultural beliefs about marital commitment.
Correct Answer: B
Rationale: The only outcome indicator clearly attainable within this time is for staff to provide the victim with information about community resources that can be contacted. Development of insight into the abusive relationship and reexamining cultural beliefs will require time. Securing a restraining order can be accomplished quickly but not while the patient is in the emergency department. Facilitating the abusers counseling may require weeks or months.
The theorist who believes in developmental crises is
- A. Sigmund Freud
- B. Carl Rogers
- C. Abraham Maslow
- D. Erik Erikson
Correct Answer: D
Rationale: Erikson's stages feature developmental crises.
When working with a patient beginning treatment for alcohol dependence, what is the nurse’s most therapeutic approach?
- A. Empathetic, supportive
- B. Strong, confrontational
- C. Skeptical, guarded
- D. Cool, distant
Correct Answer: A
Rationale: The correct answer is A: Empathetic, supportive. This approach establishes trust, shows understanding, and promotes open communication. Empathy helps build a therapeutic relationship, which is crucial in treating alcohol dependence. Being supportive encourages the patient to feel safe and willing to discuss their issues. Strong, confrontational (B) may lead to resistance and defensiveness. Skeptical, guarded (C) can create barriers and hinder progress. Cool, distant (D) may make the patient feel isolated and unsupported. Overall, empathy and support create a positive and collaborative therapeutic environment.
Which client has met the criteria for psychiatric homebound care?
- A. A 67-year-old retired teacher who has been depressed since the death of his longtime partner
- B. A 21-year-old diagnosed with paranoid schizophrenia who has delusions that the world is about to end
- C. A 45-year-old who, for the last 5 years, has experienced severe panic attacks whenever she attempts to leave her home
- D. A 16-year-old who has demonstrated obsessive-compulsive behaviors involving cleaning rituals since she was 10 years old
Correct Answer: C
Rationale: The correct answer is C because the client meets the criteria for psychiatric homebound care by experiencing severe panic attacks when trying to leave the home. This indicates significant impairment in functioning outside the home.
Explanation:
1. Criterion met: The client's severe panic attacks prevent her from leaving the home, indicating a need for care within the home environment.
2. Impairment in functioning: The client's panic attacks significantly impact her ability to engage in daily activities outside the home.
3. Duration of symptoms: The client has experienced these severe panic attacks for the last 5 years, indicating a chronic and persistent condition.
Summary of other choices:
A: Depression alone does not necessarily warrant psychiatric homebound care.
B: Delusions related to paranoid schizophrenia do not inherently restrict the client to homebound care.
D: Obsessive-compulsive behaviors, while impactful, do not specifically require homebound care unless they severely impair functioning outside the home.
A patient with HIV asks the nurse if thinking about dying frequently is common with HIV. What is an appropriate response by the nurse?
- A. HIV is a serious disease that results in death.'
- B. Thinking about death will not change the prognosis.'
- C. HIV is now considered a chronic disease with treatment.'
- D. HIV has a very high mortality rate, so it is realistic to plan for death.'
Correct Answer: C
Rationale: Rationale for Correct Answer C:
1. HIV is now considered a chronic disease with treatment, meaning many individuals can live long and healthy lives with proper medical care.
2. By informing the patient that HIV is a chronic disease, the nurse can provide reassurance and hope.
3. Acknowledging the patient's concerns while highlighting the positive advancements in HIV care can help alleviate anxiety and provide comfort.
Summary of Incorrect Choices:
A: This answer instills fear without providing accurate information about the current state of HIV treatment.
B: This answer dismisses the patient's concerns and does not offer any constructive information or support.
D: This answer is misleading as HIV mortality rates have significantly decreased with advancements in treatment, and planning for death should not be the primary focus for individuals living with HIV.