MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient living in the community and diagnosed with serious and persistent mental illness? Within 3 months, the patient w
...
MULTIPLE CHOICE
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient living in the community and diagnosed with serious and persistent mental illness? Within 3 months, the patient will:
a. deny suicidal ideation.
b. report a sense of well-being.
c. take medications as prescribed.
d. attend clinic appointments on time. ANS: B
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving role performance. The goal of recovery is to empower the individual with mental illness to achieve a sense of meaning and satisfaction in life and to function at the highest possible level of wellness. The incorrect options focus on the classic medical model rather than recovery.
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurses most caring comment.
a. Lets discuss some means of coping other than suicide when you have these feelings.
b. I understand why youre so depressed. When I got divorced, I was devastated too.
c. You should forget about your marriage and move on with your life.
d. How did you get so depressed that hospitalization was necessary? ANS: A
The nurses communication should evidence caring and a commitment to work with the patient. This commitment lets the patient know the nurse will help. Probing and advice are not helpful or therapeutic interventions.
3. In the shift-change report, an off-going nurse criticizes a patient who wears heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
a. This is a psychiatric hospital. Craziness is what we are all about.
b. Lets all show acceptance of this patient by wearing lots of makeup too.
c. Your comments are inconsiderate and inappropriate. Keep the report objective.
d. Our patients need our help to learn behaviors that will help them get along in society. ANS: D
Accepting patients needs for self-expression and seeking to teach skills that will contribute to their well-being demonstrate respect and are important parts of advocacy. The on-coming nurse needs to take action to ensure that others are not prejudiced against the patient. Humor can be appropriate within the privacy of a shift report but not at the expense of respect for patients.
Judging the off-going nurse in a critical way will create conflict. Nurses must show compassion for each other.
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which statement is an example of attending?
a. We all have stress in life. Being in a psychiatric hospital isnt the end of the world.
b. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
c. You will feel better after we get some antidepressant medication started for you.
d. Id like to sit with you a while so you may feel more comfortable talking with me. ANS: D
Attending is a technique that demonstrates the nurses commitment to the relationship and reduces feelings of isolation. This technique shows respect for the patient and demonstrates caring. Generalizations, probing, and false reassurances are non-therapeutic.
5. A patient shows the nurse an article from the Internet about a health problem. Which characteristic of the web sites address most alerts the nurse that the site may have biased and prejudiced information?
a. Address ends in .org.
b. Address ends in .com.
c. Address ends in .gov.
d. Address ends in .net. ANS: B
Financial influences on a site are a clue that the information may be biased. .com at the end of the address indicates that the site is a commercial one. .gov indicates that the site is maintained by a government entity. .org indicates that the site is nonproprietary; the site may or may not have reliable information, but it does not profit from its activities. .net can have multiple
meanings.
6. A nurse says, When I was in school, I learned to call upset patients by name to get their attention; however, I read a descriptive research study that says that this approach does not work. I plan to stop calling patients by name. Which statement is the best appraisal of this nurses comment?
a. One descriptive research study rarely provides enough evidence to change practice.
b. Staff nurses apply new research findings only with the help from clinical nurse specialists.
c. New research findings should be incorporated into clinical algorithms before using them in practice.
d. The nurse misinterpreted the results of the study. Classic tenets of practice do not change. ANS: A
Descriptive research findings provide evidence for practice but must be viewed in relation to other studies before practice changes. One study is not enough. Descriptive studies are low on the hierarchy of evidence. Clinical algorithms use flow charts to manage problems and do not specify one response to a clinical problem. Classic tenets of practice should change as research findings provide evidence for change.
7. Two nursing students discuss career plans after graduation. One student wants to enter psychiatric nursing. The other student asks, Why would you want to be a psychiatric nurse? All they do is talk. You will lose your skills. Select the best response by the student interested in psychiatric nursing.
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be better because of the nature of patients problems.
b. Psychiatric nurses use complex communication skills, as well as critical thinking, to solve multidimensional problems. Im challenged by those situations.
c. I think I will be good in the mental health field. I do not like clinical rotations in school, so I do not want to continue them after I graduate.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical surgical nurses. That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical surgical nursing, although substantial overlap does exist. Psychiatric nurses must be able to help patients with medical and mental health problems, reflecting the holistic perspective these nurses must have.
Nurse-patient ratios and workloads in psychiatric settings have increased, similar to other specialties. Psychiatric nursing involves clinical practice, not simply documentation.
Psychosocial pain is real and can cause as much suffering as physical pain.
8. Which research evidence would most influence a group of nurses to change their practice?
a. Expert committee report of recommendations for practice
b. Systematic review of randomized controlled trials
c. Nonexperimental descriptive study
d. Critical pathway ANS: B
Research findings are graded using a hierarchy of evidence. A systematic review of randomized controlled trials is Level A and provides the strongest evidence for changing practice. Expert committee recommendations and descriptive studies lend less powerful and influential evidence. A critical pathway is not evidence; it incorporates research findings after they have been analyzed.
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