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. DIF: Cognitive Level: Application REF: Pages: 2-3 TOP: Nursing Process: Outcomes Identification MASC.: UNCLE: Health Promotion and Maintenance 2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurse’s most caring comment. . “Let’s discuss some means of coping other than suicide when you have these feelings. B. “l understand why you’re so depressed. When I got divorced, I was devastated too. ” c. Muff should forget about your marriage and move on with your life. ” d. “How did you get so depressed that hospitalizing was necessary? ” NAS: A The nurse’s 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.
DIE Top: 3. Cognitive Level: Application REF: Pages: 6-8 Nursing Process: Implementation MASC.: UNCLE: Psychosocial Integrity 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. “Let’s all show acceptance of this patient by wearing lots of makeup too. ” c. Mirror 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. ” NAS: D Accepting patients’ needs for self-expression and seeking to teach skills that will intricate 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.
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DIF: Cognitive Level: Application REF: Page: 8 TOP: Nursing Process: Implementation MASC.: UNCLE: Safe, Effective Care Environment 4. A nurse assesses a newly admitted patient with depression. Which statement is an example of “attending”? A. “We all have stress in life. Being in a psychiatric hospital isn’t the end of the world. ” “Tell me why you felt you had to be hospitalized to receive treatment for your depression. ” c. Mimi will feel better after we get some antidepressant medication started for you. ” d. “I’d like to sit with you a while so you may feel more comfortable talking with me. Attending is a technique that demonstrates the nurse’s 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 anthropocentric. DIF: Cognitive Level: Application REF: TOP: Nursing Process: Implementation Page: 8 MASC.: UNCLE: Psychosocial Integrity 5. A patient shows the nurse an article from the Internet about a health problem. Which characteristic of the web site’s address most alerts the nurse that the site may have biased and prejudiced information? A. Address ends in “. Erg Address ends in “. Com. ” Address ends in Address ends in “. Net. ” Financial influences on a site are a clue that the information may be biased. “. Com” at he end of the address indicates that the site is a commercial one. “. Gob’ indicates that the site is maintained by a government entity. “. Org” indicates that the site is nonparametric; the site may or may not have reliable information, but it does not profit from its activities. “. Net” can have multiple meanings. DIF: Cognitive Level: Comprehension REF: Page: 5 TOP: Nursing Process: Evaluation MASC.: UNCLE: Health Promotion and Maintenance 6.
A nurse says, “When I was in school I learned to call upset patients by name to get their attention, but I read a descriptive research study that says that this approach doesn’t work. I’m going stop calling patients by name. ” Which statement is the best appraisal of this nurse’s comment? A. One descriptive research study rarely provides enough evidence to change practice. 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. Descriptive research findings provide evidence for practice but must be viewed in elation 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 DIF: Cognitive Level: Analysis REF: Pages: 3-4 TOP: Nursing Process: Evaluation 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’ll 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.
I’m challenged by those situations. ” c. “l think I’ll be good in the mental health field. I do not like clinical rotations in school, so I don’t want to continue them after I graduate. D. “Psychiatric nurses don’t have to deal with as much pain and suffering as medical surgical nurses. That appeals to me. ” 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. DIF: Cognitive Level: Application REF: Page: 3 8. Which research evidence would most influence a group of nurses to change their practice? A. Expert committee report of recommendations for practice Systematic review of randomized controlled trials Nongovernmental descriptive study Critical pathway 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. DIF: Cognitive Level: Application REF: Pages: 4-6 TOP: Nursing Process: Analysis MASC.: UNCLE: Safe, Effective Care Environment 9. A bill introduced in Congress would reduce funding for the care of people with mental illnesses. A group of nurses write letters to their elected representatives in opposition to the legislation.
Which role have the nurses fulfilled? A. Advocacy Attending Recovery Evidence-based practice An advocate defends or asserts another’s cause, particularly when the other person lacks the ability to do that for him- or herself. Examples of individual advocacy include helping patients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the individuals with mental illness; the letter-writing campaign advocates for that cause on behalf of patients who are unable to articulate their own needs.
DIF: Cognitive Level: Comprehension REF: Page: 8 0. An informal group of patients discuss their perceptions of nursing care. Which comment best indicates a patient’s perception that his or her nurse is caring? “My nurse always asks me which type of Juice I want to help me swallow my medication. ” b. “My nurse explained my treatment plan to me and asked for my ideas about how to make it better. ” c. “My nurse told me that if I take all the medicines the doctor prescribes I will get discharged soon. ” d. “My nurse spends time listening to me talk about my problems. That helps me feel like I’m not alone. Caring evidences empathic understanding, as well as competency. It helps change pain and suffering into a shared experience, creating a human connection that alleviates feelings of isolation. The remaining options give examples of statements that demonstrate advocacy or giving advice. DIF: Cognitive Level: Application REF: Pages: 3-41 Page: 8 TOP: Nursing Process: Evaluation MASC.: UNCLE: Psychosocial Integrity 1 1 . A patient who immigrated to the United States from Honduras was diagnosed with schizophrenia. The patient took an antispasmodic medication for 3 weeks but showed no improvement.
Which resource should the treatment team consult for information on more effective medications for this patient? A. Clinical algorithm Clinical pathway Clinical practice guideline International Statistical Classification of Diseases and Related Health Problems (ACID) A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches drawn from large databases of information. These guidelines help the treatment team make decisions cognizant of an individual patient’s needs, such as ethnic origin, age, or gender. A clinical pathway is a map of interventions and reattempts related to a specific disorder.
Clinical practice guidelines summarize best practices about specific health problems. The ACID classifies diseases. DIF: Cognitive Level: Application REF: Page: 6 TOP: Nursing Process: Evaluation 12. Which historical nursing leader helped focus practice to recognize the importance of science in psychiatric nursing? A. Abraham Moscow Hildebrand Appeal Kuris Martinets Harriet Bailey Although all these leaders included science as an important component of practice, Hildebrand Appeal most influenced its development in psychiatric nursing.