Which outcome, focused on recovery, would be expected in the plan of care for a patient living
in the community 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. - 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.
A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce.
Select the nurse's most caring comment.
a. "Let's discuss some means of coping other than suicide when you have these feelings."
b. "I understand why you're 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?" - 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.
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. "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." - 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.
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."
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. "I'd like to sit with you a while so you may feel more comfortable talking with me." - D
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 nontherapeutic.
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 ".org."
b. Address ends in ".com."
c. Address ends in ".gov."
d. Address ends in ".net." - 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.
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.
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. - 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.
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?
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