NR 607 Week 2 | Diagnosis & Management in Psychiatric Mental Health III Exam | Questions and Answers Rated A+ | Chamberlain
NR 607 Week 2 | Diagnosis & Management in Psychiatric Mental Health III Exam | Questions and Answers Rated A+ | Chamberlain
NR 607 Week 2 | Diagnosis & Management
in Psychiatric Mental Health III Exam |
Questions and Answers Rated A+ |
Chamberlain
Art is a 52-year-old who presents to the clinic for a routine follow-up
appointment. He has a history of schizophrenia with a lack of insight,
impulsivity, and previous violent behavior. As the interview begins, Art
states that he has had homicidal ideations toward his brother and
nephew. He states that the two men have "disrupted his thinking" by
"creating a new theory of family," and he is worried that the only solution
is to kill them both. Currently, Art is calm and cooperative with
disorganized thought content and fixed delusions; his appearance is
slightly disheveled. He denies substance use and does not appear
inebriated. He denies a specific plan to kill his brother and nephew and
denies access to firearms. He endorses that he stopped taking his
medications two weeks ago because he no longer needs them and does
not think he needs additional assistance at this time. Which of the
following is the most appropriate?
- Correct Answer - begin the involuntary admission process
Rationale: The most appropriate management strategy for Art is to begin
the involuntary admission process. Art has homicidal ideations and a
history of impulsivity and prior violence. He does not recognize the need
for treatment. Therefore, the process for involuntary admission should be
implemented. Consideration should also be made as to whether Art's
family should be notified of his threats. Because Art is currently calm and
cooperative, de-escalation techniques are not necessary.
Amir is a 28-year-old who was brought to the ED by law enforcement
after his mother called 911 due to his bizarre behaviors. When the police
arrived, Amir was agitated and wandering the street naked. He refused
to follow directions and became combative with officers when
,approached. He was handcuffed and transported by a squad car. Before
transfer, his mother told police that Amir had a history of schizophrenia
with treatment nonadherence and marijuana use.
During the ride to the ED, Amir was calm and cooperative. He was
transferred to a gurney in the triage area without incident, but after
transfer to an exam room, Amir began screaming and threatening the
PMHNP and staff member. Amir tried to punch and spit at them when
they approached the bedside.
Which of the following are the most appropriate management strategies
for Amir? Select all that apply.
-begin the involuntary admission process
-use de-escalation techni
- Correct Answer - -use de-escalation techniques
-request additional staff support
-medicate with intramuscular lorazepam 0.5 mg
-remove objects from the room, such as monitors, tray tables, or other
equipment, that the client may use to injure himself or others
Rationale: Amir presents a risk of harm to self and others due to his
combative behavior; therefore, the most appropriate management
strategies for Amir include the use of de-escalation techniques, request
for additional staff support, intramuscular lorazepam 0.5 mg, and the
removal of objects from the room, such as monitors, tray tables, or other
equipment, that he may use to injure himself or others. Chemical
restraint may be necessary. Additional staff should be requested to
provide support, and de-escalation techniques should be attempted.
Items the client may be used to injure himself or others should be
secured or removed. Physical restraints may be necessary and should
be applied by the emergency department team, not law enforcement.
Madison is a 30-year-old who was brought to the ED by police. She was
apprehended at a local shopping center after several drivers called the
police to report that she was shouting and making crude gestures at their
cars. Madison is alert, oriented, and cooperative; she denies any past
, medical or psychiatric history, and no medical records are found in the
system. She admits that she does not have a home, and he has been
panhandling with little success. When the emergency department
attending physician asked her to submit a blood and urine sample, she
became agitated and verbally threatened the phlebotomist. A psychiatric
consult is initiated. Which of the following are the most appropriate
management strategies for Madison? Select all that apply.
-begin the involuntary admission process
-use de-escalation techniques
-request additional staff support
-medicate with intramuscular lorazepam 0.5 mg
-remove objects from
- Correct Answer - -ask Madison if she would like a meal or snack
-use de-escalation techniques
-request additional staff support
most common psychiatric emergencies PMHNPs may encounter:
- Correct Answer - Suicide
Hailey is a 20-year-old brought to the emergency department by EMS to
evaluate a laceration. Her roommate found her sitting on their sofa with
blood streaming down her arms and a knife beside her. Her roommate
immediately called 911 and applied pressure to the wound. The triage
nurse assessed the wound as superficial. After dressing the wound, the
PMHNP was called to perform a psychiatric evaluation. On exam, she is
awake and alert but appears withdrawn and hesitant to speak. She
continues to repeat, "I don't know why this keeps happening." Hailey
denies medical or psychiatric history; the PMHNP notes bilaterally linear
scarring on her arms. Hailey admits to self-injury behaviors and states
she has been using cutting as a coping mechanism for years. She
confirms that she did not intend to kill herself today and has never
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