PMHN Practice Questions PMHNP

A rape victim with multiple injuries has been brought to the emergency depart- ment for evaluation and treatment. The first thing that the psychiatric and mental health nurse should communicate is: A. I'm so sorry this happened to you B.You are safe here. No one can hurt you C.This was not your fault D. I'm thankful you survived this attack A patient has signed the consent form for electroconvulsive therapy under pres- sure from her spouse but confides in the psychiatric and mental health nurse that she does not want the treatment and is terrified but afraid to stand up to her spouse. The psychiatric and mental health nurse should: A. ask the patient if she wants to rescind the consent form. B. tell the patient that she must tell her spouse she does not want the treatment. C.Tell the patient she must go through the treatment since she singed the con- sent. D. notify the physician of the patient's feelings about the treatment. Answer:B.You are safe here. No one can hurt you. Rationale:Patients who have been raped are often severely traumatized emotion- ally as well as physically and are com- monly very fearful and panicked, so the first thing that the mental health nurse should communicate is "You are safe here No one can hurt you." The psy- chiatric and mental health nurse may need to repeat this a number of times because traumatized patients may block out what people are saying. The nurse should also reassure the patient that the attack was not the patient's fault and the nurse is sorry for what the patient has gone through. Answer: D. notify the physician of the patient's feelings about the treatment. Rationale: Because the patient is intimi- dated by her spouse and has stated she is afraid to stand up to him, as an advo- cate for the patient, the nurse should notify the physician of the patient's feelings about the treatment. Being coerced into signing a consent form is not the same as giving informed consent, which is re- quired by law. Because patients are vul- nerable to manipulation, the nurse must ensure that the actual wishes of the patient are respected.