Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart
Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart
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Chapter 33: Hospital-Based Psychiatric Nursing Care
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | stabilization. |
| b. | institutionalization. |
| c. | symptom remission. |
| d. | diagnostic evaluation. |
ANS: A
Stabilization is sought and then treatment continues in the community. Diagnostic evaluation already would have been performed, and institutionalization (an unwanted passive dependency that develops with long hospital stays) is not an appropriate outcome.
DIF: Cognitive Level: Comprehension REF: Text Page: 640
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
| a. | Establishing trust in the one-to-one, nurse-patient relationship |
| b. | Performing a rapid multidisciplinary physical assessment |
| c. | Contacting family for permission to treat the patient |
| d. | Determining why the patient removed all clothing |
ANS: B
When patients are severely confused and unable to care for themselves because of maladaptive coping, the multidisciplinary team will perform a rapid diagnostic evaluation, medicate to calm the patient as needed, and escort a patient to the inpatient unit. There, the goals will include stabilization with safety concerns at the forefront of the discharge planning (which starts with admission).
DIF: Cognitive Level: Analysis REF: Text Page: 640
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
| a. | Place the patient on frequent observation to assess both overall status and potential for harm. |
| b. | Anticipate the inclusion of medication therapy in the patient’s therapeutic plan of care. |
| c. | Interview the patient to obtain information regarding the identification of family and/or caregiver. |
| d. | Notify social services that the patient will be in need of both physical and social support resources. |
ANS: A
The priority nursing intervention for such a patient on the inpatient unit would include measures that prevent harm to self or others.
DIF: Cognitive Level: Analysis REF: Text Page: 640
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
| a. | “This room is off-limits for 2 weeks. I am struggling with this intolerable behavior and sorely disappointed in everyone involved.” |
| b. | “This behavior is representative of a real problem with the unit’s milieu. Let’s discuss it as you all help put the room back in its original order.” |
| c. | “People must be really angry. Everyone who was involved must help undo the damage immediately and then discuss the reasons for the behavior.” |
| d. | “It seems that there is a great deal of negative feelings in this group today. We need to share feelings regarding the problem while we all clean up the room.” |
ANS: D
Physically destructive behavior is a response that is derived from an unspoken anger or fear. The most therapeutic communication for the situation is the one that validates and supports the underlying feeling but sets limits on the maladaptive action taken. The nurse’s task is to help the destructive patients learn more adaptive ways to deal with anger, such as verbalization. Disparagement reflects the nurse’s anger, and humiliation is aggressive to patients and nontherapeutic. Enlisting everyone to help clean up is the most therapeutic option, because it promotes cohesion and may encourage patients who did not do the damage to speak up and voice their anger at the offenders for spoiling their activity room. Peer input is always very effective.
DIF: Cognitive Level: Application REF: Text Page: 643
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
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