Psych Exam 2

A nurse is caring for a patient with anorexia. The primary health care provider praises the nurse for providing effective care, as the patient is energetic and has an improved appetite. Which effective nursing intervention did the nurse likely use with the patient? 1 The nurse offered foods that the patient liked. 2 The nurse instructed the patient to avoid exercising. 3 The nurse offered three high-calorie meals during the day. 4 The nurse provided high fat foods to help the patient gain weight.

1 Anorexia is characterized by reduced appetite and low body weight. The nurse should follow proper nursing interventions to provide good nutrition to the patient, which may include offering foods that the patient prefers. The patient may not be able to eat one complete meal at a time. Therefore, the nurse should give the patient high-calorie foods in small quantities to meet the nutritional demands of the body. The nurse should provide the patient high-protein foods like tofu and beans, rather than high fat foods since poor nutrition may worsen the illness in the patient. A patient with anorexia may benefit from light (but not excessive) physical activity as it may stimulate the appetite.

Which cultural group perceives mental illness as a failure of the family? 1 Asian 2 Aboriginal 3 Native American 4 African American

1 Asian cultures may perceive mental illness as a failure of the family. These cultures emphasize the interdependence and harmony of the family. *Aboriginal and Native American cultures are more likely to place special significance on humans in the natural world. *African American cultures approach illness as an individual occurrence.

An adult patient with anxiety and a history of alcohol abuse is an inpatient on the psychiatric unit. The patient becomes angry and aggressive, strikes another patient, and then attacks a staff member. The patient is taken to seclusion and medicated with haloperidol and lorazepam. In this case, the haloperidol and lorazepam may be considered what type of intervention? 1 A restraint 2 Malpractice 3 False imprisonment 4 A medication time-out

1 Chemical restraints are defined by those medications or dose of medication that is not being used for the patient's condition. Medication time-out is incorrect; false imprisonment and malpractice refer to specific legal terms that do not have any bearing on this medication scenario.

When the nurse remarks to a depressed patient, "I see you are trying not to cry. Tell me what is happening." The nurse should be prepared to 1 Wait quietly for the patient to reply 2 Prompt the patient if the reply is slow 3 Repeat the question if the patient does not answer promptly 4 Review the patient's medical record to support the patient's response

1 Depressed patients think slowly and take long periods to formulate answers and respond. The nurse must be prepared to wait for a reply.

A nurse caring for a patient with depression instructs the patient to rest after group activity. The nurse provides warm milk to the patient in the morning and at night. What change does the nurse find in the patient after implementation of this these interventions? 1 The patient sleeps properly. 2 The patient interacts with the nurse. 3 The patient maintains good hygiene. 4 The patient has an increased appetite.

1 Depressive patients often have insomnia. The nurse should ensure that patients rest adequately after group activity. This helps to reduce fatigue, which can intensify the symptoms of depression. The patient can be given warm milk at night to induce sleep. Encouraging the patient to interact with the nurse or practice good hygiene or improving the patient's appetite may be treatment goals but they are not directly related to the nurse's intervention with warm milk.

An Asian patient diagnosed with severe anxiety states "I am a failure and a disgrace" after losing a job as an accountant. What is the likely basis for the patient's statement and diagnosis? 1 The patient feels that he or she has shamed his or her family. 2 The patient feels that he or she did not achieve personal goals. 3 The patient feels anxious because his or her failure may result in a changed fate. 4 The patient feels inadequate because he or she failed in the quest for independence and self-reliance.

1 Eastern tradition, such as in many Asian countries, sees the family as the basis for one's identity, and family interdependence as the norm. In the Eastern view one is born into an unchangeable fate. The remaining options demonstrate Western tradition, where self-reliance, individuality, and autonomy are highly valued.

A teenage patient was admitted several weeks ago after a suicide attempt. Despite family therapy, one of the parents is still struggling to cope with the child's behavior. Which teaching point would be most beneficial for the parents? 1 Depression is beyond voluntary control, but it can be managed. 2 The patient needs to be able to express anger directly at the parents. 3 The parents should also seek therapeutic help because depression is hereditary. 4 The patient should stop taking prescribed medicines if the patient mentions suicide.

1 Family support is key to improving the prognosis for depressed teenagers. Crucial to this is the parents' understanding that depression is involuntary but can be managed. The patient should not stop taking prescribed medications without consulting the doctor. The patient does need to find ways to express feelings, but expressing anger is not always a solution. Depression can be hereditary, but this does not address the parent's concern.

When is it appropriate to seclude or restrict a patient with severe mental illness? 1 When the patient is extremely aggressive 2 When the patient has serotonin syndrome 3 When the patient is experiencing impaired thoughts 4 When the patient is experiencing severe suicidal intentions

1 If patient are extremely aggressive and cause harm to themselves or others, then they should be secluded or restricted. Seclusion helps in protecting the patient and others against harm or injury. However, seclusion must be avoided if the patient has adverse reactions or side effects caused by medications because they can be fatal. Seclusion must also be avoided if the patient has impaired thoughts and delusions because the patient loses the ability to tolerate the stimulations and stressors. It may make the patient confused and more aggressive. Seclusion is also avoided if the patient has severe suicidal intentions because the patient may feel rejected.

When providing care for a patient of a Western culture, what can the nurse expect regarding the patient's involvement in the decisions about healthcare? 1 The patient will make the decisions. 2 The patient will take on a passive role. 3 The whole family will be involved in decision-making. 4 The patient will depend on the healthcare team to make decisions.

1 In Western cultures, the nurse can typically expect the patient to make the healthcare decisions. It is more common in other cultures for the patient to take a passive role, include the family in decisions, or depend on the healthcare team to make decisions.

The psychiatric nurse planning and implementing care for culturally diverse patients should understand 1 Holistic theory 2 Systems theory 3 Adaptation theory 4 Political power theory

1 In most cultures a holistic perspective prevails, one without separation of mind and body.

When assessing patients from the Western tradition, what should a nurse consider about their values related to touch? 1 Moderate touch conveys caring. 2 Touch is considered to be taboo. 3 People frequently touch each other. 4 Touch is considered to be an overt gesture.

1 In nursing practice, the touch is therapeutic and helps to build a trusting relationship between the nurse and the patient. According to the Western tradition, moderate touch conveys caring. *Touch between men and women may be considered as taboo in other cultures. *People from high-touch cultures frequently touch each other while talking. *Touch is considered an overt sexual gesture in low-touch cultures

A patient who has been admitted to a psychiatric facility away from home requests that his or her primary care physician and regular psychiatrist be informed. Why must this request be honored? 1 The patient has a right to private care providers. 2 The patient may require transfer to another hospital. 3 It cannot be honored; these physicians are not on staff. 4 The patient needs a referral in order for insurance to pay.

1 Included in the patient's right to treatment is the right to an attorney, clergy, and private care providers. The patient may be transferred, but this is not why the request must be honored. The patient's insurance is not of consequence in this scenario. The patient's physicians may not be on staff at the hospital where the patient is being treated, but the patient still has a right to consult with his or her personal care providers.

After an evaluation of an Iranian patient's performance of the range-of-motion exercises the patient has been taught, the nurse gives a thumbs up to the patient. What does the patient interpret from the nurse's gesture? 1 The patient would feel cared for by the nurse. 2 The patient would feel the need for improvement. 3 The patient would feel happy about his or her performance. 4 The patient would feel angered by the nurse's obscene behavior.

4 People who belong to the Iranian culture consider "thumbs up" to be an obscene gesture. Therefore, the Iranian patient would have been angered when the nurse made this gesture toward them

A nurse is assessing an Asian-Indian patient. While talking to the patient, the nurse observes that the patient maintains direct eye contact. What does the nurse interpret from the patient's behavior? 1 The patient has arrogant behavior. 2 The patient is paying attention to the nurse. 3 The patient is showing respect to the nurse. 4 The patient understands what the nurse says.

1 Maintaining direct eye contact is considered to be a sign of rudeness and arrogance in non-U.S. cultures; therefore, maintaining eye contact may indicate arrogant behavior in some people. On the other hand, in the United States, direct eye contact is a nonverbal behavior that indicates attentiveness, politeness, and respect, and maintaining eye contact may indicate paying attention or showing respect. Maintaining eye contact does not indicate that the patient agrees to what the nurse says. In contrast, nodding the head up and down indicates that the patient agrees with the nurse.

When assessing and planning treatment for a patient who recently has arrived in the United States from China, the nurse should be alert to the possibility that the patient's explanatory model for illness reflects 1 Imbalance 2 Inheritance 3 Negative forces 4 Supernatural causes

1 Many Eastern cultures explain illness as a function of imbalance.

A patient diagnosed with depression begins a new prescription for phenelzine. Which food is safe for this patient to consume? 1 Fresh fish 2 Pepperoni 3 Chocolate 4 Guacamole

1 Phenelzine is a monoamine oxidase inhibitor antidepressant medication. It is important to avoid foods high in tyramines. Fresh fish is safe. Pepperoni and chocolate are foods high in tyramines, which may cause a hypertensive crisis. Guacamole is made from avocados.

Which source of healing might be most satisfactory to a patient who believes illness is caused by spiritual forces? 1 Cleansings 2 Acupuncture 3 Dietary change 4 Herbal medicine

1 Rituals, cleansings, prayer, and even witchcraft may be the treatment expectation of a patient who believes illness is caused by spiritual forces.

An older adult patient being treated for depression has multiple medications. The family finds the patient delirious, spasmodic, hyperpyrexic, and hypertensive. The patient may have overdosed on which class of drugs? 1 Selective serotonin reuptake inhibitors (SSRIs) 2 Serotonin norepinephrine reuptake inhibitors (SNRIs) 3 Norepinephrine and dopamine reuptake inhibitors (NDRIs) 4 Noradrenergic and specific serotonergic antidepressant (NaSSAs)

1 SSRIs work by preventing the reuptake of serotonin. An overdose would cause a drastic rise in serotonin, causing delirium, spasms, hyperpyrexia, and hypertension. SNRIs and NaSSAs may cause this problem but to a lesser extent. NDRIs have no effect on serotonin.

A patient who has been assessed by the nurse as moderately depressed is given a prescription for daily doses of a selective serotonin reuptake inhibitor. The patient mentions that he or she will take the medication along with the St. John's wort he or she uses daily. The nurse should 1 Explain the high possibility of an adverse reaction 2 Suggest that the patient also use a sun lamp daily 3 Caution the patient to drink several glasses of water daily 4 Agree that taking the drugs at the same time will help the patient to remember them daily

1 Serotonin malignant syndrome is a possibility if St. John's wort is taken with other antidepressants.

For conducting clinical trials of a new drug, the nurse has been assigned to perform the initial screening to select Alzheimer's patients with severe impairment of thoughts and memory. As the patients' advocate, the nurse ensures that patients are well informed before signing the informed consent. Which information should be provided to the patients before obtaining informed consent? 1 Risks and benefits of the treatment 2 The 100% safety of the treatment for use 3 The unavailability of alternative treatment options 4 The inability to withdraw from the study after enrolling his or her name

1 The nurse ensures that the patients sign the informed consent form after being explained about the trial in detail. If the patient has impaired thoughts and memory, the nurse informs the patient's guardians about the risks and benefits of the treatment. The nurse informs the patients or their guardians about the alternative treatment options. The patient has the right to choose the appropriate treatment. The nurse does not give false assurance about the new drug being 100% safe, because no medication is 100% safe. The nurse indicates the probability of side effects and the success rate of the treatment. The patient has the right to refuse the treatment and can withdraw from the study at any time.

A nurse at a local mental health clinic prepares to give a patient with schizophrenia a regularly scheduled monthly antipsychotic medication injection. Just before the nurse gives the injection, the patient says, "Wait! I've changed my mind. I don't want to take that medicine anymore." Which initial action by the nurse would be legally and ethically appropriate? 1 Say, "You have a right not to take it, but let's talk about how that could affect your illness." 2 Remind the patient that this medication has been used for months with no adverse effects. 3 Assess the patient for evidence of dangerousness to self or others. 4 Call for assistance to restrain the patient and proceed with the scheduled injection.

1 The patient has the right to refuse treatment. Communicating the potential risks in making a decision to stop medication may help the patient to understand the plan of care. If the patient still refuses, the medical director of the facility reviews the treatment recommendations and is authorized to call in an outside psychiatrist for consultation.

The nurse is planning to medicate a patient against the patient's will. Under what circumstance can the nurse perform such an action, assuming the situation is a medical emergency? 1 The patient has a serious mental illness. 2 The benefits of treatment are equal to the harm. 3 The patient is not responding to less restrictive services. 4 The patient can make an informed decision but is refusing to do so.

1 When a patient has serious mental illness, use of medication against the patient's wish can be considered during a medical emergency. When less restrictive services are found useful, they should be implemented instead of medicating against a patient's will. When the benefits of treatment do not clearly outweigh the harm, medications should not be given against the patient's will. It would not be sufficient to say the benefits are equal to the harm. A patient who is capable of making an informed decision but is not doing so should be given more time or information but should not be forced to take medication against his or her will.

Which statements are associated directly with Beck's cognitive triad? Select all that apply. 1 "I'm not worth much; I can't do anything right." 2 "Things will only get worse; they never get better." 3 "I'll never find anyone who loves or values me." 4 "I don't think other people are worthless." 5 "Good luck happens to good people."

123 Three assumptions constitute Beck's cognitive triad: (1) a negative, self-deprecating view of self; (2) a pessimistic view of the world; and (3) the belief that negative reinforcement (or no validation for the self) will continue in the future. Statements such as "I don't think other people are worthless" and "Good luck happens to good people" lack the negative assumptions associated with the cognitive triad.

Which statement is true regarding an ethical dilemma? Select all that apply. 1 There is no clear solution to the dilemma. 2 There are two or more possible ways to resolve the dilemma. 3 There is a disagreement regarding beliefs among those involved in the dilemma. 4 The values of the facility and those of the care provider can at times be in conflict. 5 The possible solutions to the dilemma rarely involve unpopular consequences.

1234 An ethical dilemma results when there is a conflict between two or more courses of action, each carrying favorable and unfavorable consequences. The response to these dilemmas is based partly on morals (beliefs of right or wrong) and values and may involve unpopular consequences. At times, the nurse's values may be in conflict with the value system of the institution.

Which assessment data are associated with monoamine oxidase inhibitor (MAOI) therapy? Select all that apply. 1 Reports dizziness when standing up 2 Weight gain of five pounds in last four weeks 3 Heart rate 100 beats per minute and irregular 4 Facial twitch noted in left cheek 5 Diarrhea for last three days

1234 Some common and troublesome long-term side effects of the MAOIs are orthostatic hypotension, weight gain, change in cardiac rate and rhythm, constipation, and muscle twitching.

Which statement regarding habeas corpus as it is associated with mental health services is true? Select all that apply. 1 It is a law that protects an individual's fifth amendment rights. 2 It is the process to challenge an involuntary admission as being illegal. 3 This process is associated with due process as required by the 14th amendment. 4 All mental health admissions are dependent on this legal process. 5 This process supports an individual's right to treatment in the least restrictive form.

1235 The writ of habeas corpus is the procedural mechanism used to challenge unlawful detention by the government (such as involuntary mental health commitments). This right derives from the fifth amendment of the U.S. Constitution, which states that "no person shall . . . be deprived of life, liberty, or property without due process of law." The 14th amendment explicitly prohibits states from depriving citizens of life, liberty, and property without due process of law. The writ of habeas corpus and the least restrictive alternative doctrine are two of the most important concepts applicable to civic commitment cases. The courts have recognized that involuntary admissions result in a "massive curtailment of liberty" requiring due process protection in the civil commitment procedure. A voluntary commitment does not raise the same degree of concern.

Which example represents an exception to the rule of patient confidentiality and must be reported? Select all that apply. 1 A patient with a history of aggressive behavior shares that the patient is going to "beat my boss up really bad" when discharged. 2 A preschool-aged child describes being touched in a sexually inappropriate manner by an older family member. 3 A sexually explicit magazine is found among the personal belongings of a patient being admitted after a suicide attempt. 4 An older, cognitively impaired patient has bruises on the arms, legs, and back that are in various stages of healing. 5 A patient who has just been admitted for detoxification states, "I'm so angry right now I could just kill someone."

124 A patient with a history of aggressive behavior who has expressed a viable plan to harm another individual is an example of an exception to the rule of confidentiality. Sexual and physical abuse suspicions must be reported as well. The patient's possession of a sexually explicit magazine is not an example of a reportable incidence because there is no intention of harm to others. The claim to harm by the newly admitted patient is vague and unfocused and so not reportable.

A nurse is learning about different views regarding individuality in different cultures. In Western culture, which qualities would be most valued in an individual? Select all that apply. 1 Autonomy 2 Self-reliance 3 Dependence 4 Independence 5 Group-oriented

124 The Western tradition appreciates individuality. Thus, it values autonomy, self-reliance, and independence. Dependence is valued in traditions other than Western culture, such as Chinese and Indian traditions where importance is given to family and community. Group-oriented decision making is valued in Eastern tradition.

An experienced nurse is teaching a group of novice nurses about the conditions under which involuntary admission can be considered. Which patient conditions would call for involuntary admission? Select all that apply. 1 The patient needs psychiatric treatment. 2 The patient is unable to practice self-care. 3 The patient seeks admission for medical care. 4 The patient's behavior is dangerous for others. 5 The patient needs to be observed by the primary healthcare provider.

124 When considering involuntary admission of a patient, it must first be confirmed that the patient needs psychiatric treatment. Involuntary admission can be considered if the patient is unable to practice self-care or perform activities of daily living. When the patient's behavior is dangerous for to him or herself or to others, involuntary admission must be considered to ensure safety. When the patient seeks admission for medical care, it is considered voluntary admission rather than involuntary admission. When the patient needs to be observed by the primary healthcare provider, temporary admission is considered.

The caregivers of a patient tell the nurse that the patient has Hwa-byung. What symptoms does the nurse expect to find in the patient? Select all that apply. 1 Dyspnea 2 Bad dreams 3 Muscle aches 4 Epigastric pain 5 Sudden attack of trembling

134 Hwa-Byung is a culture-bound syndrome seen in Koreans. The chief symptoms associated with this syndrome include dyspnea, muscle aches, and epigastric pain. *Bad dreams are the chief symptoms associated with the Navajo culture-bound syndrome known as ghost sickness. *Sudden attacks of trembling are the chief symptom associated with a Latin American disease ataque de nervios.

Which antidepressant drug can be prescribed to depressed patients who also suffer from narrow-angle glaucoma? Select all that apply. 1 Bupropion 2 Amitriptyline 3 Desipramine 4 Isocarboxazid 5 Tranylcypromine

145 Bupropion is a norepinephrine dopamine reuptake inhibitor that can be prescribed to treat depression in patients with narrow angle glaucoma. It blocks the synaptic reuptake of norepinephrine and dopamine instead of the muscarinic receptors. Isocarboxazid is a monoamine oxidase inhibitor that inhibits the monoamine oxidase enzyme. It does not antagonize the muscarinic actions, so it can be prescribed to patients with narrow angle glaucoma. Tranylcypromine is a monoamine oxidase inhibitor. It does not cause side effects like blurred vision, so it is safe to be prescribed. Tricyclic antidepressants such as desipramine and amitriptyline must be avoided in depressed patients with narrow angle glaucoma. Tricyclic antidepressants are muscarinic receptor antagonists and thus cause blurred vision. These drugs would worsen the condition of narrow angle glaucoma.

What statements regarding depression is true? Select all that apply. 1 Depression can be seen in association with other mental and physical disorders. 2 While depression coexists with other disorders, it does not impact these disorders. 3 The symptomology of depression is relatively similar regardless of age or culture. 4 Social relationships can suffer when an individual is depressed. 5 Depression can range from mild to severe in its effect on individuals.

145 Depression can exist alone or in conjunction with other disorders and illnesses. Depression can present differently in different populations and different age groups and can be manifested on a continuum from mild to severe. One thing is consistent; depression results in significant pain and suffering that disrupts social relationships, performance at school or on the job, and the ability for a person to live a full and happy life. Depression also has a negative impact on physical well-being and the course of other medical diagnoses. This chapter includes basic information and therapeutic tools that will facilitate the care of patients with depression.

A patient says to the nurse, "Life doesn't have any joy in it anymore. Things I once did for pleasure aren't fun." What term would the nurse use to document this complaint? 1 Dysthymia 2 Anhedonia 3 Euphoria 4 Psychomotor retardation

2 Anhedonia is a common finding in many types of depression. It refers to feelings of a loss of pleasure in formerly pleasurable activities. Dysthymic disorder is characterized by chronic low-level depression while euphoria is an extreme sense of joy. Psychomotor retardation is related to physical movement not emotion.

The psychiatric mental health nurse working with depressed patients of the Eastern culture must realize that a useful outcome criterion might be if patient reports 1 Increased anxiety 2 Appeasement of the spirits 3 Disruption of energy balance 4 Increased somatic expressions of distress

2 Appeasement of spirits might be a viable outcome criterion if the patient believes the illness was caused by angry spirits. In each of the other options useful outcomes would be decreased somatic symptoms, reinstatement of energy balance, and decreased anxiety.

The charge nurse shares with the psychiatric technician that negligence of a patient 1 Applies only when the patient is abandoned or mistreated 2 Is an act or failure to act in a way that a responsible employee would act 3 Is an action that puts the patient in fear of being harmed by the employee 4 Means the employee has given malicious false information about the patient

2 Behaving as a wise and prudent person would act under the same circumstances is one way of judging whether the standard of care has been violated. Employers typically hope that staff will prevent patients from striking each other.

Which principle of bioethics mentions the importance of educating the nurse about the skills of nursing interventions? 1 Justice 2 Fidelity 3 Autonomy 4 Beneficence

2 Bioethics deals with the study of parameters to be implemented by a registered nurse in hospitals and clinics. The key theme of bioethics is providing patient-centered care with ethical considerations. Fidelity is a principle of bioethics that explains the role of a nurse having knowledge of strategies to be implemented for effective patient-centered care. Justice describes the role of a nurse in patient-centered care regardless of age, race, culture, and nature of illness. Autonomy is the ethical principle according to which all the patients have the right to make decisions regarding their own treatment. Beneficence describes the role of a nurse in communicating with patients for effective crisis management.

What statement about the comorbidity of depression is accurate? 1 Depression most often exists in an individual as a single entity. 2 Depression commonly is seen in individuals with medical disorders. 3 Substance abuse and depression are seldom seen as comorbid disorders. 4 Depression may coexist with other disorders, but is rarely seen with schizophrenia.

2 Depression commonly accompanies medical disorders. Depression existing most often as a single entity, seldom seen with substance abuse, and rarely seen with schizophrenia are false statements.

According to the Western scientific view of health, illness is the result of 1 Soul loss 2 Pathogens 3 Spirit invasion 4 Energy blockage

2 Disease has a cause (e.g., pathogens, toxins) that creates the effect; disease can be observed and measured.

Dysthymia cannot be diagnosed unless it has existed for 1 At least one year 2 At least two years 3 At least six months 4 At least three months

2 Dysthymia is a chronic condition that by definition has to have existed for longer than two years.

A nurse provides discharge instructions to a patient of Middle Eastern heritage who immigrated to this country 1 year ago. Which strategy ismost important to assure the patient's understanding of the instructions? 1 Handwrite the discharge instructions. 2 Use a professional interpreter when providing instruction. 3 Give instructions to a family member proficient in English. 4 Show the patient a video in the patient's dominant language.

2 If a patient is not proficient in English, a professional medical interpreter should be engaged. The interpreter can facilitate provision of instructions as well as question-and-answer.

Diverse cultural beliefs can result in dramatically varied perceptions of wellness, disease, and the treatment of disease. What is the best way for the nurse and patient initially to address these variations when planning nursing care? 1 Agree to respect each other's beliefs and values. 2 Discuss what the patient believes is the cause of his or her illness. 3 Agree that treatment planning will include family members when possible. 4 Discuss the incorporation of both traditional nursing practice and culturally based practices.

2 In terms of treatment planning, the nurse and patient need initially to agree on the nature of the patient's problem to set the foundation of effective care that incorporates the patient's cultural beliefs regarding the nature of the illness. Agreeing to mutual respect is the foundation of the nurse-patient relationship and is not unique to a culturally diverse patient. Agreeing to include family members in treatment planning is the foundation of effective planning and is not unique to a culturally diverse patient. Although discussing traditional nursing practice and culturally based practices may be appropriate in many situations, it is not the initial intervention because patient's needs must be identified first.

Which assessment finding does the nurse anticipate when caring for a patient with neurasthenia? 1 Dyspnea 2 Insomnia 3 Palpitations 4 Abnormal body movements

2 Insomnia often accompanies neurasthenia, a cultural syndrome that occurs in Chinese patients with somatic symptoms of depression.

A patient, reporting gastric pain, tells the nurse, "I think my symptoms started when a neighbor casted a spell on me." The assessment the nurse can make is that the patient 1 Has a major mental illness 2 Is expressing a culture-bound illness 3 Requires hospitalization to protect the neighbor 4 Will probably not respond to Western medical treatment

2 Many culture-bound illnesses, such as ghost illness, or hwa byung, seem exotic or irrational to American nurses. Many of these illnesses cannot be understood within a Western medicine framework. Their causes, manifestations, and treatments do not make sense to nurses whose understanding is limited to a Western perspective on disease and illness.

Which culture-bound syndrome is associated with individuals of the Chinese culture? 1 Susto 2 Neurasthenia 3 Ghost sickness 4 "Jin" possession

2 Neurasthenia syndrome is a culture-bound syndrome of the Chinese culture. *Latin American culture experience susto. *Ghost sickness is a culture-bound syndrome of the Navajo culture. *"Jin" possession is a culture-bound syndrome of the Somalian culture.

Which food can be included in the diet of a depressive patient who is prescribed a monoamine oxidase inhibitor? 1 Chocolate 2 Yogurt 3 Ginseng 4 Fava beans

2 Patients who are prescribed monoamine oxidase inhibitors must avoid food substances that contain vasopressors because of food-drug interactions such as high blood pressure. Yogurt is safe for the patient as it contains a very low amount of tyramine. Chocolate must be avoided because it can cause reactions due to the presence of phenylethylamine. Ginseng can cause a headache and mania-like reaction in the patient, so it must not be included in the diet. Fava beans contain dopamine, which can cause side effects such as agitation and an increase in blood pressure, so they must be avoided.

Subsyndromal depression primarily occurs in which population? 1 Adults 2 Elderly 3 Children 4 Teenagers

2 Subsyndromal depression is most prevalent in older adults. It occurs when the patient experiences some, but not all, of the symptoms that are seen in a major depressive episode. Children, adolescents, and adults are less susceptible to subsyndromal depression.

A patient with severe depression is brought to the mental health ward. The patient is confused and is not able to decide about the medical treatment. What action should the nurse perform with regard to admitting the patient? 1 Provide voluntary admission. 2 Suggest temporary admission. 3 Advise involuntary admission. 4 Refuse admission to the patient.

2 Temporary admission is given to patients who are confused and are not able to make their own decision regarding their medical care. Voluntary admission is given when the patient voluntarily applies in writing to be admitted. Involuntary admission is given without the patient's consent if there is need for treatment as certified by the primary health care provider. For example, if the patient poses a danger for him or herself or to others, then the patient would be admitted involuntarily. Refusing admission to the patient is not advisable as it the right of the patient to seek medical care.

The emergency psychiatric department at a large hospital is at capacity. A patient is brought in from the local jail with combative behavior and nonsensical speech after a fight earlier in the day. The patient has a history of poorly controlled bipolar disorder. What is the triage team's next step? 1 Give the patient intravenous antipsychotics. 2 Begin with a thorough medical history and evaluation. 3 Place the patient in full restraints until the team has time. 4 Place the patient in a secluded room until additional staff arrive

2 Without a thorough medical history and evaluation, there is no way to know if this patient is suffering from a psychotic break or an organic reason, such as a head injury. The patient may need to be restrained, but only as long as necessary and within the parameters required by law, and this cannot be determined without an assessment. Medication should not be administered until examination and diagnosis has been made. The patient should not be secluded without an assessment, especially since a head injury has not been ruled out.

On the fourth hospital day, a patient diagnosed with major depressive disorder took an overdose of medication. Staff later learned the patient had not been swallowing medications administered, but instead had been saving them. Which statements accurately analyze this situation? Select all that apply. 1 Nurses breached their duty to provide a safe environment for a patient at risk for self-harm. 2 Nurses created liability for themselves and their employer by failing in their duty to protect. 3 In view of the patient's diagnosis, nurses should have expected and assessed frequently for suicidal behavior. 4 Patients have the right to refuse medication; the patient's decision not to swallow the medication is an aspect of this right. 5 Suicide attempts cannot be prevented in all circumstances. Hospitalization protected the patient from potential community hazards.

23 Negligence is the failure to use ordinary care in any professional or personal situation when there is a duty to do so. When health care professionals fail to act in accordance with professional standards or fail to foresee consequences that other similar professionals with similar skills and education would be expected to foresee, they can be liable for their professional negligence, or malpractice. In this situation, nurses negligently failed to protect the patient's safety by performing mouth checks after administering medications. Risk for suicide is high in patients diagnosed with major depressive disorders.

How is a patient's medical record used in legal cases? Select all that apply. 1 To support reimbursement claims for services provided by facilities. 2 To identify the amount of existing mental disability to determine competency. 3 To determine the extent of injuries resulting from physical or sexual abuse. 4 To support a claim that medical or nursing treatment has resulted in personal injury. 5 To determine the rehabilitative potential in workers' compensation cases.

2345 Medical records find their way into a variety of legal cases for a variety of reasons. Some examples of its use include determining (1) the extent of the patient's damages and pain and suffering in personal injury cases, such as when a psychiatric patient attempts suicide while under the protective care of a hospital; (2) the nature and extent of injuries in child abuse or elder abuse cases; (3) the nature and extent of physical or mental disability in disability cases; and (4) the nature and extent of injury and rehabilitative potential in workers' compensation cases. The medical record is not used to support claims for services provided.

A nurse with Western cultural views is assessing a group of patients from other cultures. Which factors should the nurse understand regarding the beliefs about patient care in many non-Western cultures? Select all that apply. 1 Patients should be self-reliant. 2 Patients should remain passive. 3 Patients should know medical facts. 4 Family members must take care of the patient. 5 Patients must be protected from the painful truth.

245 Other cultures, such as African and Middle Eastern, believe that the patient should remain passive because passivity helps to stimulate recovery and promote health. The patient must be protected from the painful truth because it helps to preserve patient hope, which is important for recovery. According to other cultures, the patient should remain passive, and family members must take care of the patient. According to Western culture, the patient should be self-reliant and independent as much as possible. The patient should know the medical facts and be informed in order to make a fair decision.

A patient says to the nurse, "I once enjoyed going to parks and museums with my family but that is not fun anymore." How would the nurse document this complaint? 1 Anergia 2 Euthymia 3 Anhedonia 4 Self-deprecation

3 Anhedonia means that there is no pleasure or joy in life. It is a common finding with depression. Anergia refers to a lack of energy or physical passivity. Euthymia refers to a mood state that is normal and moderate, with neither depression nor mania. Self-deprecation refers to negative statements about self.

Which ethical principle refers to the individual's right to make his or her own decisions? 1 Fidelity 2 Veracity 3 Autonomy 4 Beneficence

3 Autonomy refers to self-determination, or the right to make one's own decisions.

A nurse assesses an adult patient with a foot ulcer that will not heal. The patient is of Cuban heritage, has been in the United States for 2 years, and is fluent in English. Which question should the nurse include in the assessment? 1 What are your main cultural values and beliefs? 2 Do you believe evil spirits caused your problem? 3 How have you been treating your foot sore at home? 4 Have you used any folk medicine treatments on your foot?

3 Cultural competence requires respect for diversity and an understanding of the attitudes, beliefs, behaviors, practices, and communication patterns of multiple cultures and their languages. Health care providers have become more aware of alternative therapies and have included some in the plan of care as complementary measures.

A nurse assesses an adult patient with complaints of insomnia and frequent crying spells. The patient is of Puerto Rican heritage, has been in the United States for 2 years, and is fluent in English. Which assessment question by the nurse most likely will generate important information? 1 "What are your main cultural values and beliefs?" 2 "Do you believe evil spirits caused your problem?" 3 "What do you and your family members think about your problem?" 4 "Have you used any folk medicine treatments to treat these problems?"

3 Culturally sensitive questions allow a patient to feel heard and understood. They also help in eliciting culture-bound syndromes. The correct response offers an open-ended question and includes the family's role in determining the problem.

Assessment of the thought processes of a patient diagnosed with depression is most likely to reveal 1 Good memory and concentration 2 Delusions of persecution 3 Self-deprecatory ideation 4 Sexual preoccupation

3 Depressed patients never feel good about themselves. They have a negative, self-deprecating view of the world.

Patients of another culture are at greatest risk for misdiagnosis of a psychiatric problem because of 1 Biased assessment tools 2 Insensitive health care providers 3 Insensitive interviewing techniques 4 Lack of the availability of cultural translators

3 Inaccurate information or insufficient information may be obtained if the interviewer is not culturally sensitive. Only when assessment data are accurate can effective treatment be planned.

Benjamin Franklin invented the lightning rod, a device that saved lives and property in early American history. He refused to patent the invention because he wanted it widely shared for the well-being of humankind. Franklin's action can be correlated best to which ethical principle in health care? 1 Parity 2 Autonomy 3 Beneficence 4 Distributive justice

3 Individuals who work in the health care field have a special duty and responsibility to act in a manner that is going to benefit and not harm patients. The term beneficence refers to bringing about good, or first do no harm. The goal in mental health treatment is to assist individuals in returning to a mentally healthy way of life.

With which culture is "Jin possession," a culture-bound syndrome, associated? 1 Korean 2 Chinese 3 Somalian 4 Vietnamese

3 Jin possession is a culture-bound syndrome associated with the Somalian culture. It is characterized by psychological distress and anxiety caused by the belief that one is possessed by a "Jin." Hwa-Byung is a culture-bound syndrome in Korea. Wind illness is a culture-bound syndrome associated with the Chinese and the Vietnamese.

A depressed patient tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse can identify this cognitive distortion as an example of 1 Self-blame 2 Catatonia 3 Learned helplessness 4 Discounting positive attributes

3 Learned helplessness results in depression when the patient feels no control over the outcome of a situation.

As a community mental health nurse prepares to administer a regularly scheduled antipsychotic medication injection to a patient diagnosed with schizophrenia, the patient stands and says, "I'm leaving. I don't want any more of that medicine." Which initial action by the nurse is appropriate? 1 Postpone the injection and reschedule the patient's visit in 1 week. 2 Confer with the pharmacist about preparing the medication in oral form. 3 Stop with the procedure and say to the patient, "I'd like to talk with you about how you are feeling about this matter." 4 Say to the patient, "You have been taking this medication for 2 years and have never had any problems with it in the past."

3 Patients have the legal right to self-determination as well as an ethical right to autonomy. Patients have the right to receive treatment and the right to refuse it, including medication in most instances. The nurse should stop the procedure and discuss the patient's feelings before taking any other action. Patients may withhold or withdraw consent at any time.

It is likely that a patient diagnosed with seasonal affective disorder will begin to experience fewer symptoms in the 1 Fall 2 Winter 3 Spring 4 Summer

3 Seasonal affective disorder occurs during the months when sunlight diminishes. Patients may begin to feel effects in the late fall and will be affected throughout the winter. They improve during the spring and feel well during the summer.

Family members are worried about a depressed relative whose job recently was terminated. The family requests hospitalization of this person. An assessment reveals the person is moderately depressed but without intent or thoughts about self-harm. Which action demonstrates application of the least restrictive alternative doctrine? 1 Hospitalize the person as a temporary admission. 2 Contact with the person's prior employer for additional information. 3 With the person's agreement, arrange for immediate outpatient counseling. 4 Admit the person involuntarily to an inpatient mental health treatment unit.

3 The least restrictive alternative doctrine mandates that the least drastic means be taken to achieve a specific purpose. Outpatient counseling is the least restrictive intervention. With the person's agreement, this intervention will provide services. Temporary admission is used for people who are so confused or demented they cannot make decisions on their own or are so ill they need emergency admission. Contacting the person's prior employer violates confidentiality. Involuntary admission is necessary when a person is in need of psychiatric treatment, presents a danger to self or others, or is unable to meet his or her own basic needs. This scenario does not fulfill those criteria.

An 8-year-old patient has been showing signs of disruptive mood regulation disorder, including irritability, tantrums, and anger. What other factor must be considered to confirm the diagnosis? 1 The symptoms must be present daily. 2 The symptoms must occur at school. 3 The symptoms must occur in two different settings. 4 The symptoms must be noticed by members of the family.

3 The symptoms of disruptive mood regulation disorder must occur in at least two separate settings, such as the home and school. The symptoms typically occur three or more times a week, not daily. Some children with this disorder manage to maintain control at school. Although family is most likely to notice symptoms, teachers and peers may notice them as well

A nurse is caring for a patient with severe depression. After 4 months of treatment, the nurse tells the patient, "Depression is an illness that is beyond a person's voluntary control." In which phase of treatment is this an appropriate statement by the nurse? 1 Acute phase 2 Orientation phase 3 Continuation phase 4 Maintenance phase

3 There are three phases of treatment for depression: the acute phase, the continuation phase, and the maintenance phase. After 4 to 9 months of treatment patients are in the continuation phase, during which they are educated about depression in hopes that they will better adhere to the treatment plan and avoid relapse. Explaining depression is beyond a person's control is an example of this teaching. The other stages of treatment have different goals, such as the acute phase (the initial 12 weeks) in which the patient is given interventions to simply reduce symptoms of depression. After 1 year of treatment, patients are typically in the maintenance phase, where they may already be well educated about depression and the treatment focuses on avoiding further complications due to relapse of the illness. The orientation phase is not one of the three phases of the treatment. It is a part of the group development phase in which patients are encouraged to interact with each other.

A depressed patient is noted to pace most of the time, pull at his or her clothes, and wring his or her hands. These behaviors are consistent with 1 Senile dementia 2 Hypertensive crisis 3 Psychomotor agitation 4 Central serotonin syndrome

3 These behaviors describe the psychomotor agitation sometimes seen in patients with the agitated type of depression.

A nurse is learning about enculturation. What is the best definition of this term? 1 Deviance from cultural expectation 2 Making individual choices against culture 3 Transmission of cultural beliefs to its members 4 Considering one's own thinking as the only correct way

3 Transmission of cultural beliefs to its members, such as from parents to children, is called enculturation. Deviance from cultural expectation of a particular group is called illness. Making individual choices in enculturation is permitted from a certain range of options. Considering one's own thinking as the only correct way is known as ethnocentrism.

The nurse pays a home visit to a mentally ill patient and finds that the patient has suicidal tendencies but refuses to seek treatment. Which nursing action may give rise to an abandonment issue? 1 The nurse enlists the assistance of law for involuntary admission of the patient. 2 The nurse informs the family members and advises them to keep the patient safe. 3 The nurse respects the patient's right and does not force the patient to seek treatment. 4 The nurse ensures that the patient is in a safe environment with minimal risk for injury.

3 Abandonment happens when the nurse fails to ensure patient's safety despite knowing the risk of harm. If the patient has suicidal tendencies and the nurse does not force the patient to seek treatment, the patient may commit suicide. This action amounts to abandonment of the patient. To prevent abandonment, the nurse should enlist the assistance of law for involuntary admission of the patient. This helps to prevent self-injury in the patient. Alternatively, the nurse may ensure safety of the patient's environment and ensure that the family members are informed of the patient's suicidal tendencies.

What statement regarding how depression affects both children and older adults is true? Select all that apply. 1 Children and older adults share similar symptoms of depression. 2 Depression among older adults is believed to be a normal occurrence related to aging. 3 Depression increases the risk for suicide among those older adults experiencing the disorder. 4 Incidence of depression among children between ages 13 and 17 warrant screening of that population. 5 The younger one is when the initial episode of depression occurs, the higher the risk of recurring episodes.

345 Because symptoms vary by age and circumstance, depression in children, until recently, has been underrecognized. Children and adolescents between 13 and 18 years of age have an 11.2% prevalence of depression, and 3.3% have a severe form of the illness. If the first episode of depression occurs in childhood or adolescence, the likelihood of recurrence is high, setting the stage for recurrent depression. Although depression in older adults is common, it is not a normal result of aging. A disproportionate number of older adults with depression are likely to die by suicide.

A geriatric patient is diagnosed with depression. What appropriate method does the nurse take while administering the medications to the patient? Select all that apply. 1 Administer a dose that is twice the highest adult dose 2 Adjust the dose of the medications every month 3 Check for cardiotoxicity in the patient 4 Stop administering the medication when the patient is aggressive 5 Administer a dose that is half the lowest adult dose

35 Geriatric patients do not have normal metabolic process and may practice polypharmacy, or the use of multiple medications. The drug dosages administered should be less for geriatrics, at half the dose of the lowest adult dose. The nurse should check for the signs of cardiotoxicity in the patients who suffer from hypotension. The dose should never be doubled as it can cause toxicity. Dosage adjustments must be made every seven days based on the metabolism and other conditions of the patient. The nurse should not stop the medications even if the patient is aggressive, as it can lead to discontinuation syndrome.

A patient reports to the nurse that once he's released he will make sure his wife will never again be able to have him committed to a psychiatric hospital. What action should the nurse take? 1 Ask the patient if he is threatening his wife. 2 Call the patient's wife and report the threat. 3 None, because no explicit threat has been made. 4 Report the incident to the patient's therapist and document.

4

Which statement describes the basis of an ethical dilemma? 1 "It's so difficult when the patient doesn't agree with the treatment team." 2 "The patient insists on behaving in a manner that will likely cause him or her injury." 3 "It is difficult to determine who makes decisions for an incompetent patient without a medical surrogate." 4 "There are only two treatment choices; both are very painful and neither has a high rate of success."

4 An ethical dilemma exists when a choice must be made between equally unsatisfactory alternatives. A disagreement does not by itself qualify as an ethical dilemma. The cognitive patient has the right to engage in risky behaviors as long as they don't endanger others, so no ethical dilemma exists. Although decision making for an incompetent patient is difficult and may even be a legal issue, such situations seldom are considered ethical dilemmas.

When the health care provider mentions that a patient has anhedonia, the nurse can expect that the patient: 1 Has poor retention of recent events 2 Experienced a weight loss from anorexia 3 Has difficulty with tasks requiring fine motor skills 4 Obtains no pleasure from previously enjoyed activities

4 Anhedonia is the term for the lack of ability to experience pleasure.

An experienced nurse is teaching novice nurses about the expected behavior from competent nurses. Which behavior should the nurse include when teaching them? 1 Think that patients' values are incorrect 2 Impose cultural norms on their patients 3 Believe in only their way of patient care 4 Examine their assumptions about a patient's culture

4 By examining their assumptions about a patient's culture, nurses can become more aware and educated about the patient's culture. It would help the nurse to provide the best and culturally competent patient care.

Of all healthcare workers, those working in which field are most likely to be assaulted by patients? 1 Pediatrics 2 Obstetrics 3 Psychiatric 4 Emergency

4 Emergency room nurses are most likely to be physically assaulted. Psychiatric nurses have a high incidence, but it is lower than in the emergency department. Pediatrics and obstetrics do not rank as highly.

The nurse is caring for a patient of Latin American descent. Which type of nonverbal communication is most appropriate for the nurse to use when providing care to the patient? 1 Using minimal touch 2 Avoiding personal space 3 Maintaining eye contact 4 Using close personal space

4 It is most appropriate for the nurse to use close personal space when providing care for a patient of Latin American descent.

Family members report a Native American adult is self-mutilating and experiencing auditory and visual hallucinations. The patient says, "My dead father told me to cut myself to remove the bad spirits." Which action is an appropriate nursing intervention for the nursing care plan? 1 Refer the patient for grief counseling services. 2 Initiate a consultation with the hospital chaplain. 3 Provide the patient with frequent periods alone for meditation and prayer. 4 With the patient's consent, confer with a spiritual healer from the patient's tribe.

4 Native Americans often find tribal healing ceremonies helpful as a complement to the therapeutic program. This patient may have ghost sickness, thought to be caused by an evil spirit. It is treated by overcoming the evil spirit with a stronger spiritual force. The healer, a "singer," calls forth this force through a powerful healing ritual.

An experienced nurse is teaching a group of novice nurses about different beliefs that patients have about diseases. Which information should the nurse include when teaching about the patient's belief in science? 1 Disease is caused by a lack of personal harmony. 2 Disease is caused by an improper diet and routine. 3 Disease is caused by an imbalance in energy forces. 4 Disease is caused by a pathogen and can be measured.

4 Patients who believe in science consider disease to be a result of a pathogen or toxin and it can be observed and measured.

A nurse is planning care management for a mentally ill patient. When should the nurse plan for seclusion of the patient? 1 The patient experiences delirium. 2 The nursing staff is busy in an emergency case. 3 The patient has severe suicidal tendencies. 4 The patient exhibits self-destructive behavior

4 Seclusion of a patient can be considered if the patient exhibits self-destructive behavior that can cause harm to others or to the patient. Seclusion is not advisable for patients with delirium as they need close monitoring. It is not advisable to keep the patient secluded when the nursing staff is busy in managing an emergency case. The staff from another division can be asked to look after the patient rather than placing a patient in seclusion unnecessarily. Seclusion is not advisable for patients with severe suicidal tendencies as they need close monitoring.

A patient has been taking citalopram for two years for depression. The patient's outcomes have been achieved and the patient wants to discontinue the medication. Which information should the nurse provide? 1 "Citalopram is an antidepressant medication that usually is taken for life." 2 "Stopping this medication all of a sudden can cause serotonin syndrome." 3 "Because your depression is alleviated, you may discontinue the medication." 4 "It's important for you to gradually stop taking this drug over two to four weeks."

4 Selective serotonin reuptake inhibitors (SSRIs) should be tapered off gradually over a period of two to four weeks to avoid a withdrawal syndrome. Symptoms of the withdrawal syndrome include headache, gastrointestinal upset, dizziness, insomnia, anxiety, and flulike symptoms. Serotonin syndrome is a potentially life-threatening consequence of drug interactions with SSRIs.

An adult was hospitalized three days ago with a diagnosis of major depression with suicidal ideation. Which comment by this patient best reflects an improvement in the depression? 1 "I am hungry all the time." 2 "My family can get along fine without me." 3 "Group therapy may be helpful to others but I find it tiresome to listen." 4 "I talked with my family about ways we can celebrate holidays together."

4 The correct response indicates this patient is looking toward the future, which would not occur in the presence of continued suicidal thinking. An improved appetite is a positive finding but could be attributed to medication side effects or other events; it is not the best answer. Saying one's family can get along without him or her and not wanting to go to group therapy indicate hopelessness and continued severe depression.

A patient says to the nurse, "I had my first episode of depression after I got divorced about 10 years ago. I recognized what was happening to me because both of my parents suffer from depression." Which theory regarding the etiology of depression has the patient described? 1 Cognitive theory 2 Biochemical factors 3 Learned helplessness 4 Diathesis-stress model

4 The diathesis-stress model of depression takes into account the interplay between genetic and biological predisposition toward depression and life events. The physiological vulnerabilities, such as genetic predispositions, biochemical makeup, and personality structure, are referred to as a diathesis. The stress part of this model refers to the life events that impact individual vulnerabilities. Cognitive theory recognizes the role of early life experiences in the development of depression. Biochemical factors include genetic and biological variables in the etiology of depression. Learned helplessness refers to a theory about depression replacing anxiety.

The nurse is working on an inpatient psychiatric unit and caring for the patient, who is becoming agitated. The nurse speaks with the patient one to one in a private setting to find out the reason for the agitation and then assists the patient with ways to calm down, possibly including as-needed medication to prevent further escalation of the patient's agitation, which could lead to seclusion or restraints. The nurse is making care decisions based on what concept? 1 Veracity 2 Bioethics 3 Writ of habeas corpus 4 Least restrictive alternative doctrine

4 The least restrictive alternative doctrine is described as using the least drastic means of achieving a specific goal. By doing the actions described the nurse possibly is preventing the more restrictive setting of seclusion or restraints. Writ of habeas corpus is a legal term meaning a written order "to free the person." Veracity is one of the five ethical principles or guidelines. Bioethics refers to ethics in a health care setting.

Which statement is true regarding mail sent to an involuntarily admitted patient residing on a psychiatric inpatient unit? 1 Mail must first be opened and inspected by staff. 2 The patient can receive mail from only family and legal sources. 3 Receipt of mail is considered a privilege accorded the patient for compliance. 4 Mail is a form of social interaction and so receiving mail is a patient's civil right.

4 The patient's civil rights are intact, despite hospitalization. The right to communicate with those outside the hospital is ensured.

An adolescent patient was voluntarily admitted by his or her parents for suicidal ideation. The treatment team suggests a 2-week intensive inpatient therapy, but the parents disagree and demand the child's release. What kind of release does this most illustrate? 1 Discharge 2 Conditional release 3 Unconditional release 4 Release against medical advice

4 When a patient or the patient's guardians disagree with the healthcare team's recommendations, the release is against medical advice, or AMA. Discharge is too vague of a term. Unconditional release is one without restriction. It may be a result of satisfactory patient progress, or it could be court-ordered. Conditional release is contingent upon a patient's ability to remain competent enough to care for him or herself and remain safe.

Antidepressants administered alone can cause an adverse reaction in patients with bipolar disorder. What additional drug class should be prescribed? 1 Sedative 2 Anxiolytic 3 Antipsychotic 4 Mood stabilizer

4 When administered solely to patients with bipolar disorder antidepressants can cause a psychotic episode. A mood-stabilizing drug should be given concurrently. Anxiolytic medication may be prescribed as well, but only if symptoms of anxiety are present. Sedatives serve no purpose in this situation. Antipsychotics would be of use if a psychotic episode occurs but not as a prophylactic measure.

What assumption can be made about the patient who has been admitted on an involuntary basis? 1 The patient can be discharged from the unit on demand. 2 For the first 48 hours, the patient can be given medication over objection. 3 The patient has agreed to fully participate in treatment and care planning. 4 The patient is a danger to self or others or is unable to meet basic needs.

4 Involuntary admission implies that the patient did not consent to the admission. The usual reasons for admitting a patient over his or her objection is if the patient presents a clear danger to self or others or is unable to meet even basic needs independently.

A patient hospitalized for mental health treatment shows improvement and wishes to leave. There is no risk of harming self or others and the patient can manage basic needs. However, the health care provider insists on extending the patient's stay. What should the nurse plan for this patient? 1 Conditional release 2 Unconditional release 3 Continued hospitalization 4 Release against medical advice

4 When the patient has improved and there is no reason to involuntarily continue hospital stay, the patient can be released. Conditional release involves outpatient treatment for a specific period to determine the patient's performance. When the patient has to be released by court or administrative order, it is called an unconditional release. Continued hospitalization is not appropriate because the patient has shown improvement and wishes to leave.

Which type of culturally competent care is the nurse practicing when incorporating the use of a translator into patient care? Skill Knowledge Awareness Encounters

Skill Cultural skills includes the use of a medical translator in patient care. It is the ability to perform a cultural assessment in a sensitive way, such as ensuring communication is meaningful with the patient by seeking out a medical interpreter when needed.