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During group, the patient states, "I've never been good at art, these groups are dumb." The nurse knows that they can reframe this thinking by....
Recognizing positive aspects of the patients participation in the activity. This is an example of distorted thinking and over generalization
What are the three main components of a therapeutic milieu?
Structure, security and promotes healing.
The patient confides in you that they stole a pen from the nurses station and used it to harm themselves. The patients asks you not to say anything. You agree. The nurses actions violate...
A boundary with the client
Your patient is manic, hallucinating and has been awake for three days. As a nurse you know that the two main neurotransmitters involved in this state are...
Dopamine (adrenal hormones) and Serotonin (sleep regulation). Also, norepinephrine d/t activation of the SNS from stress.
The police contact a male who is shouting, "I am an alien who came here from Mars and I am here to save the world!" A stranger passing by bumps into him and the male hits them. What M1 criteria will be used to involuntary hold the patient?
Violence toward others.
Under what circumstances would a patient lose their patient rights?
None. Being committed and/or incompetent does not negate the Patient's Bill of Rights.
You overhear another nurse telling a patient, "If you don't stop yelling, I am going to put you in the seclusion room. Is this appropriate?
No. Patients have the right to the least restrictive environment appropriate to meet their needs.
You are assessing a patient who insists they know you and that you have met before. This is an example of...
Transference/delusional behavior. Set clear limits without rejecting the patient.
What neurotransmitter is targeted to manage the side effects of tardive dyskinesia and extrapyramidal symptoms?
The cholinergic acetylcholine (stimulates the parasympathetic nervous system)
What is the primary purpose of the DSM-V?
The DSM provides standard nomenclature, presents defining characteristics, and identifies underlying causes of mental disorders.
Appearance, behavior, mood, affect, and thought content are all components of what exam?
Mental Status Examination
A delusional patient states, "I am a superhero and I can use my powers to read minds." The nurse states, "that would be very unusual." Is this therapeutic?
Yes. It is important to not challenge the belief system of a delusional patient as it will cause distrust.
Confidentiality is a critical aspect of mental health nursing. Your patient tells you, "I'm going to kill my ex-girlfriend when I get out." The best response is...
Have the patient contract for safety and explain that they must inform the staff of their intentions. Confidentiality does not apply to safety issues.
The patient hands a letter to be mailed to the nurse. The nurse opens it and reads it. Is this a violation of patient rights?
Yes. This violates confidentiality.
During admission, the patient makes the statement, "My wife can't divorce me; if she does not change her mind, I will take care of it in my own way." What is the best initial action by the nurse?
Ask the patient if he has a plan. Duty to assess and warn.
A conflict erupts in the unit, and the staff implements a show of force to separate the two patients and have them return to their rooms. Once in the room the patient continues to yell. What is the best question for the nurse to ask the patient?
Would you like something to help you calm down? (offer a PRN PO med)
During the intake of a patient to the unit, the patient endorses suicidal ideation. What are appropriate interventions by the nurse?
Contract for safety. Ask if the patient has a plan and what the plan is to assess for lethality. Explain to the patient that this information will be shared with staff. Search the patient and belongings for hazards (drugs, items that can be used for self or other harm, items that can be used for ligature).
The patient expresses feelings of sadness and openly discusses them with the nurse. According to Peplau's theory the relationship has entered which phase?
Identification (Working) is when the client works independently with the nurse and expresses feelings and feels stronger.
A conflict erupts in the unit, and the staff implements a show of force to separate the two patients and have them return to their rooms. What standards need to be maintained?
The client's rights were maintained, and the least restrictive environment was used.
Your patient continues to make requests that violate the unit rules. What do you do?
Maintain consistency with the rules. If you make special accommodations, it blurs boundaries.
Your are conducting a group and one member is making negative comments about other patients. What comments are therapeutic? (select all that apply)
1. "I'd rather you keep your negative comments to yourself."
2. "An expectation in the group is being sensitive to others' feelings"
3. "I notice you are commenting negatively about others in the group. Would you like to share your thoughts?