Chapterv1 Psychiatric–MentalvHealthvNursingvandvEvidence-BasedvPractice
1 Whichvofvthevfollowingvquestionsvwouldvbevmostv helpful
.
invbeginningvanvinitialvassessmentvinterviewvforvavpatientvwhovhasvjustvbe
envadmittedvtovavpsychiatricvinpatientv unit?
A)
Havevyouvhadvanyvpreviousvpsyc
hiatricvadmissions?
B) Whatvbringsvyouvintovthevhospitalv today?
C) Havevyouvhadvanyvthoughtsvaboutvtryingvtovharmvyourself?
D) Howvwouldvyouvdescribevyourvrelationshipvwithvyourvspouse?
2.
Avpatientvisvbeingvadmittedvtovthevpsychiatricvunit.vWhilevexplainingvhi
svreasonvforvseekingvadmission,vhevdescribesvhowvhisv32-year-
oldvsonvrecentlyvdiedvofvavheartvattack.vWhichvresponsevbyvthevnursevwou
ldvenhancevtheveffectivenessvofvthisvinterview?
A) Howvisvyourvwifevhandlingvyourvsonsv death?
B)
Dovyouvhavevanyvothervlivingvchildrenvthatvcanvhelpvyouvcopevwit
hvthisvloss?
C) Thisvmustvbevavveryvdifficultvtimevforv you.
,D) Ivknowvexactlyvhowvyourevfeeling;vmyv23-year-
oldvsonvdiedvunexpectedlyvlastvyear.
3.
Avpatientvwasvadmittedvtovthevhospitalvaftervavsuicidevattemptvmadevafterv
hisvdaughtervwasvkilledvinvanvautomobilevaccidentvduringvwhichvhevhadvbee
nvdrivingvandvsurvivedvwithvonlyvminorvinjuries.vEvenvthoughvthevaccidentv
wasvunavoidable,vhevfeelsvresponsible.vDuringvthevassessmentvinterview,vt
hevpatientvbeginsvtovdescribevthevlastvconversationvhevhadvwithvhisvdaughter
vbeforevhevlost vcontrolvofvthevautomobile.vAsvhevspeaksvaboutvhis vdaughter,v
hisvvoicevtrembles,vandvavsilentvtearvrollsvdownvhisvface.vHevmakesvavvisible
vattempt vtovstraightenvupvandvsmilesvsuperficiallyvatvthevnurse,vstating,vIllvge
tvovervthis.v Ivjustvneedvtovkeepvavstiffvuppervlip.vIvthinkvallvIvneedvtovdovisvsta
yvovernight.vIllvbevasvgoodvasvnewvbyvtomorrow.vWhichvresponsevbyvthevnu
rsevwouldvbevmostv appropriate?
A)
Tellvmevaboutvyourvdaughter.vHowvwouldvyouvdescribevthevrelati
onshipvyouvhadvwithvher?
B) Imvsurevyouvarevright;vavgoodvnightsvrestvshouldvmakevavbigvdifference.
C) Asvgoodvasvnew?
D)
Youvmadevavseriousvattemptvonvyourvlife;vyouvwillvnotvbevrea
dyvgovhomevbyvtomorrow.
,4.
Aftervassessingvavpatient,vthevnursevnotedvthevfollowing:vhevwasvtearful,vh
evtriedvtovkillvhimselfvbeforevcomingvintovthevhospital,vhevhadvnovimmediate
vplanvforvanothervsuicidevattempt,vhevwas vunablevtovconcentrate,vandvhevrep
ortedvhavingvtroublevsleepingvandvhavingvlittlevorvnovappetite.vThevnursevals
ovnotedvthatvthevpatientsvappearancevwasvunkempt,vthatvhevspokevinvavlowvm
onotone,vandvthatvhevwasvunablevtovestablishvandvmaintainveyevcontact.vBas
edvonvthisvinformation,vwhichvnursingvdiagnosesvwouldvbevthevmostvapprop
riate?
A) IneffectivevRolevPerformance
B) RiskvforvInfection
C) RiskvforvSuicide
D) RiskvforvSelf-Mutilation
5.
Avstaffvnursevonvavpsychiatricvunitvknowsvthatvpatientsvoftenvhavevtroubl
evsleepingvbecausevofvtheirvpsychiatricvconditions.vWhichvofvthevfollowin
gvwouldvreflectvavpsychiatricvnursingvinterventionvtovappropriatelyvaddres
svthisvproblem?
A) Limitingvamountsvofveveningvsnacksvandv beverages
B) Involvingvpatientsvinvavvolleyballvgamevimmediatelyvbeforevbedtime
C)
Enforcingvthevrulevthatvallvpatientsvbevinvbedvwithvlightsvoutvbyv
10:30vPM
D) Encouragingvpatientsvtovtakevshortvnapsvinvthevafternoons
6.
Thevnursevisvdeterminingvthevsuccessvofvavpatientsvplanvofvcarevbyvevaluati
ngvoutcomevindicators.vThevnursevunderstandsvthatvthesevindicatorsvarevusua
llyvdeterminedvinitiallyvatvwhichvtime?
, A) Onvthevdayvofvdischarge
B) Duringvthevassessmentvprocess
C) Atvthevinitialvinterview
D) Withvgoal-settingvprocess
7.
Basedvonvassessmentvdata,vthevnursevformulatesvthevnursingvdiagnosi
svforvavpatientvasvsleepvpatternvdisturbance.vAftervteachingvthevpatientvh
owvtovrelaxvbeforevbedtime,vthevnursevdeterminesvthatvthevteachingvwa
sveffectivevbyvwhichvoutcome?
A) Discussesvfeelingsvaboutvnotvbeingvablevtovfallv asleep
B) Reportsvfeelingvrestedvonvawakeningvinvthevmorningvwithinv3vdays
C) Requestsvsleepingvmedicationveachvnightvbeforevbedtime
D) Isvablevtovsleepvforvshortvintervalsvthroughoutvthev night
8.
Avpatientvwasvbroughtvtovthevemergencyvdepartmentvforvanvinjuryvhevrece
ivedvwhilevworkingvasvavmigrantvworker.vItvsoonvbecomesvevidentvthatvthevp
atientvcannotvspeakvEnglish.vAvnursevonvdutyvoffersvtovfindvanvinterpretervso
vthevpatient vcanvcommunicatevwithvthevmedical vstaff.vThevnursesvoffervisvanv
examplevofvwhichvtypevofvnursingvintervention?
A) Milieuvtherapy
B) Conflictvresolution
C) Culturalvbrokering
D) Structuredvinteraction