Nursing 3381- Psychiatric-Mental Health Nursing of Individuals, Families, and Groups
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Free Nursing 3381- Psychiatric-Mental Health Nursing of Individuals, Families, and Groups Questions
A team of nurses wants to integrate evidence-based practice into a facility's clinical pathways. Which step should the team implement first?
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Apply the research findings to clinical practice
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Ask questions to identify clinical problems
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Acquire findings from published literature
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Assess the performance of clinical practices
Explanation
The Correct Answer is:
B. Ask questions to identify clinical problems.
Detailed Explanation:
The first step in the evidence-based practice (EBP) process is to ask a well-formulated clinical question that identifies a problem or area for improvement. This step guides the rest of the process by focusing the inquiry on a specific, measurable, and relevant issue. The PICO framework (Population, Intervention, Comparison, Outcome) is often used to structure these questions.
Once the clinical problem is clearly defined, the team can acquire evidence from credible sources, appraise the quality and applicability of the research, apply the findings to practice, and finally assess outcomes to determine effectiveness.
Your patient sometimes forgets to eat. In which part of the nursing care plan would the nurse expect to find this statement:
"Offer snacks and finger foods frequently."
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Intervention
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Planning/Goals
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Assessment
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Diagnosis
Explanation
The Correct Answer is:
A. Intervention.
Detailed Explanation:
The statement “Offer snacks and finger foods frequently” describes a nursing intervention, which outlines the specific actions the nurse will take to address an identified patient problem. Interventions are designed to help the patient achieve established goals and are based on the nurse’s clinical judgment and evidence-based practice.
In this case, offering snacks and finger foods is a behavioral and environmental strategy intended to promote adequate nutrition for a patient who forgets to eat—often due to cognitive impairment, depression, or another mental health condition.
Which of the following side effects is associated with the blockade of attachment of norepinephrine to α₁-receptors?
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Orthostatic hypotension
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Increased psychotic symptoms
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Severe appetite disturbance
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Hypertensive crisis
Explanation
The Correct Answer is:
A. Orthostatic hypotension.
Detailed Explanation:
α₁-adrenergic receptors are located in vascular smooth muscle and are responsible for vasoconstriction when stimulated by norepinephrine. When these receptors are blocked—as can occur with certain antipsychotics (e.g., chlorpromazine) or antidepressants (e.g., tricyclics)—the blood vessels fail to constrict properly upon standing, leading to orthostatic (postural) hypotension.
This results in symptoms such as dizziness, lightheadedness, blurred vision, or fainting when changing positions. The risk is highest during the initiation of therapy or with dose increases.
A nurse should assess a patient taking a medication with anticholinergic properties for inhibition of what function?
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Peripheral nervous system
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Sympathetic nervous system
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Parasympathetic nervous system
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Reticular activating system
Explanation
The Correct Answer is:
C. Parasympathetic nervous system.
Detailed Explanation:
Medications with anticholinergic properties block the action of acetylcholine at muscarinic receptors in the parasympathetic nervous system. Because the parasympathetic system controls “rest and digest” functions, inhibition leads to decreased secretions and smooth muscle activity. As a result, patients may experience dry mouth, constipation, urinary retention, blurred vision, and tachycardia.
A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?
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Dry mouth
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Orthostatic hypotension
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Pseudoparkinsonism
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Gynecomastia
Explanation
The Correct Answer is:
A. Dry mouth.
Detailed Explanation:
Muscarinic-receptor blockers (anticholinergic drugs) inhibit the action of acetylcholine on parasympathetic (muscarinic) receptors. This leads to a reduction in parasympathetic activity, producing anticholinergic side effects. The most common of these include dry mouth, blurred vision, constipation, urinary retention, and tachycardia.
Medications with anticholinergic properties—such as certain antipsychotics, tricyclic antidepressants, and antihistamines—require careful monitoring, especially in older adults, because these side effects can contribute to dehydration, confusion, and falls.
The nursing student understands that the purpose of completing a process recording for the nurse–patient interview is to:
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provide the client with a way to identify abnormalities in their communication style.
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analyze the effect of their communication style on the client.
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identify abnormalities in the client’s communication techniques.
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allow the client to explore alternate communication techniques that can be used
Explanation
The Correct Answer is:
B. analyze the effect of their communication style on the client.
Detailed Explanation:
A process recording is a tool used primarily in psychiatric and mental health nursing education to help students develop self-awareness and therapeutic communication skills. It involves a detailed written account of an interaction between the nurse and the patient, including both verbal and nonverbal communication. The purpose is for the nursing student to analyze their own communication techniques—what was said, how it was said, and how the patient responded.
By reviewing the process recording with an instructor, the student gains insight into how their words, tone, and body language influence the patient’s reactions and emotions. This reflective exercise promotes growth in therapeutic communication and helps identify areas for improvement.
A patient diagnosed with schizophrenia had an exacerbation of hallucinations and delusions related to medication non-adherence and was hospitalized for 10 days. The patient is stabilized and discharge is planned. The patient's family is concerned that the patient's symptoms will return after discharge. Acting as an advocate for the patient's rights, the nurse's best response is:
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To contact the psychiatrist for an order to cancel the impending discharge.
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To notify hospital security to handle a potential disturbance and escort the family off the unit.
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To ask the case manager to arrange a transfer to a long-term care facility.
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To explain that the patient will continue to improve if the medication is taken regularly.
Explanation
The Correct Answer is:
D. To explain that the patient will continue to improve if the medication is taken regularly.
Detailed Explanation:
The nurse’s role as an advocate includes educating both the patient and family about the illness, treatment, and recovery process. The best response reassures the family and emphasizes the importance of medication adherence to prevent relapse and maintain stability after discharge. This approach supports the patient’s right to the least restrictive environment while promoting self-management and family involvement in ongoing care.
A patient is taking a first-generation antipsychotic medication. What should the nurse teach about the drug’s strong dopaminergic effect?
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To arise slowly from bed
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To report muscle stiffness
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To chew sugarless gum
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To increase dietary fiber
Explanation
The Correct Answer is:
B. To report muscle stiffness.
Detailed Explanation:
First-generation (typical) antipsychotics—such as haloperidol or chlorpromazine—work by blocking dopamine (D₂) receptors in the brain. While this reduces psychotic symptoms, the strong dopaminergic blockade can also produce extrapyramidal symptoms (EPS), which are drug-induced movement disorders.
Early signs of EPS include muscle stiffness, tremors, drooling, bradykinesia, and restlessness (akathisia). Severe muscle rigidity can progress to acute dystonia or neuroleptic malignant syndrome (NMS), both of which require immediate medical attention. Therefore, patients should be instructed to report muscle stiffness or rigidity immediately so treatment (e.g., benztropine or diphenhydramine) can be started.
After teaching a class about the rights of persons receiving mental health services, the nurse determines a need for additional discussion when the group wrongly identifies which as a right?
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Freedom from restraints or seclusion
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Refusal of treatment during an emergency situation
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Access to one's own mental health records upon request
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An individualized written treatment plan
Explanation
The Correct Answer is:
B. Refusal of treatment during an emergency situation.
Detailed Explanation:
While patients receiving mental health services generally have the right to refuse treatment, this right can be overridden during an emergency if the patient poses a danger to self or others. In such cases, emergency interventions—including medications, restraints, or seclusion—may be used to protect life and ensure safety. These actions must follow strict legal and ethical guidelines, be documented thoroughly, and end as soon as the crisis resolves.
A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?
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Buspirone (Buspar)
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Venlafaxine (Effexor)
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Imipramine (Tofranil)
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Alprazolam (Xanax)
Explanation
The Correct Answer is:
D. Alprazolam (Xanax).
Detailed Explanation:
Alprazolam (Xanax) is a benzodiazepine that provides rapid relief of acute anxiety and panic symptoms by enhancing the effect of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that calms neuronal activity in the central nervous system. It has a quick onset of action, making it ideal for short-term or emergency management of panic attacks. However, due to the risks of tolerance, dependence, and withdrawal, benzodiazepines should be used only for short-term relief and under close medical supervision.
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