Nurse in Psychiatry Test Bank

Correct Answer: D

Rationale: Step-by-step rationale for why choice D is correct: 1. Maslow's hierarchy of needs places self-esteem as a fundamental psychological need. 2. Patient hygiene and dress contribute to self-esteem by promoting a sense of dignity and self-worth. 3. Attending to hygiene and dress before spousal visits shows respect for the patient's self-esteem. 4. This strategy directly addresses the self-esteem needs of elderly patients by enhancing their sense of self-worth and respect. Summary of why other choices are incorrect: A: Providing privacy for spouses does not directly address the patient's self-esteem needs. B: Arranging dining with spouses may enhance social needs but not directly address self-esteem. C: Including patients and spouses in educational sessions may promote social interaction but does not directly target self-esteem needs.

Correct Answer: D

Rationale: The correct answer is D: Ask clear, simple questions using concrete language. This strategy is most helpful because older adults with schizophrenia may have cognitive impairments that affect their ability to process complex information. Clear and simple questions using concrete language can help the patient understand and respond effectively. Choice A (Ask questions that can be answered with yes or no) limits communication and may not provide enough information for the nurse to assess the patient's condition comprehensively. Choice B (Use silence often and let the patient take the lead) may not be effective as the patient may struggle to communicate effectively due to cognitive impairments. Choice C (Use open-ended, indirect questions) may lead to confusion or misinterpretation for a patient with cognitive challenges.

Correct Answer: A

Rationale: The correct answer is A because positive transference with a staff member in the orientation phase indicates a developing therapeutic relationship, which is crucial for effective treatment. This outcome shows the patient is beginning to trust and feel safe with a staff member, enhancing their engagement in therapy. Choice B is incorrect because the ability to ask for help in meeting needs may not be fully developed by the end of the orientation phase. Choice C is incorrect as commitment to long-term therapy is usually not established this early in the process. Choice D is incorrect because the ability to manage symptoms independently typically requires more time and therapy progress.

Correct Answer: A

Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions. Summary: Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is

Correct Answer: A

Rationale: The correct answer is A because the teen is expressing a fear of losing control over her emotions if she starts crying. This is evident from her belief that she will never stop crying once she starts. Option B (Losing the support of her friends and family) is incorrect as the statement does not suggest concern about losing support. Option C (Embarrassing herself by crying in public) is incorrect as the fear expressed is more about not being able to stop crying rather than embarrassment. Option D (Appearing emotionally immature) is incorrect as there is no indication that the teen is worried about how others perceive her emotional maturity.