Synopsis of Psychiatry Test Bank

Correct Answer: B

Rationale: Assessing the risk of self-directed violence is the priority when dealing with a patient diagnosed with dysfunctional grieving. Individuals experiencing complicated grief may be at an increased risk for self-harm or suicidal ideation. By assessing the risk of self-directed violence first, the nurse can ensure the patient's safety and provide appropriate interventions if necessary. Once the risk is assessed and managed, the nurse can then proceed with other interventions such as promoting interaction with others and facilitating the expression of feelings related to the loss.

Correct Answer: B

Rationale: Children often express anxiety through physical complaints like stomachaches, especially in situations that cause distress or discomfort, such as visiting a noncustodial parent.

Correct Answer: D

Rationale: A therapeutic milieu is characterized by focusing on the needs and goals of the patients. By establishing specific patient-centered goals that are agreed upon mutually by the patient and the staff, it ensures that the care provided is individualized and tailored to the patient's needs. This approach fosters a collaborative and empowering environment where the patient feels heard and supported in their recovery journey. It also promotes a sense of ownership and accountability for both the patient and the staff in working towards these goals together. In contrast, rigid adherence to timelines and unit routine (option A) may not always take into account the unique needs of each patient, and relaxation of boundaries (option B) can potentially compromise the therapeutic process by blurring professional boundaries. Therefore, establishing patient-centered goals is a key component of creating a therapeutic environment on a nursing unit.

Correct Answer: C

Rationale: Grief work involves actively processing emotions, integrating the loss, and adapting to life without the deceased. It is not solely about stress coping or progress evaluation.

Correct Answer: D

Rationale: The person with the greatest potential for developing dysfunctional grief is an adult who has dealt with the loss of several family members over their lifetime. Losing multiple family members can create a cumulative effect, leading to unresolved grief and complicated bereavement reactions. These repeated losses can overwhelm an individual's coping mechanisms and increase the risk of developing dysfunctional grief patterns. The ongoing experience of loss and grief can make it challenging for the individual to process their emotions effectively and adjust to their new reality, potentially leading to prolonged and complicated mourning.