A new nurse asks the mentor, “How can I be sure I’m developing a therapeutic environment for my unit?” The mentor uses as a basis for the response the fact that a therapeutic milieu is characterized by:

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Question 1 of 5

A new nurse asks the mentor, “How can I be sure I’m developing a therapeutic environment for my unit?” The mentor uses as a basis for the response the fact that a therapeutic milieu is characterized by:

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.

Question 2 of 5

A patient asks the nurse manager to help resolve a situation between her and another patient. Which action would best support the patient’s feelings of safety when experimenting with new ways of being?

Correct Answer: D

Rationale: Offering to be present and help the patient discuss her feelings about the incident with the other patient would best support the patient’s feelings of safety when experimenting with new ways of being. This option encourages open communication between the two patients in a safe and mediated environment. It allows the patient to express her feelings assertively while feeling supported by the nurse manager. Mediation can help both patients understand each other's perspectives, resolve conflicts, and potentially prevent similar incidents in the future. Ultimately, this approach empowers the patient to address the situation directly while providing a sense of safety and support.

Question 3 of 5

A novice mental health nurse shares that, “I’ll never get used to playing cards or other games with patients. It seems like a poor use of scarce nursing time.” The best response for the nurse’s mentor would be:

Correct Answer: C

Rationale: The best response for the nurse’s mentor would be to highlight the importance of activities in mental health nursing. Participating in activities such as playing cards or games with patients is not just about passing time, but it also serves a therapeutic purpose. Engaging in activities helps patients to develop social skills, build relationships, and take small risks in a safe environment. As mental health nurses, it is crucial to understand that these activities are not a waste of time but rather an essential part of the therapeutic process. By participating in activities with patients, nurses can actively support their mental well-being and contribute to their overall treatment and recovery.

Question 4 of 5

When leading a therapeutic group, the nurse demonstrates an understanding of the need to act as the group’s executive when:

Correct Answer: A

Rationale: When leading a therapeutic group, the nurse's role as the group's executive involves setting and maintaining boundaries, ensuring adherence to the group's rules, and creating a safe and structured environment for all members. Restating rules when a new member joins helps to establish expectations and maintain consistency within the group. It allows the nurse to assert authority and guide the group in a direction that is conducive to therapeutic progress. By upholding the rules and boundaries of the group, the nurse helps to create a sense of safety and trust among the members, allowing for open and productive communication and shared growth.

Question 5 of 5

The physician has ordered atropine 5 mg intramuscularly (IM) for a patient to be administered 30 minutes prior to ECT. The rationale for use of this medication is that it reduces secretions and:

Correct Answer: A

Rationale: The rationale for using atropine 5 mg IM prior to ECT is to protect against vagal bradycardia, not to improve the scope of convulsive activity, reduce the need for recovery room staff, or prevent incontinence of bladder and bowel. Atropine is a muscarinic antagonist that blocks the effects of acetylcholine on muscarinic receptors, leading to an increase in heart rate and protection against bradycardia that can occur during ECT.

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