A nurse assigned to a mental health hotline receives a call from a nurse who has been working on a Covid-19 unit. The caller states, 'I just don't think I can be a nurse anymore.' Which of the following types of trauma should the nurse recognize this person is experiencing?

Correct Answer: D

Rationale: The correct answer is D) Secondary trauma. In this scenario, the nurse working on a Covid-19 unit is likely experiencing secondary trauma, which occurs when an individual is indirectly exposed to traumatic events through their work with traumatized individuals. The nurse on the mental health hotline is hearing about the struggles of the nurse from the Covid-19 unit, leading to emotional distress and a questioning of their nursing career. Option A) Acute trauma refers to a single traumatic event, which does not fit the ongoing stress and impact of working on a Covid-19 unit. Option B) Chronic trauma typically involves repeated exposure to traumatic events over time but does not capture the indirect nature of the trauma experienced by the nurse on the hotline. Option C) Complex trauma involves exposure to multiple traumatic events, often in childhood, and does not align with the current situation described in the question. Understanding secondary trauma is crucial for nurses working in behavioral health settings as it can impact their own mental health and job satisfaction. Recognizing the signs and symptoms of secondary trauma allows nurses to seek support, practice self-care, and continue providing effective care to their patients.

Correct Answer: B

Rationale: In caring for a patient with bipolar disorder in the manic phase, providing a calm environment to reduce external stimulation (option B) should be implemented first. This intervention is crucial as it helps decrease the patient's agitation and can prevent escalating behavior. Encouraging social activities (option A) may exacerbate the symptoms due to increased stimulation. Offering medication (option C) is important but may not have an immediate effect in managing acute manic symptoms. Setting firm limits (option D) may agitate the patient further and should be used cautiously. Educationally, understanding the importance of environment in managing acute behavioral health crises is key. Nurses need to prioritize interventions that promote a safe and calming atmosphere to support patients in regaining control during manic episodes. This rationale highlights the significance of tailored care strategies in psychiatric nursing practice.

Correct Answer: B

Rationale: In this scenario, option B) Assess the patient for a history of renal problems is the correct choice. Elevated BUN and creatinine levels indicate possible renal impairment, which can manifest as psychiatric symptoms. By assessing the patient for a history of renal problems, the nurse can gather crucial information to understand the underlying cause of the psychiatric symptoms and initiate appropriate interventions. Option A) Report the findings to the health care provider is not the best immediate action because further assessment is needed before involving the provider. Option C) Assess the patient's family history for cardiac problems is irrelevant to the current situation and does not address the elevated BUN and creatinine levels. Option D) Arrange for the patient's hospitalization on the psychiatric unit is premature without determining the root cause of the symptoms. Educationally, this question highlights the importance of a comprehensive assessment in nursing practice, especially in cases where physical and psychiatric symptoms overlap. It underscores the need for nurses to consider all possible contributing factors to provide holistic and patient-centered care. Understanding the connections between physical and mental health is essential in the field of behavioral health nursing.

Correct Answer: D

Rationale: The most appropriate nursing diagnosis for the patient described is option D) Hopelessness. In major depressive disorder, feelings of hopelessness are common and can significantly impact a patient's mental well-being. By selecting this diagnosis, the nurse acknowledges the patient's emotional state and initiates appropriate interventions to address these feelings of despair and helplessness. Option A) Impaired social interaction may not fully capture the depth of the patient's emotional distress and does not address the core issue of hopelessness. Option B) Risk for suicide is a serious concern in major depressive disorder, but the patient's statement does not indicate immediate suicidal intent. Option C) Ineffective coping may be relevant, but it does not specifically address the patient's profound sense of hopelessness as expressed in the statement. Educationally, understanding how to accurately assess and diagnose mental health conditions is crucial for nurses working in behavioral health settings. By selecting the most appropriate nursing diagnosis, nurses can tailor interventions to support patients effectively in managing their mental health challenges. In this case, identifying hopelessness as the primary issue allows for targeted and holistic care planning to address the patient's emotional needs.

Correct Answer: A

Rationale: In caring for a patient with bipolar disorder in the manic phase, the priority nursing intervention is to provide a quiet environment and limit stimulation (Option A). This is essential because individuals in a manic state are often overwhelmed by their own racing thoughts and heightened energy levels. Creating a calm and quiet space can help reduce external stimuli that may exacerbate their symptoms and promote a sense of grounding for the patient. Encouraging the patient to engage in social activities (Option B) may further escalate their symptoms due to the already heightened energy levels and impulsivity present during mania. Administering sedatives (Option C) should not be the initial approach as it may not address the underlying causes of the manic behavior and can have potential side effects. Offering medications to address the manic symptoms (Option D) is important, but creating a safe and calming environment is the immediate priority to ensure the patient's well-being and safety. From an educational perspective, understanding the principles of therapeutic communication, environmental management, and prioritization of care in mental health nursing is crucial for nurses caring for patients with bipolar disorder or other psychiatric conditions. By prioritizing non-pharmacological interventions like providing a quiet environment, nurses can help promote patient comfort, safety, and overall therapeutic outcomes.