A nurse interacts with a newly hospitalized patient. Select the nurse's comment that applies the communication technique of 'offering self.'

Correct Answer: D

Rationale: Offering self' is a technique that should be used in the orientation phase of the nurse-patient relationship. Sitting with the patient, an example of 'offering self,' helps to build trust and convey that the nurse cares about the patient. Two incorrect responses are ineffective and nontherapeutic. The other incorrect response is therapeutic but is an example of 'offering hope.'

Correct Answer: C

Rationale: In this scenario, the most appropriate nursing diagnosis for a patient diagnosed with generalized anxiety disorder who expresses worrying about everything, even things beyond their control, is option C) Anxiety. The correct answer, "Anxiety," is the most suitable nursing diagnosis because the patient's statement directly aligns with the defining characteristics of generalized anxiety disorder, which include excessive worry and inability to control that worry. By selecting this option, the nurse acknowledges the patient's condition and can plan interventions to address the anxiety symptoms effectively. Option A) Imbalanced nutrition: Less than body requirements, is incorrect as there are no indicators in the scenario that suggest issues with nutrition intake. Option B) Ineffective coping is not the most appropriate choice in this case because the patient is not displaying maladaptive coping mechanisms but rather expressing excessive worry, which aligns more closely with symptoms of anxiety disorder. Option D) Risk for self-directed violence is also not the most suitable option as there is no evidence in the scenario to suggest that the patient is at an immediate risk for self-harm. In an educational context, understanding how to accurately assess and diagnose patients with mental health conditions is crucial for nurses to provide effective care. By selecting the correct nursing diagnosis, nurses can tailor their interventions to address the specific needs of the patient and promote positive outcomes in their mental health treatment.

Correct Answer: B

Rationale: In this scenario, the most appropriate intervention for the nurse to prioritize is option B: Set firm limits on impulsive behaviors and provide clear boundaries. This is because individuals with bipolar disorder often struggle with impulsivity, and setting clear boundaries helps establish structure and safety for the patient. By setting limits, the nurse can help prevent harmful consequences of impulsive actions and guide the patient towards more controlled decision-making. Option A, encouraging the patient to limit social interactions, may not address the core issue of impulsive behaviors associated with bipolar disorder. Social isolation can also have negative effects on mental health, so this intervention could potentially worsen the patient's condition. Option C, providing positive reinforcement for responsible decisions, is important in behavioral interventions. However, in this case, the impulsive behaviors of excessive spending and poor judgment require more immediate and direct intervention through setting limits rather than solely relying on positive reinforcement. Option D, encouraging group therapy and social activities, can be beneficial for overall mental health support. However, in the context of managing impulsive behaviors, establishing clear boundaries and limits should take precedence to ensure the patient's safety and well-being. In an educational context, understanding the rationale behind prioritizing interventions in managing behavioral symptoms of mental health disorders is crucial for nurses and healthcare professionals. By effectively addressing impulsive behaviors in patients with bipolar disorder, nurses can contribute to better outcomes and improved quality of life for their patients.

Correct Answer: D

Rationale: In this scenario, the priority nursing intervention for a patient with bipolar disorder in the manic phase exhibiting impulsive behaviors like excessive spending is option D: Limit the patient's access to money and credit cards. This intervention is crucial because it addresses immediate patient safety concerns by preventing financial harm and potential legal consequences due to reckless spending. Option A, encouraging the patient to think through consequences, may not be effective during the manic phase when judgment is impaired. Administering mood-stabilizing medication (Option B) is important but is not the immediate priority in managing impulsive behaviors. Providing a calm environment (Option C) is beneficial but may not directly address the impulsive spending behavior. From an educational perspective, understanding the urgency of addressing safety concerns in patients experiencing manic episodes is crucial in psychiatric nursing. Limiting access to potential harm-inducing items reflects a proactive approach to ensuring patient well-being during periods of altered mental states. This case emphasizes the significance of prioritizing interventions based on the immediate needs of the patient to promote their safety and stability.

Correct Answer: B

Rationale: The correct answer to the question is B) Assess the patient for a history of renal problems. This is the best next action for the nurse because elevated BUN and creatinine levels indicate possible kidney dysfunction, which could be causing the psychiatric symptoms. By assessing the patient for a history of renal problems, the nurse can gather important information that may help in determining the underlying cause of the symptoms and guide further interventions. Option A) Report the findings to the health care provider is not the best next action because simply reporting the lab results without further assessment may delay appropriate care for the patient. It is important for the nurse to gather more information before involving the healthcare provider. Option C) Assess the patient's family history for cardiac problems is incorrect as it is not directly related to the elevated BUN and creatinine levels. While family history is important in healthcare, in this scenario, focusing on renal history is more relevant. Option D) Arrange for the patient's hospitalization on the psychiatric unit is not the best next step as the primary concern is the medical cause of the symptoms indicated by the abnormal lab results. Placing the patient on a psychiatric unit without addressing the medical issue would not be appropriate. In an educational context, this question highlights the importance of thorough assessment and critical thinking in nursing practice. It emphasizes the need for nurses to consider all relevant information, including lab results and patient history, to provide safe and effective care. Understanding the significance of abnormal lab values and knowing how to proceed with assessment and intervention are essential skills for nurses in various healthcare settings.