A nurse is caring for a client who reports a recent increase in stressors. Which of the following concepts should the nurse use to develop necessary context to both understand and deliver nursing care for this client?

Correct Answer: C

Rationale: The correct answer is C) Adaptive vs. maladaptive. This concept is essential for the nurse to understand and deliver appropriate care to a client experiencing increased stressors. By assessing whether the client's responses to stress are adaptive (helpful in coping with stress) or maladaptive (detrimental to well-being), the nurse can tailor interventions to promote effective coping mechanisms and improve the client's overall well-being. Option A) Good vs. bad is overly simplistic and does not provide the nuanced understanding needed to address the complex nature of stress and coping mechanisms in healthcare settings. Option B) Justified vs. unjustified focuses more on moral or ethical considerations rather than the psychological aspects of stress and coping. Option D) Right vs. wrong is also too binary and does not capture the multidimensional nature of stress responses and coping strategies. In an educational context, understanding the difference between adaptive and maladaptive responses to stress is crucial for nurses to provide holistic and patient-centered care. By recognizing maladaptive coping mechanisms, nurses can intervene early to support clients in developing healthier strategies to manage stress and maintain their well-being. This knowledge enhances the nurse's ability to promote positive health outcomes and build therapeutic relationships with clients.

Correct Answer: D

Rationale: In this scenario, option D, "I can't get my mind to stop racing at night. I'm only sleeping a couple of hours," is consistent with manifestations of depression. This statement reflects symptoms such as racing thoughts and insomnia, which are common in individuals experiencing depression. Option A is incorrect as it describes a physical health condition (high blood pressure) rather than emotional or mental health concerns associated with depression. Option B indicates increased alertness and improved focus, which are not typical symptoms of depression but could suggest other conditions like anxiety. Option C describes restlessness and a need for constant activity, which is more indicative of conditions like anxiety or hyperactivity rather than depression. Educationally, it's crucial for nurses to be able to differentiate between physical and mental health symptoms to provide appropriate care. Understanding the nuances of mental health conditions like depression helps nurses in accurately assessing and supporting patients, leading to better outcomes and quality of care.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: Exploring alternative options with a patient regarding medications. This choice aligns with the ethical principle of autonomy, which emphasizes the right of individuals to make their own decisions about their healthcare. By engaging in a collaborative discussion with the patient about medication options, the psychiatric nurse respects the patient's autonomy and empowers them to actively participate in their treatment plan. Option A is incorrect because intervening when a self-mutilating patient attempts to harm themselves may be necessary for patient safety, but it may not always align with promoting autonomy as it involves overriding the patient's actions without their input. Option B is incorrect because staying with a patient who is anxious is a supportive measure but does not directly address the ethical principle of autonomy or involve the patient in decision-making about their care. Option C is incorrect as suggesting that two fighting patients be restricted to the unit is more about maintaining a safe environment and managing behavior rather than promoting autonomy through collaborative decision-making. In an educational context, it is crucial for nurses to understand the ethical principles that guide their practice, including autonomy. By selecting the correct answer, nurses can learn how to respect and promote their patients' autonomy while providing high-quality care that is patient-centered and empowering. This question highlights the importance of involving patients in decisions about their care to uphold ethical standards and foster positive patient outcomes.

Correct Answer: A

Rationale: The correct answer is option A because it demonstrates the most concrete evidence of treatment effectiveness. The patient being abstinent for 10 days indicates immediate compliance with the treatment plan. Additionally, stating "I can maintain sobriety one day at a time" reflects a key principle of Alcoholics Anonymous and recovery programs, showing the patient's understanding of their journey. Moreover, the fact that the employer is willing to allow the patient to return to work in 3 weeks suggests positive progress and support from the external environment. Options B, C, and D are incorrect as they each have red flags indicating potential relapse or misalignment with effective treatment outcomes. Option B's statement of "My problems are under control" may indicate overconfidence or denial of ongoing issues. Option C's focus on helping others and finding jobs for them instead of personal recovery suggests a lack of self-awareness. Option D's statement about being able to handle one or two drinks raises concerns about boundaries and potential relapse triggers. In an educational context, this question assesses the nurse's ability to interpret patient progress and treatment effectiveness based on documentation. It highlights the importance of looking for concrete evidence of compliance with treatment plans, understanding of recovery principles, and integration of support systems in evaluating patient outcomes in alcohol treatment programs. By understanding these nuances, nurses can provide more effective care and support to individuals struggling with addiction.

Correct Answer: B

Rationale: In this scenario, option B is the most appropriate response for the nurse to assist the patient in reframing their overgeneralization. By suggesting to explore a specific event to identify alternative explanations, the nurse is guiding the patient towards critical thinking and challenging their automatic negative thoughts. This approach helps the patient recognize that not all bad outcomes are solely their fault, promoting a more balanced perspective. Option A is incorrect because it simply dismisses the patient's belief without offering a constructive alternative. This response may come off as invalidating and not supportive of the patient's feelings. Option C, while showing empathy, does not actively engage the patient in challenging their negative thought pattern. It acknowledges the patient's self-criticism but does not provide a strategy for cognitive restructuring. Option D is unrelated to the patient's statement and does not address the overgeneralization presented. Bringing up the patient's belief in fate or cultural heritage does not directly assist in reframing the negative thought pattern the patient is experiencing. Educationally, this question highlights the importance of active listening and therapeutic communication skills in nursing practice. It emphasizes the role of nurses in guiding patients towards more adaptive thought processes and promoting mental well-being through cognitive restructuring techniques. By understanding the rationale behind each response, nurses can enhance their ability to support patients with mental health challenges effectively.