A nurse is reviewing the documentation for a newly admitted client and notes the following entry, 'Client verbalizes the use of coping mechanisms when experiencing stress.' Which of the following can the nurse expect when interacting with this client?

Correct Answer: C

Rationale: The correct answer is C) The client adapts well to change. When a client verbalizes the use of coping mechanisms during stress, it indicates that they have developed healthy strategies to manage challenging situations. Coping mechanisms help individuals navigate stressors effectively, leading to better adaptability to changes in their environment or health status. Option A) The client prefers solitary activities to group activities is incorrect because coping mechanisms do not necessarily indicate a preference for solitude. It simply means the client has strategies to manage stress. Option B) The client follows all rules is incorrect as it does not directly relate to the use of coping mechanisms. Following rules may be a behavior unrelated to stress management. Option D) The client prefers to sit quietly is incorrect as it assumes a specific behavior that may not be indicative of how the client copes with stress. Educationally, this question highlights the importance of recognizing and understanding coping mechanisms in nursing practice. It emphasizes the significance of assessing clients' abilities to manage stress and adapt to changes, which are essential skills for providing holistic and effective care. Nurses need to be aware of clients' coping strategies to support their overall well-being and resilience.

Correct Answer: B

Rationale: The correct answer is B) Schedule weekly clinic appointments because it allows the nurse to closely monitor the patient's mood over time without immediately escalating to a more restrictive intervention like hospitalization or crisis intervention. This approach respects the patient's autonomy by involving them in the decision-making process and giving them the opportunity to engage in their treatment plan actively. Option A) Arrange for a short hospitalization may be too drastic of a step at this point and could potentially infringe on the patient's autonomy by taking away their independence and control over their care without exploring less restrictive options first. Option C) Referring the patient to the crisis intervention clinic may be premature and could escalate the situation unnecessarily. It may not be the most appropriate response for a patient who is not in immediate crisis but rather showing a decline in mood. Option D) Calling the family to observe the patient closely may breach the patient's confidentiality and may not provide an accurate assessment of the patient's current state as they may behave differently in front of their family members. It is essential to prioritize the patient's autonomy and confidentiality in mental health care. In an educational context, understanding the importance of assessing and responding to changes in mental health behavior while respecting patient autonomy is crucial for nursing practice. By choosing less restrictive interventions that involve the patient in decision-making, nurses can build trust with their patients and promote a collaborative approach to care. It is essential to approach each situation with sensitivity, empathy, and a commitment to upholding ethical principles in mental health nursing.

Correct Answer: A

Rationale: In a psychiatric inpatient setting, the principle of resolving behavioral crises using the least restrictive intervention possible takes priority for several important reasons. Firstly, it upholds the ethical principle of beneficence by prioritizing the well-being and autonomy of the individual patient. By choosing the least restrictive intervention, the staff respects the patient's dignity and right to self-determination. Additionally, this approach aligns with the recovery-oriented care philosophy in mental health, which emphasizes empowering individuals to actively participate in their care and decision-making process. By minimizing the use of coercive measures, staff can build trust with patients and foster a therapeutic relationship essential for long-term recovery. On the other hand, options B and C prioritize the collective over individual rights, potentially compromising the therapeutic alliance and patient-centered care. Option D, although advocating for patient autonomy, neglects the responsibility to ensure the safety of all individuals in the unit. Educationally, understanding the rationale behind choosing the least restrictive intervention not only enhances clinical decision-making skills but also reinforces the importance of respecting patients' rights and promoting a recovery-focused approach in psychiatric nursing practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Guilt and despair. The nurse, after working with a patient with major depressive disorder for 3 weeks without improvement, may start to feel guilty for not being able to help the patient effectively and may experience despair due to the lack of progress despite their efforts. This emotional response is common when healthcare professionals feel personally responsible for a patient's well-being and outcomes. Option A) Overinvolvement is incorrect because the nurse is not showing excessive involvement but rather a lack of improvement in the patient's condition. Option C) Disinterest and apathy is incorrect as it does not reflect the emotional toll of caring for a patient who is not improving. Option D) Ineffectiveness and frustration is incorrect as it does not capture the specific emotional response of guilt and despair that is likely in this situation. From an educational perspective, understanding the emotional responses that healthcare providers may experience when faced with challenging patient situations is crucial for self-awareness, self-care, and effective patient care. It highlights the importance of providing support and resources for nurses to cope with the emotional demands of their profession to prevent burnout and maintain well-being.

Correct Answer: A

Rationale: The correct answer is A) Clarification because the nurse is seeking to obtain more information and a better understanding of the patient's experience by encouraging them to verbalize the content of the auditory hallucinations. This technique helps to clarify the patient's thoughts and feelings, fostering a therapeutic relationship based on trust and empathy. Option B) Reflection involves paraphrasing the patient's words to show understanding and empathy, which is not demonstrated in the given scenario where the nurse is specifically asking for more details about the hallucinations. Option C) Restating involves repeating the main idea expressed by the patient, which is not what the nurse is doing in this situation as she is seeking specific information about the hallucinations. Option D) Focusing involves directing the conversation to a specific topic, which is not the case here as the nurse is aiming to explore the content of the auditory hallucinations. In an educational context, understanding therapeutic communication techniques is crucial for nurses to effectively communicate with patients, especially those with mental health conditions like schizophrenia. By using appropriate techniques like clarification, nurses can build rapport, gather important information, and provide better care for their patients.