A nursing instructor has prepared a lecture about the scope and standards of practice of psychiatric nurses. The instructor determines that the teaching was effective when the students identify which of the following as common to both basic and advanced level practice?

Correct Answer: A

Rationale: The correct answer is A: Case management. This is common to both basic and advanced level practice for psychiatric nurses because it involves coordinating care, advocating for patients, and ensuring continuity of services. Basic level nurses may handle simpler cases, while advanced level nurses may manage more complex cases. Choice B: Program development may be more common in advanced practice where nurses may be involved in creating new programs or services. Choice C: Clinical supervision is typically a responsibility of advanced practice nurses who oversee and guide other staff members. Choice D: Community interventions may also be more common in advanced practice where nurses may lead community-based initiatives.

Correct Answer: B

Rationale: The correct answer is B: Albert Bandura's social cognitive theory. The nurse is integrating this theory by demonstrating behaviors for the patient to develop through observational learning and modeling. Bandura's theory emphasizes that individuals learn by observing others and imitating their behaviors. The treatment team is likely using this approach to encourage the patient to adopt positive behaviors by showcasing them through the nurse's actions. Incorrect Choices: A: Erikson’s model of psychosocial development - This theory focuses on stages of psychosocial development and identity formation, not on observational learning or modeling. C: Skinner’s operant conditioning - This theory revolves around reinforcement and punishment to shape behavior, which is different from the observational learning emphasized in the scenario. D: Freud’s psychoanalytic model - This theory is based on unconscious processes and early childhood experiences, not on observational learning and modeling as seen in the nurse's behavior.

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Patient's self-report of feeling better is subjective and reflects the patient's perception, not the nurse's actions or decisions. 2. This documentation does not involve any direct intervention or action by the nurse, hence reducing legal liability. 3. It reflects positive progress in the patient's condition, which is generally a favorable indicator in psychiatric care. 4. It does not raise concerns about potential adverse outcomes or deviations from standard practice. Summary: - Choice A is least likely to increase legal liability as it is a subjective report by the patient. - Choices B, C, and D involve direct actions or interventions by the nurse that could have legal implications and potential risks to patient safety.

Correct Answer: A

Rationale: The correct answer is A: Behavioral. Privilege systems involve using reinforcement and consequences to modify behavior, which aligns with behavioral theories. Behavioral theories focus on observable behaviors and how they are influenced by the environment. Developmental theories focus on growth and maturation over time, humanistic theories emphasize self-actualization and personal growth, while cognitive theories focus on mental processes like perception and problem-solving. Therefore, the other choices are incorrect as they do not directly relate to the use of reinforcement and consequences in modifying behavior as seen in privilege systems.

Correct Answer: B

Rationale: The correct answer is B because competency involves the ability to communicate one's choices. Competency is determined by the patient's capacity to understand information, make reasoned decisions, and communicate preferences. This enables the patient to actively participate in their healthcare decisions. Choices A, C, and D are incorrect because speaking coherent English, writing a living will, and complying with a medical regimen do not solely demonstrate competency in decision-making and communication of choices. These actions may be important but do not encompass the full scope of competency in the context of psychiatric-mental health nursing.

Correct Answer: C

Rationale: The correct answer is C: A domain of information. The multiaxial diagnostic system of the DSM-IV-TR includes five axes, each representing a different domain of information about an individual's mental health. Axis I is for clinical disorders, Axis II is for personality disorders and intellectual disabilities, Axis III is for general medical conditions, Axis IV is for psychosocial and environmental stressors, and Axis V is for global assessment of functioning. Therefore, each axis represents a distinct category or domain of information rather than an evidence-based research finding (A), an experimental design (B), or a laboratory test finding (D). The axes serve to provide a comprehensive and holistic assessment of an individual's mental health status.

Correct Answer: B

Rationale: The correct answer is B because when documenting administration of PRN medication, the nurse must include the reason for administration, dosage, route, and response every time it is given. This ensures comprehensive documentation for monitoring the patient's response to the medication and helps in evaluating the effectiveness of the treatment. Option A is incorrect because documenting the response is necessary each time, not just the first time. Option C is incorrect as it does not include documenting the response, which is crucial for assessing the medication's effectiveness. Option D is also incorrect as it excludes documenting the response, which is essential for evaluating the patient's progress.

Correct Answer: C

Rationale: The correct answer is C because speaking to the patient in his native language may not always guarantee effective communication. The patient may have acculturated to English and prefer to communicate in English. It is important to assess the patient's language preference first. Demonstrating genuine interest (A) is important for building trust. Avoiding assumptions (B) helps prevent stereotyping. Acquiring information about the patient's country (D) can enhance understanding of the patient's background.

Correct Answer: A

Rationale: The correct answer is A: Case management. This is common to both basic and advanced level practice for psychiatric nurses because it involves coordinating care, advocating for patients, and ensuring continuity of services. Basic level nurses may handle simpler cases, while advanced level nurses may manage more complex cases. Choice B: Program development may be more common in advanced practice where nurses may be involved in creating new programs or services. Choice C: Clinical supervision is typically a responsibility of advanced practice nurses who oversee and guide other staff members. Choice D: Community interventions may also be more common in advanced practice where nurses may lead community-based initiatives.