A patient diagnosed with a somatic symptom disorder says, "Why has God chosen me to be sick all the time and unable to provide for my family? The burden on my family is worse than the pain I bear." Which nursing diagnoses apply to this patient? (Select all that apply.)

Correct Answer: A

Rationale: The correct nursing diagnosis for the patient in this scenario is A) Spiritual distress. This diagnosis is appropriate because the patient is expressing feelings of questioning their faith and purpose in relation to their illness, indicating a spiritual struggle. This diagnosis focuses on the patient's beliefs and values, and the impact of these on their health and well-being. Option B) Decisional conflict is not the most appropriate choice in this case because the patient is not expressing uncertainty or indecision regarding treatment options or choices related to their care. Option C) Adult failure to thrive is not the best fit as this diagnosis typically refers to a decline in physical, emotional, or cognitive function that impacts a person's ability to meet basic needs, rather than a spiritual or existential struggle. Option D) Impaired social interaction does not align with the patient's statement about feeling burdened by their illness and its impact on their family. This diagnosis would be more relevant if the patient exhibited difficulties in engaging with others or maintaining relationships due to their condition. In an educational context, understanding and applying the correct nursing diagnosis is crucial for providing holistic care to patients. By selecting the appropriate diagnosis, nurses can address the patient's spiritual needs and provide support in a way that is meaningful and therapeutic. This case highlights the importance of considering the psychological, emotional, and spiritual aspects of a patient's experience in addition to their physical symptoms.

Correct Answer: D

Rationale: In this scenario, the correct response is option D: "Are you having thoughts of hurting yourself or others?" This is the highest priority response because the individual's statement indicates intense anger and distress, which could potentially escalate to harmful thoughts or actions. The nurse needs to assess the client's risk of harm to ensure their safety and the safety of others. Option A suggests medication, which may be necessary at some point but is not the priority in this immediate situation. Option B focuses on resources, which is important but not as critical as assessing for safety. Option C addresses support from family and friends, which is valuable but does not directly address the potential for harm. Educationally, this question highlights the importance of recognizing cues indicating potential harm or risk in clients experiencing intense emotions. It emphasizes the need for nurses to prioritize safety assessments in such situations to provide appropriate care and support. Understanding the significance of addressing safety concerns promptly is crucial in mental health and behavioral nursing practice.

Correct Answer: D

Rationale: In the context of behavioral nursing, a situational crisis is typically defined as an unexpected event or series of events that overwhelms an individual's ability to cope effectively, leading to a state of emotional disequilibrium. In this scenario, option D, a riot at a rock concert, best exemplifies a situational crisis. The sudden and chaotic nature of a riot can trigger intense feelings of fear, helplessness, and confusion, disrupting an individual's sense of safety and security. Option A, the death of a child from sudden infant death syndrome, represents a developmental crisis involving profound loss and grief. While this event is undoubtedly distressing and can lead to significant emotional turmoil, it is not classified as a situational crisis, as it is not a sudden, external event. Option B, the development of a heroin addiction, is an example of a maturational crisis, where an individual must navigate the challenges of a significant life change or transition. Addiction involves complex psychological, social, and physiological factors that develop over time, rather than being a sudden, external event. Option C, the retirement of a 55-year-old person, is an example of a transitional crisis related to life-stage changes. While retirement can bring about significant adjustments and emotional challenges, it is a predictable life event rather than a sudden, overwhelming situation like a riot. Understanding the distinctions between different types of crises is crucial for behavioral nurses, as it guides their assessment and intervention strategies. By recognizing the unique characteristics of situational crises, nurses can provide tailored support and resources to help individuals navigate these challenging circumstances effectively.

Correct Answer: B

Rationale: This community has experienced a catastrophic event. There are five phases of the disaster management continuum. The nurses' activities applied to mitigation (attempts to limit a disaster's impact on human health and community function) and response (actual implementation of a disaster plan). Preparedness occurs before an event. Recovery actions focus on stabilizing the community and returning it to its previous status. Evaluation of the response efforts apply to the future.

Correct Answer: B

Rationale: The conference room would provide a quiet, private area with few distractions, separate from other patient areas and effective for teaching and learning about a private topic. The auditorium is too large, and members' anxiety or lack of trust might lead them to spread out too far from each other, interfering with group process. The day room and the music therapy room are too busy and exposed, reducing privacy and increasing distractions.