A patient in an alcohol rehabilitation program says, 'I have been a loser all my life. I’m so ashamed of what I have put my family through. Now, I’m not even sure I can succeed at staying sober.' Which nursing diagnosis applies?

Correct Answer: A

Rationale: The correct answer is A: Chronic low self-esteem. The patient's statement reflects long-standing feelings of inadequacy and worthlessness, indicating a chronic issue rather than a temporary situation (situational low self-esteem). The statement also reveals a negative perception of self, which aligns with chronic low self-esteem. Disturbed personal identity refers to confusion in one's sense of self, which is not evident in the patient's statement. Ineffective health maintenance pertains to the inability to identify, manage, and seek help for health problems, which is not the primary issue in this scenario. Therefore, A is the most appropriate nursing diagnosis.

Correct Answer: D

Rationale: The correct answer is D because having one's only child leave home to attend college is an example of a maturational crisis. This event represents a significant life transition that can trigger emotional distress and force a reevaluation of one's identity and roles as a parent. It is a normal developmental milestone that signifies a shift in family dynamics and requires adjustment to an empty nest. A: Experiencing an unplanned pregnancy is not a maturational crisis as it is more related to a situational crisis. B: Losing one's job within months of retiring is not a maturational crisis but rather a situational crisis related to financial security. C: Working at a bank that was recently robbed is not a maturational crisis but a situational crisis related to work safety and stress.

Correct Answer: A

Rationale: The correct answer is A because it demonstrates the systematic and consistent implementation of evidence-based practice guidelines in documenting negative responses to suicidal ideation assessments for clients diagnosed with depression. This approach ensures that crucial information is captured regularly, aiding in monitoring and managing the clients' mental health effectively. Choice B focuses on the outcome of a specific treatment but does not directly address the implementation of evidence-based practice guidelines. Choice C expresses personal satisfaction rather than adherence to guidelines. Choice D reflects the client's subjective opinion and does not provide evidence of following specific guidelines. Thus, A is the correct choice as it directly relates to evidence-based practice implementation.

Correct Answer: D

Rationale: The correct answer is D because it highlights the current status of the benefit of family involvement for individuals who are mentally ill. It acknowledges that while the benefits of family involvement are well documented, the actual service is not consistently offered in most mental health systems. This indicates a gap between research evidence and practical implementation, hindering the full realization of the benefits. Explanation for why other choices are incorrect: A: Incorrect because although confidentiality laws like HIPAA may pose challenges, they do not necessarily limit family involvement entirely. B: Incorrect because family involvement is crucial throughout the mental health journey, not just after stabilization. C: Incorrect because with proper support and resources, families can have a significant impact on the mental health of their loved ones.

Correct Answer: D

Rationale: The correct answer is D because psychiatric nurses must understand the unique needs of the mentally ill to effectively advocate for them. By recognizing the value of their understanding, nurses can tailor their advocacy efforts to address these specific needs. Choice A is incorrect as legislative knowledge is important but not the primary requirement. Choice B is incorrect as partnership with the AMA is not necessary for advocacy. Choice C is incorrect as unity alone is not sufficient without a clear understanding of the mental health issues.