A patient nervously says, Financial problems are stressing my marriage. Ive heard rumors about cutbacks at work; I am afraid I might get laid off. The patients pulse is 112/minute; respirations are 26/minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement?

Correct Answer: B

Rationale: The patient is responding to stress with increased arousal of the sympathetic nervous system, as evident by elevated vital signs. These will have a negative effect on his health and increase his perception of being anxious and stressed. Stimulating the parasympathetic nervous system will counter the sympathetic nervous systems arousal, normalizing these vital-sign changes and reducing the physiological demands stress is placing on his body. Other options do not address his physiological response pattern as directly or immediately.

Correct Answer: A

Rationale: The patients profession that he may be able to learn to cope more effectively reflects hope. Groups can instill hope in individuals who are demoralized or pessimistic. Altruism refers to doing good for others, which can result in positive feelings about oneself. Catharsis refers to venting of strong emotions. Cohesion refers to coming together and developing a connection with other group members.

Correct Answer: A

Rationale: Subgroups, small groups isolated within a larger group and functioning separately from it, sometimes form within therapy groups. When this occurs, subgroup members are cohesive with other subgroup members but not with the members of the larger group. Members of the subgroup may be bored or frustrated or expressing passive aggression, but the primary dynamic is the splitting off from the main group.

Correct Answer: A

Rationale: Patients with schizophrenia almost universally have problems associated with everyday living in the community, so discussing ways to manage the illness would be an important aspect of psychoeducation. Discussing concerns about daily life would be a goal to which each could relate. Developing trust and cohesion is desirable but is not the priority outcome of a psychoeducational group. Understanding unconscious motivation would not be addressed. Insight would be difficult for a patient with residual schizophrenia because of the tendency toward concrete thinking.

Correct Answer: D

Rationale: In the context of providing care for a patient with depression who is not responding to medications, the correct answer is D) Electroconvulsive therapy (ECT). ECT is considered when other treatments have not been effective, especially in severe cases of depression where rapid relief is needed. ECT involves passing electrical currents through the brain to induce controlled seizures, which can help alleviate symptoms of depression. Option A) Neuroleptic medication is typically used to treat conditions like schizophrenia and bipolar disorder, not depression. Option B) Short-term seclusion is not a recommended treatment for depression and can be harmful to the patient. Option C) Psychosurgery is a very rare and extreme treatment option, usually considered as a last resort and not commonly used for depression. From an educational standpoint, it is crucial for healthcare providers to understand the appropriate indications for different treatment modalities in managing mental health conditions. Recognizing the limitations of medication therapy and knowing when to consider alternative treatments like ECT is essential for providing comprehensive and effective care for patients with depression.