A patient's 5-year-old poodle ran in front of a car and was killed. The patient continues to be upset by her pet's death, and she explains to a community counseling center nurse that she can't stop crying because, 'My Precious meant the world to me, and now my world will never be the same!' If the nurse were to determine that the patient was experiencing a crisis, which of the following types of crisis would it most likely be?

Correct Answer: B

Rationale: The correct answer is B: Situational crisis. In this scenario, the patient's overwhelming emotional response to her pet's death is due to a specific, unexpected event - the loss of her beloved pet. Situational crises are triggered by external events that disrupt an individual's normal functioning. The patient's distress is directly linked to the situation at hand, which is the sudden death of her poodle. Choice A: Maturational crisis, involves normal life transitions or stages. The patient's response is not related to a typical life event but to a specific incident. Choice C: Traumatic crisis, typically involves a life-threatening or deeply disturbing event. While the loss of a pet can be traumatic, in this case, the patient's distress seems more related to the emotional bond with her pet rather than the traumatic nature of the event. Choice D: Developmental crisis, occurs when an individual struggles to achieve a new developmental stage. The patient's grief is not related to a failure

Correct Answer: C

Rationale: Grounding physical activities help individuals focus and stay present. Aerobic exercise, such as jogging or jumping jacks, can help regulate emotions and reduce stress by increasing endorphins. It also promotes mindfulness through rhythmic movements. Drumming (A), while rhythmic, may not provide the same level of physical activity. Rocking in a rocking chair (B) may not be stimulating enough for grounding. Yoga (D) focuses more on relaxation and mindfulness rather than the energizing effect needed for de-escalation.

Correct Answer: B

Rationale: The correct answer is B because accessing professional databases like CINAHL ensures access to peer-reviewed research articles and studies. These databases are specifically designed to provide credible and evidence-based information for healthcare professionals. Asking a supervisor (A) may be helpful but may not guarantee access to reputable sources. Performing a Wikipedia search (C) is not recommended as it is not a reliable source for evidence-based practice. Asking a librarian (D) may be useful in guiding the nurse on how to effectively search and utilize professional databases like CINAHL, but the nurse should ultimately rely on accessing these databases directly for credible sources.

Correct Answer: A

Rationale: The correct answer is A: Interpersonal relations. Harry Stack Sullivan is known for his focus on interpersonal relations as a major concept in psychiatric-mental health nursing. Sullivan emphasized the importance of understanding and improving relationships between individuals as a key factor in mental health. He believed that a person's development and well-being are greatly influenced by their interactions with others. This concept is fundamental in psychiatric nursing practice as it guides therapeutic communication and relationship-building with patients. Choices B, C, and D are incorrect because they do not directly align with Sullivan's emphasis on interpersonal relations in the context of psychiatric-mental health nursing.

Correct Answer: A

Rationale: The correct answer is A: Restating a feeling or thought the patient has expressed. This technique, known as reflective listening, shows active listening and empathy towards the patient. By restating the patient's feelings or thoughts, the nurse demonstrates understanding and encourages further communication. This approach validates the patient's emotions and promotes a therapeutic relationship. Choice B (Asking a direct question) may come off as interrogative and can feel less empathetic. Choice C (Making a judgment) can be perceived as dismissive or critical, hindering open communication. Choice D (Saying "I understand what you're saying") may seem insincere unless followed by specific examples of understanding.

Correct Answer: D

Rationale: The correct answer is D: yoga. Adjunctive treatments are used alongside primary treatments to enhance outcomes. Yoga is a complementary therapy that can improve mental health by reducing stress, anxiety, and improving overall well-being. It is non-invasive and can be used in conjunction with other treatments like psychotherapy. Antipsychotic medication (A) is a primary treatment for certain mental health conditions like schizophrenia. Hospitalization (B) is a severe intervention for acute mental health crises. Psychotherapy (C) is a primary treatment involving talk therapy. Yoga (D) stands out as an adjunctive treatment due to its holistic approach and ability to support mental health alongside other therapies.

Correct Answer: D

Rationale: The correct answer is D because making eye contact and responding if the client engages maintains professionalism and acknowledges the client's presence without compromising confidentiality. It shows respect and empathy, which are important in nursing practice. A: Inquiring about the client's well-being can breach confidentiality and may not be appropriate in a public setting. B: Ignoring the client can be seen as rude and may harm the therapeutic relationship. C: Talking to the client without using names may still breach confidentiality and does not fully acknowledge the client's presence.

Correct Answer: B

Rationale: The correct answer is B because the scenario indicates that time-out is no longer effective for April. The fact that April's mother puts her in time-out up to 20 times a day suggests overuse, leading to desensitization. This renders time-out ineffective as a therapeutic tool. April's increasing agitation and lack of self-control despite time-outs indicate the need for a different approach. Choices A and C are incorrect because they assume time-out is still effective, which contradicts the scenario. Choice D is incorrect as seclusion and restraint should only be considered as a last resort due to ethical and safety concerns.

Correct Answer: C

Rationale: The correct answer is C: Decreased REM sleep. Caffeine is a stimulant that can interfere with the sleep cycle by reducing the amount of REM (rapid eye movement) sleep, which is crucial for restorative functions. Here's the rationale: 1. Caffeine blocks adenosine receptors, which can disrupt the natural sleep stages, including REM sleep. 2. REM sleep is important for memory consolidation and cognitive function, so a decrease in REM sleep can lead to cognitive impairments. 3. Choices A and B are incorrect because caffeine typically increases sleep latency and decreases total sleep time. 4. Choice D is incorrect because caffeine is known to reduce slow-wave sleep, which is the deep, restorative stage of sleep.