A patient tells the nurse, “My husband lost his job...” What risk factor was most predictive...?

Correct Answer: A

Rationale: In the context of psychiatric emergencies, understanding risk factors that can lead to adverse outcomes is crucial for nurses and healthcare providers. The correct answer is A) History of family violence. This is the most predictive risk factor in the scenario described because the patient's statement about their husband losing his job may be an indicator of increased stress and potential escalation of violence within the family dynamic. Option B) Loss of employment, while a significant stressor, does not directly predict violence unless there is a history of family violence present. Option C) Abuse of alcohol is also a significant risk factor for psychiatric emergencies, but it is not directly related to the information provided in the question. Option D) Poverty is a social determinant of health that can contribute to increased stress and mental health issues, but it is not the most predictive risk factor in this specific scenario. Educationally, this question highlights the importance of recognizing and assessing risk factors for psychiatric emergencies, especially in situations involving potential family violence. Nurses need to be vigilant in identifying signs of distress and potential violence to intervene promptly and ensure the safety of all individuals involved. Understanding the interconnectedness of social determinants, stressors, and mental health is essential in providing effective care in psychiatric emergencies.

Correct Answer: A

Rationale: In the context of psychiatric emergencies, it is crucial to assess the effectiveness of interventions aimed at managing violent behaviors. Option A, "Expresses frustration verbally instead of physically," indicates a successful plan because it demonstrates a shift towards non-violent expression of emotions. This verbal expression can serve as a safer outlet for the individual, reducing the risk of harm to themselves or others. Option B, "Explains the rationale for behaviors to the victim," while promoting communication, may not directly address the issue of physical violence. Understanding the rationale behind behaviors is important, but it does not ensure the immediate safety of individuals involved in a crisis situation. Option C, "Identifies three personal strengths," though valuable for building self-awareness and self-esteem, may not directly address the immediate need to manage violent behavior during a crisis. Option D, "Agrees to seek counseling," is beneficial for long-term management and prevention of future crises but may not address the current situation of physical violence effectively. Educationally, understanding the rationale behind each option highlights the importance of selecting interventions that directly address the immediate safety concerns in psychiatric emergencies. It emphasizes the need for interventions that focus on de-escalation and harm reduction strategies to ensure the well-being of all individuals involved.

Correct Answer: A

Rationale: The correct answer is option A) "Tell me how you discipline your children." This question facilitates the interview by encouraging the family to openly discuss their parenting practices, discipline strategies, and beliefs. This can help the nurse assess the family dynamics, communication styles, and identify any potential concerns related to child welfare or psychiatric emergencies. Option B) "How do you stop your baby from crying?" is incorrect as it focuses solely on infant care and does not address the broader aspects of parenting and family dynamics that are crucial in a psychiatric emergency assessment. Option C) "Caring for four small children must be difficult." is incorrect as it makes an assumption about the family's situation without allowing them to express their own perspectives, concerns, or challenges. Option D) "Do you or your husband ever spank your children?" is incorrect as it is a leading question that may make the family feel judged or defensive. It does not create a supportive and open environment for the family to share their parenting practices. In an educational context, it is important for healthcare professionals, especially nurses, to develop strong communication skills to effectively assess and support families in various situations, including psychiatric emergencies. Open-ended, non-judgmental questions like the correct option A can help build rapport, gather valuable information, and provide appropriate care and interventions.

Correct Answer: D

Rationale: In this scenario, the correct coping strategy exhibited by the patient is "Denial" (option D). Denial is a defense mechanism where individuals refuse to acknowledge a stressful situation or emotion. In the case of a patient who has experienced a traumatic event like abduction and rape, saying "I can’t talk about it..." demonstrates a form of denial as a way to protect themselves from the overwhelming emotions and memories associated with the trauma. Option A, Compensation, involves making up for a perceived weakness by emphasizing a strength in a different area. This is not demonstrated by the patient in the scenario. Option B, Somatization, involves the expression of psychological distress through physical symptoms. The patient's response does not indicate this coping mechanism. Option C, Projection, involves attributing one's thoughts or emotions to someone else. Again, this is not evident in the patient's response. In an educational context, understanding different coping strategies is crucial for healthcare providers, especially those dealing with psychiatric emergencies. Recognizing these defense mechanisms can help in providing appropriate support and care to individuals experiencing trauma or distress. By identifying the patient's coping strategy, healthcare professionals can tailor interventions to support the patient effectively.

Correct Answer: D

Rationale: In this scenario, option D, "You feel as though this would not have happened if you had not been alone," is the most therapeutic response. This answer acknowledges the patient's feelings without assigning blame or judgment. It validates the patient's emotions and demonstrates empathy, which is crucial in supporting someone who has experienced trauma like rape. Option A, "Rape can happen anywhere," while factual, does not address the patient's feelings of self-blame and may come across as dismissive. Option C, "You are right. You should not have been alone on the street at night," places blame on the victim and can further exacerbate feelings of guilt and shame. Option B, "Blaming yourself increases your anxiety and discomfort," while supportive, does not directly address the patient's statement and may not be as validating as option D. Educationally, it's important to teach healthcare providers the significance of using empathetic and non-judgmental language when interacting with individuals who have experienced trauma. By understanding the impact of their words, healthcare professionals can create a safe and supportive environment for patients to express their emotions and begin the healing process.