A patient was admitted to the psychiatric unit 3 days ago because of suicidal ideation. His suicidal risk has lessened considerably, and he currently denies having any desire to kill himself. In addition, he is able to identify reasons why he wants to be alive. Which nursing intervention would be most appropriate at this time?

Correct Answer: B

Rationale: The correct answer is B: Developing a personal plan for managing suicidal thoughts when they occur. This is the most appropriate intervention at this time because the patient's suicidal risk has lessened considerably and he is able to identify reasons for wanting to live. By creating a personalized plan, the patient can learn coping strategies and techniques to manage suicidal thoughts if they resurface in the future. This empowers the patient to take control of their mental health and provides them with tools to prevent future crises. Incorrect Choices: A: Assigning nursing staff to stay with him during his suicidal crisis - This is not necessary as the patient's suicidal risk has considerably lessened. C: Advising the patient that he should consider electroconvulsive therapy treatments - This is an extreme intervention that is not warranted based on the current improvement in the patient's condition. D: Administering psychotropic drugs that decrease the patient's serotonin levels - This intervention is not appropriate as the patient's current state does not indicate the need for immediate

Correct Answer: B

Rationale: The correct answer is B: Care is centered on the patient. QSEN emphasizes patient-centered care in the treatment of mental illness. This approach involves understanding and addressing the patient's unique needs, preferences, and values to provide individualized and effective care. It focuses on fostering a therapeutic relationship between healthcare providers and patients to enhance treatment outcomes. Explanation of why other choices are incorrect: A: All genomes are unique - This statement is not directly related to the specific component of treatment recognized by QSEN. C: Healthy development is vital to mental health - While healthy development may contribute to mental health, it is not the specific component highlighted by QSEN. D: Recovery occurs on a continuum from illness to health - While recovery is an important aspect of mental health treatment, it is not the specific component emphasized by QSEN, which is patient-centered care.

Correct Answer: D

Rationale: The correct answer is D (4) on the mental health continuum. The statement indicates a high level of mental well-being, self-esteem, and understanding of the relationship between effort and outcomes, aligning with Level 4. This level signifies positive self-esteem, a sense of purpose, and the ability to cope effectively with life's challenges. Choices A, B, and C are incorrect because they represent lower levels of mental health with characteristics such as low self-esteem, negative emotions, and difficulty coping with stressors.

Correct Answer: C

Rationale: The correct answer is C: fetal alcohol syndrome. Fetal alcohol syndrome is a learning disability caused by prenatal exposure to alcohol, making it avoidable by abstaining from alcohol during pregnancy. Fragile X, Down syndrome, and Prader Willi syndrome are genetic conditions not caused by environmental factors, so they are not avoidable. Therefore, the correct answer is C as it is the only type of learning disability with an avoidable cause.

Correct Answer: C

Rationale: Rationale: Choice C, giving the client enalapril 2.5 mg PO twice daily, is the correct answer as it is a common prescription for managing congestive heart failure by reducing workload on the heart. Enalapril is an ACE inhibitor that helps decrease blood pressure and improve heart function. It is crucial in managing symptoms and improving outcomes for clients with congestive heart failure. Choices A, B, and D are incorrect because they do not address the underlying issue of heart failure or follow evidence-based guidelines for treatment. Monitoring respiratory rate, giving IV bolus, or monitoring pulse rate are important but do not directly address the management of congestive heart failure as effectively as prescribing enalapril.

Correct Answer: D

Rationale: The correct answer is D: Axis IV. Axis IV in DSM-IV is used to assess psychosocial and environmental stressors impacting the individual. Mrs. Green's recent experiences of her dog's death and her mother's cancer diagnosis are significant stressors that would be categorized under Axis IV. These stressors can contribute to her current mental health condition and treatment plan. Choice A (Axis I) refers to clinical disorders, which are not directly related to external stressors. Choice B (Axis II) pertains to personality disorders, which are not the focus here. Choice C (Axis III) involves general medical conditions, which are not the primary concern in this scenario. Hence, the correct choice is D as it specifically addresses the psychosocial stressors impacting Mrs. Green's mental health.

Correct Answer: D

Rationale: The correct answer is D because it shows empathy and acknowledges the client's emotions. It validates the client's feelings without minimizing their pain. Option A is dismissive and implies the client should be relieved. Option B is insensitive and lacks empathy. Option C is premature and focuses on logistics rather than emotional support.

Correct Answer: B

Rationale: The correct answer is B because ensuring access to protective resources through social services is crucial in providing immediate support and safety for Harper. This initial goal focuses on addressing any immediate risks or needs related to her PTSD diagnosis. Play therapy (A) may be beneficial later but is not the primary concern at this stage. Teaching relaxation techniques (C) and understanding human response to trauma (D) are important but not as urgent as ensuring access to protective resources.

Correct Answer: C

Rationale: The correct answer is C: Has anyone told you about why you are here today? This question is the most appropriate as it helps establish the child's understanding of the situation and allows the nurse to assess the child's level of awareness and perception. By asking this question first, the nurse can ensure the child is informed and prepared for the counseling session. Choice A (How are you feeling?) is not the best first question as it jumps straight into emotions without setting the context. Choice B (How old are you?) is irrelevant and does not address the purpose of the counseling session. Choice D (Why do you think I'm talking to you alone without your parents here?) may make the child feel defensive or anxious, and it assumes the child has already formed opinions about the situation.