A patient who was responding to auditory hallucinations earlier in the morning now approaches the nurse shaking a fist and shouts, 'Back off!' and then goes to the dayroom. While following the patient into the dayroom, the nurse should

Correct Answer: A

Rationale: The correct answer is A, as it prioritizes safety by ensuring physical space between the nurse and the patient, reducing the risk of potential harm. By creating distance, the nurse can prevent escalation and maintain a safe environment for both parties. This approach allows for de-escalation and assessment of the situation without provoking further agitation. Choice B is incorrect as it may trap the patient and limit their options, potentially increasing their distress. Choice C is incorrect as maintaining a fixed distance may not be sufficient if the patient becomes physically aggressive. Choice D is incorrect as immediately engaging in conversation may exacerbate the situation and lead to further agitation.

Correct Answer: C

Rationale: The correct answer is C: Stigma associated with the diagnosis. Stigma can lead to feelings of shame, isolation, and discrimination for families of patients with psychiatric disorders, causing significant stress. Families may struggle with societal judgment and misconceptions about mental illness, impacting their ability to seek support and cope effectively. Understanding and addressing stigma is crucial in supporting families. Explanation of why the other choices are incorrect: A: Severity of the patient's symptoms - While the severity of symptoms can be distressing for families, it is not the primary underlying issue related to stress. B: Barriers faced by the patient - Although barriers faced by the patient can contribute to stress, it is not the primary underlying issue experienced by families. D: Risk for relapse - While the risk for relapse can be a concern, it is not necessarily the primary underlying issue related to stress for families of patients with psychiatric disorders.

Correct Answer: D

Rationale: The correct answer is D because psychotherapy is a key treatment for personality disorders, including cluster A disorders like schizoid or paranoid personality disorder. While medications may help manage symptoms, they do not treat the core issues. Option A is incorrect because personality disorders are deeply ingrained and not typically cured. Option B is incorrect as DBT primarily targets emotion regulation in borderline personality disorder. Option C is incorrect as medications are not considered primary treatment for personality disorders.

Correct Answer: A

Rationale: The correct answer is A because brief psychodynamic therapy is typically suitable for individuals with specific, time-limited issues like the aftermath of an extramarital affair. This type of therapy focuses on exploring unconscious conflicts and patterns related to the specific problem. Choices B, C, and D present more complex and severe issues that would likely require longer-term or more intensive therapies such as cognitive-behavioral therapy, dialectical behavior therapy, or medical interventions. It is important to match the therapy approach to the individual's needs and presenting concerns.

Correct Answer: B

Rationale: The correct answer is B because maintaining regular bedtimes and rising times helps establish a consistent sleep schedule, which is crucial for managing insomnia. This intervention promotes the client's natural sleep-wake cycle and overall sleep quality. Encouraging the client to consider stopping smoking (Choice A) is important for overall health but may not directly address the immediate sleep issue. Taking frequent naps (Choice C) can disrupt the client's ability to fall asleep at night. Administering sleep medications (Choice D) should be a last resort and not the initial intervention.