A patient with a history of anger and impulsivity was hospitalized after an accident resulting in multiple injuries. The patient loudly scolds nursing staff, 'I'm in pain all the time but you don't give me medicine until YOU think it's time.' Which nursing intervention would best address this problem?

Correct Answer: B

Rationale: The correct answer is B because switching from prn (as-needed) pain medication to patient-controlled analgesia empowers the patient to manage their pain effectively, addressing the issue of feeling powerless and dependent on nursing staff for pain relief. This intervention also aligns with the patient's impulsivity and need for immediate gratification. Choice A is incorrect because teaching coping strategies may not address the immediate pain relief the patient desires. Choice C is incorrect as it focuses on addressing the behavior without addressing the underlying issue of pain management. Choice D is incorrect because it does not provide a solution to the immediate problem of pain control and may not be relevant to the patient's current behavior.

Correct Answer: C

Rationale: The correct answer is C because maintaining contact and assuring the client that seclusion will maintain their safety is the priority nursing intervention for a client deemed a danger to others. This intervention helps build trust, reduce anxiety, and promote a therapeutic relationship. A: Having little contact with the client may increase feelings of isolation and exacerbate the client's distress. B: Providing privacy is important, but in this case, ensuring the client's safety is the priority over maintaining confidentiality. D: Teaching relaxation techniques and coping strategies is beneficial, but it is not the immediate priority when the client is in seclusion due to being a danger to others.

Correct Answer: A

Rationale: The correct answer is A because it addresses the potential impact of the stigma associated with criminality on nursing care. Nurses may indeed be reluctant to care for mentally ill criminals due to safety concerns, both for themselves and other clients. This response acknowledges the realistic fears that may exist and how they can influence the quality of care provided. Now, let's analyze why the other choices are incorrect: B: This choice suggests that nurses may prefer to care for forensic clients because they don't believe criminals can be mentally ill, which is not relevant to the question asked. C: This choice implies a generalization that forensic clients only experience mild mental health problems, which is not accurate and does not address the impact of stigma associated with criminality on nursing care. D: This choice mentions unfounded fears about what clients might do post-treatment, which is not directly related to the stigma associated with criminality influencing nursing care.

Correct Answer: A

Rationale: The correct answer is A: Rapport. Rapport is crucial in building a therapeutic nurse-client relationship. It involves creating a connection based on acceptance, warmth, and a nonjudgmental attitude, which helps in establishing trust and communication. Building rapport fosters a positive environment for effective care and understanding between the nurse and client. Trust (B) is built on rapport and is a result of it. Respect (C) and professionalism (D) are important in nursing practice but do not directly address the specific characteristic described in the question.

Correct Answer: D

Rationale: The correct answer is D because the nurse would expect family members to express the negative impact of the client's sleep problem. Lack of sleep can lead to irritability and mood disturbances, affecting family dynamics. Choice A is incorrect as it dismisses the issue. Choice B is incorrect as it suggests no change, which is unlikely. Choice C is incorrect as lack of sleep typically does not have a positive effect on individuals or their families.

Correct Answer: B

Rationale: The correct answer is B: Your child may seem unduly anxious in the presence of strangers. This response is most appropriate as it aligns with the typical behavior of young children who have experienced a traumatic event like an automobile accident. Children at this age may exhibit increased anxiety and fear when around unfamiliar individuals due to the stress and uncertainty of their situation. This behavior is a common reaction to trauma. Choice A is incorrect because while changes in appearance may impact the child, it is not the most immediate concern in this scenario. Choice C is incorrect as guilt feelings are less likely to be prominent in a 3-year-old child. Choice D is also incorrect as mood swings are not the primary behavior expected in this situation, and the statement lacks specificity compared to the appropriate response.

Correct Answer: A

Rationale: The correct answer is A because placing a daily calendar in the kitchen helps individuals with Alzheimer's disease maintain a sense of time and routine. This aids in reducing confusion and anxiety. Choice B is incorrect as it does not directly address the cognitive needs of the individual. Choice C is incorrect as it may not be feasible or necessary for everyone. Choice D is incorrect as maintaining a consistent routine is beneficial for individuals with Alzheimer's disease to reduce disorientation.

Correct Answer: B

Rationale: The correct answer is B because it indicates a personal connection and emotional reaction from the nurse due to her past experiences with alcoholic parents, suggesting countertransference. Choice A focuses on the patient's denial, not the nurse's reaction. Choice C pertains to the patient's lack of goals, not the nurse's feelings. Choice D relates to the patient's comment about the nurse, not the nurse's emotional response. In summary, B is correct as it directly reflects the nurse's personal history impacting her feelings towards the patient, while the other choices do not address the nurse's emotional reaction.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Safety of all individuals is paramount in an inpatient setting. 2. Least restrictive intervention aligns with ethical principles and respects individual autonomy. 3. It prioritizes de-escalation techniques over coercive measures. 4. Emphasizes the importance of promoting patient dignity and minimizing harm. 5. Encourages collaborative problem-solving and empowerment of the individual. Summary of why other choices are incorrect: B. Swift intervention may escalate the crisis and disregard patient autonomy. C. Majority rule does not justify violating individual rights in a mental health setting. D. Allowing patients to regain control without intervention can pose risks to themselves and others.