A student appears very nervous on the first day of clinical in a psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions? Select one that does not apply.

Correct Answer: C

Rationale: Listening carefully, showing genuine interest, and caring about the client are extremely important rather than speaking about oneself. The student must deal with his or her own anxiety about approaching a stranger to talk about very sensitive and personal issues. Student nurses should not see the client's unwillingness to talk to a student nurse as a personal insult or behavior. Being available and willing to listen are often all it takes to begin a significant interaction with someone. Questions involving personal matters should not be the first thing a student says to the client. These issues usually arise after some trust and rapport have been established. The nursing instructor and staff are always available to assist if the client is shocking or distressing to the student. If the student recognizes someone he or she knows, it is usually best for the student to talk with the client and reassure him or her about confidentiality. The client should be reassured that the student will not read the client's record and will not be assigned to work with the client.

Correct Answer: B

Rationale: The correct answer is B) Care is centered on the patient. In the context of the psychiatric nurse certification exam and the Quality and Safety Education for Nurses (QSEN) framework, the emphasis on patient-centered care is crucial in the treatment of mental illness. Patient-centered care recognizes the individuality of each patient, their unique needs, preferences, values, and ensures that they are active participants in their own care. Option A) "All genomes are unique" is incorrect for this question as it does not directly address the component of treatment of mental illness recognized by QSEN. Option C) "Healthy development is vital to mental health" while important, does not specifically align with the patient-centered care aspect highlighted by QSEN. Option D) "Recovery occurs on a continuum from illness to health" is a relevant concept in mental health treatment but does not directly address the patient-centered focus advocated by QSEN. Educationally, understanding the principles of patient-centered care not only aligns with best practices in nursing but also ensures that psychiatric nurses provide effective, holistic, and individualized care to patients with mental illnesses, promoting better outcomes and patient satisfaction.

Correct Answer: D

Rationale: In this scenario, the correct patient to admit to the psychiatric unit is Option D, the individual who is a new parent and hears voices saying, "Smother your baby." This patient is experiencing auditory hallucinations that pose an immediate risk to themselves and others, specifically the newborn. It indicates a potential for harm and requires urgent psychiatric intervention to ensure the safety of the patient and the infant. Option A, the patient feeling anxiety and a sad mood after separation from a spouse, could benefit from outpatient therapy and support services rather than immediate inpatient psychiatric care. Option B, the individual who self-inflicted a superficial cut after a family argument, may require psychiatric evaluation but does not present an imminent danger warranting immediate admission. Option C, the patient experiencing side effects from haloperidol, should be managed by adjusting the medication dosage or providing supportive care rather than requiring immediate hospitalization. In an educational context, it is crucial for psychiatric nurses to prioritize patient safety and assess for imminent risk when determining the need for psychiatric hospitalization. Understanding the urgency of symptoms like command auditory hallucinations that pose a threat to self or others is essential in making appropriate clinical decisions to provide timely and effective care for individuals experiencing psychiatric crises.

Correct Answer: B

Rationale: In the context of psychiatric nursing in an emergency department, the most appropriate level of prevention activities that a nurse would employ most often is secondary prevention, which is option B. Secondary prevention focuses on early detection and intervention to prevent the progression of mental health issues and crises. In an emergency department setting, nurses are often the first point of contact for individuals experiencing psychiatric emergencies. By employing secondary prevention strategies, such as conducting mental health assessments, crisis intervention, and facilitating referrals to appropriate mental health services, nurses can effectively intervene and provide timely support to individuals in crisis. Primary prevention (option A) aims to prevent mental health issues from occurring in the first place through education, awareness campaigns, and promoting mental well-being. While these activities are important in the community and public health settings, they are not typically the primary focus in an emergency department setting where the immediate concern is managing acute psychiatric crises. Tertiary prevention (option C) involves rehabilitation and support services for individuals who have already experienced mental health issues to prevent further complications or relapses. While these services are crucial for long-term recovery, they are not the most frequently employed activities in the fast-paced and acute care environment of an emergency department. Option D (None) is incorrect because nurses in an emergency department are actively engaged in providing care and interventions to individuals experiencing psychiatric emergencies, making the application of prevention activities essential in this setting. In psychiatric nursing education, understanding the different levels of prevention is crucial for nurses to effectively address the varying needs of individuals across the mental health continuum. By recognizing the importance of secondary prevention in the emergency department, nurses can enhance their skills in crisis management, early intervention, and referral processes to provide optimal care for individuals in psychiatric crises.

Correct Answer: A

Rationale: In this scenario, the best nursing intervention that would demonstrate compassion and caring in the aftermath of a Category V tornado hitting a community is option A) Encouraging persons to describe their memories and feelings about the event. This option is the most appropriate because it focuses on providing emotional support and allowing individuals to express their thoughts and emotions, which are crucial in the early stages of coping with a traumatic event. By encouraging individuals to share their experiences, the nurse can help validate their feelings, promote emotional processing, and foster a sense of connection and support within the community. Option B) Arranging transportation to the local community mental health center may be important for accessing professional help, but it does not directly address the immediate emotional needs of the individuals affected by the tornado. Option C) Referring a local resident to a community food bank addresses a basic need for food, which is essential after a disaster, but it does not specifically target the emotional and psychological aspects of trauma that require attention in this situation. Option D) Coordinating psychiatric home care services may be beneficial for long-term mental health support, but in the immediate aftermath of a disaster, focusing on emotional support and processing feelings is more urgent and directly aligned with demonstrating compassion and caring. In an educational context, it is important for psychiatric nurses to understand the significance of providing emotional support in times of crisis and trauma. Listening, validating feelings, and encouraging individuals to express themselves are key components of compassionate care that can help promote healing and resilience in the face of adversity.