An adult has recently been absent from work... What is occupational health nurse’s priority assessment?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Physical injuries. The priority assessment for an occupational health nurse when an adult is absent from work should be to assess for physical injuries. This is crucial in a psychiatric emergency situation as physical injuries may indicate self-harm, violence, or trauma, which require immediate attention to ensure the individual's safety and well-being. Option A) Interpersonal relationships, while important in a holistic assessment, is not the priority in a psychiatric emergency where physical safety takes precedence. Option B) Work responsibilities and Option C) Socialization skills are also important aspects of an individual's well-being but are not immediate priorities in the context of a psychiatric emergency where physical safety and health are paramount. Educationally, understanding the prioritization of assessments in psychiatric emergencies is crucial for occupational health nurses to effectively intervene and provide appropriate care for individuals experiencing mental health crises in the workplace. By prioritizing physical injuries, nurses can address immediate safety concerns and then proceed to assess other aspects of the individual's well-being.

Correct Answer: A

Rationale: In this scenario, the correct nursing diagnosis with the highest priority is Option A: Risk for injury related to poor judgment, cognitive impairments, and inadequate supervision. This diagnosis takes precedence because safety is a fundamental need in nursing care, especially in psychiatric emergencies involving older adults with Lewy body dementia. Option B, wandering related to confusion and disorientation, is important but falls secondary to the risk of injury. While wandering poses risks, the immediate concern is preventing harm to the patient. Option C, chronic confusion related to degenerative changes, addresses a symptom rather than a potential life-threatening situation. Option D, insomnia related to sleep disruptions, is also significant but does not pose an immediate threat to the patient's safety compared to the risk of injury due to poor judgment and cognitive impairments. Educationally, understanding the priority of nursing diagnoses in psychiatric emergencies is crucial for providing effective and safe care. By prioritizing the risk for injury, nurses can implement strategies to ensure the patient's safety and prevent harm, which is foundational in psychiatric emergency nursing. It is essential for nurses to continuously assess and prioritize patient needs to deliver optimal care in these challenging situations.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Parental sessions to teach childrearing practices. This option is the priority in stabilizing the home situation for several reasons. First, by providing parental sessions, the caregiver (presumably the 10-year-old) can learn appropriate child-rearing practices, which can improve the overall care provided to the siblings. This intervention addresses the root cause of the issue by empowering the caregiver with essential skills and knowledge. Option B) Anger management counseling for the father is not the priority in this case because the primary concern is the immediate well-being and stability of the children in the home. While addressing the father's anger management issues is important, it is secondary to ensuring the children's safety and care. Option C) Continuing home visits to give support is valuable but may not directly address the need for education and skill-building in child-rearing that is essential for the 10-year-old caregiver. Option D) A safety plan for the wife and children is crucial in situations of domestic violence or abuse, but in this case, the priority is to empower the 10-year-old caregiver with the necessary knowledge and skills to provide adequate care for the siblings. From an educational perspective, it is important to prioritize interventions that address the immediate needs of the children in a psychiatric emergency situation. By focusing on providing education and support to the caregiver, we can enhance the long-term stability and well-being of the family. This rationale underscores the significance of addressing the root cause of the issue to prevent future emergencies and promote a safe and nurturing environment for the children.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Severe. The woman in this situation has experienced a traumatic event involving abduction and rape, which are highly distressing and can lead to severe psychological consequences. It is crucial to recognize that such traumatic experiences can result in an overwhelming level of anxiety, fear, and distress in the individual. Option A) Weak and Option B) Mild are incorrect because given the nature of the trauma experienced by the woman, it is highly unlikely that her anxiety level would be categorized as weak or mild. Option C) Moderate may seem plausible, but considering the extreme nature of the events she has gone through, it is more appropriate to classify her anxiety level as severe. Educationally, this question highlights the importance of understanding the psychological impact of traumatic events, especially in the context of psychiatric emergency nursing. It emphasizes the need for nurses to assess and recognize the severity of anxiety in individuals who have experienced trauma, in order to provide appropriate and timely interventions to support their mental health and well-being. By accurately identifying the woman's level of anxiety as severe in this case, nurses can ensure she receives the necessary care and support to help her cope with the aftermath of such a traumatic experience.

Correct Answer: B

Rationale: In a psychiatric emergency nursing scenario where an unresponsive victim is being assessed, the most important question among the options provided is B) Has the victim consumed any alcohol? The correct answer is crucial because alcohol consumption can lead to altered mental status, unconsciousness, and can mimic psychiatric symptoms. It is essential to assess for alcohol ingestion in an unresponsive patient to determine if their condition is a result of intoxication, which would require specific interventions and management. Option A) Does the victim have any kidney disease? is not the most important question in this scenario because kidney disease, while important to assess for in a comprehensive health history, is less likely to be immediately relevant in an unresponsive psychiatric emergency situation. Option C) What time was she given salty water? is not as critical as assessing for alcohol consumption in this scenario. Salty water intake may not be directly related to the patient's current condition of being unresponsive, and addressing this question may not provide immediate insight into the patient's presentation. Option D) Did you witness the rape? is also not the most important question to ask initially in an unresponsive psychiatric emergency assessment. While this question may be important in a different context, such as a sexual assault evaluation, it is not the priority when dealing with an unresponsive patient with potential alcohol intoxication. Educationally, this question highlights the importance of thorough assessment and prioritization in psychiatric emergency nursing. It emphasizes the significance of considering substance abuse as a potential cause of altered mental status and the need to address immediate concerns to provide appropriate and timely care to patients in psychiatric crises.