An adult outpatient diagnosed with major depression has a history of several suicide attempts by overdose. Given this patient's history and diagnosis, which antidepressant medication would the nurse expect to be prescribed?

Correct Answer: B

Rationale: Selective serotonin reuptake inhibitor antidepressants are very safe in overdosage situations, which is not true of the other medications listed. Given this patient's history of overdosing, it is important that the medication be as safe as possible in case she takes an overdose of her prescribed medication.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Guilt. The parents' response of "We should have seen this coming. We did not do enough" indicates feelings of responsibility and blame for not preventing their child's suicide attempt. This reflects guilt, as they are holding themselves accountable for the situation. Option B) Denial does not apply in this context because the parents are acknowledging the reality of the situation and their role in it. Option C) Shame is not the most appropriate choice as shame typically involves a sense of embarrassment or disgrace, which is not evident in the parents' response. Option D) Rescue feelings also do not fit as the parents' statement does not convey a desire to rescue their child but rather a sense of regret and accountability. From an educational perspective, understanding the emotions and reactions of family members in psychiatric emergency situations is crucial for nurses providing care. Recognizing and addressing feelings of guilt in parents can help in providing appropriate support and counseling to prevent further distress or negative outcomes. By choosing the correct answer and understanding why the other options are not applicable, nurses can enhance their communication skills and empathetic response in such sensitive situations.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Establish rapport with the patient. Establishing rapport is crucial in a psychiatric emergency situation as it helps to build trust and create a safe environment for the patient to express their thoughts and feelings. By establishing rapport, the nurse can create a foundation for effective communication and assessment. Option A) Assess lethality of suicide plan may seem important, but in this case, the immediate priority is to establish a connection with the patient to ensure they feel heard and supported. Jumping straight to assessing the lethality of the suicide plan without establishing rapport can lead to the patient shutting down or feeling judged, hindering effective assessment. Option B) Encourage expression of anger is not the most appropriate initial response in this situation. While acknowledging and validating the patient's emotions is important, the primary focus should be on building a therapeutic relationship through rapport building. Option D) Determine risk factors for suicide is also important but should come after rapport has been established. Without a foundation of trust and open communication, the patient may not be willing to disclose their risk factors or engage in a thorough assessment. In an educational context, this question highlights the significance of therapeutic communication and relationship-building skills in psychiatric nursing. It underscores the importance of empathy, active listening, and creating a safe space for patients to express their emotions, especially in sensitive and potentially life-threatening situations like this one. By prioritizing rapport building, nurses can lay the groundwork for effective assessment, intervention, and support for patients experiencing psychiatric emergencies.

Correct Answer: A

Rationale: In a psychiatric emergency nursing context, the behavior that best demonstrates aggression is option A) Stomping away from the nurses station, going to the hallway, and grabbing a tray from the meal cart. This behavior shows physical actions that can potentially escalate into a violent outburst, posing a risk to the individual and others. This type of behavior requires immediate assessment and intervention to prevent harm. Option B) of bursting into tears and withdrawing to cry on a bed, while distressing, does not exhibit aggression but rather indicates emotional distress and a need for emotional support. Option C) of expressing anger verbally is assertive but not necessarily aggressive, as the individual is communicating their feelings in a non-violent manner. Option D) of refusing medication is a form of resistance or non-compliance, rather than aggression. In an educational context, it is crucial for psychiatric emergency nurses to be able to accurately identify behaviors that signal aggression to intervene effectively and prevent potential harm. Understanding the nuances of different behaviors helps nurses tailor their approach to de-escalation techniques, ensuring the safety and well-being of both the individual in crisis and the healthcare team.

Correct Answer: C

Rationale: In a psychiatric emergency nursing situation, the appropriate initial intervention when a patient is pacing the hall is option C) "I’d like to talk with you about how you’re feeling right now." This response demonstrates empathy, active listening, and a patient-centered approach. It acknowledges the patient's behavior, shows concern for their feelings, and opens up a dialogue to understand their current emotional state and needs. Option A) "What is going on?" may come off as dismissive and not address the patient's emotional state directly. It lacks the empathetic approach needed in a psychiatric emergency situation. Option B) "Please be quiet and sit down in this chair immediately." is authoritarian and may escalate the situation by disregarding the patient's emotions and needs, potentially leading to further agitation. Option D) "You must go to your room and try to get control of yourself." is directive and may not effectively address the underlying issues causing the patient's behavior. It does not promote open communication or demonstrate empathy towards the patient's emotional state. Educationally, it is important for healthcare providers, especially in psychiatric emergency nursing, to prioritize therapeutic communication, empathy, and patient-centered care. By choosing option C, nurses can establish rapport, de-escalate the situation, and address the patient's emotional needs effectively, which are crucial skills in managing psychiatric emergencies.