An emergency department nurse realizes the spouse... is becoming irritable... Which intervention?

Correct Answer: C

Rationale: In this scenario, the correct intervention is option C) Periodically provide an update and progress report on the patient. This is the most appropriate action because it addresses the spouse's increasing irritability by keeping them informed about the patient's condition and treatment progress. Option A) Offering a cup of coffee may provide temporary comfort but does not address the underlying issue of the spouse's anxiety and need for information. Option B) Explaining the patient's condition is not life-threatening is important but does not actively engage the spouse in the care process. Option D) Suggesting the spouse return home may further escalate the situation by isolating them from their loved one during a stressful time. From an educational perspective, it is crucial for nurses to recognize and address the emotional needs of family members in psychiatric emergencies. Providing updates and involving them in the care process can help alleviate anxiety, build trust, and support overall patient outcomes. Effective communication and empathy are key skills in psychiatric nursing that can enhance the quality of care provided to both patients and their families.

Correct Answer: A

Rationale: The correct answer is option A, "You are feeling violated because you thought you could trust your partner." This response demonstrates empathy, validation, and understanding towards the survivor's feelings and experiences. It acknowledges the survivor's emotions and the impact of betrayal and violation on trust, showing support and building a therapeutic relationship. Option B, "I’m here for you. I want you to tell me about the bad things..." while well-intentioned, may come across as insensitive or too direct, potentially overwhelming the survivor with a request to recount traumatic events without addressing their emotional state. Option C, "I was very worried about you... in a potentially violent situation," shifts the focus to the nurse's feelings and experiences rather than validating the survivor's emotions, missing the opportunity for connection and support. Option D, "Abusers often target people who are passive... assertiveness class," introduces a teaching moment that may be helpful in a different context but is not appropriate in a psychiatric emergency situation where the immediate focus should be on building rapport and providing support to the survivor. In an educational context, it is crucial for nurses in psychiatric emergency settings to prioritize building therapeutic relationships with survivors of trauma. Empathetic and validating responses like the one in option A are essential in creating a safe and supportive environment for survivors to feel heard, understood, and supported in their healing journey. Understanding the impact of language and communication in such sensitive situations is key to providing effective and compassionate care.

Correct Answer: A

Rationale: The correct answer is A) Have been abused. This is because research has consistently shown that a history of abuse, whether physical, emotional, or sexual, is a significant risk factor for delinquent behaviors in adolescents. Adolescents who have experienced abuse may exhibit behaviors such as aggression, defiance, self-harm, substance abuse, and other maladaptive coping mechanisms. Option B) Are attention-seeking may be a common misconception, as attention-seeking behaviors are usually a manifestation of underlying issues rather than the root cause of delinquent behavior. While adolescents may exhibit attention-seeking behaviors, it is not a definitive indicator of delinquency. Option C) Have eating disorders and Option D) Are developmentally delayed are not directly linked to delinquent behaviors. While individuals with eating disorders or developmental delays may face their own set of challenges, these conditions do not inherently predispose individuals to engaging in delinquent acts. In an educational context, it is crucial for nurses working in psychiatric emergency settings to understand the complex interplay of risk factors for delinquent behaviors in adolescents. Recognizing the link between abuse and delinquency can help nurses provide appropriate interventions, support, and referrals to address the underlying trauma and prevent further negative outcomes for the adolescent. By understanding the root causes of delinquent behaviors, nurses can contribute to more effective and holistic care for adolescents in crisis.

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 answer is option A) Risk for injury related to physical abuse from partner. When a patient presents with a detached retina and has undergone treatment, it is crucial to identify potential risks and prioritize safety concerns. Physical abuse from a partner poses an immediate threat to the patient's well-being and must be addressed urgently. Option B) Social isolation related to lack of a community support system, while important, does not take precedence over the risk of physical harm in this urgent situation. Option C) Ineffective coping related to uneven distribution of power, although relevant, does not address the immediate safety concern of physical abuse. Option D) Deficient knowledge related to resources for escape is also important but does not address the immediate risk of injury that the patient may face. In an educational context, this question highlights the importance of recognizing and prioritizing safety concerns in a psychiatric emergency nursing situation. It underscores the need for nurses to be vigilant in assessing for signs of abuse and taking necessary steps to ensure the safety and well-being of their patients. By understanding the hierarchy of needs in such emergencies, nurses can provide effective and timely interventions to address critical issues.