An intramuscular dose of antipsychotic medication needs to be administered... The nurse should:

Correct Answer: B

Rationale: In psychiatric emergencies, administering medication safely and effectively is crucial in managing acute symptoms. Option B, accompanied by 3 staff, is the correct choice because it prioritizes safety for both the patient and staff. The presence of multiple staff members ensures that the medication administration process is conducted securely and reduces the risk of potential harm. Option A is incorrect as it lacks the necessary support and supervision for a potentially agitated or uncooperative patient. Option C is inappropriate as using physical restraint like a basket-hold should only be considered as a last resort in extreme cases due to the risk of escalation and harm. Option D is also incorrect as involving a guard may further escalate the situation and compromise the therapeutic relationship between the patient and healthcare provider. Educationally, this question highlights the importance of proper medication administration procedures in psychiatric settings. It emphasizes the significance of teamwork, communication, and safety measures when dealing with patients experiencing psychiatric emergencies. By choosing option B, nurses can ensure the well-being of both the patient and themselves while delivering timely and appropriate care.

Correct Answer: C

Rationale: In a psychiatric emergency scenario involving a patient with multi-infarct dementia displaying aggression, the most appropriate initial intervention is option C) Saying to the patient, “This is a safe place.” This response acknowledges the patient's feelings of distress and helps create a sense of safety and security, potentially de-escalating the situation. Option A) Gently touching the patient’s arm could escalate the situation by invading their personal space and triggering a defensive response. Option B) Asking the patient, “What do you need?” may be too direct and overwhelming for a patient experiencing heightened agitation, potentially escalating the situation further. Option D) Directing the patient to cease the behavior is confrontational and may lead to increased aggression or resistance. Educationally, understanding the importance of creating a safe environment and using calming, reassuring language in managing psychiatric emergencies is crucial for healthcare providers. By prioritizing de-escalation techniques and communication skills, healthcare professionals can better address challenging behaviors in patients with psychiatric conditions, ensuring both patient and staff safety.

Correct Answer: C

Rationale: The correct answer is option C) Continue, saying, “This is needed so your wound will not get infected.” This intervention uses a cognitive technique by offering a rationale for the action being taken, which can help the patient understand the importance of the dressing change and potentially reduce their irritability. Option A is incorrect as abruptly stopping the dressing change without any explanation or communication can escalate the situation and lead to further distress for the patient. Option B is also incorrect as it puts the responsibility solely on the patient without providing any supportive or educational information, which may not be effective in calming an irritable patient in a psychiatric emergency. Option D is incorrect as it uses a directive approach without considering the patient's feelings or providing any rationale, which can further agitate the patient and hinder effective communication and cooperation. In an educational context, it is important for healthcare providers to use cognitive techniques such as providing explanations and rationales to help patients understand the reasons behind interventions, especially in psychiatric emergencies where patients may be experiencing heightened emotions or distress. Effective communication strategies can help de-escalate situations, build trust, and improve patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) A personality style that externalizes problems. This choice is the most likely explanation for the patient being described as difficult by family members in the context of psychiatric emergencies. Understanding this requires knowledge of personality styles and their impact on how individuals perceive and interact with the world around them. Option A) Poor childrearing that did not teach respect for others is less likely as it focuses on upbringing rather than the internal disposition of the individual. While upbringing can influence behavior, it is not the most suitable explanation in this case. Option B) Automatic thinking leading to cognitive distortions is also less likely as it pertains more to cognitive processes and distorted thinking patterns rather than personality styles that influence behavior consistently over time. Option D) Delusions that others wish to deliver harm is less likely as it suggests a specific psychotic symptom rather than a general personality style contributing to difficult interpersonal relationships. Educationally, this question highlights the importance of understanding personality styles in psychiatric emergencies, as they can significantly impact how individuals express distress and interact with others. By recognizing these patterns, healthcare providers can better assess and manage challenging behaviors in such situations.

Correct Answer: A

Rationale: In the context of psychiatric emergencies, understanding the central nervous system structures associated with anger and aggression is crucial for healthcare professionals to effectively manage and intervene in such situations. The correct answer is A) Amygdala. The amygdala plays a key role in processing emotions, particularly fear and aggression. It is known to be involved in the regulation of aggressive behavior and the perception of threats, making it a central structure in the manifestation of anger and aggression. Option B) Cerebellum is primarily involved in motor control and coordination, not in the regulation of emotions like anger and aggression. Therefore, it is not the most associated structure with these behaviors. Option C) Basal ganglia is involved in motor control, learning, and habitual behaviors, but it is not as directly linked to the processing of emotions like anger and aggression as the amygdala. Option D) Temporal lobe is important for memory, language, and emotion processing, but it is not as specifically tied to the regulation of anger and aggression as the amygdala. Educationally, understanding the role of the amygdala in anger and aggression can help healthcare professionals identify potential triggers and develop appropriate interventions to manage aggressive behaviors in psychiatric emergencies. This knowledge can inform the use of targeted therapies and behavioral strategies to effectively address and de-escalate aggressive situations.