How does a psychiatric nurse best implement the ethical principle of autonomy?

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: Exploring alternative options with a patient regarding medications. This choice aligns with the ethical principle of autonomy, which emphasizes the right of individuals to make their own decisions about their healthcare. By engaging in a collaborative discussion with the patient about medication options, the psychiatric nurse respects the patient's autonomy and empowers them to actively participate in their treatment plan. Option A is incorrect because intervening when a self-mutilating patient attempts to harm themselves may be necessary for patient safety, but it may not always align with promoting autonomy as it involves overriding the patient's actions without their input. Option B is incorrect because staying with a patient who is anxious is a supportive measure but does not directly address the ethical principle of autonomy or involve the patient in decision-making about their care. Option C is incorrect as suggesting that two fighting patients be restricted to the unit is more about maintaining a safe environment and managing behavior rather than promoting autonomy through collaborative decision-making. In an educational context, it is crucial for nurses to understand the ethical principles that guide their practice, including autonomy. By selecting the correct answer, nurses can learn how to respect and promote their patients' autonomy while providing high-quality care that is patient-centered and empowering. This question highlights the importance of involving patients in decisions about their care to uphold ethical standards and foster positive patient outcomes.

Correct Answer: B

Rationale: In this scenario, option B is the most appropriate response for the nurse to assist the patient in reframing their overgeneralization. By suggesting to explore a specific event to identify alternative explanations, the nurse is guiding the patient towards critical thinking and challenging their automatic negative thoughts. This approach helps the patient recognize that not all bad outcomes are solely their fault, promoting a more balanced perspective. Option A is incorrect because it simply dismisses the patient's belief without offering a constructive alternative. This response may come off as invalidating and not supportive of the patient's feelings. Option C, while showing empathy, does not actively engage the patient in challenging their negative thought pattern. It acknowledges the patient's self-criticism but does not provide a strategy for cognitive restructuring. Option D is unrelated to the patient's statement and does not address the overgeneralization presented. Bringing up the patient's belief in fate or cultural heritage does not directly assist in reframing the negative thought pattern the patient is experiencing. Educationally, this question highlights the importance of active listening and therapeutic communication skills in nursing practice. It emphasizes the role of nurses in guiding patients towards more adaptive thought processes and promoting mental well-being through cognitive restructuring techniques. By understanding the rationale behind each response, nurses can enhance their ability to support patients with mental health challenges effectively.

Correct Answer: D

Rationale: The correct answer is D) Assess for signs of withdrawal. In this scenario, the priority nursing intervention is to assess for signs of withdrawal because the patient is exhibiting symptoms like agitation, sweating, and hand tremors, which are indicative of alcohol withdrawal. Early identification of withdrawal symptoms is crucial in preventing potential complications such as seizures, delirium tremens, or even death. By assessing the patient for signs of withdrawal, the nurse can determine the severity of the withdrawal symptoms and initiate appropriate interventions promptly. Option A) Provide a quiet, calm environment, is important in managing withdrawal symptoms, but it is not the priority at this moment. Option B) Encourage the patient to drink fluids may be beneficial, but it does not address the immediate concern of assessing for withdrawal symptoms. Option C) Administer medications as prescribed may be necessary, but without a thorough assessment of withdrawal symptoms, the nurse may not know which medications are most appropriate for the patient's condition. In an educational context, this question highlights the importance of recognizing and managing alcohol withdrawal in patients. Nurses need to be able to prioritize interventions based on the patient's condition and assess for potential complications. This question reinforces the critical thinking skills required in nursing practice to ensure patient safety and well-being.

Correct Answer: B

Rationale: In this scenario, the correct nursing diagnosis for the patient expressing feelings of failure is option B) Hopelessness. Major depressive disorder often manifests with feelings of hopelessness, helplessness, and worthlessness. By selecting this diagnosis, the nurse acknowledges the patient's emotional state and can initiate appropriate interventions to address these feelings and promote mental health. Option A) Powerlessness may not be the most appropriate diagnosis in this case as the patient is expressing feelings of failure rather than lack of control over their situation. Option C) Imbalanced nutrition: Less than body requirements is not relevant to the patient's statement about feeling like a failure. Option D) Risk for suicide, while important to assess in patients with major depressive disorder, is not the most appropriate initial nursing diagnosis based solely on the patient's statement about feeling like a failure. In an educational context, understanding how to accurately identify and prioritize nursing diagnoses is crucial for providing effective care to patients. By choosing the correct nursing diagnosis, nurses can tailor their interventions to address the specific needs of each individual patient, promoting holistic care and positive patient outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B, which is the newly admitted client who has bipolar I disorder. The rationale behind this choice lies in the acuity and potential risk associated with bipolar I disorder. This condition can involve severe mood swings, including manic episodes that may require immediate attention to ensure the safety of the client and others. Option A is incorrect because premenstrual dysphoric disorder, while significant, does not typically present an immediate threat to the client's safety that would necessitate urgent intervention. Option C, the client with disruptive mood dysregulation disorder, is also less urgent as this disorder is characterized by chronic irritability rather than acute mood disturbances that require immediate attention. Option D, the client with a history of dysthymic disorder, is not the priority as this condition is a persistent depressive disorder that does not typically involve the same level of acuity as bipolar I disorder. From an educational perspective, this question highlights the importance of prioritizing care based on the acuity of the client's condition. It emphasizes the need for nurses to assess and manage clients with more acute and potentially dangerous conditions first to ensure their safety and well-being.