In what significant ways is the therapeutic environment different for a patient who has ingested D-lysergic acid diethylamide (LSD) than for a patient who has ingested phencyclidine (PCP)?

Correct Answer: A

Rationale: The correct answer is A because for a patient who has ingested LSD, it is important to have someone stay with them and provide verbal support due to the potential for anxiety and panic attacks. This helps in grounding the patient and providing reassurance. On the other hand, for a patient who has ingested PCP, a regimen of limited contact with staff members is maintained to prevent potential aggression or unpredictable behavior. Continual visual monitoring is provided to ensure safety without directly engaging with the patient. Choice B is incorrect because placing a patient on one-on-one intensive supervision for PCP ingestion may escalate the situation due to potential paranoia or aggression. Choice C is incorrect because LSD ingestion may lead to sensory overload, so providing moderate sensory stimulation is more appropriate. Choice D is incorrect because restraints for LSD ingestion are not necessary and seizure precautions are not typically needed for PCP ingestion.

Correct Answer: A

Rationale: The correct answer is A because actively listening allows the nurse to show empathy, understanding, and respect towards the client, which are essential for building a therapeutic relationship. By actively listening, the nurse can demonstrate genuine interest in the client's thoughts and feelings, fostering trust and rapport. Choice B is incorrect as intervening when the client expresses beliefs from their illness may disrupt the client's expression and hinder the development of trust. Choice C is incorrect because evaluating behaviors and relationships may create a sense of judgment and lack of privacy, which can be detrimental to the therapeutic relationship. Choice D is incorrect because passively allowing the client to control communication may lead to a lack of direction and boundaries, potentially hindering effective communication and rapport-building.

Correct Answer: D

Rationale: The correct answer is D because having one's only child leave home to attend college is an example of a maturational crisis. This event represents a significant life transition that can trigger emotional distress and force a reevaluation of one's identity and roles as a parent. It is a normal developmental milestone that signifies a shift in family dynamics and requires adjustment to an empty nest. A: Experiencing an unplanned pregnancy is not a maturational crisis as it is more related to a situational crisis. B: Losing one's job within months of retiring is not a maturational crisis but rather a situational crisis related to financial security. C: Working at a bank that was recently robbed is not a maturational crisis but a situational crisis related to work safety and stress.

Correct Answer: A

Rationale: The correct answer is A because it demonstrates the systematic and consistent implementation of evidence-based practice guidelines in documenting negative responses to suicidal ideation assessments for clients diagnosed with depression. This approach ensures that crucial information is captured regularly, aiding in monitoring and managing the clients' mental health effectively. Choice B focuses on the outcome of a specific treatment but does not directly address the implementation of evidence-based practice guidelines. Choice C expresses personal satisfaction rather than adherence to guidelines. Choice D reflects the client's subjective opinion and does not provide evidence of following specific guidelines. Thus, A is the correct choice as it directly relates to evidence-based practice implementation.

Correct Answer: D

Rationale: The correct answer is D because it highlights the current status of the benefit of family involvement for individuals who are mentally ill. It acknowledges that while the benefits of family involvement are well documented, the actual service is not consistently offered in most mental health systems. This indicates a gap between research evidence and practical implementation, hindering the full realization of the benefits. Explanation for why other choices are incorrect: A: Incorrect because although confidentiality laws like HIPAA may pose challenges, they do not necessarily limit family involvement entirely. B: Incorrect because family involvement is crucial throughout the mental health journey, not just after stabilization. C: Incorrect because with proper support and resources, families can have a significant impact on the mental health of their loved ones.