The desired outcome for a patient experiencing insomnia is, 'Patient will sleep for a minimum of 5 hours nightly within 7 days.' At the end of 7 days, review of sleep data shows the patient sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. The nurse will document the outcome as

Correct Answer: D

Rationale: The correct answer is D) never demonstrated. In this scenario, the patient did not meet the desired outcome of sleeping for a minimum of 5 hours nightly within 7 days. The patient's average nightly sleep of 4 hours falls short of the goal, and taking a 2-hour afternoon nap further contributes to sleep fragmentation rather than achieving consolidated nighttime sleep. Option A) consistently demonstrated would be incorrect because the patient did not consistently achieve the desired outcome. Option B) often demonstrated would be inaccurate as the patient did not frequently meet the goal of sleeping for a minimum of 5 hours nightly. Option C) sometimes demonstrated would also be incorrect as the patient did not occasionally achieve the desired outcome. From an educational perspective, this question highlights the importance of setting specific, measurable, achievable, relevant, and time-bound (SMART) goals in nursing practice. It underscores the need for nurses to critically evaluate patient outcomes based on established criteria and adjust interventions accordingly to promote optimal patient care and outcomes in behavioral health nursing.

Correct Answer: A

Rationale: In this scenario, the priority nursing action is option A) Ask the patient about their suicidal thoughts and plan. The rationale behind this choice is rooted in the principle of safety and risk assessment. When a patient expresses thoughts of being a burden and not wanting to live, it raises significant concern for suicidal ideation. By directly addressing the issue of suicidal thoughts and plans, the nurse can assess the level of risk the patient poses to themselves and take appropriate actions to ensure their safety. Option B) Encouraging the patient to discuss their feelings of hopelessness is important for therapeutic communication but is not the priority when there is a potential risk of harm to the patient. Option C) Reassuring the patient that their family loves them and will support them is a supportive statement but does not address the immediate safety concern of suicidal ideation. Option D) Encouraging the patient to engage in activities that improve mood is also valuable for managing depression, but safety assessment takes precedence when there are signs of suicidal ideation. In an educational context, it is crucial for nurses to prioritize safety in mental health assessments. Understanding the hierarchy of needs in psychiatric nursing helps nurses make swift and accurate decisions to protect the well-being of their patients. By addressing suicidal ideation promptly, nurses can initiate appropriate interventions and prevent potential self-harm or harm to others.

Correct Answer: B

Rationale: In the context of Adult Behavioral Health Nursing, understanding QSEN (Quality and Safety Education for Nurses) is crucial for providing safe and effective care to patients. The correct answer, B, is the most appropriate choice because QSEN is an initiative designed to enhance the knowledge, skills, and attitudes of nursing students and practicing nurses in quality and safety principles. By focusing on competencies such as patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics, QSEN aims to prepare nurses to deliver high-quality care. Option A, "Qualitative Standardized Excellence in Nursing," is incorrect because it does not accurately reflect the purpose or focus of the QSEN initiative. QSEN emphasizes quantitative measures and evidence-based practices rather than qualitative standards. Option C, "Quantitative Effectiveness in Nursing," is also incorrect because while QSEN does emphasize quantitative measures in promoting quality and safety in nursing care, the term "effectiveness" does not fully capture the comprehensive nature of the QSEN competencies. Option D, "Quick Standards Essential for Nurses," is incorrect as it does not accurately represent the core principles of QSEN, which are focused on developing a strong foundation of knowledge and skills in quality and safety over time, rather than quick or expedited standards. In an educational context, understanding QSEN is essential for nursing students and practicing nurses as it provides a framework for delivering safe, high-quality care in complex healthcare settings. By incorporating QSEN principles into their practice, nurses can enhance patient outcomes, promote a culture of safety, and contribute to continuous quality improvement in healthcare delivery.

Correct Answer: C

Rationale: In this scenario, the nurse's best response is option C: "That's a good topic for you to discuss with your doctor." This response empowers the patient to take an active role in their care and encourages them to communicate directly with the doctor regarding their privileges. Option A is incorrect as it may come across as dismissive and undermine the patient's autonomy. Option B delays the discussion until the nurse sees the doctor, missing an opportunity for the patient to advocate for themselves promptly. Option D is also incorrect as it questions the patient's ability to communicate with a doctor, which can be disempowering. Educationally, this situation highlights the importance of promoting patient autonomy and self-advocacy in mental health nursing. By encouraging patients to engage in discussions about their care with their healthcare providers, nurses empower them to be active participants in decision-making processes that affect their well-being. It also emphasizes the significance of effective communication skills in nursing practice to support patient-centered care.

Correct Answer: B

Rationale: It is important not to challenge the patient's beliefs, even if they are unrealistic. Challenging undermines the patient's trust in the nurse. The nurse should try to understand the underlying feelings or thoughts the patient's message conveys. The correct response uses the therapeutic technique of reflection. The other comments are nontherapeutic. Asking to talk about something other than the concern at hand is changing the subject. Saying that the CIA is prohibited from operating in health care facilities gives false reassurance. Stating that the patient has lost touch with reality is truthful, but uncompassionate.