Walking down the aisle of a local grocery store, a nurse encounters a client the nurse has recently cared for on an inpatient psychiatric setting. Which is the appropriate reaction by the nurse?

Correct Answer: D

Rationale: The correct answer is D because making eye contact and responding if the client engages maintains professionalism and acknowledges the client's presence without compromising confidentiality. It shows respect and empathy, which are important in nursing practice. A: Inquiring about the client's well-being can breach confidentiality and may not be appropriate in a public setting. B: Ignoring the client can be seen as rude and may harm the therapeutic relationship. C: Talking to the client without using names may still breach confidentiality and does not fully acknowledge the client's presence.

Correct Answer: B

Rationale: The correct answer is B because the scenario indicates that time-out is no longer effective for April. The fact that April's mother puts her in time-out up to 20 times a day suggests overuse, leading to desensitization. This renders time-out ineffective as a therapeutic tool. April's increasing agitation and lack of self-control despite time-outs indicate the need for a different approach. Choices A and C are incorrect because they assume time-out is still effective, which contradicts the scenario. Choice D is incorrect as seclusion and restraint should only be considered as a last resort due to ethical and safety concerns.

Correct Answer: C

Rationale: The correct answer is C: Decreased REM sleep. Caffeine is a stimulant that can interfere with the sleep cycle by reducing the amount of REM (rapid eye movement) sleep, which is crucial for restorative functions. Here's the rationale: 1. Caffeine blocks adenosine receptors, which can disrupt the natural sleep stages, including REM sleep. 2. REM sleep is important for memory consolidation and cognitive function, so a decrease in REM sleep can lead to cognitive impairments. 3. Choices A and B are incorrect because caffeine typically increases sleep latency and decreases total sleep time. 4. Choice D is incorrect because caffeine is known to reduce slow-wave sleep, which is the deep, restorative stage of sleep.

Correct Answer: D

Rationale: The correct answer is D because it accurately describes the treatment goal of Assertive Community Treatment (ACT) programs. ACT aims to provide intensive treatment and support for mentally ill individuals to help them live successfully in the community. This involves a comprehensive approach that includes medication management, therapy, and other services tailored to each individual's needs. Choice A is incorrect because ACT is not solely focused on maintaining abstinence from alcohol and other substances of abuse. Choice B is incorrect as it describes a different type of program for mentally ill patients in need of stabilization, not necessarily those in the community. Choice C is incorrect as it specifically mentions incarcerated inmates, which is not a focus of ACT programs designed for community living.

Correct Answer: A

Rationale: The correct answer is A: Interpersonal relations. Harry Stack Sullivan is known for his focus on interpersonal relations as a major concept in psychiatric-mental health nursing. Sullivan emphasized the importance of understanding and improving relationships between individuals as a key factor in mental health. He believed that a person's development and well-being are greatly influenced by their interactions with others. This concept is fundamental in psychiatric nursing practice as it guides therapeutic communication and relationship-building with patients. Choices B, C, and D are incorrect because they do not directly align with Sullivan's emphasis on interpersonal relations in the context of psychiatric-mental health nursing.

Correct Answer: D

Rationale: The correct answer is D: yoga. Adjunctive treatments are used alongside primary treatments to enhance outcomes. Yoga is a complementary therapy that can improve mental health by reducing stress, anxiety, and improving overall well-being. It is non-invasive and can be used in conjunction with other treatments like psychotherapy. Antipsychotic medication (A) is a primary treatment for certain mental health conditions like schizophrenia. Hospitalization (B) is a severe intervention for acute mental health crises. Psychotherapy (C) is a primary treatment involving talk therapy. Yoga (D) stands out as an adjunctive treatment due to its holistic approach and ability to support mental health alongside other therapies.

Correct Answer: A

Rationale: The correct answer is A because the statement that complementary and alternative medicine is always less expensive than conventional medical treatment is not true. Cost is often a significant factor in healthcare decisions, but it is not the only factor that attracts patients to complementary and alternative medicine. Patients may be drawn to these practices due to a desire for more personalized care (B), a perception of lower risk compared to pharmaceuticals (C), or dissatisfaction with the effectiveness of traditional medicine (D). However, cost alone is not a primary factor in choosing complementary and alternative medicine.

Correct Answer: D

Rationale: The correct answer is D because the phase of the nurse-client relationship involving reviewing the client's record is the orientation phase. In this phase, the nurse gathers information about the client's diagnosis, health history, and current care needs to understand the client's situation. This phase focuses on setting goals, exploring attitudes, and establishing a plan of care based on the client's needs. It is essential for the nurse to understand the client's diagnosis to provide effective care. Choice A (Getting to know each other and establishing trust) is typically associated with the initial phase of the relationship, not specifically related to reviewing records. Choice B (Implementing nursing interventions to achieve outcomes) is part of the working phase, where interventions are carried out. Choice C (Achievement of independence and maintenance of health without nursing care) is more aligned with the termination phase, where the client achieves independence.

Correct Answer: A

Rationale: The correct answer is A: Angry and hostile. Individuals with paranoid personality traits often exhibit suspiciousness, mistrust, and a tendency to interpret others' actions as hostile or malevolent. This can lead to feelings of anger and hostility towards others. This affect and behavior align with the characteristics commonly seen in individuals with paranoid personality traits. Choices B, C, and D are incorrect because paranoid individuals are not typically flirtatious, seductive, fearful, anxious, friendly, or open in their interactions due to their underlying suspicious and mistrustful nature.