When a nursing student expresses concerns about how mental health nurses lose all their nursing skills, the best response by the mental health nurse is:

Correct Answer: B

Rationale: The practice of psychiatric nursing requires a different set of skills than medical-surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help patients with medical as well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical pain and suffering.

Correct Answer: C

Rationale: Evidence-based practice involves using research findings and standards of care to provide the most effective nursing care. Evidence is continuously emerging, so nurses cannot rely solely on experience. The effective nurse also maintains respect for each patient as an individual. Overgeneralization compromises that perspective. Intuition and trial and error are unsystematic approaches to care.

Correct Answer: A

Rationale: In an inpatient setting, when addressing a behavioral crisis, the principle of resolving the crisis with the least restrictive intervention possible (Option A) holds the highest priority. This approach is rooted in the ethical concept of beneficence, ensuring that the individual's autonomy and dignity are respected while promoting safety and well-being. Option B is incorrect as swift interventions, while sometimes necessary, may not always align with the least restrictive approach and can escalate the situation. This option does not prioritize the individual's rights and autonomy. Option C is also incorrect as it goes against the ethical principle of respect for autonomy. Individual rights should not be superseded by the majority, as each patient's well-being and rights are equally important. Option D is incorrect because waiting for the patient to regain control without intervention can potentially compromise the safety of others in the inpatient setting. It is essential to prioritize safety while also respecting the individual's autonomy. Educationally, understanding the principles of behavioral crisis management in nursing is crucial for providing safe and effective care. Emphasizing least restrictive interventions honors the dignity and autonomy of patients while maintaining a therapeutic environment. By prioritizing this principle, nurses can navigate behavioral crises ethically and professionally.

Correct Answer: C

Rationale: In this scenario, the correct first action for the case manager to take is option C: Obtain the patient's permission for the exchange of information. This is the most critical step as it respects the patient's autonomy and rights to privacy and confidentiality. In healthcare settings, patient confidentiality is of utmost importance, and any sharing of information with family members should only be done with the explicit consent of the patient. By obtaining the patient's permission first, the case manager ensures that they are acting ethically and in accordance with legal and professional standards. Option A, determining an appropriate location for the conference, is not the priority in this situation. While setting can be important for privacy and comfort, it is secondary to obtaining the patient's consent. Option B, supporting the discussion with examples of the patient's behavior, may be relevant during the meeting but should not be the first action taken. It is important to establish consent before sharing any patient information. Option D, determining which family members should participate in the conference, is premature without first obtaining the patient's permission. Patient autonomy and privacy should be respected before involving family members in discussions about treatment plans. In an educational context, it is crucial for healthcare professionals to understand and prioritize patient confidentiality and consent. This case highlights the significance of ethical decision-making and the legal obligations that come with sharing patient information with family members. By prioritizing obtaining the patient's permission, healthcare professionals can uphold ethical standards and build trust with their patients.

Correct Answer: D

Rationale: Early psychosocial developmental history is less relevant to successful outcomes in the community than the assessments listed in the other options. If a patient is homeless or fears homelessness, focusing on other treatment issues is impossible. Sufficient income for basic needs and medication is necessary. Adequate support is a requisite to community placement. Substance abuse undermines medication effectiveness and interferes with community adjustment.