Which comment by the nurse would best support relationship building with a survivor...?

Correct Answer: A

Rationale: The correct answer is option A, "You are feeling violated because you thought you could trust your partner." This response demonstrates empathy, validation, and understanding towards the survivor's feelings and experiences. It acknowledges the survivor's emotions and the impact of betrayal and violation on trust, showing support and building a therapeutic relationship. Option B, "I’m here for you. I want you to tell me about the bad things..." while well-intentioned, may come across as insensitive or too direct, potentially overwhelming the survivor with a request to recount traumatic events without addressing their emotional state. Option C, "I was very worried about you... in a potentially violent situation," shifts the focus to the nurse's feelings and experiences rather than validating the survivor's emotions, missing the opportunity for connection and support. Option D, "Abusers often target people who are passive... assertiveness class," introduces a teaching moment that may be helpful in a different context but is not appropriate in a psychiatric emergency situation where the immediate focus should be on building rapport and providing support to the survivor. In an educational context, it is crucial for nurses in psychiatric emergency settings to prioritize building therapeutic relationships with survivors of trauma. Empathetic and validating responses like the one in option A are essential in creating a safe and supportive environment for survivors to feel heard, understood, and supported in their healing journey. Understanding the impact of language and communication in such sensitive situations is key to providing effective and compassionate care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Physical injuries. The priority assessment for an occupational health nurse when an adult is absent from work should be to assess for physical injuries. This is crucial in a psychiatric emergency situation as physical injuries may indicate self-harm, violence, or trauma, which require immediate attention to ensure the individual's safety and well-being. Option A) Interpersonal relationships, while important in a holistic assessment, is not the priority in a psychiatric emergency where physical safety takes precedence. Option B) Work responsibilities and Option C) Socialization skills are also important aspects of an individual's well-being but are not immediate priorities in the context of a psychiatric emergency where physical safety and health are paramount. Educationally, understanding the prioritization of assessments in psychiatric emergencies is crucial for occupational health nurses to effectively intervene and provide appropriate care for individuals experiencing mental health crises in the workplace. By prioritizing physical injuries, nurses can address immediate safety concerns and then proceed to assess other aspects of the individual's well-being.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Risk for injury related to physical abuse from partner. When a patient presents with a detached retina and has undergone treatment, it is crucial to identify potential risks and prioritize safety concerns. Physical abuse from a partner poses an immediate threat to the patient's well-being and must be addressed urgently. Option B) Social isolation related to lack of a community support system, while important, does not take precedence over the risk of physical harm in this urgent situation. Option C) Ineffective coping related to uneven distribution of power, although relevant, does not address the immediate safety concern of physical abuse. Option D) Deficient knowledge related to resources for escape is also important but does not address the immediate risk of injury that the patient may face. In an educational context, this question highlights the importance of recognizing and prioritizing safety concerns in a psychiatric emergency nursing situation. It underscores the need for nurses to be vigilant in assessing for signs of abuse and taking necessary steps to ensure the safety and well-being of their patients. By understanding the hierarchy of needs in such emergencies, nurses can provide effective and timely interventions to address critical issues.

Correct Answer: A

Rationale: In this scenario, the correct nursing diagnosis with the highest priority is Option A: Risk for injury related to poor judgment, cognitive impairments, and inadequate supervision. This diagnosis takes precedence because safety is a fundamental need in nursing care, especially in psychiatric emergencies involving older adults with Lewy body dementia. Option B, wandering related to confusion and disorientation, is important but falls secondary to the risk of injury. While wandering poses risks, the immediate concern is preventing harm to the patient. Option C, chronic confusion related to degenerative changes, addresses a symptom rather than a potential life-threatening situation. Option D, insomnia related to sleep disruptions, is also significant but does not pose an immediate threat to the patient's safety compared to the risk of injury due to poor judgment and cognitive impairments. Educationally, understanding the priority of nursing diagnoses in psychiatric emergencies is crucial for providing effective and safe care. By prioritizing the risk for injury, nurses can implement strategies to ensure the patient's safety and prevent harm, which is foundational in psychiatric emergency nursing. It is essential for nurses to continuously assess and prioritize patient needs to deliver optimal care in these challenging situations.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Parental sessions to teach childrearing practices. This option is the priority in stabilizing the home situation for several reasons. First, by providing parental sessions, the caregiver (presumably the 10-year-old) can learn appropriate child-rearing practices, which can improve the overall care provided to the siblings. This intervention addresses the root cause of the issue by empowering the caregiver with essential skills and knowledge. Option B) Anger management counseling for the father is not the priority in this case because the primary concern is the immediate well-being and stability of the children in the home. While addressing the father's anger management issues is important, it is secondary to ensuring the children's safety and care. Option C) Continuing home visits to give support is valuable but may not directly address the need for education and skill-building in child-rearing that is essential for the 10-year-old caregiver. Option D) A safety plan for the wife and children is crucial in situations of domestic violence or abuse, but in this case, the priority is to empower the 10-year-old caregiver with the necessary knowledge and skills to provide adequate care for the siblings. From an educational perspective, it is important to prioritize interventions that address the immediate needs of the children in a psychiatric emergency situation. By focusing on providing education and support to the caregiver, we can enhance the long-term stability and well-being of the family. This rationale underscores the significance of addressing the root cause of the issue to prevent future emergencies and promote a safe and nurturing environment for the children.