Which nurse would qualify as a fact witness in a case dealing with a physically abused young child?

Correct Answer: C

Rationale: The correct answer is C, an emergency room nurse. In cases of physical abuse, an emergency room nurse who directly treated the child and observed the injuries qualifies as a fact witness. They can provide firsthand accounts of the child's condition and the circumstances surrounding the incident. A psychiatric nurse (A) may not have direct knowledge of the physical abuse, focusing on mental health aspects. A sexual assault nurse examiner (B) specializes in sexual assault cases, not physical abuse. A pediatric intensive care unit nurse (D) may have limited interaction with the child and lack direct knowledge of the abuse.

Correct Answer: B

Rationale: The correct answer is B: Decompensation. In the relapse cycle of co-occurring disorders, decompensation typically occurs first. Decompensation refers to a deterioration in mental health symptoms or functioning. This phase often precedes hospitalization, stabilization, and discharge. It signifies a worsening of symptoms and coping mechanisms, leading to a need for increased support and intervention. Hospitalization (choice A), stabilization (choice C), and discharge (choice D) usually occur after decompensation as steps in the treatment process to address the relapse.

Correct Answer: C

Rationale: The correct answer is C: Superego. The superego is responsible for internalizing societal norms, values, and moral standards. By rewarding and praising the child for positive behaviors such as helping a sibling and using good manners, the parent is reinforcing these moral values, which are then internalized by the child through the development of the superego. The superego acts as the conscience and strives for perfection based on societal expectations. Option A (Id) is incorrect because the Id is the instinctual and impulsive part of the personality driven by the pleasure principle. Option B (Ego) is incorrect as the Ego mediates between the Id and the external world, dealing with reality. Option D (Preconscious) is incorrect as it refers to the part of the mind that contains thoughts and memories that are not currently in awareness but can be easily accessed.

Correct Answer: C

Rationale: The correct answer is C because assuming a relaxed posture and leaning toward the client demonstrates active listening by showing empathy and interest in what the client is saying. This nonverbal behavior encourages the client to continue expressing their feelings. A: Agreeing with the client can shut down communication and invalidate the client's emotions. B: Repeating everything the client says may come across as robotic and not conducive to building rapport. D: Expressing sorrow and sadness, while empathetic, may shift the focus from the client to the nurse's emotions. In summary, actively listening involves nonverbal cues that show understanding and support without interjecting personal opinions or emotions.

Correct Answer: C

Rationale: The correct answer is C: Short-term, inpatient, locked unit. This setting is appropriate because the client is exhibiting acute symptoms of aggression and auditory hallucinations, indicating a need for close monitoring and safety precautions in a secure environment. Long-term inpatient facility (choice A) is not suitable for acute episodes. Day treatment (choice B) may not provide the level of supervision needed. Psychiatric case management (choice D) focuses on community-based care, not acute inpatient care. Therefore, choice C is the most appropriate for managing the client's current symptoms.

Correct Answer: B

Rationale: The correct answer is B: Medication may not be indicated right away; there are other options. Rationale: 1. Medication should not be the first line of intervention for behavior issues in children. 2. It is important to explore other options such as therapy, counseling, behavior modification techniques. 3. Understanding the root cause of Johnny's behavior is crucial before considering medication. 4. Rushing into medication without exploring other avenues may not address the underlying issues. Summary: A: Allowing more freedom at home could potentially worsen Johnny's behavior by reinforcing the negative actions. C: Telling Johnny his behavior is unacceptable without addressing the underlying cause may not effectively reduce his aggression. D: Allowing Johnny to skip school is not a solution; addressing the behavior and providing appropriate support is essential.

Correct Answer: A

Rationale: The correct answer is A because as a psychiatric nurse, it is important to ensure the safety of the patient, especially those with anorexia nervosa who may have harmful items in their belongings. Going through the patient's belongings allows the nurse to assess and remove any potential risks. This action aligns with the duty of care and ensures the patient's well-being. Choice B is incorrect because using a scale can trigger anxiety and reinforce unhealthy behaviors related to weight monitoring in patients with anorexia nervosa. Choice C is incorrect as stating a specific number of meals may not be suitable for every individual and could create unnecessary pressure on the patient. Choice D is incorrect because the structure of care should be based on evidence-based practices and clinical guidelines, not solely on the patient’s desire to eat.

Correct Answer: C

Rationale: The correct answer is C: Reports of the same symptoms repeatedly. In complex somatic symptom disorder, individuals often report persistent physical symptoms with no clear medical explanation. By repeatedly reporting the same symptoms, the client demonstrates a key characteristic of this disorder. Choices A, B, and D do not directly align with the diagnostic criteria for complex somatic symptom disorder. Expressions of concern about psychological problems (A) could indicate other mental health conditions. Indications that parents were always in 'good health' (B) and evidence of a need for social support from friends (D) are not specific to complex somatic symptom disorder.

Correct Answer: A

Rationale: Correct Answer: A: Limiting amounts of evening snacks and beverages Rationale: 1. Limiting evening snacks and beverages can help regulate patients' sleep patterns by reducing stimulants that may interfere with sleep. 2. Nutrition plays a role in sleep quality, and avoiding heavy meals close to bedtime can promote better sleep. 3. This intervention addresses a common issue in psychiatric patients without imposing strict rules or physical activity. 4. It focuses on a holistic approach to improving sleep quality by considering dietary factors. Summary: B: Involving patients in a volleyball game immediately before bedtime - This choice is incorrect as vigorous physical activity before bedtime can be stimulating and may disrupt sleep. C: Enforcing the rule that all patients be in bed with lights out by 10:30 PM - This choice is incorrect as it is too rigid and may not address the underlying causes of sleep disturbances. D: Encouraging patients to take short naps in the afternoons - This choice is incorrect as daytime