Which strategy will the nurse include in the plan of care for a 6-year-old child for whom operant conditioning has been recommended?

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Consistently offering praise. Operant conditioning involves modifying behavior through reinforcement or punishment. For a 6-year-old child, positive reinforcement in the form of praise is more effective than punishment. Praising the child for desired behaviors, such as completing puzzles, will increase the likelihood of them repeating those behaviors in the future. Option A) Periodically asking the child to attempt increasingly difficult puzzles may be a form of shaping behavior but lacks the immediate positive reinforcement that is crucial in operant conditioning for young children. Option C) Expecting the child to rinse and place their dirty dishes in the sink is not directly related to operant conditioning and does not provide clear reinforcement for the desired behavior. Option D) Conditioning the child to expect punishment when misbehaving is based on punishment rather than reinforcement, which is less effective in promoting positive behavior change, especially in young children. In an educational context, it is essential for nurses to understand the principles of behavior modification, such as operant conditioning, when caring for pediatric patients. By utilizing positive reinforcement strategies like offering praise, nurses can help promote desired behaviors and create a positive and supportive environment for children to learn and grow.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Examine interventions for possible revision of the target date. The rationale behind this choice is to ensure that the patient's care plan is effective in addressing the desired outcome of achieving a minimum of 5 hours of sleep nightly. By reviewing the patient's sleep data and considering the fact that they are taking a 2-hour afternoon nap, it is evident that the current plan may not be sufficient in meeting the desired goal. Option A) Continuing the current plan without changes may not lead to the desired outcome as the patient is not meeting the sleep goal. Option B) Removing the nursing diagnosis from the plan of care without addressing the issue would neglect the patient's needs. Option C) Writing a new nursing diagnosis may not be necessary if the current diagnosis is still relevant and the issue lies in the effectiveness of the interventions. Educationally, this question highlights the importance of continuous evaluation and adjustment of care plans based on patient responses and data. It emphasizes the need for critical thinking and flexibility in nursing practice to ensure optimal patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct initial nursing intervention for a 34-year-old male with catatonic schizophrenia who has been mute and motionless for several days is to establish a nonthreatening relationship (Option C). This is the most appropriate choice because individuals with catatonic schizophrenia may be experiencing extreme withdrawal and communication difficulties, and establishing a trusting and nonthreatening relationship can help create a sense of safety and security for the patient. Option A, orienting the patient to the unit, may not be the most immediate priority as the patient's primary need at this stage is to establish a connection before introducing new information. Option B, reinforcing reality with the patient, may not be effective initially as the individual may not be in a state where they can readily comprehend or engage with external stimuli. Administering prescribed medications or interventions (Option D) is important in the overall management of catatonic schizophrenia; however, in this case, establishing a relationship to assess the patient's current state and needs is the most critical first step before proceeding with medical interventions. Educationally, this question highlights the importance of therapeutic communication and relationship-building in psychiatric nursing. It emphasizes the need to prioritize interventions based on the individual's current presentation and needs, considering their unique symptoms and condition. Understanding the rationale behind each option enhances a nurse's ability to provide patient-centered care in mental health settings.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Disturbed thinking. In undifferentiated schizophrenia, one of the hallmark symptoms is disorganized thinking, which can manifest as thought disorder, delusions, or hallucinations. These symptoms are indicative of a primary deficit in thought processes. Option A) Social isolation may occur as a secondary consequence of the disturbed thinking and can be a symptom of schizophrenia, but it is not the primary deficit being assessed in this case. Option C) Altered mood states, while common in some types of schizophrenia, are not the primary deficit in undifferentiated schizophrenia. Mood disturbances are more characteristic of affective disorders. Option D) Poor impulse control is not typically a primary deficit in undifferentiated schizophrenia. While individuals with schizophrenia may exhibit impulsive behaviors, it is not the central feature of the disorder. Educationally, understanding the primary deficits in different psychiatric disorders is crucial for accurate assessment and treatment planning. By recognizing that disturbed thinking is the primary deficit in undifferentiated schizophrenia, healthcare professionals can target interventions to address this specific symptom and improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct nursing diagnosis for a patient who insists on being called "Your Highness" and exhibits loosely associated thoughts is "Disturbed thought processes" (Option D). This diagnosis is appropriate because the patient's behavior of demanding to be addressed as royalty and displaying loosely associated thoughts indicates a disruption in their cognitive processes and perception. Option A, "Risk for violence," is incorrect because the patient's behavior does not directly suggest a potential for physical harm to self or others. Option B, "Defensive coping," is incorrect as there is no evidence provided to support the patient using defensive mechanisms to manage stress or conflict. Option C, "Impaired memory," is also incorrect as the symptoms described do not specifically point to memory deficits but rather to disorganized thinking. Educationally, understanding the significance of different nursing diagnoses in psychiatric care is crucial for providing appropriate and effective patient-centered care. Recognizing and accurately identifying disturbed thought processes can guide interventions aimed at addressing the underlying cognitive challenges and promoting the patient's mental well-being. This rationale emphasizes the importance of thorough assessment and critical thinking in psychiatric nursing practice.