A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group?
a. Tricyclic antidepressants
b. Antipsychotic drugs
c. Antimanic drugs
d. Benzodiazepines
Answer: D
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Mental Health
- A patient being treated for an MI has been transferred to a step-down unit from the intensive care unit. She uses the call bell as often as every 15 minutes. Each time a staff member responds, the patient complains about her care or makes a seemingly small request. Several staff tell the primary nurse that the patient is "obnoxious" and that they feel inadequate because they can never seem to satisfy her needs. The primary nurse can be most helpful by:
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- A middle-class family is talking with the nurse about the impact a seriously mental ill son has had on the family. Insurance has only partially covered treatment expenses, and the family has spent much of their savings to care for him. The patient's younger sister mentions she feels lost because her parents are so focused on her brother that it seems as though they have no time for her. The parents are concerned that when the siblings move out and they themselves become aged, there will be no one to care for the patient. Which response would be most helpful?
- A patient with paranoid schizophrenia and anosognosia has had several hospitalizations. He responds quickly to antipsychotic medication but stops taking the medication soon after discharge. Discharge planning will include follow-up at the mental health clinic, placement in a group home, and daily attendance at a psychosocial day program. Which medication strategy will most likely be used as he transitions from hospital to community?
- The brother of a patient who is seriously mentally ill asks why the patient has been assigned a case manager. The nurse's reply should cite the major advantage of the use of case management as:
- A nurse cares for a rape victim who was given flunitrazepam (Rohypnol) by the assailant. Which intervention has priority? Monitoring for:
- A victim of a sexual assault sits in the emergency department rocking back and forth and repeatedly saying, "I can't believe I've been raped." This behavior is characteristic of:
- A nurse works a rape telephone hotline. Communication should focus on:
- The nursing diagnosis Rape-trauma syndrome is established for a rape victim in the emergency department. Select the most important outcome to achieve before discharging the patient.
- An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?
- After a person was abducted and raped at gunpoint by an unknown assailant, which assessment finding best indicates the acute phase of the rape-trauma syndrome?
- After a rape victim visited a rape crisis counselor weekly for 8 weeks, which finding best demonstrates that reorganization was successful?
- Which aspect of assessment has priority when a nurse interviews a rape victim?
- A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after a experiencing an event in which self-esteem is challenged. The most recent episodes of violence were related to feeling "upset" over a job loss. What type of therapy would provide the greatest help to the abuser?
- A child, aged 11 years, has to stay home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The father appears to be emotionally abusive. Which intervention could be used for the primary prevention of problems such as these?
- A nurse is working with a perpetrator of family violence who has a long history of violent rages when frustrated, with periods of remorse after each outburst. The nurse is most likely to establish the nursing diagnosis of:
- An 82-year-old widow with Alzheimer's disease lives with her daughter's family, which owns a catering business. During the week, the patient attends a day care center for patients with dementia. During the evenings, members of the family care for the patient. One day, the nurse at the day care center notices the patient's appearance is disheveled and that she startles easily. She has a strong odor of urine, and her hair is uncombed. When the nurse escorts the patient to the bathroom, she notices bruises on her wrists and back. What most likely explains the nurse's observations?
- A victim of physical abuse by her domestic partner is being treated for a broken humerus. Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?
- A patient being treated in the burn injury unit has demonstrated good coping skills for several weeks. Today, a new nurse is assigned to care for him and has proven to be poorly organized. The patient's usual schedule has not been followed, and by midafternoon, he is angry and raises his voice to complain to the nurse clinician. Which course of action for the nurse clinician would be best?
- A patient with severe orthopedic injuries after an automobile accident is irritable, angry, and belittles the nurses who provide his care. While the nurse is changing the dressing over a deep laceration, the patient screams, "Don't touch me! You are so stupid; you're only making it worse!" Which intervention would be most therapeutic?
- A patient on a medical unit has a history of hostile and menacing behavior toward staff and sometimes even strikes them. Which plan would be best for forestalling such incidents?
- An elderly patient with multi-infarct dementia is striking out with her arms and kicking at people who walk past in the hall. The nurse determines that the patient believes she is at home and that the other patients have broken into her home. The clinical nurse specialist suggests that staff use validation. Which of the following responses reflect this intervention?
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- A patient is pacing the hall near the nurses' station, swearing loudly. An appropriate initial intervention for the nurse would be to address the patient by name and say: