Title KEY - R12 NP5.docx ✅

4. Vanya used manipulation to get her needs met. The staff decides to apply limit-setting interventions. What is the correct rationale for this action? A. It provides an outlet for feelings of anger and frustration. B. It respects the patient's wishes so assertiveness will develop. C. External controls are necessary while internal controls are developed. D. Anxiety is reduced when staff members assume responsibility for the patient's behavior. Answer: C Rationale: The nurse must provide structure in the therapeutic relationship, identify acceptable and expected behaviors, and be consistent in those expectations. He or she must minimize attempts by these clients to manipulate and control the relationship. Limit setting is an effective technique that involves three steps: 1. Stating the behavioral limit (describing the unacceptable behavior) 2. Identifying the consequences if the limit is exceeded 3. Identifying the expected or desired behavior For clients who feel out of control, the nurse must establish external controls empathetically and non- judgmentally. These external controls provide long-term comfort to clients, though their initial response may be aggression. All staff must consistently set and enforce limits for those limits to be effective. Limits must be established by others when the client is unable to use internal controls effectively. Source: Videbeck, S. (2020). Psychiatric-Mental Health Nursing. 8th edition p. 710, 765 5. Given the behavior of Vanya or Xylo, limit setting be most essential if either of them ___________________________. A. Clings to the nurse and asks for advice about inconsequential matters. B. Flirts with and is provocative with staff members of the opposite sex. C. Displays hypervigilant behavior and refuses to attend unit activities. D. Urges a suspicious patient to hit anyone who stares. Answer: B Rationale: Erratic patterns of thinking and behaving often alienate them from others. This may be true for both professional and personal relationships. Clients can easily misinterpret the nurse’s genuine interest and caring as a personal friendship, and the nurse may feel flattered by a client’s compliments. The nurse must be quite clear about establishing the boundaries of the therapeutic relationship to ensure that neither the client’s nor the nurse’s boundaries are violated. Source: Videbeck, S. (2020). Psychiatric-Mental Health Nursing. 8th edition p. 783 Situation: Greta, 54-years old and a known hypertensive (controlled), was seen in her ophthalmologist's office for a routine eye examination. Her last examination was five (5) years ago. Reports of significant visual field loss was determined to be caused by wide-angle glaucoma. Nurse Jenny was tasked to assist the patient in her care. 6. Laser trabeculoplasty as a form of treatment was suggested to Greta. Which of the following nursing measures should receive priority in the client's plan of care after eye surgery? A. Prevent increase in intraocular pressure (IOP) and signs of infection B. Instruct on the importance of follow-up C. Instruct on how to perform the Valsalva maneuver D. Management of pain through patient-controlled analgesia (PCA) Answer: A Rationale: The primary focus of treatment is to keep the IOP low enough to prevent the patient from developing optic nerve damage. After eye surgery, include the following information in the teaching plan for the patient and caregiver: ● Proper hygiene and eye care techniques to ensure that dressings and/or surgical wound is not contaminated during eye care ● Signs and symptoms of infection (e.g., increased or purulent drainage, increased redness, any decrease in visual acuity) and when and how to report these to allow for early recognition and treatment of possible infection ● Importance of following restrictions on head positioning, bending, coughing, and Valsalva maneuver to optimize visual outcomes and prevent increased IOP ● How to instill eye medications using aseptic technique and adherence with prescribed eye medication routine to prevent infection

B. An interview with a foreign-born but English-speaking person C. A type of descriptive qualitative study or someone's experiences D. A type of quantitative study Answer: A Rationale: Ethnographic studies involve the collection and analysis of data about cultural groups. In ethnographic research, the researcher frequently spends extended periods of time with the group and becomes a part of their culture. The researcher explores with the group their rituals and customs. Source: Nieswiadomy. R.M. & Bailey, C. (2018). Foundations of Nursing Research. 7th edition p. 160 11. Nurse Rico is aware that the major advantage of observation over interview is that _____________. A. Observation may be recorded and scrutinized later B. Observations enable the recording of actual behaviors, rather than subjects' interpretations C. Observation is scientific, unlike interviews which necessary involve personal interactions D. Observations are unbiased and do not elicit reactions in human subjects. Answer: B Rationale: The research question or study hypothesis should determine the behaviors that will be observed. Psychomotor skills can be evaluated, such as the ability of clients with diabetes to perform insulin injections. Personal habits, such as smoking and eating behaviors, might be of interest. Nonverbal communication patterns, such as body posture or facial expressions, are frequently observed. Source: Nieswiadomy. R.M. & Bailey, C. (2018). Foundations of Nursing Research. 7th edition p. 70 12. Participant observation may be defined as: A. The observation of participants in the study B. The observation of the researcher’s input to a study C. Participation in a group while studying it D. The study of observational and clinical techniques Answer: C Rationale: In participant observation, the observer becomes involved in interactions with the participants. This interaction may be overt or covert. The participant observer (overt) becomes involved with participants openly and with the full awareness of those people who will be observed. In contrast, as a participant observer (covert), the observer interacts with the participants and observes their behavior without their knowledge. A participant observer participates in the functioning of the group under study and strives to observe and record information within the contexts and experiences that are relevant to participants. Source: Nieswiadomy. R.M. & Bailey, C. (2018). Foundations of Nursing Research. 7th edition p. 215 13. One of the major problems associated with the use of participant observation as a research strategy is that: A. It is more expensive than experimental approaches to implement. B. It does not allow "in-depth" study of any phenomena C. The results cannot be replicated D. May cause unrest among samples Answer: D Rationale: Participant observation faces potential problems. Observers may lose objectivity in sampling, viewing, and recording observations. Once they begin to participate in a group’s activities, the possibility of emotional involvement becomes a concern. Researchers in their member role may fail to attend to key aspects of the situation or may develop a myopic view on issues of importance to the group. Observers must overcome two major hurdles in assuming a satisfactory role vis-à-vis participants. ● First, to gain entrée into the social group under study. ● Second, to establish rapport and trust within that group. Without gaining entrée, the study cannot proceed; but without the trust of the group, the researcher will be restricted to “front stage” knowledge—information distorted by the group’s protective facades. Source: Polit, D. & Beck, C.T. (2018). Essentials of Nursing Research: Appraising Evidence for Nursing Practice. 9th edition p. 300