Tiêu đề KEY - R12 NP5.docx ✅

RECALLS 12 NURSING PRACTICE 5 Situation: Nurse Helen is aware that, although each individual is unique, they also share common characteristics. She is tasked with personality disorders. Given the case of Vanya, a client with borderline personality disorder, Nurse Helen takes on her role as a psychiatric nurse. 1. Nurse Helen was about to administer an oral medication to Vanya diagnosed with a borderline personality disorder. However, Vanya responds to this by saying "Just leave it on the table. I will take it when I finish combing my hair." The best response from Nurse Helen would be to _____________. A. Reinforce this assertive action by Mariel. Leave the medication on the table as requested. B. Respond to Manel, "I'm worried that you might not take it. I will come back later." C. Say to Mariel, “I must watch you take the medication. Please take it now.” D. Ask Mariel, "Why don’t you want to take your medication now?" Answer: C. Rationale: Using nonjudgmental language and a matter-of-fact tone avoids giving the client verbal cues to become defensive. Regardless of the clinical setting, the nurse must provide structure and limit setting in the therapeutic relationship. Be consistent with the client. Set and maintain limits regarding behavior, responsibilities, rules, and so forth. Source: Videbeck, S. (2020). Psychiatric-Mental Health Nursing. 8th edition p. 782 2. Along with her long-standing history of self-mutilation and suicide attempts, Vanya reveals feelings of depression and anger with life. Treatment was initiated by the psychiatrist with the use of a medication. Which type of medication should Nurse Helen expect to be prescribed? A. Escitalopram (Lexapro) B. Phenelzine (Nardil) C. Alprazolam (Xanax) D. Haloperidol (Haldol) Answer: A Rationale: Researchers believe that levels of neurotransmitters, especially norepinephrine and serotonin, are decreased in depression. The goal is to increase the efficacy of available neurotransmitters and the absorption by postsynaptic receptors. To do so, antidepressants establish a blockade for the reuptake of norepinephrine and serotonin into their specific nerve terminals. This permits them to linger longer in synapses and to be more available to postsynaptic receptors. Antidepressants also increase the sensitivity of the postsynaptic receptor sites. SSRIs, the newest category of antidepressants are effective for most clients. Their action is specific to serotonin reuptake inhibition; these drugs produce few sedating, anticholinergic, and cardiovascular side effects, which makes them safer for use in children and older adults. Because of their low side effects and relative safety, people using SSRIs are more apt to be compliant with the treatment regimen than clients using more troublesome medications. Option B is a MAOI while option C is anxiolytic, and option D is an antipsychotic. Source: Videbeck, S. (2020). Psychiatric-Mental Health Nursing. 8th edition p. 666 3. During the weekend, Vanya’s boyfriend, Xylo, visited her beyond visiting hours. When the security guard prohibited him from entering the hospital, he threatened the staff, ripped art off the walls, and thrown objects. With protocols in place, the security guard used force to stop Xylo. Soon, he was detained in the police community precinct. The most appropriate nursing diagnosis for Xylo would be ______________. A. Disturbed sensory perception-auditory B. Risk for other-directed violence C. Ineffective denial D. Ineffective coping Answer: B Rationale: For clients exhibiting aggressive behavior and agitated behavior, there is a high risk for other-directed violence. These behaviors are displayed by an individual indicating his or her potential to cause physical, emotional, and/or sexual harm to others. There is no defining cues stated that would indicate disturbed sensory perception-auditory, ineffective denial or ineffective coping. Source: Videbeck, S. (2020). Psychiatric-Mental Health Nursing. 8th edition p. 418


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