A patient missed a treatment option. Later, the patient appears withdrawn and avoids eye contact when discussing calling loved ones. Which is the best nursing action?

The patient is demonstrating signs of ineffective coping and should be referred for psychiatric evaluation

The patient is showing symptoms of major depressive disorder and requires immediate intervention

The patient is noncompliant with medical care due to unresolved emotional issues

The patient is progressing through the normal stages of grief

Answer and Explanation

The Correct Answer is A

Choice A reason: Withdrawn behavior and avoiding eye contact suggest ineffective coping, as the patient struggles to process missing a treatment. Psychiatric evaluation can assess underlying emotional distress, such as anxiety or depression, and provide targeted interventions, making this the correct choice for addressing the patient’s needs.

Choice B reason: Symptoms like withdrawal could suggest depression, but diagnosing major depressive disorder requires more criteria, such as persistent low mood or anhedonia, not evident here. Immediate intervention assumes severity not supported by the scenario, making this choice less accurate than a referral.

Choice C reason: Labeling the patient as noncompliant assumes intentional refusal, but the scenario suggests emotional distress, not deliberate nonadherence. Withdrawal and avoidance indicate psychological barriers, not noncompliance, making this choice incorrect for the described behavior.

Choice D reason: Normal grief involves stages like denial or sadness, but the scenario lacks evidence of a loss triggering grief. Withdrawal and avoidance suggest coping difficulties, not a clear grief process, making this choice incorrect for the patient’s presentation.

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Correct Answer is D

Explanation

Choice A reason: Voluntary commitment involves patient consent to hospitalization and treatment, often for less acute cases. The scenario describes refusal of admission, necessitating involuntary measures due to suicidal risk, making this choice incorrect as it contradicts the described process.

Choice B reason: Involuntary commitment does not require the patient’s signature or agreement, as it is initiated when they pose a risk to themselves or others. Legal paperwork is completed by professionals, not the patient, making this choice incorrect for the scenario.

Choice C reason: Immediate discharge upon request applies to voluntary admissions, not involuntary ones. Involuntary commitment restricts discharge due to assessed risks, such as suicidal ideation, requiring legal and clinical oversight, making this choice incorrect.

Choice D reason: Involuntary commitment involves admitting a patient without consent when they pose a risk of harm, as with suicidal thoughts. This legal process, governed by mental health laws, prioritizes safety through court or medical authorization, making this the correct choice.

A. It sounds like you’re feeling guilty. Would you like to talk more about that? B. Don’t blame yourself, you did the best you could. C. You can’t change the past, so just focus on getting better now. D. Millions of people have diabetes—it’s not a big deal.

Correct Answer is A

Explanation

Choice A reason: Reflecting the patient’s guilt and inviting further discussion is therapeutic, as it validates emotions and encourages exploration of feelings. This engages the patient’s emotional processing, fostering coping and reducing self-blame through empathetic communication, making this the correct choice.

Choice B reason: Telling the patient not to blame themselves dismisses their feelings, potentially inhibiting emotional expression. This nontherapeutic response fails to explore the patient’s guilt, which could stem from perceived control over their condition, making this choice incorrect.

Choice C reason: Advising to focus on the future minimizes the patient’s current emotional distress, a nontherapeutic approach. It overlooks the need to process guilt, which can affect diabetes management adherence, making this response less effective than exploring feelings.

Choice D reason: Downplaying diabetes as “not a big deal” invalidates the patient’s emotional experience, a nontherapeutic response. It fails to address guilt, which could impact psychological adjustment to the diagnosis, making this choice incorrect for therapeutic communication.

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A patient missed a treatment option. Later, the patient appears withdrawn and avoids eye contact when discussing calling loved ones. Which is the best nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is brought to the psychiatric unit by family members after expressing suicidal thoughts but refuses voluntary admission. The healthcare team proceeds with involuntary commitment. Which of the following statements best describes involuntary commitment?

Correct Answer is D

Explanation

A patient recently diagnosed with type 2 diabetes tells the nurse, “This is all my fault. If I had taken better care of myself, I wouldn’t be in this situation.” Which response by the nurse is the most therapeutic?

Correct Answer is A

Explanation

A patient recently lost her spouse and says, “I don’t know how I’m going to live without him.” Which of the following responses by the nurse is nontherapeutic?

A patient becomes agitated and physically aggressive on the unit, requiring the use of restraints. Which of the following actions by the nurse is appropriate when applying and managing restraints?

A nurse is reviewing the medication orders for four patients. Which patient should the nurse anticipate receiving a lower dose of medication?

A nurse observes a patient with bipolar disorder who suddenly shifts from laughing joyfully to crying within minutes during the therapy session. This sudden and intense change in emotional expression is an example of:

A patient with depression tells the nurse, “Sometimes I think people would be better off without me being alive.” Which closed-ended question should the nurse ask next to assess the patient’s safety?

The nurse uses a variety of therapeutic communication skills when working with patients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication?

During a mental health assessment, a patient laughs manically while describing a recent loss of a loved one. The nurse recognizes this emotional expression as:

The nurse is caring for a patient recently diagnosed with a terminal illness. The patient says, “There’s no way this is right. I’m going to get another opinion—this doctor doesn’t know what they’re talking about.” The nurse recognizes that the patient is in which stage of grief?