Which patient would a nurse refer to partial hospitalization?
One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal
One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy
One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up
One who states, “I’m not sure I can avoid using alcohol when my spouse goes to work every morning.”
The Correct Answer is B
Choice A reason: Active suicidality, linked to severe serotonin deficits, requires inpatient hospitalization for constant monitoring to ensure safety. Partial hospitalization is insufficient for acute risk, as it lacks 24-hour supervision, making this patient inappropriate for this less intensive care setting.
Choice B reason: Agoraphobia and panic episodes, driven by norepinephrine surges, benefit from partial hospitalization’s structured psychoeducation and therapy. Relaxation techniques reduce amygdala hyperactivity, supporting outpatient management with daily support, making this patient suitable for partial hospitalization’s intensive, non-residential treatment.
Choice C reason: Stable lithium levels indicate controlled bipolar disorder, not requiring partial hospitalization. Regular follow-up manages neurotransmitter balance, suitable for outpatient care. Partial hospitalization is for active symptoms, not stable patients, making this an incorrect referral choice.
Choice D reason: Alcohol use concerns suggest outpatient substance abuse programs, not partial hospitalization. While dopamine reward pathways are involved, partial hospitalization targets acute psychiatric symptoms, not substance issues alone, making this patient unsuitable for this level of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Suppressing anger ignores countertransference, which can impair therapeutic neutrality. Anger may stem from patient behaviors linked to dopamine-driven paranoia, but suppression risks unconscious bias affecting care. Addressing feelings through supervision maintains professionalism, making this response less effective for managing emotions.
Choice B reason: Discussing anger with a manager addresses countertransference, a reaction to patient behaviors like suspicion from dopamine dysregulation. This allows reflection, reducing bias and maintaining therapeutic neutrality. It supports professional care by processing emotions, aligning with evidence-based psychiatric nursing practices for managing countertransference.
Choice C reason: Expressing anger directly risks damaging the therapeutic alliance. Suspicion, tied to mesolimbic dopamine excess, may escalate with confrontation, increasing patient anxiety. This approach disregards professional boundaries and neurobiological sensitivities, making it inappropriate for maintaining effective psychiatric care.
Choice D reason: Reassigning the patient avoids addressing countertransference, neglecting professional growth. Suspicion, linked to neurobiological paranoia, requires consistent care. Reassignment disrupts continuity, potentially worsening patient trust and outcomes, making this an ineffective response compared to processing feelings through supervision.
Correct Answer is C
Explanation
Choice A reason: Denying problems reflects resistance, typical in the orientation phase, where trust is not yet established. Anger management, linked to amygdala-driven impulsivity, requires a therapeutic alliance. This statement indicates avoidance, not readiness for the working phase’s collaborative problem-solving.
Choice B reason: Questioning therapy’s value shows skepticism, common in the orientation phase. The working phase involves active goal-setting, like managing anger tied to serotonin dysregulation. This statement reflects a lack of engagement, not the transition to collaborative therapeutic work, making it incorrect.
Choice C reason: Expressing a goal to manage anger indicates readiness for the working phase, where collaborative problem-solving occurs. Anger, linked to amygdala hyperactivity and serotonin deficits, requires active intervention. This statement shows commitment to addressing neurobiological issues, marking the transition to the working phase.
Choice D reason: Difficulty discussing problems reflects orientation phase challenges, where trust is building. The working phase involves active engagement, like addressing anger’s neurobiological basis. This statement indicates discomfort, not readiness for collaborative work, making it incorrect for the phase transition.
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