: Nursing Practice in the Clinical Setting

1. Which nursing action is a reflection of Hildegard Peplau’s theoretic framework regarding psychiatric mental health nursing? a. Basing patient outcomes on expected instinctual responses b. Discussing a patient’s feelings regarding parents and siblings c. Providing the patient with clean clothes and wholesome food d. Centering professional practice in a state run psychiatric facility ANS: B Peplau’s pioneering endeavors and contributions were largely influenced by interpersonal psychotherapy. She believed that disorders evolved in the social context of interpersonal interactions. (i.e., what went on between people). Instinctual responses are more related to intrapersonal interactions. Florence Nightingale was instrumental in the holistic approach to nursing care, whereas Linda Richards’ practice was centered on institutional care of the mental ill. DIF: Cognitive Level: Application REF: Page 18 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment, Psychosocial Integrity 2. The nurse is attempting to provide a safe environment for a patient at great risk for self-harm. Which intervention shows an understanding of evidence-based practice (EBP)? a. Using physical restraints only after all other options have been proven ineffective b. Referring to the facility’s policies manual for guidelines for applying physical restraints Collecting data regarding the short-term effects of using physical restraints on an aggressiv c. patient Requiring constant monitoring of a patient whose inability to self-regulate anger has requir d. use of physical restraints ANS: B Health care systems are participating in the shift in nursing practice by encouraging research in their facilities and by implementing interventions that increase nurses’ knowledge about EBP. Nurses are participating to make evidence-based nursing practices available for their use, and they are helping to determine the outcomes that will benefit patients. The remaining options are examples of long-standing practice related to the use of physical restraints. DIF: Cognitive Level: Application REF: Page 19 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment, Psychosocial Integrity 3. Which statement by the patient reflects patient education that was based on the concept of integrated patient care? a. “I know I’m anxious when I get a tension headache.” b. “My anxiety is a result of stressors I don’t cope well with.” c. “Medication has helped me tremendously with anxiety control.” d. “Anxiety runs in my family; my entire family is trying to deal with it.” ANS: A Integrated patient care is the recognition of the interplay between physical and mental health. In integrated care, these disorders are not treated as separate illnesses; rather, they are treated together. The remaining options make no mention of a relationship between mental and physical illness. DIF: Cognitive Level: Application REF: Page 19 TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity