PSYCHIATRIC NURSING HESI FINAL EXAM 2021 THERAPEUTIC COMMUNICATION TREATMENT MODALITIES

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1. After the 4th group meeting, the informal leader makes a statement that she believes she can help the group more than the assigned facilitator and has better credentials. Identify the group dynam... ics and stage of development. - The informal leader is “testing,” which is a behavior indicative of a new group trying to establish trust. This group is still in the orientation phase of development. 2. On an in-patient psychiatric unit, clients are expected to get up at a certain time, attend breakfast at a certain time, and come for their medication at the correct time. What form of therapy is incorporated into this unit? - Milieu. 3. The wife of a man killed in a motor vehicle accident has just arrived at the emergency room and is told of her husband’s death. What nursing actions are appropriate for dealing with this crisis? - Take woman to a quiet room, ask her if there are family, friends, or clergy you can call for her. Assess her need for medication and discuss with physician. Stay with her, be firm and directive, and assess previous successful coping strategies. 4. A 10 yr. old is admitted to the children’s unit of the psychiatric facility after stabbing his sister. His behavior is extremely aggressive with the other children on the unit. Using a behavior modification approach with positive reinforcement, design a treatment plan for this child. - Assess what activities he enjoys. Set up a token system – when he displays non-aggressive behavior, he earns a token good towards participating in the activity selected. He loses a token when he becomes aggressive. 5. The 10 yr. old, his sister, mother, and the mother’s live in boyfriend are asked to attend a therapy meeting. Who is the “client” that will be treated during this session? - The entire family. 6. A 66 yr. old woman is admitted to the psychiatric unit with agitated depression. She has not responded to antidepressants in the past. What would be the medical treatment of choice for this client? - Electroconvulsive therapy (ECT). 7. Describe the nurse’s role in preparing clients for electroconvulsive therapy (ECT). - Give accurate, non-judgmental information about the treatment. Explore client’s concerns. Administer the following as ordered: Atropine sulfate to dry oral secretions, a quick-acting barbiturate to induce anesthesia such as Brevital Sodium, and a muscle relaxant such as Anectine. Check emergency equipment and O2 are available. 8. Describe the nursing interventions used to care for a client during and after electroconvulsive therapy. - Maintain patent airway. Check vital signs every 15 minutes until alert. Remain with client following treatment until conscious. Reorient, if confused. [Show More]

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