A nurse working in a psychiatric unit plans to apply milieu therapy on a patient. Which intervention would the nurse include in the therapy?

Coordinate the implementation of the nursing care plan and documents.

Provide and maintain a safe and therapeutic environment in collaboration with others.

Apply current knowledge to assess the patient's response to medication.

Give anticipatory guidance to prevent or reduce menta illness and enhance mental health.

Answer and Explanation

The Correct Answer is B

Choice A Reason:

Coordinating the implementation of the nursing care plan and documents is inappropriate. This choice is more related to general nursing responsibilities and care coordination. Milieu therapy specifically focuses on creating a therapeutic environment rather than coordinating care plans and documents.

Choice B Reason:

Providing and maintaining a safe and therapeutic environment in collaboration with others is appropriate. Milieu therapy involves creating a therapeutic environment that promotes the patient's mental health and well-being. This includes ensuring safety, providing structure, and creating a supportive atmosphere for patients. The nurse, in collaboration with the healthcare team, is responsible for establishing and maintaining this therapeutic milieu.

Choice C Reason:

Applying current knowledge to assess the patient's response to medication is inappropriate.

Assessing the patient's response to medication is an important nursing responsibility, but it is not the primary focus of milieu therapy. Milieu therapy is more concerned with the overall environment and its impact on the patient's mental health.

Choice D Reason:

Giving anticipatory guidance to prevent or reduce mental illness and enhance mental health is inappropriate. While anticipatory guidance is important in nursing care, it may not capture the essence of creating and maintaining a therapeutic environment, which is the core of milieu therapy. This choice is more related to health education and preventive measures rather than the overall therapeutic environment.

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Correct Answer is C

Explanation

Choice A Reason:

A patient who states "I have no one who cares about me. "This statement relates more to the need for belonging and love, which is a lower level on Maslow's hierarchy.

Choice B Reason:

A patient who states "I have never met my career goals." This statement relates to self-esteem and self-actualization needs, which are higher-level needs in Maslow's hierarchy.

Choice C Reason:

A patient who exhibits hostile and angry behaviors is correct. Maslow's hierarchy of needs places safety and security needs above other needs. The patient exhibiting hostile and angry behaviors may pose a threat to their own safety, the safety of others, or the overall therapeutic environment. Addressing safety concerns and de-escalating aggressive behaviors takes precedence in this situation.

Choice D Reason:

A patient upset that his family can only visit during visiting hours. This situation is related to social needs and may not be as immediate a concern as the hostile and angry behaviors described in option C.

A. "Your mother will be fine, you shouldn't work so much." B. “So, it seems that you feel responsible for what happened to your mother” C. "Why do you blame yourself? You could not have prevented the stroke” D. “You are not responsible for your mothers’ stroke but many people in your situation feel this way”

Correct Answer is B

Explanation

Choice A Reason:

This response is dismissive and invalidates the son's feelings of guilt. It does not acknowledge or address his emotional distress. Providing false reassurance and shifting focus to work is not therapeutic.

Choice B Reason:

This response reflects therapeutic communication. It validates the son’s feelings by acknowledging his guilt and encourages him to express his emotions. Reflective listening allows the nurse to build trust and support the son in processing his emotions.

Choice C Reason:

Asking "Why" can feel accusatory or judgmental, making the son defensive. While the statement attempts to provide reassurance, it fails to address his emotional state and may shut down further communication.

Choice D Reason:

Although this response provides some reassurance and normalization, it minimizes the son's emotions by focusing on generalizations. It lacks the reflective quality necessary for therapeutic communication in this situation.

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A nurse working in a psychiatric unit plans to apply milieu therapy on a patient. Which intervention would the nurse include in the therapy?

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Naxlex Comprehensive Predictor Exams

According to Maslow's hierarchy of needs, which situation on an inpatient mental health unit would require priority intervention?

Correct Answer is C

Explanation

A nurse is caring for an older adult client who had a cerebrovascular accident and has right-sided paralysis and aphasia. The client's son tells the nurse it is his fault because he did not insist that his mother live with him. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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Peplau's Interpersonal Theory of Nursing: Select one:

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