A nursing student says, “Little of what takes place on the behavioral health unit seems to be theory-based.” A nurse educates the student by identifying which is a common use of Sullivan’s theory on the inpatient psychiatric unit?

Structure of the therapeutic milieu of most behavioral health units

Assessment tools based on age-appropriate versus arrested behaviors

Frequent use of restraint and seclusion for behavior modification

Use of the nursing process to determine the best sequence for nursing actions

Answer and Explanation

The Correct Answer is A

Choice A reason: Sullivan’s interpersonal theory emphasizes therapeutic relationships and social environments to foster mental health. The therapeutic milieu, structured to promote safety and interaction, aligns with Sullivan’s focus on interpersonal dynamics, reducing symptoms like anxiety through supportive settings, which stabilize neurotransmitter imbalances, enhancing patient recovery on psychiatric units.

Choice B reason: Sullivan’s theory does not focus on age-appropriate versus arrested behaviors. It emphasizes interpersonal relationships, not developmental stages. Assessment tools for behavior typically rely on other frameworks, like Erikson’s, which address developmental milestones, not Sullivan’s interpersonal model, making this option scientifically inaccurate for the theory’s application.

Choice C reason: Restraint and seclusion are not part of Sullivan’s theory, which promotes therapeutic relationships to reduce anxiety, not coercive measures. These interventions contradict Sullivan’s focus on supportive environments, as they may exacerbate stress and neurotransmitter dysregulation, such as increased cortisol, worsening mental health outcomes in psychiatric settings.

Choice D reason: The nursing process is a general framework, not specific to Sullivan’s theory. Sullivan’s interpersonal model focuses on relationships to alleviate symptoms, not on sequencing nursing actions. While the nursing process guides care, it is not derived from Sullivan’s principles, making this option unrelated to his theoretical application.

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Correct Answer is A

Explanation

Choice A reason: Interventions, like offering snacks, address identified problems (e.g., forgetting to eat) to meet nutritional needs. This action targets physiological deficits, potentially linked to cognitive impairments from low acetylcholine in dementia, ensuring adequate caloric intake to support brain function and overall health in the care plan.

Choice B reason: Planning/goals outline desired outcomes, not specific actions. Forgetting to eat, possibly due to frontal lobe dysfunction, requires goals like “maintain adequate nutrition.” Interventions, not goals, specify actions like offering snacks, making this section incorrect for the statement’s placement in the care plan.

Choice C reason: Assessment involves data collection, like observing eating patterns, not actions like offering snacks. Forgetting to eat may reflect cognitive deficits, but assessment identifies the problem, not solutions. This section precedes interventions, making it an incorrect location for the described statement.

Choice D reason: Diagnosis identifies problems, like “impaired nutrition” due to cognitive deficits, not specific actions. Offering snacks is an intervention to address the diagnosis, not the diagnosis itself. This section is incorrect for the statement, which belongs in the intervention phase of the care plan.

A. “We are not bound if the patient threatens the life of another person.” B. “We can’t violate that confidence under any circumstances.” C. “We are obligated to answer questions asked by law enforcement.” D. “We can do that only at the discretion of the psychiatrist.”

Correct Answer is A

Explanation

Choice A reason: Confidentiality can be breached if a patient poses a threat to others, as in Tarasoff rulings, due to safety risks from delusions driven by dopamine dysregulation. This legal and ethical exception ensures protection, aligning with psychiatric principles prioritizing harm prevention over absolute confidentiality.

Choice B reason: Absolute confidentiality is incorrect, as exceptions exist for safety. Delusions, linked to mesolimbic dopamine excess, may lead to threats requiring disclosure. Legal frameworks allow breaching confidentiality to protect others, making this response scientifically and ethically inaccurate for psychiatric practice.

Choice C reason: Law enforcement inquiries do not automatically override confidentiality. Disclosure is limited to specific legal mandates, like imminent danger from dopamine-driven delusions. Routine questions do not justify breaches, making this response incorrect for the ethical and legal standards in psychiatric care.

Choice D reason: Confidentiality breaches are not solely at the psychiatrist’s discretion. Legal and ethical guidelines, like those for threats from delusional states, dictate exceptions. This option oversimplifies complex regulations, ignoring standardized protocols for managing risks in psychiatric patients, making it incorrect.

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A nursing student says, “Little of what takes place on the behavioral health unit seems to be theory-based.” A nurse educates the student by identifying which is a common use of Sullivan’s theory on the inpatient psychiatric unit?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your patient sometimes forgets to eat. In which part of the nursing care plan would the nurse expect to find this statement: “Offer snacks and finger foods frequently”?

Correct Answer is A

Explanation

The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?

Correct Answer is A

Explanation

Which neurotransmitter has both muscarinic and nicotinic receptor subtypes?

A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?

Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for a patient presenting with what characteristic?

A nurse explains to a nursing student how the therapeutic relationship differs from a social relationship. What is the best explanation for the therapeutic relationship between the nurse and patient?

Which of the following side effects is associated with the blockade of attachment of norepinephrine to alpha-1 receptors?

A patient asks the nurse, “Why did my health care provider prescribe buspirone (Buspar) for my anxiety instead of diazepam (Valium)?” The nurse’s reply is based on the knowledge of which characteristic of buspirone?

A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?