Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):

Perform a neurological assessment on a patient in seclusion to compare the nurse’s findings.

Play cards with 3 patients during unstructured time.

Review follow-up care with a patient about to be discharged.

Set a goal for the day for a patient with a borderline personality disorder.

Obtain a weight on a patient with bipolar disorder in a hypomanic state.

Answer and Explanation

Correct Answer : A,C,D

Choice A Reason: Perform a neurological assessment on a patient in seclusion to compare the nurse’s findings

This task is an example of overdelegation. Performing a neurological assessment requires specialized knowledge and skills that are beyond the scope of practice for unlicensed assistive personnel. Such assessments should be conducted by a licensed nurse or healthcare provider to ensure accuracy and appropriate clinical judgment.

Choice B Reason: Play cards with 3 patients during unstructured time

This task is appropriate for a PCT. Engaging patients in recreational activities like playing cards does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It helps in providing social interaction and can be beneficial for the patients’ mental health.

Choice C Reason: Review follow-up care with a patient about to be discharged

This task is an example of overdelegation. Reviewing follow-up care involves providing important information about the patient’s ongoing treatment and care plan, which requires clinical knowledge and the ability to answer any questions the patient may have. This responsibility should be handled by a licensed nurse or healthcare provider.

Choice D Reason: Set a goal for the day for a patient with a borderline personality disorder

This task is also an example of overdelegation. Setting therapeutic goals for patients, especially those with complex mental health conditions like borderline personality disorder, requires clinical expertise and an understanding of the patient’s treatment plan. This should be done by a licensed nurse or mental health professional.

Choice E Reason: Obtain a weight on a patient with bipolar disorder in a hypomanic state

This task is appropriate for a PCT. Obtaining a patient’s weight is a routine task that does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It is a straightforward task that can be safely delegated.

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Correct Answer is A

Explanation

The correct answer is a. I feel so defeated and want to hide after I have binged.

Choice A Reason:

Individuals with binge-eating disorder often experience intense feelings of shame, guilt, and defeat after a binge episode. This emotional response is a hallmark of the disorder and can lead to further cycles of binge eating as a way to cope with these negative emotions. The statement “I feel so defeated and want to hide after I have binged” accurately reflects the emotional turmoil that accompanies binge-eating episodes.

Choice B Reason:

The statement “I am able to control the pace of my bingeing when I start getting full” is not typically associated with binge-eating disorder. People with this disorder often feel a loss of control over their eating during a binge episode and are unable to stop even when they are full. This lack of control is a key diagnostic criterion for binge-eating disorder.

Choice C Reason:

While feeling hungry can trigger a binge, it is not the primary characteristic of binge-eating disorder. The disorder is more about the uncontrollable nature of the eating episodes and the emotional distress that follows, rather than just responding to hunger. Therefore, the statement “My binges usually start off with feeling hungry” does not fully capture the essence of the disorder.

Choice D Reason:

Binge-eating as a reward for completing difficult tasks is not a typical feature of binge-eating disorder. The disorder is more about using food as a way to cope with negative emotions rather than as a reward. The statement “I binge to reward myself for completing difficult tasks” does not align with the common emotional triggers for binge-eating episodes.

A. Prevents extrapyramidal side effects. B. Reduces agitation until the lithium takes effect. C. Cures manic symptoms. D. Ensures high-quality sleep.

Correct Answer is B

Explanation

Choice A Reason: Prevents Extrapyramidal Side Effects

Extrapyramidal side effects (EPS) are drug-induced movement disorders that include symptoms such as tremors, rigidity, bradykinesia, and tardive dyskinesia. These side effects are commonly associated with first-generation antipsychotics. While second-generation antipsychotics like olanzapine have a lower risk of causing EPS, their primary use in this context is not to prevent these side effects. Therefore, this choice is not the most appropriate response to the family’s question.

Choice B Reason: Reduces Agitation Until the Lithium Takes Effect

Olanzapine is a second-generation antipsychotic that is effective in managing acute agitation and psychotic symptoms in patients with bipolar disorder. Lithium, while effective for long-term mood stabilization, takes several days to weeks to reach therapeutic levels and exert its full effect. During this period, olanzapine can help reduce the client’s agitation and stabilize their mood. This makes it the most appropriate response to the family’s question.

Choice C Reason: Cures Manic Symptoms

While olanzapine can help manage manic symptoms, it does not “cure” them. Bipolar disorder is a chronic condition that requires ongoing management with medications and therapy. The term “cure” is misleading as it implies a permanent resolution of symptoms, which is not the case with bipolar disorder. Therefore, this choice is not accurate.

Choice D Reason: Ensures High-Quality Sleep

Olanzapine can have sedative effects and may help improve sleep in some patients. However, its primary use in this scenario is to manage acute agitation and psychotic symptoms rather than to ensure high-quality sleep. While improved sleep may be a beneficial side effect, it is not the main reason for its prescription in this context.

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Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a binge-eating disorder. Which of the following statements should the nurse expect from this client?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

A client with a history of a suicide attempt has been discharged and is being followed in an outpatient clinic. What is/are the most appropriate nursing intervention(s)? (SELECT ALL THAT APPLY)

An individual with a history of antisocial personality disorder was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected?

The nurse is caring for a client with alcohol use disorder. Which of the following nursing interventions is appropriate for a client to prevent Korsakoff’s syndrome?

A client with bipolar disorder is refusing to take mood stabilizers due to weight gain. To increase the patient’s adherence to a medication regimen, what measures could the nurse teach the client? (SELECT ALL THAT APPLY)

The nurse is caring for a client who just received naloxone. Which nursing intervention is the highest priority?

The nurse is aware that the major health complication associated with anorexia nervosa is:

A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?

The nurse is providing discharge instructions to the client taking disulfiram. Which of the following items should the nurse teach the client to avoid?