DOH Nursing Psychiatric Nursing 4

Question 1

A patient with obsessive-compulsive disorder (OCD) is spending 4 hours daily washing their hands. What is the recommended evidence-based therapy?

Accepted Answer

Exposure and response prevention (ERP)

Answer

ERP is the gold-standard psychological treatment for OCD. The patient is gradually exposed to feared stimuli (dirty hands) while preventing the compulsive response (hand washing). Over time, anxiety extinguishes without the compulsion. SSRIs are combined with ERP for moderate-severe OCD.

Question 2

Which feature differentiates a panic attack from a cardiac event in a clinical setting?

Accepted Answer

History of panic disorder, situational triggers, normal ECG, rapid resolution with cognitive/breathing techniques

Answer

Clinically, a cardiac event must be ruled out first. Features suggesting panic: known anxiety history, situational trigger, normal ECG and cardiac enzymes, symptom peak within 10 minutes, and resolution with reassurance and breathing techniques. Thorough evaluation is always required.

Question 3

A patient is placed in mechanical restraints after all alternatives have been exhausted. What is the nurse's ongoing responsibility?

Accepted Answer

Assess circulation, breathing, skin integrity, and offer release every 15 minutes; document every 15–30 minutes

Answer

Restraint use requires continuous monitoring: circulation checks (CMS), respiratory assessment, skin integrity, behavioral status, and offers of release every 15 minutes. Documentation must occur every 15–30 minutes. Restraints must be released, one limb at a time, for range of motion regularly.

Question 4

Which nursing diagnosis is the highest priority for a patient with severe depression who is refusing to eat or drink?

Accepted Answer

Risk for self-harm and imbalanced nutrition: less than body requirements

Answer

Severe depression with refusal to eat and drink presents immediate physical safety risks (dehydration, malnutrition, medical deterioration) alongside the psychiatric risk of self-harm. Both must be addressed urgently. Physical safety and nutrition take priority over social or sleep-related diagnoses.

Question 5

What is the primary purpose of group therapy in an inpatient psychiatric setting?

Accepted Answer

Provide peer support, reduce isolation, develop social skills, and promote insight through shared experiences

Answer

Group therapy in inpatient psychiatry serves multiple therapeutic functions: universality (not alone in suffering), peer support, social skill development, interpersonal learning, and behavioral rehearsal. Group dynamics under a skilled facilitator are therapeutic in themselves.

DOH Nursing Practice Test

DOH Nursing Practice Test

DOH Nursing Psychiatric Nursing 4