Answer to Question 1
D
Acknowledging and normalizing the patient's pain, along with scheduling the medication at specific intervals, will help the patient anticipate when the medication can be given and help correct his perception of nurses as uncaring or unskilled. Receiving the medication promptly on schedule, rather than expecting nurses to intuitively know his pain level, should minimize his discomfort and reduce his acting out of anxiety and anger. Suggesting that the patient might behave differently also implies that he is at fault; telling a person who already believes staff are incompetent that he is at fault is likely to evoke more anger, not less. Confronting the patient with his rudeness may meet the nurse's need to confront the patient, but it does not address the patient's pain and is likely to increase the adversarial nature of the current patient-staff relationship, when the opposite is desired instead. Unless there is specific indication of a mental illness, which is not the case here, a psychiatric consult is not indicated, and the desire to blame a mental illness suggests that the nurse is angry and retaliating. Suggesting to the patient that he is mentally ill is also likely to intensify his anger and make the nurse-patient relationship even less therapeutic.
Answer to Question 2
3
Admission to a psychiatric inpatient facility occurs when people in the environment are not able or willing to support the mentally troubled person.
Nurses may collaborate with social workers, physicians, and other members of the health care team to
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