During an admission interview (Orientation phase) in a psychiatric inpatient unit, a nurse practicing Peplau’s Interpersonal Relations Theory notices the newly admitted client with generalized anxiety disorder is visibly anxious (fidgeting, rapid speech). The nurse aims to support clarity and continuity of the client’s narrative by facilitating free expression without directing the conversation. Which action best reflects nondirective listening to achieve this therapeutic goal?

A nurse on a psychiatric inpatient unit is reviewing a client’s refusal to take prescribed antipsychotic medication. The client is involuntarily admitted under a 72-hour hold for acute psychosis but is currently calm, oriented, and not an immediate danger to self or others. The nurse considers landmark legal cases that guide psychiatric treatment decisions.Which principle should most appropriately guide the nurse’s response to ensure ethical and legally sound care?

A psychiatric nurse working on a culturally diverse unit notices a patient backing away when the nurse leans in during conversation. Which proxemics principles should guide the nurse’s behavior? Select all that apply.

A psychiatric nurse practitioner in an outpatient clinic is managing a client with treatment-resistant depression who consented to pharmacogenetic testing to guide antidepressant selection. After receiving results indicating a high genetic risk for bipolar disorder, the client expresses regret and distress about the unintended genetic risk information. Which ethical concern should the nurse prioritize to address the client’s distress and ensure ethically sound care?

A psychiatric nurse in a refugee health clinic is assessing a client who recently resettled after exposure to war-related violence. The client reports distressing flashbacks, hypervigilance, sleep disturbances, and emotional numbing that interfere with daily functioning.Which findings support a possible diagnosis of posttraumatic stress disorder (PTSD)?Select all that apply.

A psychiatric nurse assigned to an inpatient unit begins spending disproportionate time with one particular client diagnosed with borderline personality disorder, shares personal stories about the nurse’s own struggles with anxiety, and brings homemade snacks from home for that client alone. The nurse rationalizes this behavior as “building trust” to enhance the therapeutic alliance.Based on the American Nurses Association (ANA) Code of Ethics and psychiatric nursing standards regarding professional boundaries, which description best characterizes this situation?

A nurse on an inpatient psychiatric unit applies soft wrist restraints to a client who is violently attempting to strike staff during acute agitation. After ensuring circulation and immediate safety, the nurse prepares to document and manage the intervention in accordance with legal and ethical standards.Which actions reflect both legal and ethical requirements for the use of restraint and seclusion in psychiatric care?Select all that apply.

A psychiatric-mental health nurse in an outpatient clinic is developing a plan of care for a client from a non-Western cultural background who is reluctant to use Western psychotropic medications, stating they interfere with traditional healing rituals central to the client’s cultural identity. The nurse wants to respect the client’s values while still promoting therapeutic mental health outcomes.

A nurse is preparing for a workshop on delivering culturally effective psychiatric care in a community mental health setting. The workshop emphasizes Campinha-Bacote’s model of cultural competence to guide nursing practice. Which concepts are core constructs of this model?Select all that apply.

A psychiatric nurse practitioner evaluates a client of Asian descent who reports severe side effects after starting a standard dose of a selective serotonin reuptake inhibitor (SSRI) for depression. Genetic testing indicates the client is a poor metabolizer of the cytochrome P-450 2D6 (CYP2D6) enzyme.Which explanation best accounts for the client’s heightened sensitivity to the SSRI?