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?

A psychiatric-mental health nurse is subpoenaed to testify in a legal case involving a client’s involuntary commitment under a 72-hour hold and the administration of antipsychotic medication over the client’s objection. The nurse is preparing to testify as a professional witness.Which considerations should the nurse recognize when preparing to provide accurate, ethical, and legally sound testimony?Select all that apply.

A psychiatric nurse in a geriatric unit is assessing an older adult client (age 82) presenting with cognitive decline, disorientation, memory lapses, and suspected comorbid depression following recent widowhood. The client has mild hearing impairment and becomes easily fatigued during interactions. To collect accurate assessment data for differential diagnosis (dementia vs. depression vs. delirium), which approaches are most appropriate for the nurse to implement during the cognitive assessment? (Select all that apply.)

A psychiatric nurse teaches nursing students about the mechanism of action of benzodiazepines in the central nervous system. Which student statements accurately describe how benzodiazepines affect GABAergic neurotransmission? Select all that apply.

A psychiatric nurse explains to a student nurse that antipsychotic medications differ in how they affect dopamine activity across brain pathways. Which statement best describes how second-generation (atypical) antipsychotics differ from first-generation (typical) antipsychotics in their effects on dopaminergic pathways?

A psychiatric nurse explains to a client beginning lithium therapy that the medication does not exert its effects by directly increasing or blocking a single neurotransmitter. Which explanation most accurately reflects lithium’s proposed mechanism of mood stabilization?