Psychosocial and Behavioral Health Flashcards

The nurse is differentiating between delirium, dementia, and depression ('the 3 Ds') in a progressive care patient. Which feature is MOST characteristic of delirium compared to the other two?

Answer: Acute onset with fluctuating level of consciousness

Delirium is distinguished by its acute onset (hours to days), fluctuating course, and impaired consciousness, distinguishing it from the gradual progression of dementia and the mood-focused presentation of depression.

A patient with acute coronary syndrome is found to have comorbid major depression. The nurse understands that depression in cardiac patients is significant because it:

Answer: Is associated with increased mortality, poor medication adherence, and worse cardiac outcomes

Depression is an independent risk factor for adverse cardiac outcomes; it is associated with increased mortality, poor adherence to cardiac medications and lifestyle changes, and higher rates of recurrent cardiac events.

A progressive care nurse is supporting the family of a patient who has just been told the prognosis is terminal. The family members are arguing among themselves and appear angry. The nurse should recognize this behavior as:

Answer: A normal grief response that may reflect denial, fear, and helplessness

Anger and conflict among family members in crisis situations are common manifestations of grief and reflect normal emotional responses including helplessness, fear, and denial.

Which assessment tool is specifically validated for measuring delirium in acute care settings?

Answer: Confusion Assessment Method (CAM)

The Confusion Assessment Method (CAM) is the gold-standard validated tool for delirium assessment in acute/progressive care; the CAM-ICU is adapted for non-verbal/intubated patients.

A patient with a history of benzodiazepine dependence is admitted for a non-related procedure. The nurse anticipates withdrawal symptoms will most likely begin:

Answer: 12–24 hours after the last dose for short-acting agents and up to 5–7 days for long-acting agents

Benzodiazepine withdrawal timing depends on the drug's half-life; short-acting agents (e.g., lorazepam) produce symptoms within 12–24 hours, while long-acting agents (e.g., diazepam) may not produce symptoms for several days.

A nurse is providing culturally competent care to a patient from a culture where direct eye contact is considered disrespectful. Which approach should the nurse take?

Answer: Adapt communication style to avoid prolonged direct eye contact while continuing to provide complete care

Culturally competent care requires adapting communication practices — including non-verbal behaviors like eye contact — to respect cultural norms while still providing complete, individualized patient care.

Which intervention best addresses sleep deprivation in a progressive care patient?

Answer: Clustering care activities, minimizing nighttime interruptions, and reducing lighting and noise at night

Evidence-based sleep promotion bundles in the PCU include clustering care to reduce overnight interruptions, lowering light and noise levels at night, and minimizing unnecessary monitoring, which prevents delirium and promotes recovery.