Psychosocial and Behavioral Health Flashcards

A progressive care patient becomes acutely agitated, is pulling at lines, and poses a safety risk. Before applying physical restraints, the nurse should FIRST:

Answer: Attempt less restrictive alternatives such as re-orientation, removing triggers, and involving family

The least-restrictive approach must be attempted before restraints; non-pharmacologic de-escalation techniques including reorientation, removing offending stimuli, and family presence should be tried first.

Post-intensive care syndrome (PICS) includes which combination of long-term sequelae that progressive care nurses should educate patients and families about?

Answer: Cognitive impairment, psychological disturbances (PTSD/depression/anxiety), and physical weakness

PICS encompasses a constellation of new or worsening impairments in cognitive function, mental health (PTSD, depression, anxiety), and physical/functional status that persist after critical illness.

A patient with advanced heart failure has completed an advance directive designating 'comfort measures only.' The patient then loses decision-making capacity. The healthcare proxy requests aggressive interventions. The nurse should:

Answer: Follow the patient's documented advance directive, which reflects the patient's previously expressed wishes

A valid advance directive reflects the patient's own autonomous wishes and takes precedence when the patient lacks decision-making capacity; a proxy cannot override a clearly documented prior competent decision.

The nurse notices that a patient who was previously cooperative has become withdrawn, stopped eating, and states 'nothing matters anymore.' These findings are MOST consistent with:

Answer: Clinical depression requiring further assessment and intervention

Withdrawal, anhedonia (loss of interest), anorexia, and hopelessness are hallmark symptoms of clinical depression that require formal assessment using validated tools (e.g., PHQ-2/PHQ-9) and prompt intervention.

A progressive care patient with a history of PTSD becomes extremely anxious when the nurse prepares to insert a urinary catheter. Which approach is MOST therapeutic?

Answer: Explain the procedure, obtain consent, allow the patient to set the pace, and offer distraction techniques

Trauma-informed care includes providing clear explanations, maintaining patient control and consent, proceeding at the patient's pace, and using distraction or relaxation techniques to reduce re-traumatization.

Which of the following best describes the nurse's role in supporting a patient's spiritual needs in the progressive care setting?

Answer: Assessing spiritual needs, facilitating access to chaplaincy services, and respecting the patient's beliefs without imposing the nurse's own

Nurses assess and acknowledge spiritual needs using open, non-judgmental approaches and facilitate chaplaincy or other appropriate resources while respecting the patient's beliefs without imposing personal views.

A family member who has been keeping constant vigil at a critically ill patient's bedside appears exhausted and tearful. The nurse's BEST response is to:

Answer: Acknowledge the family member's distress, offer support resources, and gently encourage self-care while validating their presence

Supporting family members is within the progressive care nurse's scope; acknowledging distress, validating their support role, offering chaplaincy or social work, and encouraging self-care are all evidence-based family-centered care strategies.