A mother has come to the clinic with her 14-year-old daughter. The mother is concerned her daughter is pregnant because she isn’t having  normal menses, even though a home pregnancy test is negative. The girl mentions she is training for a gymnastics meet and hopes to go to college on a sports scholarship.

1. What should the nurse do?
2. The mother is concerned and is voicing her desire for her daughter to quit gymnastics because it will harm the baby. How can the nurse help both?
3. What are some nursing diagnoses that apply to this situation?

 Understanding the strengths of each type of therapy and which type of therapy is most appropriate for each patient is an essential skill of the psychiatric-mental health nurse practitioner. In this Assignment, you will compare humanistic-existential therapy to another psychotherapeutic approach. You will identify the strengths and challenges of each approach and describe expected potential outcomes. 

Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.

In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.

To Prepare:

• Reflect on the Resources related to digital information tools and technologies.
• Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
• Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

 Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples. 

 Project management allows for a clear and focused workflow to approach an issue or task. These approaches streamline a process, allow for checks and balances, and ensure all stakeholders are active participants in the process. Project management approaches often utilize SMART objectives to define and set the objectives for the project. 

Each letter of the acronym SMART defines a different criterion for the objective. A SMART objective is specific, measurable, assignable, realistic, and timely. These objectives help to steer the work and direct the stakeholders to the completion of the project.

For this Assignment, you will reflect on project management approaches that could be used to address a quality improvement practice gap. You will develop SMART objectives for the planning and execution of a quality improvement project, and will consider potential project management approaches or activities that could be used in executing this project.

To Prepare:

• Review the Learning Resources for this week, and consider the approaches of project management.
• Refer to the Week 3 Discussion, and reflect on the quality improvement practice gap you identified.
• Consider how you might apply the project management approaches examined this week to address the quality improvement practice gap you identified.
• Think about how you might develop SMART objectives for the planning and execution of a project to address the quality improvement practice gap you identified.
• Consider any other project management approaches or activities you might recommend using for your project that will address the quality improvement practice gap you identified.

The Assignment: (2–3 pages)

• Briefly describe the quality improvement practice gap you identified in your nursing practice or organization. Be specific.
• Develop at least two SMART objectives you might apply in the project planning phase or execution phase to address the quality improvement practice gap you identified.
• Recommend at least two project management activities you would use for your project, addressing the quality improvement practice gap you identified. Explain your justification for why these activities would provide the best support. Be specific and provide examples.

Question 1          

A PMHNP is treating a 45-year-old female patient who is upset that her brother has not been calling since his divorce. When asked to describe her brother and what prompts him not to call as frequently, she says, “Everything is about him, not me. I think he’s jealous that I have a good marriage and he wants me to be unhappy, too. So he doesn’t call to upset me and ruin my relationships.” Based on this information, the PMHNP can conclude that the patient _________.                                         

A. may lack ability to see independent motivations

B. has an insistent emphasis on the feelings of others

C. has an intrusive interpersonal relationship

D. all of the above      

Question 2

When a PMHNP is seeing a patient for the first time, what is an important step to assure that the patient and provider understand the limits of their discussion?

A. Assure the patient that she is safe to discuss her secrets

B. Talk about the importance of being truthful andopen

C. Have a discussion about the confidentiality andits limits

D. Mention the possible need for selective self-disclosure

Question 3          

You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle?

A. Encouraging catharsis

B. Encouraging abreaction to repressed feelings

C. Identifying conflict-resolution techniques

D. All of the above

Question 4          

The PMHNP is treating a 35-year-old male officer in the military. He discloses that both of his parents are deceased and that he loved them. However, he says that he had feelings of inadequacy because his parents held him to a standard that he could never achieve. He went on to say that nothing he did ever felt good enough. The PMHNP assesses that this patient has perfect creases in his uniform with no strings or tags out of place; she also notices that he has perfect posture and questions him about ritualistic behaviors. She suspects that this patient has maladaptive responses to the expectations placed on him as a teenager and young adult. Which statements made by the patient would verify the PMHNP’s suspicion?

A.”I typically don’t listen to anyone. I take care of my own wants and needs so I feel like no one can judge me or criticize me, period.”

B.”I don’t mean to hurt other people’s feelings. When people cry or say that I have made them upset in some way, that’s not my fault; some people are just sensitive.”

C.”I like to listen to the beat of my own drum; I don’t mind spending most of my days alone. I don’t need recognition or praise; I would just like to be left alone.”

D.”I believe in systems; I have to have order and rules in my everyday life. If a task must be completed, I will often complete it myself versus depending on someone else.”

Question 5          

The PMHNP is working with a patient who experiences anxiety around her parents that later leads to poor impulse control. What will the PMHNP do to employ psychodynamic psychotherapy properly for this patient?              

A. Emphasize the past

B. Focus on expressions of emotion

C. Identify patterns in relationships

D. All of the above