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A young adult male client is admitted to the psychiatric unit because of a recent suicide attempt. His wife filed for divorce six months ago, he lost his job three months ago, and his best friend moved to another city two weeks ago. Which intervention should the nurse include in this client's plan of care?
- A. Avoid discussing subjects that upset the client.
- B. Encourage activities that allow the client to exert control over his environment.
- C. Allow the client time alone to sort out his feelings.
- D. Encourage the client to interact with persons who are recovering from depression.
Correct Answer: B
Rationale: Encouraging activities that allow the client to exert control over his environment helps empower the client and regain a sense of agency, which is critical for improving mental health post-suicide attempt.
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An older man with a history of multiple falls at home tells the clinic nurse that his son, who was incarcerated last year for assault and battery, has become increasingly abusive since his release from prison six weeks ago. Which intervention is most important for the nurse to implement?
- A. Tell the client to call Adult Protective Services if his son's abuse continues.
- B. Verify the client's report by determining if there is physical evidence of abuse.
- C. Refer the client to a program for victims of domestic violence.
- D. Assist the client in developing an emergency safety plan.
Correct Answer: D
Rationale: Assisting the client in developing an emergency safety plan is the most important intervention to ensure immediate safety in the context of ongoing abuse.
A client with post-traumatic stress disorder (PTSD) is experiencing a dissociative disorder episode. The situation quickly escalates, and the client becomes physically aggressive. Which intervention should the nurse implement first?
- A. Request a team member to assist with seclusion and restraint.
- B. Administer lorazepam 1.5 mg intramuscularly twice daily as needed.
- C. Confirm the client's identity and orientation to time and place.
- D. Inspect the area for objects that can be used in a dangerous manner.
- E. None.
- F. None.
Correct Answer: D
Rationale: Inspecting the area for dangerous objects is the first priority to ensure safety during the client's aggressive behavior.
An adolescent who is exhibiting a depressed affect receives a prescription for an antidepressant drug. While the client is taking the antidepressant, which comparison of the client's behavior before and after taking the drug is most important for the nurse to obtain?
- A. Level of activity.
- B. The interactions with others.
- C. The emotional quality of attitude.
- D. Appetite.
Correct Answer: C
Rationale: The emotional quality of attitude reflects the client's internal state and is a key indicator of the antidepressant's impact on their depressive symptoms, making it the most critical aspect to assess.
A client who is an alcoholic receives a prescription for disulfiram 500 mg PO daily. Which instruction should the nurse provide to this client?
- A. Take the medication each morning beginning 48 hours after your last drink of alcohol.
- B. Take the medication with at least 8 ounces of water and limit alcohol consumption while taking this medication.
- C. Take the medication at bedtime and avoid consuming any more than one ounce of alcohol daily.
- D. Begin taking the medication immediately and take it daily, regardless of whether or not you drink alcohol.
Correct Answer: A
Rationale: Disulfiram should be taken each morning, starting 48 hours after the last drink to prevent a severe reaction, establishing a clear association between the medication and alcohol avoidance.
The nurse is caring for a client who has been the victim of intimate partner violence. During the interview, the nurse feels angry, embarrassed, and helpless. Which explanation best describes the cause of the nurse's emotions?
- A. Subconscious blame toward the client for staying in an abusive relationship.
- B. Difficulty accepting the explanation about how the injuries actually occurred.
- C. Experience in caring for clients who are affected by family violence is limited.
- D. Feelings are influencing the client's care due to a personal history of abuse.
Correct Answer: A
Rationale: Subconscious blame toward the client for staying in an abusive relationship may cause the nurse's emotions, requiring recognition to provide non-judgmental care.