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When a male client is asked about his reason for coming to the mental health clinic, he replies, “It all started because I work in a hostile work environment. My boss would not let me go to a religious service, so I went to human resources, and they didn't want to do anything. It has been a really difficult time for me.†Which response should the nurse provide?
- A. Why do you think you have a hostile work environment?
- B. Have you considered resigning from your position?
- C. Have the feelings associated with these events brought you to the clinic?
- D. How have you responded to those in your work environment about these events?
Correct Answer: C
Rationale: This response acknowledges the client's feelings and experiences, allowing for further exploration of the issues that brought him to the clinic, fostering therapeutic communication.
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A client at the mental health center reports difficulty concentrating at work, feeling very tired during the day, and sleeping 4 to 5 hours at night. To further assess for depression, which question is most important for the nurse to ask?
- A. Have you experienced recent stresses?
- B. What foods do you like to eat?
- C. Do you often feel sad?
- D. Have you experienced sleep changes?
Correct Answer: C
Rationale: Inquiring whether the client often feels sad directly addresses the emotional component of depression, critical for a comprehensive assessment.
A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?
- A. Use relaxation techniques to reduce excessive anxiety.
- B. Avoid alcohol and other sedatives while taking the medication.
- C. Move slowly from a sitting position to a standing position.
- D. Stop taking the medication if the intended effect is not immediate.
Correct Answer: D
Rationale: Stopping the medication if the effect is not immediate is incorrect, as lorazepam may take time to achieve full effect, and abrupt discontinuation can cause withdrawal.
A client who is experiencing a severe level of anxiety reports a racing heartbeat, dizziness, and expresses a sense that something dreadful will happen. The nurse observes the client pacing and waving hands rapidly. Which action should the nurse take?
- A. Help the client identify thoughts that may be triggers.
- B. Explore past behaviors that have provided relief.
- C. Attempt to distract to another focus or activity.
- D. Speak calmly to the client stating assurance of safety.
Correct Answer: D
Rationale: Speaking calmly and providing assurance of safety is the first step in managing severe anxiety, helping to stabilize the client.
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.
The charge nurse of the psychiatric unit observes clients in the day area. Which client is exhibiting symptoms of a conversion disorder?
- A. A young woman who suddenly goes blind with no indication of organic pathology.
- B. An older adult who continuously complains of a headache and back pain.
- C. An adolescent who becomes extremely anxious about going outside.
- D. A middle-aged man who is complaining of shortness of breath and is diaphoretic.
Correct Answer: A
Rationale: Sudden blindness with no organic pathology is indicative of a conversion disorder, involving neurological symptoms without a neurological basis.