A client diagnosed with borderline personality disorder tells the nurse that she frequently spaces out. Which response by the nurse would be most appropriate?

Correct Answer: C

Rationale: The correct response is C: "What's happening around you when this occurs?" This question is appropriate because it helps the nurse gather more information about the client's experiences during the spacing out episodes, which can provide insights into triggers or patterns. It allows the client to describe the context of the episodes, aiding in the assessment and potential identification of stressors or environmental factors contributing to the dissociative experiences. Incorrect answers: A: "Do you feel stressed most of the time?" This answer assumes stress as the primary cause without exploring other potential triggers. B: "Does this frighten you when it happens?" This answer focuses on the emotional response rather than the environmental context, which may not be as helpful in understanding the situation. D: "Do you feel as if you are out of your body?" This answer is more specific and may jump to conclusions about depersonalization, which may not necessarily be the client's experience.

Correct Answer: C

Rationale: The correct response is C: "What's happening around you when this occurs?" This question is appropriate because it helps the nurse gather more information about the client's experiences during the spacing out episodes, which can provide insights into triggers or patterns. It allows the client to describe the context of the episodes, aiding in the assessment and potential identification of stressors or environmental factors contributing to the dissociative experiences. Incorrect answers: A: "Do you feel stressed most of the time?" This answer assumes stress as the primary cause without exploring other potential triggers. B: "Does this frighten you when it happens?" This answer focuses on the emotional response rather than the environmental context, which may not be as helpful in understanding the situation. D: "Do you feel as if you are out of your body?" This answer is more specific and may jump to conclusions about depersonalization, which may not necessarily be the client's experience.

Correct Answer: C

Rationale: The correct answer is C: Assessment. In the continuum of care, assessment is the first step as it involves gathering information about the patient's condition and needs. This information guides the subsequent decisions and interventions. Referral (choice A) comes after assessment, when specialized care is needed. Transfer (choice B) occurs if the patient needs to move to a different facility or level of care. Discharge planning (choice D) is the final step, ensuring a smooth transition out of the care setting. Therefore, assessment is the initial and crucial step in the continuum of care.

Correct Answer: B

Rationale: The correct answer is B: Empowerment. Empowerment refers to the level of choice, influence, and control that users of mental health services can exercise over events in their lives. It involves empowering individuals to make decisions and take actions that enhance their well-being. Emotional regulation (A) refers to the ability to manage and control emotions. Mutual negotiation (C) involves reaching agreements through discussion and compromise. Self-determination (D) is the right of individuals to make choices about their own lives. However, empowerment specifically focuses on giving individuals the ability to exert influence and control over their circumstances, making it the most appropriate term in this context.

Correct Answer: D

Rationale: The correct answer is D: Integrating mental and physical health in one setting. This approach ensures that individuals with SMI receive holistic care addressing both their mental and physical health needs simultaneously. By having mental health professionals collaborate with medical providers in one setting, communication barriers are reduced, leading to more effective treatment. This integrated approach also helps in better coordination of care and ensures that all aspects of the individual's health are considered. Choice A (Seeking medical attention at the emergency department) is incorrect because it does not address the long-term need for integrated care for individuals with SMI. Choice B (Having a community clinic in the area where the SMI live) might help with accessibility but does not guarantee the integration of mental and physical health services. Choice C (Medicating the patient before a medical examination) is inappropriate as it does not address the underlying issue of healthcare disparity for individuals with SMI.