A client has been placed in seclusion because the client has been deemed a danger to others. Which is the priority nursing intervention for this client?

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Question 1 of 5

A client has been placed in seclusion because the client has been deemed a danger to others. Which is the priority nursing intervention for this client?

Correct Answer: C

Rationale: The correct answer is C because maintaining contact and assuring the client that seclusion will maintain their safety is the priority nursing intervention for a client deemed a danger to others. This intervention helps build trust, reduce anxiety, and promote a therapeutic relationship. A: Having little contact with the client may increase feelings of isolation and exacerbate the client's distress. B: Providing privacy is important, but in this case, ensuring the client's safety is the priority over maintaining confidentiality. D: Teaching relaxation techniques and coping strategies is beneficial, but it is not the immediate priority when the client is in seclusion due to being a danger to others.

Question 2 of 5

A nursing instructor is explaining to a group of nursing students that in addition to facing the stigma associated with being mentally ill, forensic clients who are mentally ill also experience the stigma associated with being a criminal. One of the students asks the instructor how the stigma associated with criminality might influence nursing care. Which response by the instructor would be most appropriate?

Correct Answer: A

Rationale: The correct answer is A because it addresses the potential impact of the stigma associated with criminality on nursing care. Nurses may indeed be reluctant to care for mentally ill criminals due to safety concerns, both for themselves and other clients. This response acknowledges the realistic fears that may exist and how they can influence the quality of care provided. Now, let's analyze why the other choices are incorrect: B: This choice suggests that nurses may prefer to care for forensic clients because they don't believe criminals can be mentally ill, which is not relevant to the question asked. C: This choice implies a generalization that forensic clients only experience mild mental health problems, which is not accurate and does not address the impact of stigma associated with criminality on nursing care. D: This choice mentions unfounded fears about what clients might do post-treatment, which is not directly related to the stigma associated with criminality influencing nursing care.

Question 3 of 5

Ophelia, a 69-year-old retired nurse, attends a reunion of her former coworkers. Ophelia is concerned because she usually knows everyone, and she cannot recognize faces today. A registered nurse colleague recognizes Ophelia's distress and 'introduces' Ophelia to those attending. The nurse practitioner recognizes that Ophelia seems to have a deficit in:

Correct Answer: D

Rationale: The correct answer is D: Social cognition. Ophelia's inability to recognize familiar faces at the reunion indicates a deficit in social cognition, which involves the ability to understand and interact with others socially. This deficit is not related to lower-level cognitive domains like memory or attention (choice A), delirium threshold (choice B), or executive function which is more related to planning and decision-making (choice C). Social cognition impairment can manifest as difficulty recognizing faces, interpreting social cues, or understanding others' emotions, all of which are evident in Ophelia's situation.

Question 4 of 5

Nurse Tuan worked with a client three weeks ago to get them set up with a community-based mental health-care treatment plan to help with the client's diagnosis of major depressive disorder. Tuan decides to make a follow-up call to the client to ask them how they're doing. What step in the nursing process does Tuan's action represent?

Correct Answer: B

Rationale: The correct answer is B: evaluation. Evaluation is the step in the nursing process where the nurse assesses the client's response to the implemented plan of care to determine if the goals were met and if any modifications are needed. In this scenario, Nurse Tuan is following up with the client to assess how they are doing after the community-based mental health-care treatment plan was put in place. This action allows Tuan to evaluate the effectiveness of the plan and make any necessary adjustments. Incorrect Choices: A: Assessment is the step where data is collected and analyzed to identify the client's problems and needs. This step precedes the implementation of the treatment plan. C: Implementation is the step where the nurse puts the plan of care into action. Tuan has already implemented the plan and is now assessing its effectiveness. D: Planning is the step where the nurse develops a comprehensive plan of care based on the assessment data. Tuan has already completed this step by setting up the community-based mental health-care

Question 5 of 5

A patient with a history of anger and impulsivity was hospitalized after an accident resulting in multiple injuries. The patient loudly scolds nursing staff, 'I'm in pain all the time but you don't give me medicine until YOU think it's time.' Which nursing intervention would best address this problem?

Correct Answer: B

Rationale: The correct answer is B because switching from prn (as-needed) pain medication to patient-controlled analgesia empowers the patient to manage their pain effectively, addressing the issue of feeling powerless and dependent on nursing staff for pain relief. This intervention also aligns with the patient's impulsivity and need for immediate gratification. Choice A is incorrect because teaching coping strategies may not address the immediate pain relief the patient desires. Choice C is incorrect as it focuses on addressing the behavior without addressing the underlying issue of pain management. Choice D is incorrect because it does not provide a solution to the immediate problem of pain control and may not be relevant to the patient's current behavior.

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