A psychiatric nurse is working in a community mental health center. They are completing an assessment on a 32-year-old pregnant female presenting with depression. They note that the client has not answered the questions about alcohol and tobacco use. Why is it important to gather this information?

Correct Answer: B

Rationale: The correct answer is B because assessing alcohol and tobacco use in a pregnant client with depression is crucial for providing comprehensive care. First, substance use can exacerbate mental health symptoms and impact treatment effectiveness. Second, substance use during pregnancy can harm both the mother and the unborn child, leading to adverse health outcomes. Third, this information is vital for developing a holistic care plan that considers both the mental health needs of the client and the safety of the unborn child. Choices A, C, and D are incorrect because: A: Failing to assess alcohol and tobacco use neglects essential information that can impact the client's well-being and treatment. C: Substance use during pregnancy can have significant long-term effects on the unborn child's health and development. D: Assessing alcohol and tobacco use is not optional, as it directly influences the client's mental health and the well-being of the unborn child.

Correct Answer: B

Rationale: The correct answer is B: Assessment. In the Calgary Family Model, the Assessment stage involves identifying and understanding the problems within the family system. This is where the nurse gathers information about the family's strengths, resources, and challenges. The nurse assesses the family's structure, communication patterns, roles, and interactions to develop a comprehensive understanding of the family dynamics. Engaging with the family (Choice A) occurs before the Assessment stage. Intervention (Choice C) comes after the Assessment stage when specific strategies are implemented. Termination (Choice D) is the final stage when the nurse concludes their work with the family.

Correct Answer: B

Rationale: Step-by-step rationale for choosing answer B: 1. Positive regard involves showing empathy and support. 2. Staying with a tearful patient shows empathy and emotional support. 3. Emotional support can enhance patient growth and well-being. 4. Making rounds, administering medication, and examining personal feelings do not directly show empathy or emotional support. Summary: - Choice A is incorrect as making rounds is a routine task, not focused on emotional support. - Choice C is incorrect as administering medication is a clinical task, not centered on emotional support. - Choice D is incorrect as examining personal feelings does not directly provide emotional support to the patient.

Correct Answer: B

Rationale: The correct answer is B: "We'll need to make sure that he has his blood count checked at least weekly." Rationale: 1. Clozapine can cause agranulocytosis, a potentially life-threatening condition characterized by a severe decrease in white blood cells. 2. Monitoring blood counts weekly is crucial to detect early signs of agranulocytosis and intervene promptly. 3. Regular blood count monitoring allows for timely adjustments in medication dosage to prevent serious complications. Summary: A: Although monitoring the client's heart is important, regular electrocardiograms are not specifically required for clozapine. C: Smoking does affect clozapine levels, but this choice does not address the crucial need for blood count monitoring. D: Weight loss is a potential side effect of clozapine, but it is not the most critical monitoring parameter for this medication.

Correct Answer: B

Rationale: The correct answer is B: Role-playing a job interview with the client. This intervention aligns with the behavioral approach by providing the client with practical skills to address the stressor of acquiring independent employment. Role-playing allows the client to practice and improve their interview skills, enhancing their confidence and ability to secure a job. A: Teaching the client to "thought block" auditory hallucinations is more aligned with cognitive-behavioral approaches and not directly related to employment needs. C: Advocating for adequate housing is important but not directly addressing the client's need for employment. D: Discussing the use of prn medications focuses on symptom management rather than improving the client's ability to secure employment.