Terrell is a thirty-two-year-old male client who was just diagnosed with bipolar disorder and alcohol abuse disorder. He does not meet criteria for hospital admission and is currently able to work and safely care for himself at home. He is also on a new medication regimen that will need frequent lab draws and adjustments for the first several weeks. What is the best setting for treatment for Terrell?

Correct Answer: B

Rationale: The correct answer is B: an intensive community (outpatient) program (IOP). This setting is appropriate for Terrell as he is able to work and care for himself at home, does not require hospitalization, and needs close monitoring due to the new medication regimen. IOP provides structured treatment while allowing Terrell to maintain his daily routine. Choice A: a halfway house, is not the best option as Terrell is currently able to live independently at home and does not need the level of structure and support provided in a halfway house. Choice C: a residential treatment center (RTC), is not necessary as Terrell does not require 24/7 supervision and can continue living at home while attending regular treatment sessions. Choice D: Narcotics Anonymous (NA) is not the best setting for Terrell as his primary issues are bipolar disorder and alcohol abuse, not narcotics addiction. An IOP will provide the appropriate level of care and support for his current needs.

Correct Answer: B

Rationale: The goal for the orientation phase is to establish trust. This is crucial for building a strong nurse-client relationship. Trust forms the foundation for effective communication and collaboration. By establishing trust, the nurse can create a safe and supportive environment for the client to open up and engage in the therapeutic process. Exploring self-perceptions (choice A) is typically done in the working phase, not the orientation phase. Promoting change (choice C) and evaluating goal attainment (choice D) are also more relevant to the later phases of the relationship when interventions and outcomes are being assessed. Therefore, the correct answer is B as it aligns with the primary focus of the orientation phase.

Correct Answer: D

Rationale: The correct answer is D because when a client makes a written application to be admitted to a psychiatric facility, they typically retain the right to make decisions about their discharge unless they are determined to be a danger to themselves or others. This is in line with the principle of autonomy and informed consent in healthcare. Choices A is incorrect because civil rights are not necessarily all revoked upon admission. Choice B is incorrect as clients usually have the right to participate in discharge decisions. Choice C is incorrect as not all clients admitted to a psychiatric facility are necessarily deemed a danger to self or others.

Correct Answer: B

Rationale: The correct answer is B: Autonomy. In community mental health nursing, the nurse often works independently, making decisions about patient care and interventions. Autonomy allows the nurse to adapt to the unique needs of each individual in the community setting. In contrast, nurses in the operating room typically work within a team and follow strict protocols, limiting their autonomy. Kindness, compassion, and professionalism are important traits for all nurses regardless of the setting, but autonomy is more crucial for a community mental health nurse due to the nature of their work.

Correct Answer: C

Rationale: Step 1: Empathy and Support - Choice C demonstrates that the nurse spends time listening to the patient's problems, providing emotional support and empathy. Step 2: Connection and Comfort - By listening to the patient, the nurse helps the patient feel understood and less alone, creating a sense of connection and comfort. Step 3: Perceived Caring - This active listening and support indicate genuine care and concern for the patient's well-being, leading to the perception that the nurse is caring. Step 4: Summary - Choices A, B, and D focus on practical actions or information sharing, lacking the emotional depth and personal connection present in choice C. Thus, choice C best indicates that the patient perceived the nurse as caring.