The mental health nurse is about to conduct an admissions interview with an older adult being admitted for depression. Which action demonstrates an understanding of the appropriate integration of the mental health status examination into an assessment interview?

Correct Answer: D

Rationale: The correct answer is D because integrating mental health questions among general assessment questions allows for a holistic understanding of the client's overall health. By including mental health questions throughout the interview, the nurse can gather information in a more natural and comprehensive manner. This approach helps in establishing a rapport with the client and avoids stigmatizing mental health issues. Conducting the interview in a quiet, private location (choice A) is important for confidentiality but does not specifically address the integration of mental health questions. Informing the client about the mental health assessment (choice B) is essential for informed consent but does not address the integration aspect. Asking mental health questions at the beginning of the interview (choice C) may disrupt the flow and rapport-building process. Thus, choice D is the most appropriate for a comprehensive assessment.

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. An ethical dilemma involves a situation where there is a conflict between two morally acceptable choices. 2. In this scenario, the dilemma is presented as having only two treatment choices which are both painful and have low success rates. 3. The basis of an ethical dilemma is the difficulty in making a decision when faced with two undesirable options. 4. Therefore, option D accurately describes the essence of an ethical dilemma. Summary of why other choices are incorrect: A. Focuses on client-team disagreement, not a true ethical dilemma. B. Describes a situation of potential harm but not a conflict between two morally acceptable choices. C. Discusses decision-making for an incompetent client, which is a different ethical issue than presented in the question.

Correct Answer: A

Rationale: The correct answer is A because establishing a mobile mental health clinic in a rural farming community directly addresses the issue of access to mental health care for an underserved group. This intervention ensures that individuals in remote areas have access to much-needed mental health services. In contrast, choices B, C, and D do not specifically target an underserved group. Choice B focuses on stress management for specific personnel, choice C targets eating disorders screenings in schools, and choice D educates parents on signs of depression but does not directly address access to mental health services for an underserved group. Therefore, choice A is the best option for meeting the needs of an underserved population.

Correct Answer: B

Rationale: The correct answer is B because it highlights the universal susceptibility to mental illness, emphasizing the importance of advocacy to reduce stigma. Mental health issues can affect anyone regardless of age, gender, or background. By acknowledging this, nurses can advocate for increased understanding and support for those struggling with mental illness. A: While stigmatization does increase stress, this does not directly explain the basis for nursing advocacy. C: Mental illness being chronic does not explain the rationale behind advocating to eliminate stigma. D: While the mentally ill deserve support, this choice does not address the underlying reason for advocacy focused on stigma reduction.

Correct Answer: B

Rationale: The correct answer is B because enrolling the client in an in-home psychiatric nursing service that provides medication by injection ensures medication adherence. This intervention eliminates the need for the client to remember to take oral medication, reducing the risk of noncompliance. Inpatient admission (A) may not address the root cause of noncompliance and can be restrictive. Outpatient daycare (C) may not directly address medication adherence. A compliance contract (D) may not address the practical challenges of medication administration. Overall, choice B directly addresses the issue of medication noncompliance by providing a practical solution.