The nurse is interviewing a client admitted to an inpatient psychiatric unit with a diagnosis of depressive disorder. Which is the primary goal in the assessment phase of the nursing process for this client?

Correct Answer: C

Rationale: Step 1: Assessment is the first phase of the nursing process. Step 2: Collecting and organizing information is crucial to understand the client's current situation. Step 3: By collecting data, the nurse can identify the client's needs and create an individualized care plan. Step 4: Building trust and rapport (Choice A) is important but is more focused on the therapeutic relationship, which is part of the implementation phase. Step 5: Identifying goals and outcomes (Choice B) is part of the planning phase. Step 6: Identifying and validating the medical diagnosis (Choice D) is the responsibility of the healthcare provider and is not the primary goal of the nursing assessment.

Correct Answer: B

Rationale: The correct answer is B: State law, which may vary from state to state. State laws govern the scope of practice for healthcare professionals, including registered nurses in psychiatric inpatient facilities. Each state has its own Nurse Practice Act outlining the specific duties and responsibilities RNs can perform. National organizations like NAMI, NLN, and federal laws do not dictate the scope of practice for RNs in specific settings. It is crucial for nurses to be aware of and adhere to the regulations set forth by their respective state to ensure safe and legal practice.

Correct Answer: B

Rationale: The correct initial nursing action for a client wanting to leave against medical advice from an inpatient locked psychiatric unit is to check the client's admission status and discuss the reasons for wanting to leave (Choice B). This approach allows the nurse to assess the client's mental status, risk factors, and reasons for wanting to leave, which are essential for providing appropriate care and interventions. By understanding the client's perspective and concerns, the nurse can work collaboratively with the client to address underlying issues and potentially prevent harm. Choices A, C, and D are incorrect because they do not prioritize understanding the client's reasons for wanting to leave or assessing the client's mental status and risk factors. Choice A dismisses the client's request without exploring the underlying issues. Choice C focuses on punitive measures rather than therapeutic communication. Choice D, placing the client on one-on-one observation, does not address the client's concerns or reasons for wanting to leave.

Correct Answer: A

Rationale: The correct answer is A because brief psychodynamic therapy is typically suitable for individuals with specific, time-limited issues like the aftermath of an extramarital affair. This type of therapy focuses on exploring unconscious conflicts and patterns related to the specific problem. Choices B, C, and D present more complex and severe issues that would likely require longer-term or more intensive therapies such as cognitive-behavioral therapy, dialectical behavior therapy, or medical interventions. It is important to match the therapy approach to the individual's needs and presenting concerns.

Correct Answer: C

Rationale: The correct answer is C: Refer the request for information to the patient's case manager. The case manager is responsible for coordinating the patient's care, including length of stay discussions with the health insurer. This ensures that the information is handled appropriately and in accordance with privacy regulations. Incorrect answers: A: Obtaining information from the medical record and relaying it to the caller may violate patient confidentiality and privacy laws. B: While patient information is confidential, it is important to address the health insurer's request through the appropriate channels. D: Referring the request to the health care provider may not be necessary as the case manager is typically the appropriate point of contact for length of stay discussions with the health insurer.