The RN is working with a male client at a community mental health center when the client reports hearing voices that tell him to get a knife from the kitchen and hurt himself. What intervention is most important for the RN to implement?

Correct Answer: A

Rationale: The correct answer is A: Don't allow the client to go into the kitchen until the hallucination has subsided. This intervention is crucial to ensure the client's safety as it helps prevent harm to himself or others. Allowing the client access to a potential weapon during a hallucination could result in serious injury. By restricting access to the kitchen, the RN can mitigate the risk and provide a safe environment for the client. Summary of other choices: B: Reporting to the client's case workers may be important, but the immediate safety of the client takes precedence. C: Assigning the UAP is not sufficient to address the safety issue at hand, as direct intervention by the RN is needed. D: While documenting the behavior is important, immediate action to prevent harm is more critical in this situation.

Correct Answer: D

Rationale: The correct answer is D: Assess and report the client's electrolyte status to the healthcare provider. This is the highest priority because electrolyte imbalances are common in clients with bulimia nervosa due to purging behaviors. Monitoring electrolytes is crucial to prevent life-threatening complications. A: Scheduling group therapy may be beneficial, but addressing the physical health concern is the priority. B: Assigning care based on age is not essential in this situation. C: Monitoring for binging activities is important but not as critical as assessing electrolyte status. In summary, ensuring the client's physical health and safety by monitoring electrolyte status is the top priority in managing a client with bulimia nervosa.

Correct Answer: B

Rationale: The correct answer is B (2 to 4 weeks) because antidepressants typically take around 2 to 4 weeks to start showing noticeable effects. Initially, the medication needs time to build up in the system and adjust serotonin levels in the brain. It takes a few weeks for the neurotransmitter balance to stabilize and for the individual to experience improvements in mood and symptoms. Choice A (1 to 2 weeks) is too soon for significant effects to occur. Choice C (4 to 6 weeks) and D (6 to 8 weeks) are too long for the typical onset of action for most antidepressants.

Correct Answer: A

Rationale: The correct answer is A because encouraging the client to actively participate in assigned activities can help distract him from his paranoid thoughts and promote engagement in therapeutic interventions. This can also help establish a routine and promote socialization. B: Confronting the client may escalate his paranoia and lead to increased distress. C: Limiting interactions may further isolate the client and exacerbate his paranoia. D: Administering PRN medication should be considered if the client becomes agitated or poses a risk to himself or others, but it does not address the underlying issue of paranoia.

Correct Answer: A

Rationale: The correct laboratory test to check for a patient administered with Lithium is serum creatinine. This is crucial because Lithium can affect kidney function, leading to potential kidney damage. Monitoring serum creatinine levels helps in early detection of kidney impairment. The other choices (B: Liver function tests, C: Complete blood count, D: Thyroid function tests) are not directly affected by Lithium administration and are not necessary for routine monitoring in patients taking Lithium.