Correct Answer: B

Rationale: The main purpose of the working phase in the nurse-patient relationship is to implement nursing interventions that are specifically tailored to achieve the expected patient outcomes. During this phase, the nurse actively works with the patient to put the care plan into action and make progress towards reaching the desired health goals. It involves the application of therapeutic communication, problem-solving, and interventions to address the patient's needs. Establishing rapport and trust is typically done in the orientation phase, while defining roles and boundaries usually occurs in the introductory phase of the relationship.

Correct Answer: B

Rationale: In this situation, the nurse's initial action should be to reassess the client to evaluate if restraints are still required before considering reapplication. This step ensures that the restraints are only used when absolutely necessary, promoting the client's safety and autonomy. Documentation and monitoring are essential, but reassessment of the client's condition takes precedence to provide individualized care.

Correct Answer: A

Rationale: Black sticky stool (melena) is a sign of gastrointestinal bleeding and should be reported to the health care provider promptly.

Correct Answer: D

Rationale: Vitamin B12 is an essential nutrient that is predominantly found in animal products. Since individuals following a vegan diet do not consume animal products, they are at a higher risk of vitamin B12 deficiency. Therefore, it is crucial for vegans to include a vitamin B12 supplement in their dietary plan to prevent deficiency-related health issues.

Correct Answer: C

Rationale: The ANA's Scope and Standards of Nursing Practice are essential guidelines for nursing practice in various specialties, including mental health. The document outlines the expectations and responsibilities of nurses in providing high-quality care within their specific practice areas. In the context of opening a mental health services department, using the Scope and Standards specific to psychiatric-mental health nursing would ensure that the unit's nursing guidelines align with best practices and professional standards in mental health care.