Which of the following symptoms should a nurse associate with increased levels of thyroid- stimulating hormone (TSH) in a newly admitted client? Select all that apply.

Correct Answer: A

Rationale: In this question, the correct symptom associated with increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client is depression (Option A). Here's a detailed rationale: Increased TSH levels are indicative of hypothyroidism, a condition where the thyroid gland is underactive. Depression is a common symptom of hypothyroidism due to the impact of inadequate thyroid hormone levels on brain function and neurotransmitter regulation. This hormonal imbalance can lead to mood disturbances, including feelings of sadness, hopelessness, and low energy levels. Option B, fatigue, is also a symptom of hypothyroidism. The underactive thyroid affects metabolism, leading to feelings of tiredness and lethargy. However, in this scenario, depression is a more specific symptom associated with increased TSH levels. Increased libido (Option C) and mania (Option D) are more commonly associated with hyperthyroidism, where the thyroid gland is overactive and produces excess thyroid hormones. In hyperthyroidism, individuals may experience heightened libido or manic symptoms due to the effects of excess thyroid hormones on the body's metabolic processes and neurotransmitter regulation. In an educational context, understanding the relationship between thyroid function and mental health is crucial for nurses working in mental health settings. Recognizing the potential psychiatric symptoms associated with thyroid disorders allows nurses to provide holistic care to clients, including appropriate referrals for further evaluation and treatment by healthcare providers specializing in endocrinology or psychiatry. This knowledge enables nurses to advocate for comprehensive assessments and individualized care plans to address both the mental health and endocrine needs of clients.

Correct Answer: A

Rationale: The correct response is A, which involves refusing to give any information to the caller and citing rules of confidentiality. As a psychiatric nurse, maintaining confidentiality is crucial to ensure the privacy and rights of the individual seeking treatment. Providing information about a client without their consent can breach confidentiality and violate ethical standards. Therefore, by declining to disclose any information to the caller, the nurse upholds the legal and ethical obligations of safeguarding client confidentiality.

Correct Answer: B

Rationale: Option B exemplifies both assault and battery. Assault occurs when the nurse threatens to tie down the client, creating a fear of harm or unwanted physical contact. Battery then occurs when the nurse proceeds to actually tie down the client against their wishes, resulting in the unwanted physical contact. Both assault (threatening to tie down) and battery (physically tying down) are present in this situation.

Correct Answer: C

Rationale: Competency is a legal term that refers to a person's ability to make rational decisions. It is not determined based on a client's compliance with treatment or the medical opinion of a physician. Competency is essential for informed consent and respecting a client's autonomy. A competent client is able to understand information presented to them, appreciate the potential consequences of their decisions, and make reasoned choices. It is important for healthcare professionals to assess a client's competency when making healthcare decisions in collaboration with the client. Refusal of medication alone does not automatically indicate incompetency, as competency is a broader concept relating to decision-making abilities.

Correct Answer: A

Rationale: Threatening a client with restraints is considered a form of assault, which is the intentional act of causing someone to fear that they will be harmed. Even if the nurse does not physically carry out the threat, the act of making the threat itself constitutes assault. Nurses have a duty to provide care in a safe and therapeutic manner, and threatening a client with restraints goes against the principles of beneficence and nonmaleficence in nursing practice. Legal actions can be taken against the nurse for engaging in such behavior, as it violates the ethical standards and can harm the trusting relationship between the nurse and the client.