A nurse is caring for a client in an acute care mental health unit who was involuntarily admitted for 72 hr after attacking a neighbor. To keep the client in the hospital when the initial time to hold the client expires, which of the following must be determined?
Whether the client is financially incapable of paying for prescribed medications.
Whether the client is a danger to herself or others.
Whether the client is unable to make arrangements to stay with someone.
Whether the client is unwilling to accept that treatment is needed.
The Correct Answer is B
Whether the client is a danger to herself or others. When a client is involuntarily admitted to a mental health unit, they are held for an initial period of 72 hours for evaluation and treatment. Afterward, a determination must be made as to whether or not the client is still a danger to themselves or others to keep them in the hospital.
Choices A, C, and D do not address the primary concern of ongoing safety for the client and others.
For choice A, the client's financial status or their ability to pay for prescribed medications is not relevant to their safety or need for hospitalization.
For choice C, the client's ability to make arrangements to stay with someone is important for discharge planning but not for determining their need for ongoing hospitalization.
Finally, for choice D, whether the client is unwilling to accept treatment is important, but not the sole determining factor as to whether they are a danger to themselves or others.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Constipation. Constipation is a common symptom of anorexia nervosa, as it can result from severe food restriction, dehydration, electrolyte imbalance, or laxative abuse. People with anorexia may also experience abdominal pain and bloating due to constipation.
Choice A. Hyperkalemia. Hyperkalemia is a condition of high potassium levels in the blood. It is not a typical symptom of anorexia, as people with anorexia tend to have low potassium levels due to vomiting, diuretic use, or inadequate intake.
Hyperkalemia can cause irregular heart rhythms, muscle weakness, and paralysis.
Choice B. Tachycardia. Tachycardia is a condition of fast heart rate. It is not a common symptom of anorexia, as people with anorexia tend to have bradycardia, which is a slow heart rate. Bradycardia can result from starvation, dehydration, or electrolyte imbalance and can lead to cardiac arrest. Tachycardia can occur in some cases of anorexia due to dehydration, anxiety or refeeding syndrome.
Choice D. Metrorrhagia. Metrorrhagia is a condition of irregular or excessive bleeding between menstrual periods. It is not a usual symptom of anorexia, as people with anorexia tend to have amenorrhea, which is the absence of
Correct Answer is D
Explanation
The client is easily startled by loud voices. Clients with posttraumatic stress disorder (PTSD) may exhibit hyperarousal symptoms, including exaggerated startle responses and hypervigilance. The client talking constantly about the traumatic experience is a possible finding in PTSD but not specific. The client is constantly drowsy and sleeping 11-12 hours daily is more associated with depression than PTSD. While the client may have satisfying personal relationships, it does not address the question of what finding to expect with PTSD, making choice C incorrect.
Reasons why the other choices are not answers:
Choice A, the client talking constantly about the traumatic experience, is a possible symptom of PTSD, but it is not specific to the disorder and may also indicate other disorders.
Choice B, the client being constantly drowsy and sleeping 11-12 hours daily, is more indicative of depression than PTSD and also does not address the question of finding expected with PTSD.
Choice C, the client reports satisfying personal relationships with family and close friends, does not address what finding is expected with PTSD, making it an incorrect answer.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today