A nurse is preparing to meet with a client who was recently admitted to an outpatient mental health facility. Which of the following actions should the nurse plan to take during the working phase of the nurse-client relationship?

identify the goals that the client achieved during the relationship.

Assist the client to make changes in her behavior.

Inform the client about confidentiality issues.

Discuss the client's responsibilities for the relationship

Answer and Explanation

The Correct Answer is B

A. Identify the goals that the client achieved during the relationship:
This activity typically occurs during the termination or closure phase of the nurse-client relationship. It involves reflecting on the progress made by the client toward their goals. During this phase, both the nurse and the client review the goals set at the beginning of the therapeutic relationship and identify which ones have been achieved. This helps in evaluating the effectiveness of the therapeutic interventions.

B. Assist the client to make changes in her behavior:
This action is a central aspect of the working phase. In this phase, the nurse and client collaboratively work on addressing the client's issues. The nurse provides support, guidance, and appropriate interventions to help the client modify their thoughts, emotions, and behaviors. The goal is to facilitate positive changes and promote the client's mental and emotional well-being.

C. Inform the client about confidentiality issues:
Discussing confidentiality is essential at the beginning of the therapeutic relationship, during the orientation phase. The nurse informs the client about the limits of confidentiality, explaining what information will be kept confidential and under what circumstances confidentiality might need to be breached (such as when there is a risk of harm to the client or others). This discussion helps establish trust and clear boundaries within the relationship.

D. Discuss the client's responsibilities for the relationship:
Clarifying the client's responsibilities occurs primarily during the orientation phase. In this phase, the nurse outlines what the client can expect from the therapeutic relationship and what is expected from them. This includes discussing the client's active participation in the process, their commitment to attending sessions, being open and honest, and actively engaging in therapeutic activities and homework assignments.

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Correct Answer is A

Explanation

A. Withholding a prescribed medication that is causing adverse effects for the client
The principle of nonmaleficence, often summarized as "do no harm," emphasizes the nurse's duty to prevent harm and to remove existing harm. If a medication prescribed to a client is causing adverse effects, the nurse should withhold the medication to prevent harm to the client.

B. Educating the client about legal rights concerning treatment
Educating the client about their legal rights falls under providing information and ensuring the client's autonomy but does not directly address the principle of non-maleficence.

C. Providing the client with quality care regardless of ability to pay for treatment
Providing quality care regardless of the client's ability to pay is an ethical practice, but it aligns more with the principles of justice and beneficence rather than nonmaleficence.

D. Being truthful with the client about the manifestations of withdrawal
Being truthful and providing accurate information to the client about withdrawal symptoms is crucial, but it doesn't directly address the principle of nonmaleficence.

A. Encourage the client to join group activities. B. Administer methylphenidate to the client. C. Dim the lights in the client's room. D. Provide detailed explanations to the client.

Correct Answer is C

Explanation

A. Encourage the client to join group activities:
Encouraging a client experiencing a manic episode to join group activities is not the best option. Manic episodes are characterized by heightened energy, impulsive behavior, and decreased attention span. Group activities may overstimulate the client, making it difficult for them to focus or participate appropriately. It's essential to minimize stimulation and provide a calm environment to help manage the symptoms of mania.

B. Administer methylphenidate to the client:
Methylphenidate is a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). Administering a stimulant like methylphenidate to a person in a manic state can exacerbate their symptoms. It would increase their already elevated energy levels, restlessness, and impulsivity, making the manic episode more intense and challenging to manage. Using stimulant medications in this context is contraindicated.

C. Dim the lights in the client's room:
Dimming the lights in the client's room is the appropriate choice. Bright lights can increase agitation and restlessness in individuals experiencing a manic episode. Dimming the lights creates a calming environment, reducing excessive stimulation and promoting relaxation. A calm atmosphere is crucial for someone going through a manic episode to help them manage their symptoms effectively.

D. Provide detailed explanations to the client:
During a manic episode, individuals often have racing thoughts and may have difficulty concentrating. Providing detailed explanations can overwhelm the client, as they might have trouble processing complex information in this state. Instead, simple and clear communication is more effective. It's important to provide straightforward instructions and information to prevent further agitation and confusion.

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A nurse is preparing to meet with a client who was recently admitted to an outpatient mental health facility. Which of the following actions should the nurse plan to take during the working phase of the nurse-client relationship?

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Correct Answer is C

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