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 C

Explanation

A. "Did you experience any childhood trauma?"
Childhood trauma, such as abuse or neglect, can contribute to various mental health conditions, including post-traumatic stress disorder (PTSD), depression, or anxiety disorders. While trauma can impact a person's mental health, it does not directly assess the risk for alcohol use disorder.

B. "Are you the result of a twin birth?"
Being a twin or the result of multiple births does not inherently indicate a risk for alcohol use disorder. This question is related to an individual's birth status and has no direct connection to the assessment of alcohol-related issues.

C. "Have you ever purposefully lost a job?"
This is the correct choice. Purposefully losing a job might indicate behavioral issues related to alcohol misuse or impairment. Individuals with alcohol use disorder may engage in behaviors that lead to job loss, such as absenteeism, poor performance, or conflict at the workplace due to alcohol consumption.

D. "Did your parent have a viral infection while pregnant with you?"
Prenatal viral infections can potentially affect fetal development and lead to certain health conditions. However, this question is not directly related to the risk of alcohol use disorder. Alcohol use disorder is primarily influenced by environmental factors, genetic predisposition, and individual behaviors related to alcohol consumption. Prenatal viral infections are not a typical indicator of alcohol-related concerns.

A. Hgb 10 g/dL B. Blood glucose 100 mg/dL C. TIBC 11 mcg/dL D. Potassium 3.7 mEq/L

Correct Answer is A

Explanation

A. Hgb 10 g/dL
Anemia (low hemoglobin levels) is a common finding in individuals with anorexia nervosa due to inadequate nutrition, leading to a decreased production of red blood cells. Hemoglobin levels below the normal range are often seen in people with severe malnutrition, such as those with anorexia nervosa.

B. Blood glucose 100 mg/dL:
A blood glucose level of 100 mg/dL is within the normal range. Anorexia nervosa typically does not cause specific changes in blood glucose levels.

C. TIBC 11 mcg/dL:
Total Iron-Binding Capacity (TIBC) is a test that measures the blood's capacity to bind to iron. The given value of 11 mcg/dL is unusually low and might not be within the typical reference range. However, the significance of this value is not clear without the specific reference range for the laboratory performing the test.

D. Potassium 3.7 mEq/L:
A potassium level of 3.7 mEq/L is within the normal range. Electrolyte imbalances, including low potassium levels (hypokalemia), can occur in individuals with anorexia nervosa due to inadequate intake and purging behaviors. While this level is within the normal range, individuals with anorexia nervosa may still exhibit electrolyte imbalances that require monitoring and management.

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