A nurse is reinforcing discharge teaching with a client who has borderline personality disorder. The client reports being a single parent caring for two toddlers. Which of the following actions should the nurse take?
Notify child protective services.
Suggest the children live with other relatives.
Encourage the children to visit the psychiatric unit when the client is leaving.
Offer the client information about a support group for parents.
The Correct Answer is D
A. "Notify child protective services." Reporting to child protective services is only necessary if there is evidence of abuse, neglect, or an inability to provide adequate care. A diagnosis of borderline personality disorder alone does not warrant an automatic report.
B. "Suggest the children live with other relatives." Encouraging a client to relinquish custody without evidence of an inability to care for the children is not appropriate. Providing support and resources to enhance parenting skills is a more beneficial approach.
C. "Encourage the children to visit the psychiatric unit when the client is leaving." While family involvement is important, exposing young children to a psychiatric unit can be overwhelming and inappropriate. Alternative ways to support parent-child bonding should be considered.
D. "Offer the client information about a support group for parents." Support groups provide a structured environment for clients to share experiences, receive guidance, and develop coping strategies, which can help manage stress and improve parenting skills.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "The procedure will take about 2 hours.": A typical transcranial magnetic stimulation (TMS) session lasts about 30 to 40 minutes. The treatment is conducted on an outpatient basis, allowing clients to resume daily activities immediately afterward.
B. "Most people only require one treatment to eliminate their depression.": TMS is typically administered in multiple sessions over several weeks. A full course usually consists of daily treatments for four to six weeks to achieve significant symptom improvement.
C. "You may experience a mild headache following the procedure.": Mild headaches and scalp discomfort are common side effects of TMS due to repeated magnetic pulses stimulating the brain. These effects are generally temporary and can be managed with over-the-counter analgesics.
D. "You will be asleep during the procedure.": TMS does not require sedation or anesthesia. Clients remain awake and alert during the procedure, as the treatment is noninvasive and does not cause significant discomfort requiring sedation.
Correct Answer is ["C","D","E"]
Explanation
A. Nylon socks. Nylon socks do not pose a significant risk for self-harm and can be safely kept with the client. They are not considered a ligature risk or a hazardous object.
B. Cotton underwear. Cotton underwear is not a safety concern in a mental health unit. It does not present a strangulation risk or any other immediate danger.
C. Lace-up tennis shoes. Lace-up shoes contain long laces that could be used as a ligature, posing a strangulation risk. Clients in a mental health unit are typically provided with slip-on or Velcro shoes to enhance safety.
D. Glass-framed picture of the client's partner. A glass frame poses a significant risk as it can be broken and used as a sharp object for self-harm. The nurse should ask the partner to take it home or provide a safer alternative, such as a laminated photo.
E. Necklace. A necklace can be used for strangulation, making it unsafe for a client at risk of self-harm. Removing items that could be used for ligature or harm is essential in suicide prevention.
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