A nurse on a mental health unit is planning care for a client who has a new diagnosis of non- suicidal self-harm (NSSH). Which of the following interventions should the nurse include in the plan?

Explain to the client that self-harm behaviors do not increase their risk for accidental death.

Inform the client that self-harm behavior cannot become a serious problem in the future.

Encourage the client to identify the emotions they feel immediately before performing the self- harm behavior.

Place the client in one-on-one direct observation due to overt suicidal intent.

Answer and Explanation

The Correct Answer is C

C Encouraging the client to identify the emotions they feel immediately before performing the self-harm behavior is an important intervention. It can help the client develop insight into triggers and underlying emotions that contribute to the behavior. Identifying and addressing these emotions can be a crucial step in developing healthier coping mechanisms.

A. It is crucial to convey the potential risks associated with self-harm and emphasize the importance of seeking help and safer coping strategies.

B. Non-suicidal self-harm is a significant concern that requires attention and appropriate intervention. While NSSH does not necessarily indicate immediate suicidal intent, it can indicate significant distress

D. NSSH does not necessarily indicate suicidal intent, and placing the client in constant observation without clinical justification may be intrusive and undermine therapeutic rapport.

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Correct Answer is D

Explanation

D. It emphasizes the importance of addressing the client's immediate emotional and psychological needs. Reassurance and comfort can help alleviate the client's distress and promote a sense of security, which is essential for their well-being.

A. Participation in group activities may be beneficial for some clients with schizophrenia but it is not the priority when the client is experiencing confusion and distortions in thinking.

B. Medication management is an important aspect of caring for clients with schizophrenia. However, the decision to administer PRN medications should be based on a comprehensive assessment of the client's symptoms and needs.

C. Distraction techniques may be helpful for managing symptoms of anxiety or agitation in some clients, but they are not the priority.

A. Variability in the effects of stressors based on socioeconomic status B. Increased sensitivity of older adult clients to risk factors C. Increased susceptibility among vulnerable groups D. Resilience of clients to risk factor

Correct Answer is C

Explanation

C. Vulnerable populations, such as those with low socioeconomic status, the elderly, racial and ethnic minorities, and individuals with certain health conditions, may experience higher levels of health risks due to various factors such as limited access to healthcare, environmental exposures, social determinants of health, and underlying health disparities.

A. Although variability of response to stressors is important it is not the primary concern

B. Although older individuals are vulnerable to risk factors, the nurse should include all vulnerable groups.

D. While resilience can mitigate the impact of risk factors on health outcomes, it is not a determinant of health risk itself.

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A nurse on a mental health unit is planning care for a client who has a new diagnosis of non- suicidal self-harm (NSSH). Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been diagnosed with schizophrenia and appears confused and has distortions in their thinking and speech patterns. Which of the following is the priority nursing intervention for this client?

Correct Answer is D

Explanation

A nurse is reviewing factors that determine a client's health risk with a newly licensed nurse. Which of the following factors should the nurse include?

Correct Answer is C

Explanation

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