A nurse on an acute care mental health unit is examining the belongings of a client who is being admitted following a suicide attempt. Which of the following belongings should the nurse ask the client's partner to take back home? (Select all that apply)
Necklace
Lace-up tennis shoes
Nylon ankle socks
Cotton underwear
A glass-framed picture
Correct Answer : A,B,E
Choice A reason:
A necklace can pose a risk for clients with suicidal tendencies as it can be used to inflict self-harm. In an acute mental health unit, it is crucial to remove any items that could potentially be used in another suicide attempt. The nurse should ensure that the environment is safe and free from objects that could be used for hanging or strangulation.
Choice B reason:
Lace-up tennis shoes have laces that can be removed and used by the client to harm themselves. It is a standard safety precaution in mental health units to remove any items with strings or laces, such as belts, drawstrings, or shoe laces, to prevent their use in self-harm or suicide attempts.
Choice C reason:
Nylon ankle socks are generally considered safe and do not typically need to be removed. They do not pose a significant risk for self-harm. Therefore, the client can keep these for personal comfort and hygiene.
Choice D reason:
Cotton underwear is a basic necessity and does not present a risk for self-harm. It is important for the client's dignity and hygiene to have access to personal undergarments while in the mental health unit.
Choice E reason:
A glass-framed picture, while sentimental, poses a risk due to the glass, which can be broken and used to inflict self-harm. For safety reasons, any items made of glass or other breakable materials should be removed from the client's access in a mental health unit.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Aspirin is not used to reverse the effects of opioids. It is an anti-inflammatory drug that can reduce pain and fever, but it does not have the capability to counteract opioid effects.
Choice B reason: Acetaminophen, also known as Tylenol, is a pain reliever and a fever reducer. It does not have the properties to reverse opioid overdoses and is not an antidote for opioids.
Choice C reason: Naloxone is the correct medication to reverse the effects of opioids. It is an opioid antagonist that can quickly restore normal breathing in a person if their breathing has slowed or stopped because of an opioid overdose. Naloxone binds to opioid receptors and can reverse and block the effects of other opioids.
Choice D reason: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, fever, and inflammation. Like aspirin and acetaminophen, it does not reverse the effects of an opioid overdose.
In conclusion, naloxone is the medication that is used to reverse the effects of opioids in the case of an overdose. It is a critical drug in emergency situations involving opioids and can save lives by reversing life-threatening respiratory depression caused by opioid overdose. Healthcare providers should be prepared to administer naloxone and provide appropriate follow-up care after its use.
Correct Answer is B
Explanation
Choice A reason:
Locking the doors and securing windows may prevent an escape attempt, but it does not address immediate risks within the client's environment. It can also make the client feel trapped or punished, which could exacerbate their distress.
Choice B reason:
Removing any objects that could be used for self-harm is a direct intervention that reduces immediate risk. It is a standard safety precaution in managing suicidal clients and helps create a safer environment while further assessments and interventions are planned.
Choice C reason:
Providing plastic eating utensils is a safety measure, but it is not as comprehensive as removing all objects that could be used for self-harm. This action should be part of a broader strategy to ensure safety.
Choice D reason:
Assigning a staff member to stay with the client can provide supervision and prevent an attempt at self-harm. However, it may not be feasible as a long-term solution and does not remove the means for self-harm.
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