During the admission assessment to the mental health unit, a client reports that the people at the office, where the client works, are antagonistic, and the client is thinking of shooting the supervisor. The client asks the nurse not to reveal this to anyone else. The nurse immediately notifies the client's therapist and other team members of the client's thoughts. The therapist then calls the client's supervisor and shares the client's thoughts about shooting the supervisor. Which outcome is best based on the action of the nurse?

Both the nurse and therapist are reprimanded for divulging confidential patient information to others.

The nurse and therapist will be asked to educate other team members on appropriate sharing of client information.

The nurse is reprimanded for divulging confidential patient information without obtaining informed consent.

The therapist is reprimanded for divulging confidential patient information without obtaining consent.

Answer and Explanation

The Correct Answer is B

A.   Both the nurse and therapist took action to ensure safety; therefore, reprimanding might not be appropriate.
B.   The best outcome is an educational approach for the team to understand appropriate information sharing in cases of potential harm to others while maintaining patient confidentiality.
C.   The nurse's immediate notification was based on safety concerns, which may take precedence over obtaining informed consent.
D.   The therapist's action aimed at ensuring safety but might have breached confidentiality without explicit consent.

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Correct Answer is A

Explanation

A. This comment is crucial as it involves access to lethal means, which is a significant risk factor for suicidal behavior.
B. While feelings of emptiness are concerning, it might not immediately indicate imminent danger.
C. Panic attacks might signify anxiety, but this statement doesn't directly suggest an immediate risk of harm.
D. While the daughter being a reason to keep trying is positive, it doesn't address the immediate risk of access to firearms.

A. Provide for personal space. B. Stand in the doorway. C. Request backup from the staff D. Encourage the client to sit down.

Correct Answer is A

Explanation

A. Providing personal space allows the client to feel less threatened and gives them room to express their emotions without feeling cornered.
B. Standing in the doorway might block the client's exit and could escalate the situation.
C. Requesting backup might be necessary in some situations but should not be the initial response to the client's agitation.
D. Encouraging the client to sit down might not be well-received and could escalate the situation further.

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Naxlex Comprehensive Predictor Exams

A client is admitted to the hospital with suicidal ideation. When completing the health history and admission assessment interview, which client comment is most important for the nurse to document?

Correct Answer is A

Explanation

When responding to a call light, the nurse finds a client with aggressive behaviors pacing and restless in the room. The client shouts, "What took you so long to get in here!" Which action should the nurse implement?

Correct Answer is A

Explanation

A client with schizophrenia returns to the clinic two weeks after receiving a prescription for haloperidol. To assess for neuroleptic malignant syndrome (NMS), which information is most important for the nurse to obtain during this visit?

A client with post-traumatic stress disorder (PTSD) is admitted to the psychiatric unit. Which intervention is most important for the nurse to include in this client's plan of care?

The nurse plans to use role-playing as a therapeutic measure. Which individual is most likely to benefit from this type of therapeutic intervention?

A client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. Which intervention is best for the nurse to implement?

A client with depression does not want to communicate with friends, uses television watching as a means of escaping responsibilities, and describes the inability to handle personal circumstances. Which coping strategy should the nurse include in the plan of care?