Following the visit, what are appropriate actions for the nurse? Select all that apply.

Mail education items to the home for batterer treatment options

Provide referrals from the physician for mental health services

Follow up with the client in a few weeks

Call the police as a mandatory reporter

Document verbatim statements about the abuse

Answer and Explanation

Correct Answer : B,C,E

A.   Mailing education items to the home for batterer treatment options might not be appropriate without the client's consent or discussion.
B.   Providing referrals for mental health services aligns with addressing the client's needs.
C.   Following up with the client in a few weeks ensures continuity of care and monitoring of the client's progress.
D.   Calling the police as a mandatory reporter might be necessary if there's an immediate threat, but it's not mentioned in the scenario.
E.   Documenting verbatim statements about the abuse is crucial for accurate record-keeping and legal purposes.

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Correct Answer is D

Explanation

A. White blood cell count might be relevant for other conditions but is not specific to NMS.
B. 24-hour urinary output might help evaluate kidney function but is not specific to NMS.
C. Blood sugar level might be important but is not the primary indicator of NMS.
D. Vital signs, such as temperature, blood pressure, heart rate, and respiratory rate, are crucial in assessing for NMS as it typically presents with changes in these parameters.

A. Determine if the mother has other children who do not have developmental disabilities. B. Ask the mother if she has ever thought about harming herself or her child. C. Encourage the mother to write thoughts and feelings in a journal. D. Reassure the mother that her child will achieve some growth and development milestones.

Correct Answer is B

Explanation

A. Inquiring about the mother's other children might not directly address her current emotional distress and might not be an immediate concern.
B. Asking if the mother has ever thought about harming herself or her child is essential to assess the severity of her depressive thoughts and the risk of harm.
C. Encouraging journaling can be helpful as part of coping, but in this context, addressing immediate concerns about self-harm is more crucial.
D. Reassurance is important, but in this case, providing false hope or assurance about achieving milestones may not be realistic and might not address the mother's current distress.

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Following the visit, what are appropriate actions for the nurse? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

The mother of an 8-month-old infant with profound mental and physical disabilities tells the nurse how depressed she is because she realizes that her child will never achieve normal growth and development milestones. How should the nurse respond to this mother?

Correct Answer is B

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?

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 female college student is admitted to the mental health unit following a drug overdose. The student tells the nurse that she took the overdose following the end of a romantic relationship. Which is the primary goal for hospitalization that should be included in this client's plan of care?

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?

An antidepressant medication is prescribed for a client who reports sleeping only four hours in the past two days and a weight loss of nine pounds within the last month. Which client goal is most important to achieve within the first three days of treatment?

Prior to initiating a treatment regimen with the antidepressant sertraline, it is most important for the nurse to obtain which information?