A nurse is caring for a newly admitted client who has obsessive-compulsive disorder.
Which of the following actions should the nurse take first? .

The nurse has reviewed the nurses' notes, provider's note, and vital signs at 0400.

Nurses' Notes 0205: Client brought to the ED by police after being found wandering on the street.

Client able to provide identity to police but not able to identify place or time.

Family notified.

0230: Client confused and agitated.

Appearance is disheveled.

Mucous membranes dry.

Lungs clear and equal, heart rhythm regular.

During data collection, the client states, "Can you ask that person to leave my room?" Client is pointing to an empty chair.

The client's adult child arrived at the ED and went to the client's room.

The client identified the family member.

The client is pacing and agitated and states, "I don't understand why I am here.”. The adult child asks the nurse to talk outside of the room and states, "I don't know why they are so confused.

They are not normally like this.”. The adult child.

Which of the following interventions should the nurse include in the client's care? Select the 3 interventions the nurse should implement.

Approach client slowly.

Alternate nursing staff daily.

Maintain a low stimulation environment.

Reorient client to person, place, and time frequently.

Provide the client with limited information about the diagnosis.

A nurse is collecting data from an adult client in an outpatient mental health clinic.
The nurse should identify which of the following events as a potential cause of a maturational crisis?.

A nurse is caring for a client who becomes extremely agitated and asks if they can go to a separate room to be alone for an hour.
The nurse should document which of the following de-escalation techniques in the client's medical record?.

A nurse is contributing to the plan of care for a client who has a new prescription for lithium.
Which of the following interventions should the nurse recommend?.

A nurse is assisting with reminiscence therapy for a group of older adult clients.
Which of the following strategies should the nurse implement? .

A nurse is reviewing the medical record of a client who is to receive electroconvulsive therapy.
The nurse should notify the provider for which of the following findings?.

A nurse is assisting with teaching a group of older adult clients about behavioral expectations.
Which of the following actions should the nurse take to help eliminate barriers to learning?.

A nurse is preparing to administer sertraline 50 mg PO once daily to a client who has depressive disorder.

Available is sertraline oral solution 20 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth.

Use a leading zero if it applies.

Do not use a trailing zero.).

A nurse is caring for multiple clients on a mental health unit.
Which of the following clients should the nurse attend to first?.

A nurse is caring for a client who experienced a fall.

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to collect data about the client's progress.