The nurse working in the ED of an urban hospital notifies the manager that there are several clients with mental health disorders still present in the ED that have been there over 48 hours. Which issue related to this phenomenon does the nurse discuss with the manager?

Temporary detaining orders for clients.

The revolving door for clients.

Decision to practice boarding.

The cost of holding clients in the ED for over 48 hours.

Answer and Explanation

The Correct Answer is C

Boarding refers to the practice of holding patients in the emergency department (ED) for extended periods, often beyond the recommended timeframe, due to a lack of available mental health treatment options or appropriate placement. In this scenario, the nurse is notifying the manager about the presence of clients with mental health disorders who have been in the ED for more than 48 hours. This situation suggests that the hospital is likely practicing boarding for these clients.

Boarding of mental health patients in the ED can have significant negative consequences. It can contribute to overcrowding in the ED, leading to delays in care for other patients. It can also compromise the quality of care and exacerbate the distress and discomfort experienced by individuals with mental health disorders. Additionally, it is not an optimal environment for mental health treatment and recovery.

By discussing the issue of boarding with the manager, the nurse is addressing the need for timely and appropriate placement for clients with mental health disorders. This conversation may involve exploring solutions such as improving access to mental health services, establishing dedicated mental health units or crisis stabilization centers, and collaborating with community resources to ensure a smooth transition of care for these clients.

The other options mentioned are not directly related to the issue of clients with mental health disorders being present in the ED for over 48 hours:

● Temporary detaining orders for clients: This refers to legal mechanisms that allow for the temporary detention of individuals with mental health disorders who may pose a risk to themselves or others. While it may be related to the care of these clients, it does not address the issue of prolonged stays in the ED.

● The revolving door for clients: This concept refers to the frequent readmission or return of clients to the ED or hospital due to ongoing mental health issues. While it is a concern in mental health care, it does not specifically pertain to the issue of clients remaining in the ED for an extended period.

● The cost of holding clients in the ED for over 48 hours: While the cost implications of extended stays in the ED are relevant, the primary concern in this scenario is the quality of care, appropriate placement, and the impact on both the clients and the ED's functioning.

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Correct Answer is B

Explanation

A. “I can see you are anxious. Let's stop for a minute."This option interrupts the exposure process. In systematic desensitization, the goal is to continue exposure while employing relaxation techniques, so stopping would not promote the gradual reduction of anxiety.

B. “Use the deep breathing techniques we practiced yesterday."This statement encourages the client to utilize a relaxation technique (deep breathing) while facing their fear, which is the core of systematic desensitization. By practicing relaxation in the presence of the feared stimulus, the client learns to associate the stimulus with calmness rather than anxiety.

C. "What is the worst that will happen if you confront this fear?"This option uses a form of cognitive restructuring, which is more aligned with cognitive-behavioral therapy (CBT) rather than systematic desensitization. This focuses on changing thought patterns rather than gradually exposing the person to their fear while inducing relaxation.

D. “Tell me how you are feeling right now."While it is important for the client to reflect on their feelings, this option does not promote relaxation or directly help the client manage their anxiety response during exposure. It focuses more on emotional processing rather than applying the desensitization technique.

A. The client reports being unable to find anything meaningful within their life B. The client attributes life's problems to being without family support. C. The client is unable to find work and does not have enough money for housing D. The client states that they are discriminated against due to their country of origin. E. The client reports not belonging anywhere and is without family support

Correct Answer is ["B","C","D","E"]

Explanation

The client attributes life's problems to being without family support: Lack of family support can significantly impact an individual's mental health and well-being. It can lead to feelings of isolation, loneliness, and a lack of emotional support, potentially contributing to the development or exacerbation of mental illness.

The client is unable to find work and does not have enough money for housing: Financial instability, unemployment, and inadequate housing are social determinants of mental health. These factors can contribute to stress, anxiety, and a sense of hopelessness, which may impact the client's mental well-being.

The client states that they are discriminated against due to their country of origin: Experiencing discrimination based on one's country of origin can lead to feelings of marginalization, social exclusion, and psychological distress. Discrimination is a social factor that can contribute to the development of mental illness or exacerbate existing mental health conditions.

The client reports not belonging anywhere and is without family support: Feeling a lack of belonging or a sense of disconnectedness can have a negative impact on mental health. It can contribute to feelings of isolation, low self-esteem, and depression. Additionally, lacking family support further compounds the client's sense of not belonging, potentially affecting their mental well-being.

Incorrect:

The client reports being unable to find anything meaningful within their life: While this statement suggests a lack of purpose or fulfillment in the client's life, it does not specifically address social or cultural factors that could contribute to their mental illness. It may be important to explore further during the assessment to identify underlying issues, but it does not fall under the social/cultural category.

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The nurse working in the ED of an urban hospital notifies the manager that there are several clients with mental health disorders still present in the ED that have been there over 48 hours. Which issue related to this phenomenon does the nurse discuss with the manager?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting a client who is working on the technique of systematic desensitization. Which statement made by the nurse best uses the principle of technique?

Correct Answer is B

Explanation

The nurse is performing an admission assessment for a client admitted to the behavioral health unit. Which social/cultural category will the nurse document that may be contributing to the client's degree of mental illness? Select all that apply. (Select All that Apply.)

Correct Answer is ["B","C","D","E"]

Explanation

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