To determine the number of capsules the nurse will administer, we need to consider the dosage prescribed and the available strength of the capsules.

The prescription states: cephalexin (Keflex) 0.5 g p.o. qid (four times a day).

Given that the available strength of cephalexin capsules is 250 mg, we need to convert the prescribed dosage from grams (g) to milligrams (mg) to match the capsule strength.

1 g = 1000 mg

0.5 g = 0.5 * 1000 mg = 500 mg

Now we know that the prescribed dosage is 500 mg, and each capsule contains 250 mg.

To calculate the number of capsules needed, we divide the prescribed dosage by the strength of each capsule:

Number of capsules = Prescribed dosage / Capsule strength

Number of capsules = 500 mg / 250 mg

Number of capsules = 2

Therefore, the nurse will administer 2 capsules of cephalexin (Keflex) for each dose.

When creating a plan of care for a client attending a psychiatric rehabilitation program after being in inpatient care for relapsing schizophrenia, the primary outcome should be chosen based on the client's specific needs and goals. However, let's examine each option and explain why it may or may not be the primary outcome:

The client will have an improvement in the quality of life: Improving the quality of life is an essential aspect of mental health treatment. It encompasses various areas such as social functioning, relationships, occupational functioning, and overall well-being. Enhancing the client's quality of life is a significant outcome to consider, as it focuses on promoting overall

wellness and satisfaction.

Improving the quality of life encompasses a holistic approach to recovery, considering various aspects of well-being, functioning, and personal satisfaction. It aligns with the client-centered approach and acknowledges that each individual's goals and aspirations may differ. By focusing on enhancing the overall quality of life, it allows for a comprehensive and individualized plan of care that addresses the client's unique needs.

The other choices are incorrect because:

The client will have stabilization and management of symptoms: This outcome focuses on achieving stability and effective management of symptoms related to schizophrenia. It is a crucial goal in the treatment of schizophrenia, as it aims to reduce the frequency and intensity of symptoms, leading to an improved quality of life. While this outcome is important, it may not necessarily be the primary outcome because it is often a means to achieve broader goals.

The client will return to prior level of functioning: This outcome specifically targets returning the client to their previous level of functioning before the relapse of schizophrenia. It aims to restore the client's ability to perform daily activities, engage in social interactions, and pursue their personal goals. While this outcome can be meaningful for certain individuals, it may not be applicable or feasible for all clients, especially if their prior level of functioning was significantly impaired.

The client will be adherent to the medication regimen: Adherence to medication is crucial in managing schizophrenia and preventing relapses. It ensures that the client receives the appropriate treatment and helps maintain symptom stability. While medication adherence is an important aspect of treatment, it is typically considered a treatment process goal rather than a primary outcome. It supports the achievement of other outcomes such as symptom stabilization, improved quality of life, and functional recovery.

When creating a plan of care for a client experiencing a situational crisis, it is important to set measurable and obtainable goals that can guide the client's progress and provide clear indicators of achievement.

Considering the options provided, the most measurable and obtainable goal for the client experiencing a situational crisis would be:

The client will resume the pre-crisis level of functioning.

This goal is measurable as it involves assessing the client's functioning before the crisis and monitoring their progress in returning to that level. It is also obtainable as it focuses on restoring the client's previous abilities and skills, rather than relying on subjective or introspective factors. By setting specific criteria to determine the pre-crisis level of functioning and regularly evaluating the client's progress, the nurse can measure the client's achievement of this goal and adjust the plan of care accordingly.

The client will resume the pre-crisis level of functioning: Resuming the pre-crisis level of functioning is a measurable and obtainable goal. It involves identifying the client's previous level of functioning and working towards returning to that state. By assessing the client's functional abilities before the crisis and monitoring progress over time, it is possible to measure and track the extent to which they have regained their previous level of functioning.

The client will discover a new sense of self-sufficiency in coping: While this goal is important for the client's long-term growth and development, it is not easily measurable or obtainable in a specific timeframe. "Discovering a new sense of self-sufficiency" is a subjective and introspective process that may require extensive self-reflection and personal growth, making it difficult to measure and set a concrete timeline for achievement.

The client will express anger regarding the crisis event: Expressing anger can be a normal and healthy part of the healing process during a crisis. However, it is not necessarily the most

measurable or obtainable goal. The expression of anger can vary greatly among individuals, and it may not be an appropriate or necessary response for everyone. Additionally, the focus of the plan of care should extend beyond anger expression and encompass a broader range of emotions and coping strategies.

The client will identify possible causes for the crisis: While understanding the possible causes of the crisis can be an important part of the recovery process, it may not be the most measurable or obtainable goal on its own. Identifying the causes of a crisis can involve complex factors that may require professional assessment and a deeper exploration of the client's history and circumstances. It is more appropriate as an ongoing process within therapy rather than a specific goal with a clear endpoint.

The purpose of asking the client to describe their problems during the assessment is to obtain information about their perception of the problem. By asking the client to describe their problems

in their own words, the nurse gains insight into how the client perceives and understands their current situation. This information helps the nurse to understand the client's subjective experience, their concerns, and their specific needs related to the problem. It allows for a more accurate assessment of the client's situation and helps in developing an individualized plan of care tailored to their unique needs.

● Personal needs: While understanding a client’s personal needs is important in providing care, it is not the primary purpose of this specific question. The nurse may ask other questions to gather information about the client’s personal needs.

● Communication skills: Assessing a client’s communication skills may be important in some cases, but it is not the primary purpose of this specific question. The nurse may use other methods to assess the client’s communication skills.

● Admitting diagnosis: The admitting diagnosis is typically determined by a physician and is based on medical tests and examinations. While the nurse may gather information that can contribute to determining the admitting diagnosis, it is not the primary purpose of this specific question.

1 fluid ounce (fl oz) is equal to approximately 29.57 milliliters (ml). The conversion factor between fluid ounces and milliliters is not an exact value due to the difference between the U.S. fluid ounce and the metric milliliter. However, for most practical purposes, 1 fluid ounce is commonly rounded to 30 milliliters (ml) for simplicity.

The statements by the client that would require the nurse to notify the health care provider to cancel the MRI procedure are:

● “I had a pacemaker inserted a few years ago because my heart was not beating fast enough.”

● "I fell down my basement steps last year and broke my hip and had to have a hip replacement.”

● “When I was diagnosed with mitral valve prolapse, they had to replace the valve with a prosthetic valve."

These statements indicate that the client has metallic implants or devices in their body, which can be affected by the strong magnetic field of an MRI machine. This can pose a risk to the client’s safety and may interfere with the accuracy of the MRI results.

The other statements do not necessarily require the cancellation of the MRI procedure, but the nurse may need to take additional precautions or provide additional support to ensure the client’s comfort and safety during the procedure.

Here is a detailed explanation of why the other choices do not necessarily require the cancellation of the MRI procedure:

● “I have such terrible anxiety, I don’t know if I can remain still throughout the procedure.”: While anxiety can make it difficult for a client to remain still during an MRI procedure, it does not necessarily require the cancellation of the procedure. The nurse may provide additional support or medication to help the client manage their anxiety and remain still during the procedure.

● “I have diabetes mellitus type and have been taking insulin for many years.”: Having diabetes and taking insulin does not necessarily require the cancellation of an MRI procedure. The nurse may need to take additional precautions to ensure that the client’s blood sugar levels are stable during the procedure, but it does not pose a direct risk to the client’s safety or interfere with the accuracy of the MRI results.

The identification phase of the nurse-client relationship is characterized by the client feeling comfortable and secure enough to open up and share their feelings, emotions, and personal experiences with the nurse. It involves establishing trust and rapport, which allows the client to feel supported and understood by the nurse. Sharing feelings and emotions indicates that the client has reached a level of comfort and trust in the therapeutic relationship, making it a key indicator of the identification phase.

The other behaviors mentioned in the options are not specifically related to the identification phase:

● The client attending therapy sessions and utilizing services provided is an important aspect of engagement and active participation in the therapeutic process. However, it does not specifically indicate the identification phase of the relationship.

● The client stating that they feel the issues have been resolved and no longer need to come suggests the termination phase of the nurse-client relationship rather than the identification phase. The termination phase occurs when the client feels they have achieved their goals and no longer require ongoing therapy.

● The client answering questions related to the plan of care is a general indicator of communication and collaboration in the therapeutic process. It does not specifically signify the identification phase but rather active involvement in the treatment plan.

To convert pounds (lbs) to kilograms (kg), we need to use the conversion factor: 1 pound = 0.45359237 kilograms

Now, let's calculate the weight of the baby in kilograms:

Weight in kilograms = Weight in pounds * Conversion factor

Weight in kilograms = 10 lbs * 0.45359237 kg/lb

Weight in kilograms ≈ 4.5359237 kg

Therefore, the baby weighs approximately 4.54 kilograms.

Culturally competent care involves understanding and respecting the diverse cultural backgrounds of clients. It requires the nurse to acquire knowledge about the client's specific culture and how it influences their healthcare preferences and practices. By taking the time to learn about the client's cultural background, the nurse can better understand their unique needs, beliefs, and values related to health and healthcare.

While continuing education and gaining knowledge about different cultures are important aspects of providing culturally competent care, it is essential to go beyond generalized expectations about cultural groups. Each individual within a culture can have unique beliefs and preferences, so it is crucial to approach each client as an individual rather than relying solely on broad cultural stereotypes.

Behaving as appropriate for the nurse's own culture may lead to misunderstandings or misinterpretations of the client's needs and preferences. It is important for the nurse to be aware of their own cultural biases and to approach care in a culturally sensitive and respectful manner.

Therefore, the best approach for the nurse to provide culturally competent care is to find out as much as possible about the client's specific cultural values, beliefs, and health practices. This

knowledge can guide the nurse in tailoring care that is respectful, responsive, and appropriate for the client's cultural background.

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.