A. To create a safe and healing environment for the client: Trauma-informed care (TIC) focuses on providing a supportive, safe, and empowering environment for clients who have experienced trauma. The goal is not to force resolution but to foster trust, autonomy, and recovery.

B. To repair and resolve the client's trauma: While healing may occur, TIC does not aim to "resolve" trauma directly. Instead, it emphasizes understanding the impact of trauma and reducing retraumatization.

C. To focus solely on the client's trauma history: TIC considers the trauma history but also focuses on the present needs, coping strategies, and overall well-being of the client. It does not exclusively dwell on past trauma.

D. To minimize the client's trauma manifestations: The goal is not to suppress trauma symptoms but to acknowledge them, provide appropriate care, and promote a sense of safety and control for the client.

A. "Allow the client's family to attend all group therapies with the client." While family involvement can be beneficial, a client’s autonomy and confidentiality must be respected. Some clients may not feel comfortable sharing in the presence of family members.

B. "Listen attentively to a client and summarize their comments." Active listening and summarization demonstrate empathy and understanding, reinforcing the therapeutic relationship. This technique also helps ensure that the nurse accurately understands the client's concerns.

C. "Asking questions easily answered with one-word responses is important with mental health clients." Closed-ended questions limit the client’s ability to express emotions and thoughts, which can hinder the therapeutic process. Open-ended questions encourage meaningful discussion.

D. "Avoid asking clients direct questions regarding suicidal behaviors or thoughts." It is essential to directly ask about suicidal thoughts in a nonjudgmental manner. Avoiding these questions can lead to missed warning signs and inadequate intervention.

A. Sharing patient information with a family member without consent. This violates patient confidentiality unless the patient has given explicit consent or the family member is a legal guardian in the case of minors or incapacitated patients.

B. Talking about patient care in a public setting where others might overhear. This breaches confidentiality and violates HIPAA regulations. Discussions about patient care should occur in private settings.

C. Releasing information to authorities if the patient poses a threat to themselves or others. Healthcare professionals are legally and ethically obligated to breach confidentiality if a patient poses a risk of harm to themselves or others. This falls under the duty to warn and protect principle.

D. Discussing patient details with another healthcare provider who is not involved in the patient's care. Only healthcare providers directly involved in the patient’s care should have access to their medical information. Sharing details with unauthorized providers is a confidentiality breach.

A. Taking on extra shifts to compensate for staffing issues. Overworking increases stress and exhaustion, contributing to burnout rather than preventing it. Nurses need adequate rest to provide quality care.

B. Neglecting to seek support from colleagues and supervisors. Avoiding support leads to isolation and increased emotional distress. Seeking help from colleagues, supervisors, or mental health professionals is crucial in managing stress.

C. Maintaining a balanced diet and regular exercise. Proper nutrition, physical activity, and self-care help nurses maintain physical and mental well-being, reducing burnout risk.

D. Avoiding self-care activities to focus solely on work. Self-care is essential for long-term resilience in nursing. Ignoring personal well-being to prioritize work leads to exhaustion and decreased job satisfaction.

A. "Do you need any more resources or information?" This question focuses on resource provision rather than emotional clarification. While important, it does not specifically invite the client to explore their feelings.

B. "You feel like you have the support needed to be successful." This is a statement, not a question, and may lead the client to agree rather than express their true emotions. A better approach would involve open-ended questioning.

C. "Tell me what kind of coping skills you have." This open-ended question encourages the client to reflect on their coping mechanisms and emotional responses, facilitating deeper discussion and emotional clarification.

D. "Do you understand your next step in treatment?" This focuses on treatment adherence rather than the client’s emotions. While important for education, it does not directly encourage emotional exploration.

A. "Competency and capacity are often discussed as being the same thing, but they are different." Competency is a legal determination made by a court, while capacity is a clinical assessment made by healthcare providers. Although they are related, they are distinct concepts.

B. "Capacity and competency are the same thing and can be used interchangeably." This is incorrect because capacity refers to a person's ability to make a decision at a specific moment, while competency is a broader legal determination regarding decision-making ability.

C. "A client who has been deemed legally incompetent can provide informed consent for treatment." A legally incompetent client cannot provide informed consent. Instead, a legally designated surrogate (guardian or power of attorney) makes medical decisions on their behalf.

D. "Competency and capacity are rarely a concern when caring for clients who have a mental illness." Mental illness can impact decision-making capacity, making assessments crucial. Competency and capacity evaluations are common in mental health settings, especially for clients with cognitive impairment or psychosis.

A. Autonomy refers to a client’s right to make their own decisions regarding care. Allowing them to choose between morning and afternoon therapy respects their independence and decision-making ability.

B. Justice refers to fairness and equal treatment in healthcare. While offering a choice is ethical, it is not related to ensuring fair resource distribution.

C. Beneficence means acting in the best interest of the client to promote well-being. While giving choices can be beneficial, this scenario specifically highlights autonomy.

D. Nonmaleficence means "do no harm." While respecting choices can prevent distress, this principle is more related to avoiding harm rather than promoting independence.

A. "The gathering spaces should have the chairs positioned around the perimeter of the day room." Seating arrangements should encourage interaction and engagement, not isolation. A circular arrangement fosters group discussion and socialization.

B. "The milieu consists of the physical and psychosocial environmental factors." Therapeutic milieu refers to the structured environment of a mental health unit, which includes both physical (safety, layout) and psychosocial (staff interactions, routines) components that support healing.

C. "The clients can keep any personal items they would like in their rooms." While personal items can be comforting, safety concerns may limit what clients can keep. Sharp objects, lighters, or items that could be used for self-harm are typically restricted.

D. "A therapeutic milieu requires unstructured programming, allowing clients to focus on their interests." A structured routine is essential in a therapeutic milieu to promote stability, predictability, and therapeutic engagement. Unstructured environments may increase anxiety or behavioral issues.

A. Cultural humility involves recognizing and respecting differences in beliefs and values while maintaining self-awareness. It does not explain erratic emotional responses.

B. Countertransference occurs when a nurse projects personal emotions onto a client, leading to overinvolvement (excessive kindness) or negative reactions (hostility). This can affect professional boundaries and care.

C. Transference occurs when a client unconsciously transfers feelings about past relationships onto the nurse (e.g., treating the nurse as a parental figure). This is the reverse of countertransference.

D. Professional competency refers to maintaining clinical skills and ethical behavior. Displaying inconsistent emotional responses toward a client is not an example of competency.

A. The client must be calm and cooperative. Restraints should be removed as soon as the client is calm and no longer poses a threat to themselves or others. Continued use without justification can be considered unethical and unlawful.

B. The client must verbalize remorse for their behavior. Remorse is not a requirement for restraint removal. Some clients may lack insight into their actions due to mental illness or cognitive impairment. The focus should be on safety, not forced expressions of regret.

C. The client only verbalizes anger toward the staff. Expressing anger alone is not a justification for continued restraint. As long as the client is not aggressive or violent, they should not remain restrained.

D. The provider who prescribed the restraints must be present to assess the client before the restraints can be removed. Nurses can remove restraints without the provider physically present if the client meets the criteria for release. However, they must document the assessment and notify the provider.