A nurse in a mental health facility is contributing to the plan of care for a new client. Which of the following actions should the nurse plan to include in the working phase of the nurse-client relationship?

Determine whether the client's goals are met.

Collect data about the client's current health status.

Provide the client with information on problem-solving.

Establish a regular meeting time with the client.

Answer and Explanation

The Correct Answer is C

Choice A reason: Determining whether the client's goals are met is part of the evaluation phase of the nurse-client relationship. This phase comes after the working phase and focuses on assessing the outcomes of the interventions and the progress made toward achieving the client's goals.

Choice B reason: Collecting data about the client's current health status is typically part of the assessment phase, which occurs at the beginning of the nurse-client relationship. During this phase, the nurse gathers comprehensive information about the client's physical, psychological, and social health to inform the care plan.

Choice C reason: Providing the client with information on problem-solving is an essential component of the working phase of the nurse-client relationship. During this phase, the nurse and client work collaboratively to address issues, develop coping strategies, and implement interventions aimed at improving the client's mental health. Teaching problem-solving skills helps empower the client to manage their condition effectively.

Choice D reason: Establishing a regular meeting time with the client is part of the orientation phase of the nurse-client relationship. In this initial phase, the nurse and client get to know each other, build rapport, and establish the parameters for the relationship, including setting up regular meetings.

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Correct Answer is B

Explanation

Choice A reason: Delirium is characterized by an acute onset, typically developing over hours to a few days. It is a sudden change in mental status that differs from conditions like dementia, which have a gradual onset. Therefore, gradual onset is not a characteristic finding of delirium.

Choice B reason: Impaired judgment is a common finding in delirium. Clients with delirium often have fluctuating levels of consciousness, attention deficits, and disorganized thinking, all of which can contribute to poor judgment. This cognitive impairment can lead to unsafe behaviors and difficulty in making decisions.

Choice C reason: Difficulty swallowing, or dysphagia, is not typically associated with delirium. Dysphagia is more often related to neurological conditions such as stroke, Parkinson's disease, or other disorders affecting the muscles involved in swallowing. While clients with delirium may have various physical symptoms due to underlying causes, difficulty swallowing is not a direct symptom of delirium itself.

Choice D reason: Slowed, flat speech is not a typical finding in delirium. Clients with delirium may exhibit rapid, incoherent, or disorganized speech due to their altered mental state. Slowed, flat speech is more commonly seen in conditions like depression or certain types of dementia rather than in acute delirium.

A. The client's home has lead paint on the walls. B. The client's twin sibling has schizophrenia. C. The client is opioid dependent. D. The client's mother used tobacco products during pregnancy.

Correct Answer is B

Explanation

Choice A reason: Lead paint exposure is associated with various health issues, particularly in children, but it is not a recognized risk factor for schizophrenia. Lead poisoning can cause cognitive and behavioral problems, but it does not directly increase the risk of developing schizophrenia.

Choice B reason: Having a family member, especially a twin sibling, with schizophrenia significantly increases the risk of developing the condition. Genetics play a crucial role in the development of schizophrenia, and individuals with a first-degree relative who has schizophrenia are at a higher risk of developing the disorder.

Choice C reason: Opioid dependence is associated with various mental health issues, including depression and anxiety, but it is not a direct risk factor for schizophrenia. Substance abuse can exacerbate existing mental health conditions, but it does not inherently cause schizophrenia.

Choice D reason: While maternal tobacco use during pregnancy is linked to various adverse outcomes, including low birth weight and developmental issues, it is not specifically identified as a risk factor for schizophrenia. The relationship between prenatal tobacco exposure and schizophrenia is not well-established.

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A nurse in a mental health facility is contributing to the plan of care for a new client. Which of the following actions should the nurse plan to include in the working phase of the nurse-client relationship?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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