A nurse is admitting a client who has posttraumatic stress disorder (PTSD) to a community mental health facility. Which of the following manifestations should the nurse expect when completing the admission assessment?

“Decreased startle response to loud noises.”

“Reports uninterrupted sleep of 10 to 12 hr each night.”

“Reluctance to discuss the event that precipitated the distress.”

“Reports feelings of acute distress that began to 2 weeks ago.”

Answer and Explanation

The Correct Answer is C

A. “Decreased startle response to loud noises.”: Individuals with PTSD often have an exaggerated startle response to loud noises or unexpected stimuli. This heightened startle response is a common symptom of hyperarousal associated with PTSD. Therefore, a decreased startle response would be unexpected in this context.

B. “Reports uninterrupted sleep of 10 to 12 hr each night.”: Sleep disturbances are common among individuals with PTSD. Symptoms can include difficulty falling asleep, staying asleep, or experiencing nightmares related to the traumatic event. Therefore, reports of uninterrupted sleep for 10 to 12 hours each night would be unexpected in someone with PTSD.

C. “Reluctance to discuss the event that precipitated the distress.”: Avoidance of trauma-related thoughts, feelings, or reminders is a hallmark symptom of PTSD. Individuals with PTSD often avoid discussing or thinking about the traumatic event to cope with distressing memories or emotions. Therefore, reluctance to discuss the precipitating event is a common manifestation of PTSD.

D. “Reports feelings of acute distress that began 2 weeks ago.”: PTSD symptoms typically develop shortly after experiencing a traumatic event, but the diagnosis of PTSD requires that symptoms persist for at least one month. Acute distress that began two weeks ago may indicate an acute stress reaction rather than PTSD. PTSD involves persistent symptoms beyond the acute phase of the trauma.

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Correct Answer is B

Explanation

A. A client who is a voluntary admission does not have the right to request to be discharged.

This statement is incorrect. Clients admitted voluntarily to a mental health unit have the right to request discharge from the facility. However, there may be specific procedures and legal requirements to be followed for discharge, but the client ultimately has the right to request it.

B. A client who is admitted involuntarily has the right to refuse to participate in therapy.

This statement is generally true. Even if a client is admitted involuntarily, they still retain certain rights, including the right to refuse treatment such as therapy. However, there may be situations where treatment is deemed necessary for the client's safety or the safety of others, and in such cases, treatment may be provided against the client's wishes following appropriate legal processes.

C. A client who is admitted involuntarily cannot refuse to take prescribed psychotropic medications.

This statement is generally false. While involuntary admission may involve certain limitations on the client's autonomy, such as restrictions on leaving the facility, clients generally retain the right to refuse medications, including psychotropic medications. However, there are exceptions to this rule, such as when a client's refusal poses an imminent risk to their safety or the safety of others, in which case treatment may be provided following legal procedures.

D. A client who is a voluntary admission cannot withdraw consent after it has been given.

This statement is incorrect. Clients who are admitted voluntarily have the right to withdraw their consent for treatment or participation in any aspect of their care, including interventions previously agreed upon. However, similar to involuntary admissions, there may be situations where treatment is deemed necessary for the client's well-being, and in such cases, withdrawal of consent may be overridden following appropriate legal processes.

A. These clients can receive packages after they are privately inspected by security. B. These clients cannot be considered for a research study. C. These clients can vote in local and federal elections. D. These clients cannot refuse their prescribed antipsychotic medications.

Correct Answer is C

Explanation

A. These clients can receive packages after they are privately inspected by security: While security measures may be in place to ensure the safety and appropriateness of packages received by clients in a mental health facility, the ability to receive packages is not necessarily dependent on the client's involuntary admission status. Policies regarding package inspections may vary by facility and are not specific to involuntary admission status.

B. Involuntarily admitted clients can be considered for research studies, provided they give informed consent and the study meets ethical guidelines.

C. Clients who are involuntarily admitted retain their right to vote, provided they meet the usual eligibility requirements for voting. Their legal status regarding involuntary admission does not affect their voting rights.

D. Involuntarily admitted clients do have the right to refuse medications, unless a court order mandates treatment or an emergency situation exists where the client poses a danger to themselves or others.

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A nurse is admitting a client who has posttraumatic stress disorder (PTSD) to a community mental health facility. Which of the following manifestations should the nurse expect when completing the admission assessment?

Nursing Test Bank

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