A nurse is assessing a client who has a mental illness. Which of the following factors are important when assessing social determinants of mental health? (Select all that apply)
Living in a homeless shelter
Access to a grocery store
Employed part-time at minimum wage
History of diabetes mellitus
Owning a small dog
Correct Answer : A,B,C
Rationale:
A. Living in a homeless shelter is a significant social determinant that can impact mental health due to instability, lack of privacy, and increased stressors.
B. Access to a grocery store is important because food insecurity and lack of access to nutritious food can negatively affect mental and physical health.
C. Being employed part-time at minimum wage can contribute to financial stress, impacting mental health due to economic instability and potential lack of access to healthcare.
D. While a history of diabetes mellitus is relevant to overall health, it is not a direct social determinant of mental health.
E. Owning a small dog may have a positive impact on mental health due to companionship but is not a primary social determinant in this context.
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Correct Answer is D
Explanation
Rationale:
A. Reviewing the client's history and reading progress notes are important for understanding the client's situation but are secondary to ensuring the nurse's readiness.
B. Reviewing current provider prescriptions is relevant but does not address the immediate need for self-preparation.
C. Performing self-reflection is essential to ensure that the nurse is emotionally prepared and empathetic, which is crucial when dealing with clients experiencing significant grief.
D. Performing self-reflection is the most critical first step as it ensures the nurse is emotionally prepared and able to provide empathetic and non-judgmental support to the client during a difficult time.
Correct Answer is ["B","D","E","F"]
Explanation
A. The ECG shows persistent sinus bradycardia on both December 1 and December 15. While sinus bradycardia is common in anorexia nervosa, its persistence may not necessarily reflect a therapeutic response.
B. The respiratory rate improved from 24/min to 20/min and the respirations are described as even and unlabored on December 15. This indicates a positive response to treatment.
C. The temperature data for December 15 is not provided. However, an increase toward normal temperature would indicate a therapeutic response, but without this data, we cannot confirm.
D. The weight increased from 34.5 kg (76 lb) to 37.2 kg (82 lb), which is a significant therapeutic improvement, reflecting progress in treatment.
E. The sodium level improved from 128 mEq/L to 130 mEq/L. Although the level is still slightly below normal, the upward trend indicates improvement.
F. The creatinine level decreased from 1.2 mg/dL to 0.9 mg/dL, showing improvement in kidney function and response to treatment.
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