A nurse is assisting in the admission of a 30-year-old client to an inpatient mental health facility.

Exhibits

For each finding, click to specify if the finding is consistent with opioid, stimulant, or hallucinogen intoxication. Each finding may be consistent with more than 1 substance or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Choice A rationale

Asking "Do you feel like your anger is becoming more manageable?" directly assesses the client's subjective experience of their anger levels. This is a crucial indicator of the treatment's effectiveness as it reflects the client's internal perception of change in their emotional regulation. While objective measures are also important, the client's self-report provides valuable insight into the practical impact of therapy on their daily life.

Choice B rationale

Asking "What do you do when something makes you angry?" explores the client's behavioral responses to anger-provoking situations. While this provides information about their coping mechanisms, it doesn't directly evaluate whether their anger is becoming more manageable overall. The client might still be engaging in maladaptive behaviors even if they are learning new strategies.

Choice C rationale

Asking "Did you learn any coping strategies from your counselor?" assesses the client's acquisition of new skills taught in therapy. While learning coping strategies is a goal of anger management, it doesn't necessarily indicate that the client is effectively applying these strategies or experiencing a reduction in the intensity or frequency of their anger.

Choice D rationale

Asking "Have you been attending your anger management group?" evaluates the client's adherence to the treatment plan. While attendance is important for progress, it doesn't directly measure the effectiveness of the therapy itself. A client may attend sessions without actively engaging or experiencing a reduction in their anger.

The findings that indicate possible partner violence and should be reported to the provider include:

• Bruises noted in various stages of healing to the face, bilateral arms, and abdomen.
• Client is tearful, does not make eye contact, and only speaks when spoken to.
• Client reports poor appetite and difficulty sleeping.
• Client requests not to notify their partner because they do not want them to have to miss work or worry.
• Client states, “I fell getting out of the shower and scraped my face and shoulder on the bathroom counter. I tried to catch myself when I fell, and that is how I broke my arm.”

These signs, particularly the bruising in different healing stages, avoidance of eye contact, emotional distress, reluctance to notify the partner, and vague or inconsistent injury explanations, may indicate potential intimate partner violence. Ensuring proper screening, support, and intervention is crucial in situations like these. The client’s safety and well-being should remain a priority, and reporting these findings to the healthcare provider allows for further assessment and assistance.