A nurse is reviewing the medical record of a 50-year-old male client who has schizophrenia in an inpatient mental health facility

Exhibits

Which of the following findings should the nurse report to the provider? (Select all that apply.)

Choice A rationale

"Who do you talk to when you are upset?" explores the client's social support system, which is a critical component of their psychosocial status. Social support can buffer stress, provide emotional comfort, and contribute to overall well-being. Understanding who the client relies on for support helps assess their coping mechanisms and social connectedness.

Choice B rationale

"Do you have medical insurance?" pertains to the client's access to healthcare resources and socioeconomic status. While these factors can influence overall well-being, they are not direct indicators of the client's psychosocial status, which focuses more on their mental, emotional, and social functioning.

Choice C rationale

"When did you last have a mammogram?" is a question related to the client's physical health and preventive care practices, specifically relevant for female clients. It does not directly assess their psychosocial status, which encompasses their emotional state, social interactions, and coping abilities.

Choice D rationale

"How old were you when you started your menses?" is a question about the client's sexual and reproductive health history, relevant for female clients. While significant life events can indirectly impact psychosocial well-being, this specific question does not directly assess their current emotional state, social relationships, or coping mechanisms.

Choice A rationale

Seeking out a staff member during urges to self-harm demonstrates the effectiveness of a verbal safety contract. This behavior indicates the client is adhering to the agreement by reaching out for support instead of acting on the urges, signifying an increased ability to manage self-destructive impulses through communication and engagement with the treatment team.

Choice B rationale

Spending time alone when experiencing overwhelming feelings might indicate avoidance rather than effective coping. While some alone time can be therapeutic, relying solely on isolation could prevent the client from practicing new coping skills and engaging with support systems, potentially undermining the safety contract's goal of seeking help.

Choice C rationale

Avoiding discussion of difficult emotions with the treatment team suggests a lack of trust or engagement in the therapeutic process. An effective safety contract relies on open communication about feelings and urges to ensure the client receives timely support and can work through difficult emotions in a safe environment.

Choice D rationale

Attempting to suppress feelings of anger and frustration is an unhealthy coping mechanism. Suppressing emotions can lead to a buildup of internal tension, potentially increasing the likelihood of acting on self-harm urges. A safety contract aims to help the client identify and express emotions in constructive ways, not suppress them.