A nurse on a mental health unit is planning care for a client who has a new diagnosis of non- suicidal self-harm (NSSH). Which of the following interventions should the nurse include in the plan?
Explain to the client that self-harm behaviors do not increase their risk for accidental death.
Inform the client that self-harm behavior cannot become a serious problem in the future.
Encourage the client to identify the emotions they feel immediately before performing the self- harm behavior.
Place the client in one-on-one direct observation due to overt suicidal intent.
The Correct Answer is C
C Encouraging the client to identify the emotions they feel immediately before performing the self-harm behavior is an important intervention. It can help the client develop insight into triggers and underlying emotions that contribute to the behavior. Identifying and addressing these emotions can be a crucial step in developing healthier coping mechanisms.
A. It is crucial to convey the potential risks associated with self-harm and emphasize the importance of seeking help and safer coping strategies.
B. Non-suicidal self-harm is a significant concern that requires attention and appropriate intervention. While NSSH does not necessarily indicate immediate suicidal intent, it can indicate significant distress
D. NSSH does not necessarily indicate suicidal intent, and placing the client in constant observation without clinical justification may be intrusive and undermine therapeutic rapport.
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Related Questions
Correct Answer is B
Explanation
B. Experiencing cyberbullying can have significant negative effects on an adolescent's mental health and well-being. Addressing cyberbullying promptly is crucial to ensuring the client's safety and mental health.
A. Journaling their feelings about their sister's death suggests that they are actively processing their emotions, which can be a healthy coping mechanism.
C. Addressing dietary habits and providing education on healthy eating is important but it may not be as urgent as addressing issues such as cyberbullying or mental health concerns.
D. While supporting the client with managing their allergies is important, it may not be the priority for immediate intervention compared to issues such as cyberbullying or mental health concerns.
Correct Answer is A
Explanation
A. Dissociative amnesia involves difficulty remembering important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. In the case of a client who has been sexually assaulted and is having difficulty remembering events related to the assault, dissociative amnesia is the likely experience.
B. Depersonalization/derealization disorder involves persistent feelings of detachment from oneself or one's surroundings. While this condition can occur in response to trauma, it typically involves a sense of detachment rather than memory loss.
C. Dissociative identity disorder (DID) involves the presence of two or more distinct personality states, each with its own pattern of perceiving and interacting with the world.
D. Factitious disorder involves the deliberate falsification or exaggeration of physical or psychological symptoms in oneself. It is not directly related to memory loss or difficulty remembering events.
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