A nurse working on a psychiatric unit receives a telephone call from a client’s employer. The employer asks for a copy of the client’s latest laboratory work and psychological testing results so that the client’s medical records in employee health can be updated. Based on the nurse’s knowledge of breach of confidentiality, which response would be appropriate?

“Sure, give me your address, and I will see that the information is sent to you.”

“I’ll have to get the client’s signed consent before we can send that information to you.”

“I’m sorry, we’re not allowed to give out that information about our client.”

“I am unable to acknowledge whether or not your employee is a client on this unit.”

Answer and Explanation

The Correct Answer is D

Choice A reason:
Agreeing to send the information without the client’s consent is a breach of confidentiality. Healthcare providers must protect patient privacy and cannot disclose medical information without explicit permission from the client.
Choice B reason:
While obtaining the client’s signed consent is necessary before releasing information, this response still acknowledges that the person in question is a client, which could be a breach of confidentiality.
Choice C reason:
Stating that the information cannot be given out is correct, but it still indirectly confirms that the person is a client, which could be a breach of confidentiality.
Choice D reason:
“I am unable to acknowledge whether or not your employee is a client on this unit” is the most appropriate response. This statement protects the client’s privacy by not confirming or denying their presence in the unit, thus maintaining confidentiality.

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Correct Answer is C

Explanation

Choice A reason:

Anticipating removing the restraints every 4 hours is not the best practice. Restraints should be checked frequently, typically every 2 hours, to assess the client’s circulation, skin integrity, and need for continued restraint. The goal is to use restraints for the shortest duration possible.

Choice B reason:

Securing the restraints to the lowest bar of the side rail is incorrect. Restraints should be secured to a part of the bed frame that moves with the client, not to the side rail, to prevent injury and ensure the client’s safety.

Choice C reason:

Securing the restraints using a quick-release tie is the correct action. This ensures that the restraints can be quickly and easily removed in case of an emergency, prioritizing the client’s safety.

Choice D reason:

Ensuring four fingers fit under the restraints to prevent constriction is not accurate. The correct practice is to ensure that two fingers can fit between the restraint and the client’s skin to prevent constriction and ensure proper circulation.

A. Dependence on parents to participate in the client’s care B. A need for continued intensive monitoring in the home C. A decrease in admission frequency to inpatient psychiatric hospitals D. A need for crisis intervention services on an ongoing basis

Correct Answer is C

Explanation

Choice A reason:
Dependence on parents to participate in the client’s care indicates that the client is not progressing towards independence. Effective in-home mental health care aims to empower clients to manage their own health and reduce reliance on others. Therefore, this response does not demonstrate effective care.
Choice B reason:
A need for continued intensive monitoring in the home suggests that the client’s condition remains unstable and requires constant supervision. Effective care should lead to improved stability and a reduction in the need for intensive monitoring.
Choice C reason:
A decrease in admission frequency to inpatient psychiatric hospitals indicates that the client’s condition is stabilizing and that they are managing their mental health more effectively at home. This outcome demonstrates that the in-home mental health care is effective in reducing the need for hospitalization.
Choice D reason:
A need for crisis intervention services on an ongoing basis suggests that the client continues to experience frequent crises. Effective in-home mental health care should help the client develop coping strategies and support systems to manage their condition, reducing the need for frequent crisis interventions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A newly licensed nurse is applying prescribed wrist restraints on a client. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is providing in-home mental health care and determines that the care is effective when the client demonstrates which response?

Correct Answer is C

Explanation

When applying the biopsychosocial model to a client with a mental health problem, the nurse addresses which psychological domain?

A nurse is preparing to assist with electroconvulsive therapy (ECT). Which of the following pieces of equipment should the nurse set up in the room prior to the treatment? (Select all that apply)

A nurse is discussing quality of life with a client who has schizophrenia. Which of the following statements should the nurse include?

A psychiatric-mental health nurse is working on an inpatient unit that uses a privilege system. The nurse understands that this intervention integrates which group of theories?

Which client would a nurse determine to be the most likely candidate for involuntary commitment?

A nurse is developing a plan of care integrating Maslow’s hierarchy of needs. Which area would the nurse identify as the priority?

A nurse is talking with a client who has schizophrenia. Suddenly the client states, “I’m frightened. Do you hear that? The voices are telling me to do terrible things.” Which of the following responses by the nurse is appropriate?