During the admission assessment to the mental health unit, a client reports that the people at the office, where the client works, are antagonistic, and the client is thinking of shooting the supervisor. The client asks the nurse not to reveal this to anyone else. The nurse immediately notifies the client's therapist and other team members of the client's thoughts. The therapist then calls the client's supervisor and shares the client's thoughts about shooting the supervisor. Which outcome is best based on the action of the nurse?

Both the nurse and therapist are reprimanded for divulging confidential patient information to others.

The nurse and therapist will be asked to educate other team members on appropriate sharing of client information.

The nurse is reprimanded for divulging confidential patient information without obtaining informed consent.

The therapist is reprimanded for divulging confidential patient information without obtaining consent.

Answer and Explanation

The Correct Answer is B

A.   Both the nurse and therapist took action to ensure safety; therefore, reprimanding might not be appropriate.
B.   The best outcome is an educational approach for the team to understand appropriate information sharing in cases of potential harm to others while maintaining patient confidentiality.
C.   The nurse's immediate notification was based on safety concerns, which may take precedence over obtaining informed consent.
D.   The therapist's action aimed at ensuring safety but might have breached confidentiality without explicit consent.

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Correct Answer is B

Explanation

A. Inquiring about the mother's other children might not directly address her current emotional distress and might not be an immediate concern.
B. Asking if the mother has ever thought about harming herself or her child is essential to assess the severity of her depressive thoughts and the risk of harm.
C. Encouraging journaling can be helpful as part of coping, but in this context, addressing immediate concerns about self-harm is more crucial.
D. Reassurance is important, but in this case, providing false hope or assurance about achieving milestones may not be realistic and might not address the mother's current distress.

A. Ask the client to describe and identify the source of the feelings. B. Provide education about ways to cope with anxiety. C. Escort the client from the group to reduce stimuli. D. Assist the client with relaxation techniques in the group.

Correct Answer is D

Explanation

A. Asking the client to describe and identify the source of feelings might escalate the anxiety and might not be immediately helpful in reducing anxiety levels.
B. Providing education about coping with anxiety might be beneficial, but in a moment of severe anxiety, immediate intervention to reduce anxiety is more crucial.
C. Escorting the client from the group might be necessary in some cases, but assisting with relaxation techniques within the group setting can offer immediate support and relief.
D. Assisting the client with relaxation techniques in the group can help reduce anxiety and provide immediate support.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The mother of an 8-month-old infant with profound mental and physical disabilities tells the nurse how depressed she is because she realizes that her child will never achieve normal growth and development milestones. How should the nurse respond to this mother?

Correct Answer is B

Explanation

A nurse who is co-leading group therapy recognizes that a client is beginning to experience severe levels of anxiety. Which intervention is best for the nurse to implement?

Correct Answer is D

Explanation

A client with depression does not want to communicate with friends, uses television watching as a means of escaping responsibilities, and describes the inability to handle personal circumstances. Which coping strategy should the nurse include in the plan of care?

A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and lack of motivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?

A female college student is admitted to the mental health unit following a drug overdose. The student tells the nurse that she took the overdose following the end of a romantic relationship. Which is the primary goal for hospitalization that should be included in this client's plan of care?

An antidepressant medication is prescribed for a client who reports sleeping only four hours in the past two days and a weight loss of nine pounds within the last month. Which client goal is most important to achieve within the first three days of treatment?

A client with schizophrenia returns to the clinic two weeks after receiving a prescription for haloperidol. To assess for neuroleptic malignant syndrome (NMS), which information is most important for the nurse to obtain during this visit?

A client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. Which intervention is best for the nurse to implement?

Following the visit, what are appropriate actions for the nurse? Select all that apply.

The nurse is admitting a male client who takes lithium carbonate twice a day. Which information should the nurse report to the healthcare provider immediately?