A client arrives to the clinic describing concerns to the nurse about mood swings, insomnia, and a lack of focus. Which information should the nurse obtain first?

Onset of symptoms.

Methods to cope with stress.

Recent life changes.

Aggravating factors.

Answer and Explanation

The Correct Answer is A

A. Onset of symptoms: Determining when the symptoms began helps establish a timeline, differentiate between acute and chronic issues, and guide further assessment or intervention. This is essential for prioritizing care and identifying possible causes or patterns.

B. Methods to cope with stress: Exploring coping mechanisms is important in mental health assessment, but it is secondary to understanding the origin and duration of the client's current symptoms.

C. Recent life changes: Life events may contribute to mood and sleep disturbances, but the nurse first needs to know the timeline of the symptoms to interpret this information meaningfully.

D. Aggravating factors: Identifying what worsens symptoms is useful for management, but understanding when symptoms started lays the foundation for further focused questions and assessment.

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Correct Answer is B

Explanation

A. Assess peripheral oxygen saturation: While evaluating oxygenation is important in altered mental status, it is not the priority after restraints have been applied. Oxygen saturation may contribute to confusion, but neurological assessment is more directly relevant.

B. Determine baseline neurologic status: Establishing a neurological baseline is crucial after a sudden change in consciousness and behavior. It helps monitor for further deterioration or improvement and guides decisions about restraint necessity and care interventions.

C. Schedule a sitter around the clock: A sitter may be needed, but this decision should be based on a full assessment of the client’s condition and risk factors. It is not the first priority immediately after application of restraints.

D. Administer an IV anxiolytic medication: Medication may be considered later if the behavior persists or worsens, but it must be based on assessment findings and provider orders. The initial focus should be on identifying the underlying cause of the behavioral change.

A. Call the pharmacy to see which medications should be taken. B. Notify the healthcare provider (HCP) a fever develops. C. Use movement techniques taught by the physical therapists. D. Verify that a follow up appointment has been scheduled.

Correct Answer is A

Explanation

A. Call the pharmacy to see which medications should be taken: This indicates a misunderstanding of discharge instructions. The healthcare provider or nurse should clearly explain prescribed medications. Pharmacies do not determine which medications a patient should take post-discharge.

B. Notify the healthcare provider (HCP) a fever develops: This is an appropriate response, as a fever may indicate postoperative infection and requires prompt medical evaluation.

C. Use movement techniques taught by the physical therapists: Following movement and mobility instructions helps prevent injury and supports recovery, showing the client understands rehabilitation guidance.

D. Verify that a follow-up appointment has been scheduled: Ensuring continuity of care through a scheduled follow-up visit is appropriate and indicates responsible post-discharge planning.

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