The nurse asks the client, “What was it like for you when you first realized you had no place to go?” The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic?

Apologize for asking such a personal and intrusive question

Encourage the client to make a list of their concerns and offer to discuss it with them on how to cope with homelessness

Divert the subject to something the client will readily discuss

Sit quietly allowing the client time to process before responding

Answer and Explanation

The Correct Answer is D

Choice A reason: Apologizing for the question may imply it was inappropriate, undermining the therapeutic intent to explore emotions. Homelessness is a valid topic in mental health care, and apologizing could discourage further discussion, disrupting trust and the client’s ability to process and express difficult emotions.

Choice B reason: Encouraging a list of concerns shifts focus to problem-solving prematurely, potentially overwhelming the client who is processing emotions. This action disregards the client’s need for reflection, which is critical in therapeutic communication to facilitate emotional expression and address underlying psychological distress effectively.

Choice C reason: Diverting the subject avoids the client’s emotional response, missing a therapeutic opportunity to explore feelings about homelessness. This can signal discomfort with the topic, reducing trust and hindering the client’s ability to process trauma, which is essential for mental health recovery and coping.

Choice D reason: Sitting quietly allows the client time to process complex emotions about homelessness, fostering a safe therapeutic environment. Silence supports reflection, enabling the client to articulate feelings at their pace, which enhances trust and facilitates deeper emotional exploration, making it the most therapeutic response in this context.

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Correct Answer is A

Explanation

Choice A reason: Stating intent to harm self and others meets criteria for involuntary hospitalization (e.g., 302 commitment), as it indicates imminent danger. Mental health laws prioritize safety, requiring inpatient evaluation to prevent suicide or violence, making this client eligible for involuntary admission to stabilize their condition.

Choice B reason: Refusing a diabetic diet is nonadherence but does not meet criteria for involuntary mental health hospitalization, which requires mental health-related danger to self or others. This behavior may warrant medical intervention, but it lacks the psychiatric urgency needed for involuntary admission.

Choice C reason: Uncontrolled rage with assaultive behavior indicates imminent danger to others, meeting criteria for involuntary hospitalization. Mental health laws allow commitment to protect others and stabilize the client, as assault reflects a severe mental health crisis requiring inpatient intervention to prevent further harm.

Choice D reason: Poor hygiene does not constitute imminent danger to self or others, a requirement for involuntary hospitalization. While it may indicate mental health issues, it lacks the acute risk needed for commitment, making outpatient evaluation or support more appropriate than involuntary admission.

A. Be coerced to accept treatment B. Have the client’s family petition for a 302 as they recently witnessed the client’s behavior C. Continue to refuse treatment D. Be committed by their doctor involuntarily to receive needed treatment

Correct Answer is C

Explanation

Choice A reason: Coercing treatment violates the voluntary client’s autonomy. Legally, voluntary patients can refuse medication unless they pose imminent danger, requiring involuntary commitment. Manipulation or disruption does not meet legal criteria for forced treatment, as mental health laws prioritize patient rights absent clear harm risks.

Choice B reason: A 302 (involuntary commitment) requires evidence of imminent danger to self or others, not just disruptive behavior. Family petitions cannot override this legal threshold without clinical justification, and manipulation alone does not qualify, making this option incorrect for enforcing treatment in a voluntary client.

Choice C reason: As a voluntary client, the individual retains the right to refuse treatment unless deemed a danger to self or others. Mental health laws protect autonomy, and manipulation or lack of progress does not justify forced medication, making refusal a legal right in this scenario.

Choice D reason: Involuntary commitment by a doctor requires evidence of imminent danger or inability to care for oneself, not just disruptive behavior or nonadherence. Without such criteria, the client’s voluntary status protects their right to refuse, making involuntary commitment legally inappropriate in this situation.

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The nurse asks the client, “What was it like for you when you first realized you had no place to go?” The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is evaluating clients in the emergency department (ED) for pending mental health admissions. Which client will be admitted for involuntary hospitalization?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

A client is fearful and reluctant to talk after a traumatic event. Which technique will the nurse employ that is most effective when trying to engage the client in interaction?

Which significant change in the treatment of people with mental illness occurred in the 1950s?

A nurse is performing safety assessments on a client in mechanical restraints as required by policy. Which action by the nurse demonstrates the ethical principle of nonmaleficence?

The nurse is receiving the morning report on four clients on a medical-surgical unit. Based on the information provided, which clients are at greatest risk for developing end-stage renal disease (ESRD)? (Select all that apply)

A novice nurse is beginning work on a behavioral health unit and states to the preceptor, “What if I encounter a client who is sexually aggressive?” Which is the appropriate response by the preceptor?

A nurse is assigned to administer oral medications to a client. Which action will the nurse do first if a client refuses to take prescribed oral medications?