The nurse working in the ED of an urban hospital notifies the manager that there are several clients with mental health disorders still present in the ED that have been there over 48 hours. Which issue related to this phenomenon does the nurse discuss with the manager?
Temporary detaining orders for clients.
The revolving door for clients.
Decision to practice boarding.
The cost of holding clients in the ED for over 48 hours.
The Correct Answer is C
Boarding refers to the practice of holding patients in the emergency department (ED) for extended periods, often beyond the recommended timeframe, due to a lack of available mental health treatment options or appropriate placement. In this scenario, the nurse is notifying the manager about the presence of clients with mental health disorders who have been in the ED for more than 48 hours. This situation suggests that the hospital is likely practicing boarding for these clients.
Boarding of mental health patients in the ED can have significant negative consequences. It can contribute to overcrowding in the ED, leading to delays in care for other patients. It can also compromise the quality of care and exacerbate the distress and discomfort experienced by individuals with mental health disorders. Additionally, it is not an optimal environment for mental health treatment and recovery.
By discussing the issue of boarding with the manager, the nurse is addressing the need for timely and appropriate placement for clients with mental health disorders. This conversation may involve exploring solutions such as improving access to mental health services, establishing dedicated mental health units or crisis stabilization centers, and collaborating with community resources to ensure a smooth transition of care for these clients.
The other options mentioned are not directly related to the issue of clients with mental health disorders being present in the ED for over 48 hours:
● Temporary detaining orders for clients: This refers to legal mechanisms that allow for the temporary detention of individuals with mental health disorders who may pose a risk to themselves or others. While it may be related to the care of these clients, it does not address the issue of prolonged stays in the ED.
● The revolving door for clients: This concept refers to the frequent readmission or return of clients to the ED or hospital due to ongoing mental health issues. While it is a concern in mental health care, it does not specifically pertain to the issue of clients remaining in the ED for an extended period.
● The cost of holding clients in the ED for over 48 hours: While the cost implications of extended stays in the ED are relevant, the primary concern in this scenario is the quality of care, appropriate placement, and the impact on both the clients and the ED's functioning.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Systematic desensitization is a therapeutic technique used to help individuals gradually overcome their fears or phobias by exposing them to the feared stimulus in a controlled and systematic way. The goal is to reduce anxiety and increase relaxation through a step-by-step process.
The statement "What is the worst that will happen if you confront this fear?" aligns with the principle of systematic desensitization because it encourages the client to explore and challenge their negative beliefs or catastrophic thinking associated with their fear. By questioning the potential negative outcomes, the nurse is helping the client to reevaluate their fear response
and consider more realistic expectations. This process can contribute to the client's ability to confront their fear gradually and reduce anxiety over time.
The other statements are still helpful and supportive, but they do not specifically address the principles of systematic desensitization:
“I can see you are anxious. Let's stop for a minute." acknowledges the client's anxiety but does not actively engage in the technique of systematic desensitization.
"Use the deep breathing techniques we practiced yesterday." focuses on relaxation techniques, which can be helpful in managing anxiety but does not specifically address the principles of systematic desensitization.
“Tell me how you are feeling right now." encourages the client to express their feelings but does not directly engage in the technique of systematic desensitization.
Correct Answer is A
Explanation
The identification phase of the nurse-client relationship is characterized by the client feeling comfortable and secure enough to open up and share their feelings, emotions, and personal experiences with the nurse. It involves establishing trust and rapport, which allows the client to feel supported and understood by the nurse. Sharing feelings and emotions indicates that the client has reached a level of comfort and trust in the therapeutic relationship, making it a key indicator of the identification phase.
The other behaviors mentioned in the options are not specifically related to the identification phase:
● The client attending therapy sessions and utilizing services provided is an important aspect of engagement and active participation in the therapeutic process. However, it does not specifically indicate the identification phase of the relationship.
● The client stating that they feel the issues have been resolved and no longer need to come suggests the termination phase of the nurse-client relationship rather than the identification phase. The termination phase occurs when the client feels they have achieved their goals and no longer require ongoing therapy.
● The client answering questions related to the plan of care is a general indicator of communication and collaboration in the therapeutic process. It does not specifically signify the identification phase but rather active involvement in the treatment plan.
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