1. A nurse on a mental health unit is assisting with the plan of care for a
newly admitted client who has anorexia nervosa. Which of the following
actions should the nurse include in the plan of care?: Offer liquid
supplements to the client.
The nurse should offer liquid supplements to the client because the
client might be unable to eat solid foods when he is first admitted.
2. A nurse in a mental health facility is caring for a client who has
schizophre- nia. The client becomes violent in the dayroom and begins
throwing objects at staff and other clients. After calling for assistance,
which of the following actions should the nurse take next?: Tell the client
calmly to sit down.
When providing client care, the nurse should first use the least
restrictive interven- tion. Therefore, the nurse should use verbal de-
escalation techniques after calling for assistance for a client who is
aggressive.
3. A nurse is caring for a group of clients on a mental health unit. Which of
the following client behaviors should the nurse report to the charge nurse?:
A client who is manic has been pacing the unit for several hours
1/
,The nurse should identify that excessive physical activity in a client who
is experi- encing a manic episode places the client at risk for physical
exhaustion and possible death. The nurse should report this client's
behavior to the charge nurse.
4. A nurse is collecting data from a client who is taking valproic acid for
treatment of bipolar disorder. The nurse should identify that which of the
following findings is priority to report to the provider?: Bleeding gums
When using the urgent vs nonurgent approach to client care, the
nurse should determine that the priority finding is bleeding gums
because of the risk of throm- bocytopenia.
5. A nurse is attempting to resolve an ethical dilemma that involves a client's
medical decisions and his own personal values. After collecting data and
identifying the problem, which of the following actions should the nurse
take next?: Determine the benefits and consequences of respecting the
client's medical decisions.
The first action the nurse should take using the nursing process is to
collect data from the client. After the nurse collects the data and
identifies the problem, the nurse should determine the benefits and
consequences of respecting the client's medical decisions as the next
2/
, step in the ethical decision-making model.
6. A nurse is reinforcing teaching with a client who has obsessive-
compulsive disorder and performs hand hygiene to decrease anxiety. Which
of the follow- ing actions should the nurse take to demonstrate modeling as
a behavioral intervention strategy?: Demonstrating performing hand
hygiene at appropriate times
3/
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