Nursing Elites

1. When preparing to administer a domestic violence screening tool to a female client, which statement should the RN provide?

• A. If you are experiencing abuse from your partner, I am required to ask you these questions.
• B. It is a requirement by law for me to inquire if you are a victim of domestic violence.
• C. Your healthcare provider must be informed if you are facing any domestic abuse.
• D. All clients undergo screening for domestic abuse due to its prevalence in our society.

Correct answer: D

Rationale: The correct answer is D because screening all clients for domestic abuse as a routine part of care helps in early identification and support. Choice A is incorrect as it may imply that the questions are only asked if abuse is already suspected. Choice B is incorrect because it emphasizes the legal obligation rather than the importance of routine screening. Choice C is incorrect as it focuses on the healthcare provider's need rather than the benefit to the client of routine screening.

2. During an admission assessment and interview, which channels of information communication should the healthcare professional be monitoring? Select all that apply.

• A. Auditory
• B. Visual
• C. Written
• D. Tactile

Correct answer: A

Rationale: During an admission assessment and interview, healthcare professionals should monitor auditory, visual, and non-verbal cues. Auditory communication involves listening to the patient's spoken words, tone of voice, and any other sounds they make. Visual communication includes observing the patient's facial expressions, body language, and gestures. Written communication, such as forms or notes, may also provide valuable information. Tactile communication pertains to touch, which is not typically utilized during an admission interview setting. While all channels of communication are important, in this context, auditory cues are particularly crucial for gathering verbal information during the assessment process, making choice A the correct answer. Visual cues and written information are also significant but may not be as critical as auditory cues during an interview. Tactile communication is generally not a primary channel used during a standard admission assessment and interview, hence it is not a key focus in this scenario.

3. The mental health team is determining treatment options for a male patient experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.

• A. Is the patient expressing suicidal thoughts?
• B. Does the patient have experiences with either community or inpatient mental healthcare facilities?
• C. Does the patient require a therapeutic environment to support the management of psychotic symptoms?
• D. Is the patient experiencing delusions or hallucinations?

Correct answer: B

Rationale: To determine whether a community outpatient or inpatient setting is most appropriate for a patient experiencing psychotic symptoms, it is crucial to consider if the patient has had experiences with either community or inpatient mental healthcare facilities. This helps assess the familiarity and comfort level of the patient in those settings, aiding in decision-making regarding the level of care needed. Choice A, addressing suicidal thoughts, is important for risk assessment and safety planning but does not directly help in determining the setting appropriateness between community outpatient or inpatient care. Choice C, about the need for a therapeutic environment, is significant but does not specifically assist in deciding between outpatient or inpatient care. Choice D, related to delusions or hallucinations, is relevant in assessing the symptomatology but does not directly guide the choice between community outpatient or inpatient care.

4. A client with major depressive disorder is beginning a new antidepressant medication. Which instruction should the nurse include in the discharge teaching?

• A. “It may take several weeks to notice improvement.”
• B. “You should see immediate effects of the medication.”
• C. “You can stop taking the medication once you feel better.”
• D. “Avoid discussing your symptoms with your therapist.”

Correct answer: A

Rationale: The correct instruction the nurse should include in the discharge teaching for a client starting a new antidepressant medication is that “It may take several weeks to notice improvement.” This is because antidepressants often require several weeks before the individual starts to feel the full therapeutic effects. Choice B is incorrect because immediate effects are not typically seen with antidepressants. Choice C is incorrect as stopping the medication abruptly can lead to worsening symptoms or withdrawal effects. Choice D is incorrect as open communication with the therapist is crucial for effective management of major depressive disorder.

5. A young adult male is hospitalized due to depression and an attempted suicide. The client reports that he lost his job and was angry with his employer for firing him when he took an overdose of pain medications. Which behavior best indicates to the nurse that his condition is improving?

• A. Initiates interactions with other clients.
• B. Describes verbally when he is angry.
• C. Participates in a job search with a social worker.
• D. Denies plans to harm himself or others.

Correct answer: A

Rationale: The best indicator of improvement in a client with depression is initiating interactions with others. This behavior demonstrates that the client is becoming less withdrawn and more self-directed, showing an improvement in social engagement and coping mechanisms. Choice B, describing anger verbally, may show some progress in emotional expression but does not necessarily indicate overall improvement in depression. Choice C, participating in a job search with a social worker, may be positive but does not directly address social interactions, which are crucial for improving depression. Choice D, denying plans to harm himself or others, is important for safety but does not directly reflect improvement in the client's social functioning or coping skills.

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