Mental Health

A nurse is caring for a client who has binge-eating disorder. Which of the following client statements should the nurse expect?

"After I binge, I feel so disgusted with myself."

A nurse in a high school is caring for an adolescent who has recently suffered a traumatic loss of a classmate and is crying. Which of the following actions should the nurse take first?

Create a safe, nonjudgmental environment

A nurse is discussing the characteristics of disordered eating with a group of clients who have binge-eating disorder. Which of the following should the nurse include as a characteristic of disordered eating?

obsessive thoughts about food

A nurse is providing teaching about eating disorders with a group of clients. Which of the following statements should the nurse include?

orientation

A nurse is caring for a client who has anorexia nervosa, restricting sub type. Which of the following findings should the nurse expect?

patches of hair loss on the scalp

Which of the following has been identified as a priority outcome of ensuring a nurse's physical and mental well-being?

A growing and sustainable future nursing workforce

RN grief and

loss assessment

A nurse is caring for a client who is dying. The clients family is at the bedside and have placed pictures and objects on the bed with the client. Which of the following actions should the nurse take?

Ask the family about the objects and their meaning

A nurse is discussing euthanasia with a coworker. Which of the following statements indicates an understanding of the role of nurses and euthanasia.

Euthanasia is illegal in the United States and the core values of nursing do not support it.

A nurse is planning to provide care to a client who has an eating disorder. Which of the following principles should the nurse use to guide their actions?

Therapeutic relationships are the cornerstone of psychiatric nursing care

A nurse is caring for a client who has a eating disorder. Which of the following client statements should the nurse expect?

"I feel imprisoned by the rules of my eating disorder."

A nurse manager is assessing their unit for factors that contribute to the development of compassion fatigue which of the following factors should the nurse manager identify as increasing the risk for compassion fatigue?

A large number of nurses are working extra shift hours

A client who is experiencing prolonged grief (PGD) is at risk for which of the following?

Suicide, social dysfunction

A nurse is admitting a client who has an eating disorder. Which of the following actions should the nurse plan to take during the pre-interaction phase of the nurse-client relationship?

perform a self-reflection activity

A nurse is contributing to the plan of care for a client who has bulimia nervosa and borderline personality disorder. Which of the following should the nurse recommend including in the plan of care?

schedule weekly staff meeting to discuss care planning

A nurse is admitting a client who has bulimia nervosa. Which of the following client statements should the nurse expect?

"I first started purging to reduce weight during my high school wrestling years."

A nurse is caring for a client who has anorexia nervosa. Which of the following personality traits should the nurse expect the client to exhibit?

perfectionism

The unit manager is evaluating the nurses understanding of occupational stress. Which of the following statements are examples the effects of occupational stress?

"Everyone is sick sometimes, but lately, with all the client deaths, the number of people calling in sick is increasing". "we had three more nurses hurt themselves during work last month". "sometimes, I have to work on other units where everyone feels negative. It is rough being on a different unit,". "We have had so many of our longtime clients die these last few weeks. It's so overwhelming."

A nurse is caring for a client who has an eating disorder. Which of the following client statements should the nurse expect about an upcoming holiday party?

"I'll try to come up with excuses for why I cannot make it to the holiday party."

A nurse is providing teaching to the family of a child who has bulimia nervosa. The nurse should include that which of the following models explains that eating disorders are influenced by both nature and nurture?

Diathesis-stress model

A nurse is reviewing the laboratory results of a client who has bulimia nervosa. Which of the following results should the nurse expect?

elevated pancreatic enzyme levels

A nurse is caring for a client who has recently experienced the death of a partner. Based on the client findings which of the following three actions, should the nurse take?

Perform an ongoing assessment of the clients emotional status Encourage the client to talk about the death of their partner Encourage the client to discuss their daily routine

A nurse is providing education about medical aid in dying with a group of newly hired nurses. Which of the following statements by the newly hired nurse, indicates an understanding of the education.

An adult person with proven mental capacity self ingests the prescribed medication to die

A nurse is caring for a client who recently lost their partner in a motor vehicle crash. Which of the following actions should the nurse take to provide supportive grief informed care?

Ask the client how they met their partner

The nurse is caring for a client who is grieving and states no matter what I do I just can't stop crying. It feels like I am in the grave which of the following actions should the nurse take first

Ask the client what they mean by, "I'm in the grave"

The nurse is conducting a follow up visit with a client who is child was recently killed in a school shooting. The client states I don't know how to act or what to say. My child was the shooter. The nurse should determine that the client statement is consistent with which the following?

Disenfranchised grief

A nurse is caring for a client who is actively dying. The clients partner is crying and holding the clients hand which of the following responses should the nurse make

I know this is difficult. Would you like me to sit with you?

The nurse is caring for a client who was diagnosed with ALS, has been hospitalized for aspiration pneumonia, and has failed a swallowing evaluation. The provider determined the need for a feeding tube to be inserted. However, the client is refusing to have the tube inserted. The nurse is experiencing moral distress, which of the following actions should the nurse take first?

Identify the area of concern

A nurse on an inpatient eating disorder unit is caring for a client who has anorexia nervosa. Exhibit 1 Exhibit 2 Exhibit 3 Vital Signs ​1100: Heart rate 48/minRespiratory rate 24/minBlood pressure 78/52 mm HgTemperature 35.6° C (96° F)SaO2 93% on room air For each potential nursing action, click to specify if the action is indicated or contraindicated for the client. Nursing Actions Indicated Contraindicated Allow the client to schedule their own mealtime. Allow the client the choice of looking at the scale during weigh-ins. Help the client to accept that perfection is unrealistic. Weigh the client two times daily. Limit the client's physical activity until an established weight gain has occurred. Use bargaining techniques if the client is resistance to the treatment plan. Observe the client for 1 hr following meals. Observe the client during meals.

Indicated:Observe the client for 1 hr following meals, allow the client the choice of looking at the scale during weigh-ins, observe the client during meal times, limit the client's physical activity until an established weight gain has occured, help the client accept that perfection is unrealistic Contradiction:Weight the time client two times, use bargain technique if the client is resistance to the treatment plan.

A nurse is teaching about the purpose of participating in a therapy group about coping strategies. Which of the following client statements indicates an understanding of the teaching?

Learning positive coping strategies can help me adapt to life after the death of my partner

A charge nurse is reviewing medical records of a client. Select the three findings found in the medical record that require immediate follow up by the charge nurse.

Nurses comment regarding their faith Nurses reference to euthanasia Nurses reference to clients age

A nurse is preparing a presentation for newly hired nurses about the role that nursing self care has on the social determinants of health. Which of the following information should the nurse include in the presentation?

Nurses must lead and model well-being among themselves before they can truly partner with others

A nurse is preparing education for community support group about complicated grief, and resilience. Which of the following factors should the nurse identify as reducing a clients risk for developing complicated grief.

Regular religious or spiritual practice .A sense of personal health and well being. A reliable support system .

A nurse is preparing to begin caring for a client in discovers that the client adult children were recently killed as a result of gun violence. Which of the following actions should the nurse take?

Spend time reflecting and planning to avoid imposing any personal bias

A nurse invites a client on the eating disorder unit to a special morning activity as a reward for consuming all their breakfast. The nurse should identify this as an example of which of the following treatment models?

behavioral therapy

A nurse is caring for a child whose parent is concerned about their eating behavior. Which of the following behaviors is an indication of pica?

The child pretends to make pies out of mud and eats them

A nurse is participating in a wellness check for an eight-year-old who was recently in a motor vehicle crash where both guardians were killed which of the following findings should the nurse identify as an indication that the child is experiencing traumatic guilt?

The child reports frequent stomach aches

The nurse is caring for a client who has sustained life-threatening injuries. The healthcare team is discussing withdrawal of life-sustaining treatment. The decision to withdraw treatment is made by which of the following?

The health care team and the family

A nurse is caring for a client who reports having a headache, nausea, difficulty sleeping. The client states " my dog died a few weeks ago and I miss them so much". Which of the following statements by the nurse demonstrates a grief informed approach.

The loss of your dog must be difficult. Can you share what happened?

A nurse manager observes, a nurse, crying in the nurses locker room. Which of the following actions should the manager take first?

Use therapeutic communication to determine why the nurses crying

A nurse in an outpatient mental health clinic is caring for a client who has bulimia nervosa. What 5 responses indicate a therapeutic response to the treatment plan.

coping skills, ECG report, Potassium level, Creatinine level, Laxative use

A nurse is caring for a client who has bulimia nervosa. Which of the following actions should the nurse plan to take during the working phase of the nurse-client relationship?

explore the client triggers that lead to purging

A nurse at a community mental health center is caring for a client who has a binge-eating disorder. Which of the following should the nurse identify as a manifestation of this condition?

feelings of powerlessness

The nurse is caring for an adolescent client, whose parents died four years ago. The clients other parent states that the client has been coming home drunk, lost her driving license due to reckless driving, and has been skipping school. Which of the following actions is the nurses priority.

Assess the client for risk of suicide

A nurse is teaching a client who has a eating disorder about how to restructure their thoughts related to body image. This is an example of which of the following treatment modalities?

Cognitive behavioral therapy

A nurse in an outpatient mental health clinic is caring for a client who has bulimia nervosa. Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4 History and Physical November 1:Height 157.5 cm (62 in)Weight 53.1 kg (117 lb) BMI 21.4Erosion of teeth, reports numerous dental cariesParotid swellingCalluses on handsPeripheral edemaClient reports overeating with subsequent induced vomiting every day of the week; takes laxatives every morning.Reports being depressed for a long time and "feeling worse lately." Reports having no close friends and working from home since the beginning of the pandemic, so has limited interaction with people. Family lives in another state. States, "I'm just really lonely. I think that's why I eat so much. But I don't want to be fat. I'm really ashamed that I can't control this."December 1:Height 157.5 cm (62 in)Weight 54 kg (119 lb) BMI 21.8Client reports that they has been working with a nutritionist and keeping a food diary. States they have not been able to completely stop the overeating/purging cycle. Has discontinued daily laxative use.Has attended each scheduled group therapy session and is participating in discussions. States, "It's really helpful to know I'm not the only person that has this problem."Reports working with a counselor in individual psychotherapy on developing coping skills to combat feelings of loneliness. Has joined a book club at the local library and has been reaching out to coworkers to meet for coffee after work. Reports joining a gym and beginning an exercise regimen to supplement medication therapy for depression. States, "I'm feeling a little bit better about myself. Maybe there's hope for me." Reviewed diagnostic reports with client. A nurse in an outpatient mental health clinic is assessing a client during a follow-up visit. Select the 5 assessment findings that indicate a therapeutic response to the treatment plan.

Coping Skills, ECG, Potassium,creatinine, Laxative use

A nurse in a mental health facility is caring for a client who has an eating disorder. Exhibit 1 Exhibit 2 Exhibit 3 History and Physical 1000:An adolescent client is brought to the facility by their parent who states the client "passed out" at home. The parent is concerned about the client's recent weight loss. The parent reports the client rarely eats a meal at home by stating, "I've already eaten." Parent states having heard the client throwing up on several occasions. The parent also reports finding several boxes of over-the-counter laxatives and diuretics in the client's bedroom. Client states, "I just don't want to be fat!"Height 163 cm (64 in)Weight 40 kg (88 lb)BMI 15.1Client is thin and emaciatedSkin is cold, dry, poor turgor, mottled with bluish tint to extremitiesLanugo on armsDecreased muscle tonePeripheral edemaPulses weakRespirations unlabored Hyperactive bowel sounds Complete the following sentence by using the lists of options. The client is at risk for developing due to . INCORRECT My Answer Upon collecting data from the client and analyzing the client's laboratory findings, the nurse's priority hypothesis is that the client is experiencing anorexia nervosa. The nurse should determine that the client is at greatest risk of developing dysrhythmias as evidenced by the client's potassium level, which is below the expected reference range. The client's potassium level of 2.9 mEq/L is a critical value that should be reported to the provider immediately.

Dysrhythais,Potassium Level

A nurse is preparing to provide education to a client who is experiencing grief, which of the following information should the nurse include

Feelings of sadness can fluctuate in intensity when a person is grieving

A nurse is planning an in-service for nursing staff about the mortality of eating disorders. Which of the following information should the nurse include?

One out of 10 people who have anorexia nervosa die within 10 years of the onset of the condition.

A nurse in a mental health clinic is caring for a client who is grieving the loss of a child. Complete the following sentence by using the list of options

The nurse should provide client education about (complicated grief therapy) =that focuses on (strengthening relationships)

A nurse is providing discharge instructions to a caregiver of a client who is dying. Drag words from the choices below to fill in each blank of the following sentence.

The nurse should recognize that the caregiver is experiencing (burnout) and (compassion fatigue)

A nurse is discussing the causes of eating disorders during a multidisciplinary health care team meeting. Which of the following statements explains the relationship between culture and eating disorders?

The rate of eating disorders is higher in countries where being thin is valued

A nurse is caring for a client who was recently diagnosed with prolonged grief disorder(PGD) which of the following client statements should the nurse address?

There is nothing to do I just can't go on living without my child

A nurse is caring for a client who has end-stage pancreatic cancer. The client has decided to forgo any additional treatment and be allowed to die. Which of the following responses should the nurse make to honor the clients request?

This action is supported by your right of self-determination.

For each of the following findings exhibited by the client, click to specify if the finding is consistent with uncomplicated grief of maladaptive.

Uncomplicated Grief: Somatic issues noted on admission, and Feeling a sense of loss when thinking about the client Maladaptive Grief: Disheveled and unclean appearance, and Reports having trouble sleeping