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A nurse on an acute care mental health unit is examining the belongings of a client who is being admitted following a suicide attempt. Which of the following belongings should the nurse ask the client's partner to take back home? (Select All that Apply.)

A nurse is caring for a client who has a serious mental illness and has developed tardive dyskinesia from anti-psychotic medication use. Which of the following adverse effects from anti-psychotic medication use would be expected for the client?

A nurse is caring for a client who has borderline personality disorder. Which of the following defense mechanisms is commonly used by clients who have this disorder and has the potential to create division amongst the healthcare team?

A nurse on an inpatient mental health unit attends a training session about nurse burnout. The nurse should identify that burnout is most common in nurses who have which of the following traits?

A nurse is caring for a client who was hospitalized with a high blood alcohol content level. The provider fears the client may go into withdrawal and require medical supervision. The client's manifestations included anxiety, tremors, BP 166/100 mm Hg, and tachypnea about 1 hr ago. Now the client begins yelling out that they are seeing spiders crawling all over the walls. They believe they are at home and begin calling for their mother. The nurse should recognize that the client is experiencing which of the following stages of alcohol withdrawal?

A nurse in a mental health clinic is caring for a client who is grieving.

Nurses' Notes

1000:

Client presents to the mental health clinic and is tearful and angry recently experienced the loss of a child due to illness. Information provided to client about group therapy and individual therapy.

1100:

Client is continuing to sob and states, "I can't go on living without my child." Current list of home medications reviewed. Client states they have not been taking the prescribed medication "because it will not help."

1300:

Client spoke in group therapy session regarding feelings and prescribed treatment. Acknowledges the role of the therapist and expectations of support group, yet confides, "My anger and sadness are still very

Medication Administration

1000:

Sertraline 100 mg PO BID

Vital Signs

1015:

Temperature 36.8°C (98.4° F)

Heart rate 85/min

Respiratory rate 15/min

BP 147/86 mm Hg

Oxygen saturation 99%

A nurse is caring for a client who is grieving. Which of the following findings should the nurse identify as a priority to address? Select all that apply.

The nurse is collecting the health history of a client and determines that the client has risk factors for developing mental illness. Which of the following should the nurse identify as a possible contributing factor in the development of a mental health disorder?

A charge nurse on a mental health unit is describing assessments for suicide risks to a group of newly licensed nurses. Which of the following tests should the nurse include? (Select All that Apply.)

A nurse is caring for a client who is receiving total parenteral nutrition via a peripherally inserted central catheter (PICC). When assessing the client, the nurse notes swelling of the client's arm above the PICC insertion site. Which of the following actions should the nurse take first?

A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion?

A nurse on a mental health unit is caring for a client who has a new diagnosis of borderline personality disorder. The client states "I will just see my regular doctor at my annual checkup after I am discharged." Which of the following responses should the nurse make?