A nurse on an inpatient mental health unit is assisting with a series of group therapy sessions for a small group of clients.
Nurses Notes
Session 1:
Client A states they are fearful at times.
Client B is sobbing and states they can't go a day without their partner.
Client C remains silent during the session.
Client D wears boots 24 hr per day.
Client E continuously twists their hair.
Session 4:
Client A admits to having an extreme fear of mice, among other things.
Client B brings a picture of their partner to the session and cries when looking at the photo.
Client C has yet to speak during a group session.
Client D tells the group they wear boots all the time because they have the world’s ugliest feet and don’t want anyone to see them.
Client E is now pulling out hair after they have twisted it
The nurse is reviewing the observations made from the various group sessions. Drag words from the choices below to fill in each blank in the following sentences.
1. Client A is exhibiting manifestations of ___Target 1
2. Client B is experiencing manifestations of ____Target 2
3. Client C continues to exhibit manifestations of ____Target 3
4. Client D is displaying manifestations of ___Target 4
5. Client E has worsening manifestations that have now progressed to ___Target 5
Word Choices
separation anxiety
trichotillomania
murophobia
Mutism
Body dysmorphism
The Correct Answer is C, A, D, E, B
Rationale:
Murophobia: Client A's extreme fear of mice indicates a specific phobia. In this case, it is specifically referred to as murophobia.
Separation anxiety: Client B's distress over their partner's absence aligns with separation anxiety.
Mutism: Client C's continued silence in group sessions suggests mutism, a form of non-verbal behavior often associated with anxiety or trauma.
Body dysmorphism: Client D's behavior of wearing boots due to negative feelings about their feet reflects body dysmorphic disorder, where a person has a distorted view of their body.
Trichotillomania: Client E’s behavior of pulling out their hair after twisting it indicates trichotillomania, a disorder characterized by compulsive hair pulling.
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Correct Answer is D
Explanation
Rationale:
A. The medication administration record is important for verifying the order but should be used in conjunction with the patient’s identification.
B. The order sheet provides the details of the blood product to be administered but is not the primary source for verifying patient identity.
C. The chart includes medical history and orders but does not provide direct patient identification for blood administration.
D. The identification wristband is the primary and most direct method for verifying the patient’s identity to ensure that the correct blood product is administered to the correct patient.
Correct Answer is B
Explanation
Rationale:
A. Removing the PICC line should only be done if directed by a provider after further assessment.
B. The first action is to measure the circumference of both arms to assess for possible complications such as thrombosis or infiltration. This measurement will help determine the extent of the swelling and inform subsequent actions.
C. Notifying the provider is important but should be done after gathering relevant assessment data, such as the arm circumference.
D. Applying a cold pack may be appropriate for reducing swelling but is not the first step. Assessment should come first.