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 B
Explanation
Rationale:
A. While skin color may be an indicator of overall health, it is not the most crucial data point before administering packed RBCs.
B. The hemoglobin level is the most important data to assess before administering packed RBCs, as it provides direct information about the client’s need for the blood transfusion and helps evaluate the effectiveness of the intervention.
C. Fluid intake is important in overall client assessment but is not as immediately relevant as hemoglobin levels when preparing to administer packed RBCs.
D. Temperature should be monitored to check for any signs of infection, but it is not the primary concern when deciding to proceed with a blood transfusion.
Correct Answer is D
Explanation
Rationale:
A. An inverted P wave is not specifically associated with hypokalemia; it can be seen in various other conditions.
B. An elevated ST segment is not characteristic of hypokalemia; it is more associated with other conditions such as myocardial ischemia.
C. A wide QRS complex can occur with hypokalemia but is also seen in other conditions.
D. An abnormally prominent U wave is a classic sign of hypokalemia and can be seen in EKG changes associated with low potassium levels.