A nurse working in a community health center is speaking with a client who has a serious mental illness. The client states that they are unable to find employment and they do not understand why. Which of the following questions should the nurse ask? (Select all that apply.)
"What is your expected salary range?"
"Have you served time in prison?"
"What type of vehicle do you drive?"
"Do you use drugs?"
"Are you taking antipsychotic medication?"
Correct Answer : B,D,E
Rationale:
A. Asking about salary range is not directly relevant to the client’s mental health condition and would not help in understanding the barriers to employment.
B. Inquiring if the client has served time in prison may reveal a history that could impact their employability, as some employers may have restrictions on hiring individuals with criminal records.
C. Asking about the type of vehicle the client drives is not directly related to the client’s mental health or barriers to employment, and it would not provide insight into why the client is struggling to find work.
D. Asking about drug use is pertinent as substance abuse can interfere with employment opportunities and overall functioning.
E. Knowing whether the client is taking antipsychotic medication is important because adherence to treatment can significantly affect the client’s ability to function in a work environment.
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Correct Answer is ["B","D","E","F"]
Explanation
Rationale:
A. The ECG shows persistent sinus bradycardia on both December 1 and December 15. While sinus bradycardia is common in anorexia nervosa, its persistence may not necessarily reflect a therapeutic response.
B. The respiratory rate improved from 24/min to 20/min and the respirations are described as even and unlabored on December 15. This indicates a positive response to treatment.
C. The temperature data for December 15 is not provided. However, an increase toward normal temperature would indicate a therapeutic response, but without this data, we cannot confirm.
D. The weight increased from 34.5 kg (76 lb) to 37.2 kg (82 lb), which is a significant therapeutic improvement, reflecting progress in treatment.
E. The sodium level improved from 128 mEq/L to 130 mEq/L. Although the level is still slightly below normal, the upward trend indicates improvement.
F. The creatinine level decreased from 1.2 mg/dL to 0.9 mg/dL, showing improvement in kidney function and response to treatment.
Correct Answer is ["A","B","C"]
Explanation
Rationale:
A. Living in a homeless shelter is a significant social determinant that can impact mental health due to instability, lack of privacy, and increased stressors.
B. Access to a grocery store is important because food insecurity and lack of access to nutritious food can negatively affect mental and physical health.
C. Being employed part-time at minimum wage can contribute to financial stress, impacting mental health due to economic instability and potential lack of access to healthcare.
D. While a history of diabetes mellitus is relevant to overall health, it is not a direct social determinant of mental health.
E. Owning a small dog may have a positive impact on mental health due to companionship but is not a primary social determinant in this context.