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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.)

A.

"What is your expected salary range?"

B.

"Have you served time in prison?"

C.

"What type of vehicle do you drive?"

D.

"Do you use drugs?"

E.

"Are you taking antipsychotic medication?"

Question Solution

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 ["A","B","E"]

Explanation

Rationales:

A. The client's statement, "I can't go on living without my child," indicates a potentially serious risk to their safety and well-being. This statement suggests that the client may be experiencing suicidal ideation or extreme despair, which requires immediate attention and intervention.

B. While sadness and anger are expected components of grief, the intensity of these feelings and their persistence need to be assessed for any signs of complicated grief or potential for self-harm. Addressing these emotions is critical to ensuring the client’s safety and providing appropriate support.

C. While understanding the expectations during group meetings is important for therapy, it is not as immediately critical as addressing the client's statements about their outlook on living and their medication adherence.

D. Knowledge about the therapist’s role is important for therapeutic alliance, but it is less urgent compared to addressing the client’s potentially dangerous outlook on living and their medication issues.

E. The client’s refusal to take the prescribed medication, with the belief that it "will not help," indicates a possible issue with medication adherence or effectiveness. This needs to be addressed to ensure that the client is receiving appropriate treatment for their mental health needs.

Correct Answer is C

Explanation

Rationale:

A. Reporting the incident to other RNs on the shift does not ensure that the appropriate actions will be taken to address the issue.

B. Agreeing not to report the incident in exchange for the coworker seeking treatment is unethical and does not follow the correct reporting protocol.

C. Reporting the incident to the appropriate person in the chain of communication, such as a supervisor or nurse manager, is the correct course of action. This ensures that the situation is handled according to hospital policy and legal requirements, protecting patient safety and addressing the coworker's substance use disorder.

D. Agreeing not to report the incident if the coworker promises to report themselves is also unethical and fails to meet professional responsibilities.

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