During the process of restraining an aggressive client, the nurse communicates the need for these actions by stating:

Which of the following statements about the treatment of clients with panic disorder is FALSE?

Ellen would do anything to “act-out” a suicidal gesture, including cutting herself or attempting to hang herself with her bra. You analyze Ellen’s behaviors as indicative of which personality disorder?

The nurse must plan health teaching for a client with generalized anxiety disorder who is taking lorazepam (Ativan). Which topic should be included?

CASE STUDY – QUESTION 6 The nurse cares for a 44-year-old male with a known diagnosis of post-traumatic stress disorder (PTSD) in a behavioral health urgent care clinic. Phase Sheet   Name James Wheeler Gender M Age 44 Weight 162 lbs (73.5 kg) Allergies NKDA Preferred language English Marital status Married Clinic Notes   1030/Initial Assessment: Diagnosed with PTSD 5 years ago. Appears disheveled, anxious, and easily startled. Reports increased difficulty sleeping over the last month due to nightmares that cause him to wake up in a panic. Client lost his job two weeks ago due to missing too much time from work and he has not been able to get himself together enough to look for a new one. When he lost his job, he also lost his health insurance. He reports missing 2 scheduled clinic appointments and 3 of his weekly group sessions over the last month. Denies a history of self-harm. He states his wife is supportive, but has been upset with him because he has been so irritable, and he doesn’t blame her. Client states, “She would probably be better off if I wasn’t around.”   1100:  Suicide risk assessment completed. Client admits to fleeting, passive suicidal thoughts. “Sometimes I think it would be better if I went to bed and did not wake up, but I would never kill myself. I couldn’t do that to my family, plus I know God does not want me to do that.”  No history of suicide attempts and client states, “I have been down before, but I have always gotten better.” 1130: Administered acetaminophen 650 mg PO for headache and hydroxyzine 25 mg PO for anxiety.   1230:  Client reports feeling more relaxed. States meeting with case manager has provided him with a plan. Information provided on trauma-informed care & hydroxyzine; client verbalized understanding. Prescriptions for hydroxyzine 25 mg PO  every 8 hours as needed for 3 days provided. Client and wife in agreement with plan. Per case manager, appointment made with clinic provider in 2 days for medication management and treatment needs.     Vital Signs   Time 1030 1200   T ◦F ( ◦C) 97.8 F (36.6 C) 97.4  (36.3 C)   P 98 80   RR 20 18   B/P 138/90 130/82   Pulse oximeter 97%  (RA) 98% (RA)   Pain Headache 7/10 Headache at 2/10   Orders   Acetaminophen 650 mg PO now & prn headache/discomfort Hydroxyzine 25 mg PO x 1 dose now Hydroxyzine 25mg PO every 8 hours as needed for anxiety x 3 days Refer to case manager for assistance with insurance and access to care   The nurse reassesses the client at 1230. Complete the following sentence by choosing from the list of options.  ***ONLY TYPE THE LETTER OF THE CORRECT CHOICE*** The nurse determines the client’s status is            Select                                                                                       A –  Improving                                                                                       B   –  Deteriorating                                                                                       C   –  Unchanged The nurse should now                                            Select                                                                                      A – Facilitate admission to the inpatient psychiatric                                                                                                  unit                                                                                                         B – Contact provider to schedule appointment for                                                                                                     electroconvulsive therapy (ECT)                                                                                      C – Discharge client with a plan of care as discussed

Which of the following interventions would be most helpful for a client with dissociative disorder who has difficulty expressing feelings?

CASE STUDY – QUESTION 4 The nurse cares for a 44-year-old male with a known diagnosis of post-traumatic stress disorder (PTSD) in a behavioral health urgent care clinic. Phase Sheet   Name James Wheeler Gender M Age 44 Weight 162 lbs (73.5 kg) Allergies NKDA Preferred language English Marital status Married Clinic Notes   1030/Initial Assessment: Diagnosed with PTSD 5 years ago. Appears disheveled, anxious, and easily startled. Reports increased difficulty sleeping over the last month due to nightmares that cause him to wake up in a panic. Client lost his job two weeks ago due to missing too much time from work and he has not been able to get himself together enough to look for a new one. When he lost his job, he also lost his health insurance. He reports missing 2 scheduled clinic appointments and 3 of his weekly group sessions over the last month. Denies a history of self-harm. He states his wife is supportive, but has been upset with him because he has been so irritable, and he doesn’t blame her. Client states, “She would probably be better off if I wasn’t around.”   1100:  Suicide risk assessment completed. Client admits to fleeting, passive suicidal thoughts. “Sometimes I think it would be better if I went to bed and did not wake up, but I would never kill myself. I couldn’t do that to my family, plus I know God does not want me to do that.”  No history of suicide attempts and client states, “I have been down before, but I have always gotten better.” Vital Signs   Time 1030   T ◦F ( ◦C) 97.8 F (36.6 C)   P 98   RR 20   B/P 138/90   Pulse oximeter 97%  (RA)   Pain Headache 7/10     For each potential nursing or collaborative intervention, click to specify whether the intervention is appropriate (1) or not appropriate (2) to include in the plan of care.

A client previously diagnosed with dissociative identity disorder (DID) presents to the emergency room with deep cuts on both arms and no memory of how this occured.  She is admitted to your in-patient behavioral health unit.  The priority nursing intervention for this client would be:

A client tells the nurse at the anxiety disorders clinic that he experiences palpitations, difficulty breathing, and a sense of overwhelming dread whenever he goes out of his home. This problem began after he was beaten and robbed on his way to work. He has been unable to go to his office for over a month. He asks the nurse: Don’t you agree that not being able to go out is pretty stupid? The most therapeutic reply from among those listed below is:

What nursing care plan interventions would NOT be appropriate for a client with obsessive compulsive disorder (OCD).