An 81-year-old client with chronic non-cancer-related lumbar pain and stage 3 renal insufficiency requests stronger medication after reporting inadequate relief with nonopioid therapy. The provider considers initiating an opioid. The client lives with extended family members.Which plan of care by the psychiatric-mental health nurse best reflects evidence-based opioid management in older adults?

An adult with a history of mental illness is hospitalized with pneumonia. The client and family are very anxious. What is the best outcome to add to the plan of care for this family?

A client has tried a variety of complementary and alternative medicine (CAM) approaches to manage health concerns. The nurse asks, “How is going to CAM practitioners different from seeing your medical doctors?” What is he client most likely response?

Describe relaxation techniques that help to manage stress responses.

A client presents to a rural emergency department 6 hours after a sexual assault. The facility does not have a trained Sexual Assault Nurse Examiner (SANE) on staff. The charge nurse states, “We can treat injuries, but forensic evidence collection and legal documentation should wait until a SANE is available tomorrow.” Which response by the primary nurse reflects the most appropriate understanding of specialized sexual assault services?

An 84-year-old client with advanced dementia becomes increasingly irritable and resists bathing and repositioning. The client is nonverbal and unable to describe discomfort. The family requests hospitalization for “a full medical workup” and asks whether antibiotics and artificial nutrition should be initiated “just in case.” The primary nurse applies principles of palliative dementia care.Which intervention best reflects evidence-based palliative care for advanced dementia?

A client is being discharged from an acute care setting 24 hours after a sexual assault. During discharge planning, the nurse evaluates whether short-term outcome criteria for rape-trauma response have been met. Which client statement most clearly demonstrates achievement of an appropriate acute-phase outcome rather than a longer-term recovery goal?

Identify the three types of crises—maturational, situational, and adventitious—and provide an example of each.

A 35-year-old client with schizoaffective disorder reports discontinuing part-time employment because increased earnings would have jeopardized Medicaid eligibility and access to psychiatric medications. The client has missed multiple outpatient appointments after being referred to different agencies for therapy, housing support, and vocational services. The nurse notes that the client appears overwhelmed navigating the system and states, “I don’t know who’s responsible for what anymore.”Which interpretation by the psychiatric-mental health nurse most accurately reflects systemic challenges within comprehensive community treatment for serious mental illness (SMI)?

A 64-year-old client with metastatic cancer states, “There must be a mistake. I’ve made an appointment with two more specialists because this diagnosis doesn’t make sense.” Two weeks later, the same client angrily tells the nurse, “Why is this happening to me? I’ve taken better care of myself than most people.” The family reports the client has recently said, “If I can just live long enough to see my grandson graduate, I’ll do anything.”Using Kübler-Ross’s theory of death and dying, which interpretation by the nurse is most conceptually accurate?