1. When admitting a client to an inpatient mental health facility, a nurse notices that the client seems withdrawn and appears fearful. To establish a trusting nurse-client relationship, the nurse sho... uld first a. Introduce the client to other clients in the day room (working phase) b. Inform the client that her admission will be confidential (orientation phase) c. Assist the client in facilitating behavioral change (working phase) d. Determine coping strategies that the client has used in the past (working phase) 2. A nurse is reviewing the potential adverse effects of lithium with a client who began the medication 2 weeks ago. For which of the following should the nurse instruct the client to monitor and report to the provider? a. Hearing loss b. Dry persistent cough c. Bruising d. Coarse hand tremor (indication toxicity ) 3. A nurse is caring for a child who has conduct disorder and is behaving in a destructive manner, throwing objects, and kicking others. Which of the following therapeutic nursing interventions is the highest priority? a. Encourage expression of feelings (acknowledge them) b. Promote attendance at an assertiveness training group (how to be assertive rather than aggressive) c. Assist the client to perform relaxation breathing (assist the child to calm down) d. Use a therapeutic holding technique (the greatest risk to this child and others is harm? Therefore, the nurse’s priority intervention is to use a therapeutic holding technique to de-escalate the behavior and prevent injury) [Show More]
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