RN Mental Health Online Practice 2023 B with NGN w/ Rationales 100% correct: latest version

RN Mental Health Online Practice 2023 B with NGN w/ Rationales 100% correct: latest version 1. A nurse is caring for a client who is in an abusive relationship and is assisting in the development of a safety plan. Which of the following actions is the first component of a safetyplan? a. Identify signs of escalation of violence i. It is important for the client to be able to identify signs of escalation of violence, which are the greatest risk to the client. Therefore, this is the first component of the safety plan because it increases awareness of when danger is imminent and it is time to leave. 2. 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 interventionsis the priority? a. Reduce environmental stimuli. i. The greatest risk to the child and others is harm. Therefore, the nurse's priority intervention is to reduce environmental stimuli in an attempt to de-escalate the behavior and prevent injury. 3. A nurse is updating the POC for a client who has bulimia nervosa and is 5% above their idealbody weight. Which of the following interventions should the nurse include in the plan? a. Identify the client's trigger foods. i. The nurse should identify the trigger foods that initiate the client's binge and assist the client to understand their thoughts and behavior that relate to the food. 4. A nurse is assisting a client who has a terminal illness adjust to progressive loss of independence. Which of the following statements made by the client indicates acceptance ofher illness?Alberts academics a. "I am going to order a wheelchair for when I'm unable to walk." i. The client is recognizing the reality of continued loss of independence and is anticipating the need for assistive devices, which indicates the behavioral response of acceptance. 5. A nurse is reviewing the medication administration for a client who is experiencing adverse effects of chlorpromazine. The nurse should administer benztropine to relieve which of thefollowing adverse effects? a. Acute dystonia i. The nurse should administer benztropine, an anticholinergic agent, to relieve acute dystonia, which is an extrapyramidal adverse effect of chlorpromazine 6. A nurse is caring for an older adult client who is experiencing delirium. Which of the followinginterventions should the nurse include in the client's plan of care? a. Permit the client to perform daily rituals to decrease anxiety. i. The nurse should provide a client who has delirium with a plan of care that decreases agitation and anxiety by permitting the client to perform daily rituals 7. A nurse is receiving change-of-shift report for four clients. Which of the following clientsshould the nurse plan to see first? a. A client who is taking clozapine and reports sore throat and chills. i. When using the urgent vs. nonurgent approach to client care, the nurse should determine to first see the client who is taking clozapine and reports a sore throat and chills. Clozapine can cause agranulocytosis, a serious adverse effectthat causes neutropenia. The nurse should withhold the medication and notifythe provider of these findingsAlberts academics 8. A nurse is planning care for a client who has made repeated physical threats toward others onthe unit. Although the client does not want to leave the unit, the nurse requests the provider to transfer the client to another unit, the nurse request the provider to transfer the client to aunit that is equipped to manage violent behavior. Which of the following ethical principles should the nurse apply in the situation? a. Nonmaleficence i. It is the responsibility of the nurse to do no harm to clients. The nurse is applying the ethical principle of nonmalecence by requesting to transfer this client to a unit better able to manage their behavior and thereby prevent injuryto others on the unit.