Uworld p1 Mental Health Concepts

Mental Health Concepts Abuse Test Id: QId: 35171 () 1 of 75 A A A 0 After listening to the parents' reports and seeing the following pediatric clients, the nurse knows that which client demonstrates signs of abuse that may necessitate mandatory reporting? 1. 1-year-old with dyspnea, drooling, and a swollen tongue after eating part of a houseplant [2%] 2. 2-year-old who is crying and has a large forehead hematoma after falling out of a chair [5%] 3. 3-year-old with second-degree burns on the face after pulling a cup of hot tea off the table [3%] 4. 5-year-old whose x-ray reveals 1 new and 2 healed humerus fractures after falling from a tree [87%] Correct Answered correctly 87% Time: 77 seconds Updated: 09/18/2017 Explanation: The nurse should be aware of signs of physical, sexual, and emotional abuse and comply with state or provincial mandatory reporting. Signs of abuse may include:  Shaken baby syndrome (ie, irritability or lethargy, poor feeding, emesis, seizures)  Burns in the shape of household items (eg, iron, spatula), from cigarettes, or from immersion in scalding liquid  Repeated injuries in varied stages of healing (eg, bruises, burns, fractures) (Option 4)  Injuries to genitalia  Lapsed time between the injury and the time when care is sought  Inconsistency between the injury and the caregiver's explanation of the injury (eg, client's developmental age, mechanism of injury) (Options 1, 2, and 3) Toddlers and young children are prone to many accidental injuries (eg, aspiration or poisoning from foreign objects in the mouth, climbs onto and falls from furniture, pulling of objects from the table). The injuries and caregivers' explanations are reasonable for these clients. Prior to discharge, the nurse should instruct caregivers on child safety measures within the home to prevent future injury. Educational objective: The nurse should be aware of signs of physical, sexual, and emotional abuse, including repeated injuries in varied stages of healing, shaken baby syndrome, and injuries to genitalia. Suspicion of abuse necessitates mandatory reporting according to state or provincial laws. Copyright © UWorld. All rights reserved. Safety/Infection Control Room assignments Test Id: QId: 32381 () 2 of 75 A A A 0 The charge nurse is responsible for making room assignments for multiple clients. Which pair of client assignments to a shared room is appropriate? 1. Client with blood loss anemia and client with intractable diarrhea [11%] 2. Client with gastroenteritis and client with chemotherapy-induced nausea and vomiting [6%] 3. Client who had a bowel resection 1 day ago and client with asthma exacerbation [80%] 4. Client who had a total hip arthroplasty 2 days ago and client with influenza [1%] Incorrect Correct answer 3 Answered correctly 80% Time: 215 seconds Updated: 06/20/2017 Explanation: When making room assignments, it is important to remember that a client with an active or suspected infection should not be paired with a client who has a fresh surgical wound or is immunocompromised. A client having an asthma exacerbation does not have an infection and is not at risk for spreading infection to a client who had recent bowel resection surgery (Option 3). (Option 1) A client with uncontained or excessive excretions, drainage, or secretions (eg, profuse diarrhea, draining wounds) is more likely to spread infection, if present, and therefore should be assigned to a private room. (Option 2) The client who has chemotherapy-induced nausea and vomiting is likely immunocompromised secondary to the chemotherapy and is therefore vulnerable to infection from a client with gastroenteritis. (Option 4) A client who has a fresh surgical wound has an increased risk of infection and should not be paired with a client with an active influenza infection, which is transmitted through the droplet route. Educational objective: When preparing room assignments, the nurse should not place a client who has a fresh surgical wound or is immunocompromised in a room with a client who has an active or suspected infection. Copyright © UWorld. All rights reserved. Leadership & Management Concepts Advance directives Test Id: QId: 34718 () 3 of 75 A A A 0 The nurse cares for a client with a terminal disease who has an advance directive supporting a do not resuscitate (DNR) code status. The client stops breathing and loses a pulse. The client's adult child states, "I changed my mind. Do whatever you can to save him!" Which intervention is most appropriate at this time? 1. Call for help to initiate cardiopulmonary resuscitation [10%] 2. Call the health care provider to confirm the DNR status [6%] 3. Explain the client's wishes to the client's child [79%] 4. Offer to call the hospital chaplain to provide support [4%] Correct Answered correctly 79% Time: 57 seconds Updated: 06/28/2017 Explanation: Advance directives outline the client's choices for medical care (eg, cardiopulmonary resuscitation [CPR], mechanical ventilation) ahead of time. This allows the family and care team to follow the client's wishes at the end of life, when the client may be unable to make choices known. Clients can sign a do not resuscitate (DNR) directive instructing that CPR and other life-saving measures be withheld. With an advance directive in place, the client's wishes are followed, even if they conflict with the wishes of loved ones (Option 3). This is different from a medical power of attorney (health care proxy) in which the client designates a person to make decisions on their behalf. (Option 1) Initiating CPR on a client with a DNR status does not respect the wishes of the client to forgo life-saving measures and allow natural death. Nurses must advocate for clients' wishes, even if family members are in disagreement. (Option 2) The client has a terminal illness and in an advance directive expressed wishes that were verified prior to initiating DNR status; therefore, there is no need to clarify with a health care provider. (Option 4) The client's child should be offered support from the hospital chaplain after the client's wishes are explained. Educational objective: Advance directives outline the client's choices for medical care at the end of life, including resuscitation status. Client's wishes for medical care are honored over the wishes of family members. Copyright © UWorld. All rights reserved. Mental Health Concepts Suicide Test Id: QId: 35155 () 4 of 75 A A A 0 The clinic nurse is assessing a client who is being treated for depression and suicidal ideation. Which client statement best indicates that the client is not currently at risk for suicide? 1. "I lost my imipramine prescription. Could I have a refill?" [2%] 2. "I plan to attend my granddaughter's graduation next month." [78%] 3. "I seem to have a lot more energy since I started therapy." [3%] 4. "I will sign a 'no-suicide' contract at today's appointment." [14%] Correct Answered correctly 78% Time: 44 seconds Updated: 06/19/2017 Explanation: Suicide risk & protective factors Risk factors  Psychiatric disorders, prior suicide attempts  Hopelessness