Author Question: A nurse performed the following actions and interventions in the course of a day while caring for a ... (Read 31 times)

mrsjacobs44 · **on:** Jul 19, 2018

A nurse performed the following actions and interventions in the course of a day while caring for a
client with psychosis:

1 . Removed embroidery scissors from client's possession
2 . Arranged for client to make an appointment with a lawyer
3 . In client's presence, opened a package mailed to client
4 . Remained within arm's length of client during the shift
5 . Permitted client to refuse oral psychotropic medication
Which intervention, if any, violated a right of the client?
A. none
B. 1
C. 2
D. 3
E. 4
F. 5

Question 2

A client tells the nurse I don't think I'll ever get out of here.. A therapeutic response would be

a. You shouldn't talk that way. Of course you'll leave here
b. Everyone feels that way sometimes..
c. You don't think you're making progress?
d. Keep up the good work and you certainly will..

Natalie4ever · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: A
Rationale: Actions 1 and 4 preserve the client's right to be protected against the possible impulse to
harm self or others. Action 2 preserved the client's right to legal counsel. Action 3 preserved the
client's rights to send and receive mail and be present during package inspection. Action 5 preserved
the client's right to refuse treatment.

Answer to Question 2

ANS: C
In option C the nurse is reflecting by putting into words what the client is hinting. By making
communication more explicit, issues are easier to identify and resolve. Options A, B, and D are
nontherapeutic techniques. Option A is disapproving. Option B minimizes feelings. Option D is
falsely reassuring.