Answer to Question 1
ANS: D
A client who has been voluntarily admitted as a psychiatric inpatient has the right to demand and
obtain release in most states. However, as a client advocate, the nurse is responsible for weighing
factors related to the client's wishes and best interests. By asking for information, the nurse may be
able to help the client reconsider the decision. Option A is not a true statement. Option B:
Facilitating discharge without consent is not in the client's best interests before exploring the reason
for the request.
Answer to Question 2
A
Severe constraints on the community mental health nurse's time will probably not allow more time
than what is mentioned in option A, yet important principles can be used. A severely withdrawn
client should be met at the client's own level, with silence accepted. Short periods of contact are
helpful to minimize both the client's and the nurse's anxiety. Predictability in returning as stated will
help build trust. Option B: An hour may be too long to sustain a home visit with a withdrawn client,
especially if the nurse persists in leveling a barrage of questions at the client. Option C: Twice-daily
visits are probably not possible, and leaving after 10 minutes would be premature. Touch may be
threatening. Option D: Working on reports suggests the nurse is not interested in the client.
Client position when assessing jugular vein distention.
B, The nurse teaches the postoperative client to use an incentive spirometer to expand the lungs.
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