A nurse at the mental health clinic is leaving his job and ...

[cagreen833]

A nurse at the mental health clinic is leaving his job and relocating to another part of the country in 6 months. What is the best way for him to deal with his clients?
 
  a. Begin to prepare clients for his departure by assisting to transition them to another nurse.
  b. Increase dosage of medications for each client in anticipation of the effect his leaving will have on their progress.
  c. Do not inform clients until after the nurse leaves to avoid additional anxiety.
  d. Wait until the nurse's last day to inform clients to allow them to say good-bye, but avoid additional anxiety.

Question 2

Which assessment data most suggests that the patient is experiencing a fugue state?
 
  a. After being caught in an affair, a man disappeared only to reappear months later without memory of what had occurred while he was missing.
  b. A woman reports that when she feels tired or stressed, it seems like her body isn't real and is somehow growing smaller, which seems crazy to her.
  c. A man is extremely anxious about his problems and sometimes zones out, finding that several minutes have passed without conscious awareness of them.
  d. A woman finds unfamiliar clothes in her closet, is recognized when she walks into restaurants she's never been to, and complains of blackouts despite not drinking.

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Answer to Question 1

A
Planning changes for clients slowly and incrementally allow for minimal resistance. Although there may be a sense of anxiety and loss, it is diminished if done in steps. Increasing medication dosages and not informing clients until the nurse is gone or on his last day do not provide for the open communication and preparation.

Answer to Question 2

A
The patient in a fugue state relocates and lacks recall of his life before the fugue began. Often fugue states follow traumatic experiences and sometimes involve assuming a new identity. Such persons at some point find themselves in their new surroundings, unable to recall who they are or how they got there. A feeling of detachment from one's body or from the external reality is an indication of depersonalization disorder. Losing track of several minutes when highly anxious is not an indication of a dissociative disorder and is not unusual in states of elevated anxiety. Finding evidence of having bought clothes or gone to restaurants without any explanation for these is suggestive of dissociative identity disorder, particularly when periods of time are lost to the patient (blackouts).

[cagreen833]

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