Page 2318 - Saunders Comprehensive Review For NCLEX-RN

Content Area: Mental Health
Health Problem: Mental Health: Addictions
Priority Concepts: Addiction; Family Dynamics
Reference: Varcarolis (2017), p. 319.

820. Answer: 1

Rationale: Most health care facilities have documents that the client is asked to
sign relating to the client’s responsibilities when the client leaves against medical
advice. The client should be asked to wait to speak to the PHCP before leaving and
to sign the “against medical advice” document before leaving. If the client refuses to
do so, the nurse cannot hold the client against the client’s will. Therefore, in this
situation, the nurse should call the nursing supervisor. The nurse can be charged
with false imprisonment if a client is made to believe wrongfully that she or he
cannot leave the hospital. Restraining the client and calling security to block exits
constitutes false imprisonment. All clients have a right to health care and cannot be
told otherwise.
Test-Taking Strategy: Keeping the concept of false imprisonment in mind,
eliminate options 2 and 3 because they are comparable or alike. Eliminate option 4,
knowing that all clients have a right to health care. From the options presented, the
best action is presented in the correct option.
Level of Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process—Implementation
Content Area: Mental Health
Health Problem: Mental Health: Addictions
Priority Concepts: Clinical Judgment; Health Care Law
Reference: Varcarolis (2017), pp. 68-69.

821. Answer: 1, 3, 4

Rationale: Clients with bulimia nervosa initially may not appear to be physically
or emotionally ill. They are often at or slightly below ideal body weight. On further
inspection, a client exhibits dental decay and loss of tooth enamel if the client has
been inducing vomiting. Electrolyte imbalances are present. Dry, scaly skin (rather
than moist, oily skin) is present.
Test-Taking Strategy: Focus on the subject, assessment findings in bulimia
nervosa. It is necessary to recall that in anorexia nervosa the body weight is normally
well below ideal body weight and that clients with bulimia nervosa are often at or
slightly below ideal body weight. Also, remember that skin texture will be dry and
scaly.
Level of Cognitive Ability: Analyzing
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Mental Health
Health Problem: Mental Health: Eating Disorders
Priority Concepts: Anxiety; Nutrition

2318