1. A nurse in dialysis is caring for a client who has a new diagnosis of end-stage kidney disease. when he arrives for his first dialysis treatment, he tells the nurse, "I Decided to come today, but I am not sure if I wi
...
1. A nurse in dialysis is caring for a client who has a new diagnosis of end-stage kidney disease. when he arrives for his first dialysis treatment, he tells the nurse, "I Decided to come today, but I am not sure if I will need to come back again this week. I am feeling much better since my discharge from the hospital and I think my kidneys are working again.” The nurse should identify that this client is demonstrating which of the following Kubler-Ross stages of grieving?
A. Bargaining B. Denial
C. Depression
D. Anger
2. A nurse at a college campus mental health counseling center is caring for a student who just failed an exam. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as an example of the defense mechanism of:
A. Conversion
B. Projection (pt refuses to acknowledge unacceptable personal characteristics and transfers feelings, thoughts, or traits onto another person)
C. Undoing
D. Regression
3. A nurse is planning care for a client who has dementia. Which of the following interventions is appropriate to include in the plan of care?
A. Rotate assignment of daily caregivers
B. Provide an activity schedule that changes from day to day
C. Limit the client's choices for daily activities.
D. Talk the clinet through tasks one step at a time
4. a nurse in a psychiatric unit is caring for several clients. Which of the following clinets should the nurse recommend for group therapy?
A. A client who has been taking amitriptyline for 3 months for depression
B. A client exhibiting psychotic behavior
C. A client admitted 12 hrs ago for acute mania
D. A client who is experiencing alcohol intoxication
5. A nurse in an emergency department is assessing a client for suspected cocaine intoxication. The nurse should know that which of the following manifestations is consistent with cocaine intoxication?
A. Nystagmus B. Dilated pupils
C. Hypersomnia
D. Depression
6. A nurse in a drug and alcohol detoxification center is caring for a client who has a long history of alcohol abuse. Which of the following should be the nurse's primary focus of care during the early phase of alcohol withdrawal?
A. Helping the client identify positive personality traits B. Providing for adequate hydration and rest
C. Confronting the use of denial and other defense mechanisms
D. Education the client about the consequences of alcohol misuse
7. A nurse is caring for a client who has delusional behavior and states, "I can't go to group today. I am expecting a high level official to visit today!" The nurse responds, "I understand, but it is time for group and we expect everyone to attend. Let's walk over together." Why is this nurse's response considered therapeutic?
A. It clearly articulates what is expected of the client
B. It demonstrates empathy towards the client
C. It sets limits on the client’s manipulative behavior
D. It uses reflection when talking with the client
8. A nurse is talking with a 13-year old female at her annual health screening visit. Which of the following comments made by the client should the nurse be most concerned about?
1. My parents treat me like a baby sometimes
2. I haven't gotten my period yet, and all my friends have theirs 3. None of the kids at school like me, and I don't like them either
4. There's a big pimple on my face and I worry that everyone will notice
9. A nurse is assessing a family as a system. Which of the following factors should the nurse include when assessing sociocultural context?
A. The sense of self among individual family members
B. The future goals of the family
C. The roles of the family members
D. The family’s religious practices
10. A nurse is teaching about ECT with a newly licensed nurse. The nurse should identify that the newly licensed nurse understands the teaching when she states that ECT treats which of the following disorders?
A. Narcotic addiction
B. Vegetative depression
C. Personality disorder
D. Eating disorder
11. A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth living anymore." Which of the following responses should the nurse make?
A) "of course people care, your family comes to visit every day"
B) "why do you feel that way?"
C) "tell me who you think doesn't care about you"
D) "I care about you, and I am concerned that you feel so sad"
12. A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting, and now the client is pacing up and down the corridors of the unit. Which of the following actions should the nurse take?
A) instruct the client to sit down and stop pacing
B) allow the client to pace alone until physically tired
C) have a staff member escort the client to their room D) walk with the client at a gradually slower pace
13. A nurse
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