EXAM 2- PSYCH

The nurse is discussing expectations of raising a child with a pregnant teenager expecting her first baby. The father will not be a participant in the parenting. Which of the following statements made by the expectant mother would be of greatest concern to the nurse? A) ìI am going to rely on my sisters for a lot of help raising my baby.î B) ìI was raised with very strict discipline.î C) ìMy child will love me unlike my parents ever did.î D) ìI am not sure how I am going to pay for all the things my child will need.î

C) ìMy child will love me unlike my parents ever did.î

22. A young client tells the nurse that the client's spouse died 3 months ago, and the client is feeling alone and vulnerable. Which statement indicates that the client's coping skills are adequate? A. "I can't understand why this happened to me." B. "I'm mentally healthy. I can solve my own problems." C. "I will find a support group to help me through this." D. "What can I do? My spouse abandoned me."

C. "I will find a support group to help me through this."

9. The nurse is working with a client who experienced their youngest child's death 2 months ago. When the nurse approaches, the client yells, "I don't want to talk to you. You have no idea what it's like to lose a child!" Which response is most therapeutic to the client? A. "Please lower your voice and speak to me respectfully." B. "I understand exactly what you are going through right now." C. "I would like to sit with you. We don't need to talk right now." D. "I will leave so you don't have to talk to me if you don't want to

C. "I would like to sit with you. We don't need to talk right now."

7. The nurse is preparing a client that has been in the behavioral health unit with depression from the loss of a family member for discharge. The client states to the nurse, "I just didn't care before about eating or doing anything to care for myself." Which is the best response by the nurse? A. "You probably won't feel like doing much for the next few weeks while you are on this depression medication." B. "You have done so well why you have been here that I would hate to see you slip into old patterns." C. "It's important for you to eat a nutritious diet, hydrate, and exercise to help relieve stress and tension." D. "It is time that you get out and meet new people and start enjoying your life. Life is too short."

C. "It's important for you to eat a nutritious diet, hydrate, and exercise to help relieve stress and tension."

29. A client comes to the health care provider's office for an annual checkup. During the interview, the client informs the nurse that the spouse died unexpectedly of a heart attack 2 months ago. Which is the most appropriate response by the nurse? A. "At least you and your spouse enjoyed life right until the end." B. "It's better to go quickly like your spouse did instead of suffering." C. "The loss of your spouse must be very painful for you." D. "You'll feel better after you get over the shock of your spouse's death."

C. "The loss of your spouse must be very painful for you."

25. The nurse approaches a client who looks very sad and is sitting alone crying. Which is the best response by the nurse in this situation? A. "I'm sorry you are sad. Is there anything I can do to help you feel better?" B. "Please don't cry. It will get better." C. "You look very sad. What is happening?" D. "I know you are upset but things will look better tomorrow"

C. "You look very sad. What is happening?"

3. A young adult client is scheduled for a hysterectomy and states to the nurse, "I don't know why I'm so upset about it, it's not like I am going to have more children." Which is the most therapeutic response by the nurse? A. "I had a hysterectomy when I was about your age and felt so much better after it." B. "If you think about it logically, it really is just like getting your appendix taken out."C. "Your feelings are valid. Let's talk about your feelings about having the surgery and what bothers you most." D. "You'll do fine during your surgery because you have one of the best surgeons performing the procedure."

C. "Your feelings are valid. Let's talk about your feelings about having the surgery and what bothers you most."

13. The nurse is providing care to a client experiencing bereavement after the death of a family member. Which action is most effective in order to provide the most culturally competent care? A. Understand the practices associated with a client's culture. B. Suggest developing a new ritual to make mourning meaningful. C. Ask the client which rituals are personally meaningful. D. Contact a spiritual leader from the client's culture to become involved.

C. Ask the client which rituals are personally meaningful.

4. A client has just been informed of a diagnosis of terminal cancer. The client states, "God has to have mercy on me because my children need me. God knows I'll change if I get through this." The nurse documents that the client is expressing signs of which of Kübler-Ross's stages of grief? A. Denial B. Anger C. Bargaining D. Depression

C. Bargaining

6. The client with terminal lung cancer says to the nurse, "I really want to see my first grandchild born before I die. Is that too much to ask?" Which stage of grieving will the nurse document the client is experiencing? A. Acceptance B. Anger C. Bargaining D. Depression

C. Bargaining

17. The nurse is caring for a client who was recently in a motor vehicle accident and paralyzed from a T6 spinal cord fracture. Which is most likely to prevent the client from experiencing complicated grief? A. The client's tendency to suppress emotions B. A history of depression treated with medication C. The client places trust in people familiar to them. D. The client is dependent on others to meet their needs

C. The client places trust in people familiar to them.

35. A nurse cared for a terminally ill client over a month and developed a therapeutic nurse-client relationship. After the client's death, feelings of sadness, sleeping poorly, and feeling mildly depressed were experienced by the nurse. Which is the best action to improve resolution of grief? A. The nurse needs to use stress reduction strategies. B. The nurse needs to seek therapy for dysfunctional grief. C. The nurse and should seek an informal forum for discussing death. D. The nurse needs to consider taking a leave of absence to pursue healing.

C. The nurse and should seek an informal forum for discussing death.

Which one of the following statements about anger is most accurate? A) Anger is an abnormal human emotion that is always negative. B) It is best to express anger by whatever means possible to minimize its consequences. C) Most men are socialized to suppress anger. D) Anger awareness and expression are necessary for women's growth and development.

D) Anger awareness and expression are necessary for women's growth and development

Which of the following is most important to maintain therapeutic boundaries when working with aggressive clients? A) Encourage clients to express how the nurse can avoid causing emotional irritation. B) Discuss difficult patient care situations with a supervisor. C) Reflect on your actions that may have instigated the client's anger, D) Do not personalize a client's anger

D) Do not personalize a client's anger

The nurse observes two clients in the day room arguing. One client runs into the corner and huddles while the other follows and continues with verbal abuse. Which is the best action by the nurse? A) Take an authoritatively step between the two clients. B) Comfort the client huddled in the corner. C) Directly address both clients and ask what is going on. D) Engage the attention of the client who is still yelling and ask what is happening

D) Engage the attention of the client who is still yelling and ask what is happening

Which of the following statements about the crisis phase of aggression when the client becomes physically aggressive is true? A) All staff should act to take charge of the situation. B) The client must be restrained or sedated at once. C) Staff should avoid communicating with the client. D) Four to six trained staff members are needed to restrain.

D) Four to six trained staff members are needed to restrain

What is the major difference between post traumatic stress disorder(PTSD)and acute stress disorder? A) In acute stress disorder, the client is likely to develop exacerbation of symptoms. B) In PTSD, the recovery rate is 80% within 3 months. C) The severity and duration of the trauma are the most important variables in acute stress disorder. D) In PTSD, the symptoms occur 3 months or more after thetrauma

D) In PTSD, the symptoms occur 3 months or more after the trauma

The community health nurse meets with the family members of an elderly client. The nurse includes which of the following in the plan of care as a preventive measure to guard against elder abuse? A) Reassure the primary caregiver that he or she in the best position to provide care to the elder B) Teach the primary caregiver skills to meet all of the elder's needs C) Assist in the transfer of legal authority for elder care to the primary caregiver D) Provide the primary caregiver with additional resources to meet the elder's need

D) Provide the primary caregiver with additional resources to meet the elder's need

A coherent elderly woman has been financially and emotionally abused by her adult children for the past several years, but has failed to report the abuse to anyone. Which is the most likely reason that the woman neglects to report the abuse? A) She cannot claim abuse if there is no evidence of physical harm. B) Laws do not provide protection against abuse when the suspect(s) is/are family members. C) She has no financial resources to hire legal representation against her children. D) She is emotionally close to her children and does not want to bring them harm.

D) She is emotionally close to her children and does not want to bring them harm

The nurse is working in the emergency department with a woman who was raped 1 hour ago. Which of the following is most important for the nurse to remember when planning care? A) The client should set aside any angry feelings until physical care is completed. B) Evidence collection according to procedures is not as important as treating the client's injuries. C) The nurse will need to make decisions for this client. D) The woman may feel threatened by some of the procedures.

D) The woman may feel threatened by some of the procedures.

A female college student comes to the counseling center and tells the nurse she is afraid of her boyfriend. She states, ìHe is so jealous and overprotective; he wants to know where I am and who I'm with every minute.î Which of the following is most likely true of the situation? A) The student is overreacting. B) This is a situation requiring a restraining order. C) The student's boyfriend is simply insecure and needs reassurance. D) This is characteristic of the tension-building phase of the violence cycle

D) This is characteristic of the tension-building phase of the violence cycle

A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints. Which statement should the nurse make to explain the use of restraints to the client? A) ìThe length of time you'll be in restraints is undetermined.î B) ìThe staff will monitor your behavior closely.î C) ìThis is what happens when you lose control.î D) ìThis is a means of keeping you and others safe.î

D) ìThis is a means of keeping you and others safe.î

After.an angry out burst, the client is tearful and remorseful.Which statement by the nurse would be most supportive? A) ìYou still need to work on your problem-solving skills.î B) ìI will not allow you to get that angry again.' C) ìYou should not have let your anger buildup like you did.î D) ìWhat could you have done when you first started to feel angry?î

D) ìWhat could you have done when you first started to feel angry?î

The nurse is working with a client at the battered women's shelter who is in a violent and abusive relationship. The client is considering a separation and asks the nurse, ìWhat do you think about that?î Which is the best response by the nurse? A) ìBatterers never change, so it would be best for you to leave.î B) ìIf you don't leave, he'll think you're going to continue to endure his abuse.î C) ìIf you leave, maybe he'll see that he has to change his behavior.î D) ìYou may be in more physical danger after you leave him.î

D) ìYou may be in more physical danger after you leave him.î

A client suddenly jumps up from the chair and begins yelling and cursing at the nurse. Which would be the best response by the nurse? A) ìI can see that you need attention; you should calmly ask for what you want.î B) ìI don't want to hear that kind of language; don't ever do that again.î C) ìI will limit your smoking privileges if you can't control yourself.î D) ìYou seem angry. Tell me more about how you're feeling.î

D) ìYou seem angry. Tell me more about how you're feeling.î

5.The nurse is performing an assessment for a client that is unkempt and withdrawn and reports fatigue and spending most of the days in bed after losing a job. Which is the most therapeutic response by the nurse? A. "Why did you lose your job? B. "Have you considered looking for another job?" C. "Do you have a history of depression?" D. "Have you considered harming yourself?"

D. "Have you considered harming yourself?"

26. A client has just been served divorce papers from a spouse. The client has no financial resources and little social support. The client states, "My spouse is not really leaving, they will be back." Which is the most therapeutic response by the nurse? A. "Has your spouse done this before?" B. "I'll call social services and get you signed up for financial assistance." C. "You have to face reality. Here are the papers." D. "How is this affecting you right now?"

D. "How is this affecting you right now?"

28. A client who has been grieving the loss of the client's spouse 2 weeks ago says to the nurse, "The best part of my day is when I am back at work. Is that wrong?" Which is the most therapeutic response by the nurse?A. "You cannot work effectively this soon. You should finish grieving first." B. "Working reminds you of your loss. It may be too early to go back." C. "Working is your way of avoiding grief, which will make it harder for you to move on." D. "Working is letting you take an emotional break from grieving. There's nothing wrong with that."

D. "Working is letting you take an emotional break from grieving. There's nothing wrong with that."

30. A nurse is providing care to a client who has just delivered a stillborn infant. Which would be the most appropriate nursing response to address the client's grief?A. "Can I do anything for you?" B. "If something was wrong, it's better this way." C. "Your child is in heaven with God now." D. "Would you like to hold your child?"

D. "Would you like to hold your child?"

36. The nurse is working with a client who lost a life partner nearly 3 weeks ago. The client has recently become less emotional and expressed an interest in possibly returning to work. Which response by the nurse is most appropriate at this time? A. "I am concerned. You are starting to show signs of ineffective grieving." B. "You must feel some anger. It is all right to let that out." C. "Let's look at the things in your life that you still enjoy." D. "You are just starting to accept that this loss is real."

D. "You are just starting to accept that this loss is real."

15. A client has just had an elective abortion to end an unintended pregnancy. Afterward, the client cries because although they wanted to have children in future years, this pregnancy was not well timed. Which type of grief is this client most likely to experience? A. Anticipatory grief B. Absence of grief C. Complicated grief D. Disenfranchised grief

D. Disenfranchised grief

23. A couple comes to the emergency department with their 5-month-old child that is not breathing or with a pulse. After resuscitation efforts, the child dies in the emergency department (ED) with the parents in attendance. Which action by the parents will help with the grieving process? A. Postpone notification to the extended family. B. Delay expressing grief until ready to cope. C. Minimize discussion of the death with others. D. Plan funeral arrangements for the child.

D. Plan funeral arrangements for the child.

14. A nurse has been caring for a gunshot victim who has just died. Various family and friends are present. One of the visitors privately discloses to the nurse that the visitor and the client were having an affair. Which is the best action by the nurse after learning of this relationship? A. Give the name of a clergy to the visitor and suggest the visitor contact the person for support. B. Encourage the visitor to ask for support from the friends who are present. C. Ignore the information about the affair and tend to the family. D. Privately offer support to the visitor who was having the affair with the client.

D. Privately offer support to the visitor who was having the affair with the client.

34. A nurse is caring for a client who is grieving the loss of a loved one. Which factor will the nurse identify as contributing to the possibility of complicated bereavement? A. The client was relatively independent of the deceased. B. The client had few unresolved conflicts in the relationship with the deceased. C. The client has a good support system with meaningful relationships evident.

D. The client has experienced a number of previous losses.

21. The nurse is talking with a client that has been feeling depressed lately. Which situation that the client is experiencing indicates that the client is feeling a loss of self-esteem? A. The client is having an amputation of the left leg due to diabetes. B. The client realizes that they will never be able to have a child. C. The client is the survivor of a mass shooting in a synagogue. D. The client is fired from a job they had worked at for over 25 years

D. The client is fired from a job they had worked at for over 25 years

2. The nurse is meeting with a client that is experiencing complicated grieving from the death of their child to suicide. In order to establish a therapeutic nurse-client relationship, which will the nurse do prior to the meeting? A. The nurse will evaluate previous methods of interventions that were beneficial. B. The nurse will share personal information for the client related to the loss experienced by the nurse. C. The nurse will establish the goals for the process and present to the client. D. The nurse should examine their personal attitudes related to loss and grieving.

D. The nurse should examine their personal attitudes related to loss and grieving.

27. An older adult client living alone after the death of a spouse is having difficulty maintaining the home. The client states to the nurse, "I don't need help. I've been managing for years." Which response helps the client shift from denial to consciously coping with the situation? A. "You don't think you need any help? But your family is worried about you." B. "It must be hard to lose your independence. I'll ask a social worker to see what can be arranged." C. "If you were to need help with your house, who might you ask for help?" D. "If you don't ask for some help then the only option is to move to an assisted living facility."

c- if you were to need help with your house, who might you ask for help?

After an angry outburst, a client quickly appears more calm and rational. The nurse approaches the client. Which of the following is the most helpful response to the client at this time? A) ìWe will have to talk about this later.î B) ìYou really scared me. I'm glad you are okay.î C) ìWhat happened that got you so upset?î D) ìWhat can you do differently next time you get angry?

c- what happened that got you so upset?

11. The nurse is conducting a history and physical exam on a client who is grieving the unwanted loss of a marriage by divorce. Which subjective physical symptom of grief would the nurse most likely assess when performing the assessment? a- hair loss b- insomnia c- compulsive behavior d vomiting

insomnia

Which of the following are common characteristics of violent families regardless of the type of abuse that exists? Select all that apply. A) Abuse of power and control B) Alcohol and other drug abuse C) Intergenerational transmission D) Social isolation E) Victim instigates

A) Abuse of power and control B) Alcohol and other drug abuse C) Intergenerational transmission D) Social isolation

Anger management is likely to be included in the care of clients with which of the following psychiatric diagnoses? Select all that apply. A) Alzheimer's dementia B) Schizophrenia C) Anorexia nervosa D) Acute alcohol intoxication E) Generalized anxiety disorder

A) Alzheimer's dementia B) Schizophrenia D) Acute alcohol intoxication

The nurse is assessing an elderly female in the emergency department. There are many bruises present on her body in varying stages of healing. After documenting the bruising in the assessment, what should the nurse do next? A) Ask the client when and how the bruises occurred B) Call the nursing supervisor immediately C) Follow the facility's policy and procedures for reporting abuse D) Notify the physician that abuse is suspected

A) Ask the client when and how the bruises occurred

An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following? A) Call for an emergency response from trained personnel. B) Approach the client and firmly say, ìStop, put it down.î C) Calmly call the client by name and encourage verbal expression of anger. D) Assist the client to use problem-solving techniques instead of aggression

A) Call for an emergency response from trained personnel.

When interacting with a client in the day room, the nurse determines that a violent outburst is imminent. Which of the following should the nurse do first? A) Call for assistance. B) Give the client choices. C) Remove the other clients. D) Talk to the client calmly.

A) Call for assistance.

A young woman telephones the emergency department and loudly tells the nurse, ìI've been raped! Please help me!î Which of the following is the priority for the nurse to determine? A) If the client was in a safe place, her condition, and if transportation is available B) If the client knew her assailant, knew her location, and had notified the police C) If the client has insurance, if she could get to the hospital by herself, and if pregnancy is a possibility D) If the client had bathed, douched, or changed clothes

A) If the client was in a safe place, her condition, and if transportation is available

A nurse is working with a client who has a history of repeated abusive intimate relationships. The nurse has difficulty understanding why a woman would repeatedly enter into relationships with abusive partners. When working with this client, the nurse can best maintain a therapeutic relationship through which of the following approaches? A) Keeping focused on the client's feelings about her life situation B) Honestly asking the client why she repeats the cycles of victimization C) Convincing the client to develop a self-rescue plan D) Not prying into the details of the client's private life

A) Keeping focused on the client's feelings about her life situation

The nurse is involved in a community education program for new parents and plans to include information on child abuse. The nurse will teach the parents that the most common form of child abuse is which of the following? A) Neglect B) Physical abuse C) Sexual abuse D) Emotional abuse

A) Neglect

Which of the following are important issues for nurses to be aware of when working with angry, hostile, or aggressive clients? Select all that apply. A) Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution. B) Nurses must not allow themselves to become angry under any circumstances. C) Nurses must know that a client's anger or aggressive behavior is preventable by a skilled nurse. D) Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses. E) Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.

A) Nurses must be aware of their own feelings about anger and their use of assertive D) Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses. E) Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.

Which of the following are common behavioral and emotional responses to abuse? Select all that apply. A) One third of abusive men are likely to have come from violent homes. B) Women who grew up in violent homes are 50% more likely to expect or accept violence in their own relationships. C) Dependency on the abuser is a common trait found in victims of domestic violence. D) The victim caused the abuse. E) It is critical for the nurse to demonstrate acceptance after hearing about the abuse so that the victim may begin to gain self-acceptance.

A) One third of abusive men are likely to have come from violent homes. B) Women who grew up in violent homes are 50% more likely to expect or accept violence in their own relationships. C) Dependency on the abuser is a common trait found in victims of domestic violence. E) It is critical for the nurse to demonstrate acceptance after hearing about the abuse so that the victim may begin to gain self-acceptance.

Which of the following interventions are most effective in managing the environment to reduce or eliminate aggressive behavior? Select all that apply. A) Planning group activities such as playing games B) Scheduling one-to-one interactions with the client C) Providing structure and consistency in the unit D) Avoiding discussions among clients on the unit E) Discouraging clients from negotiating solutions

A) Planning group activities such as playing games B) Scheduling one-to-one interactions with the client C) Providing structure and consistency in the unit

One of the first steps that a nurse should take to deal effectively with aggressive clients is which of the following? A) Reflect on abilities to handle own feelings of anger B) Learn professional skills of anger management C) Become proficient using reflective communication techniques D) Understand how to activate crisis response teams

A) Reflect on abilities to handle own feelings of anger

which of the following are common reasons why abused women remain with the abusive partner? Select all that apply. A) The abused person is personally and financially dependent on the abuser. B) The abused person has low self-esteem and defines her success as a person by the ability to make the relationship work. C) The abused person is convinced that she has been abusive toward the abuser at some point and that the abuse is her fault. D) The abused person believes that she is unable to function without her husband. E) The abused person is afraid that the abuser will kill her if she tries to leave.

A) The abused person is personally and financially dependent on the abuser. B) The abused person has low self-esteem and defines her success as a person by the ability to make the relationship work. D) The abused person believes that she is unable to function without her husband. E) The abused person is afraid that the abuser will kill her if she tries to leave.

The nurse is collecting assessment data on a client who is suspected to be a victim of violence. Which assessment data would support the suspicion that the client is a victim of abuse? Select all that apply. A) The client has few friends. B) The client holds a dominant role in the family. C) The client is in charge of the family finances. D) There is a moderate amount of alcohol use in the home. E) The client reports that the father was abusive during childhood

A) The client has few friends. D) There is a moderate amount of alcohol use in the home. E) The client reports that the father was abusive during childhood

The nurse is caring for a 16-year-old boy with a history of sexual abuse. What might the nurse expect to assess with this client? A) The client will experience long-term emotional trauma. B) The client will have no ill effects due to his age. C) The client will have high self-esteem. D) The client will easily share his concerns with the nurse.

A) The client will experience long-term emotional trauma.

A school nurse is educating a group of adolescent girls about rape and sexual assault. The nurse evaluates the students' understanding when they report which of the following as a high-risk factor regarding the incidence of rape? A) The highest incidence of rape occurs in adolescents and young adult women. B) Most rapes are committed by strangers. C) Most rapes are random acts of violence. D) A victim is at highest risk in unfamiliar neighborhoods.

A) The highest incidence of rape occurs in adolescents and young adult women.

Which of the following are typical characteristics of the perpetrator of intimate partner abuse? Select all that apply. A) The perpetrator often believes that the partner is his own property. B) The perpetrator is often irrationally jealous, even of his own children. C) The perpetrator is emotionally immature and needy. D) The perpetrator respects his partner. E) The perpetrator is intimidated by his

A) The perpetrator often believes that the partner is his own property. B) The perpetrator is often irrationally jealous, even of his own children. C) The perpetrator is emotionally immature and needy.

A woman has just presented at the emergency department after being raped.The initial nursing action would be to A) provide emotional support. B) refer her to a rape crisis hotline. C) encourage her to file charges immediately. D) perform a nursing history and physical as quickly as possible

A) provide emotional support.

A client approaches the nurse and loudly states, ìI'm not putting up with this anymore!î The most appropriate response by the nurse would be which of the following? A) ìI can see you are angry. Tell me what's going on.î B) ìYou are not allowed to make threats. Please keep your voice down.î C) ìWhy do you say that?î D) ìYou are here voluntarily. You can leave if you want.î

A) ìI can see you are angry. Tell me what's going on.î

8. Friends of two teenagers recently killed in a car accident are discussing their sense of loss. Which comment best indicates that the friends are trying to make sense of the loss cognitively? A. "Why did they have to die so young?" B. "They shouldn't have been driving so recklessly." C. "If we had only stayed longer, they would not have been on that road." D. "It took the ambulance too long to get there."

A. "Why did they have to die so young?"

12. The nurse is caring for a client whose death is imminent and receiving home hospice care. In preparing the family members for the imminent death of their loved one, how will the hospice nurse assist the family in the grieving process? Select all that apply. A. Dealing with the shock of losing a loved one B. Burial plans after death has occurred C. Efforts to stay connected to the client after death D. Use of support from family and friendsE. Anger at the loss of a loved one

A. Dealing with the shock of losing a loved one C. Efforts to stay connected to the client after death E. Anger at the loss of a loved one

The school nurse is teaching a health class about recognizing the signs of abusive relationships. The nurse describes the cycle of violence. The nurse would document effective teaching if the students identify the cycle of violence to be which of the following patterns? Select the order in which the events occur. A. Tension building B. Honeymoon period C. Violent behavior D. Period ofremorse

A. Tension building C. Violent behavior

24. The nurse is creating a plan of care for a grieving client. Which outcome will the nurse establish that will be most beneficial? A. The client will develop a plan for coping with the loss. B. The client will demonstrate self-reliance during the grief process. C. The client will suppress emotions related to the loss. D. The client will verbalize that loss will not adversely affect the quality of life.

A. The client will develop a plan for coping with the loss.

18. A nurse is assessing several clients who have experienced loss. Which client will the nurse identify as experiencing complicated grieving? Select all that apply. A. The spouse of a person who died 7 years ago and visits the grave several times a day B. The grandchild of a soldier killed in war who visits the grave once a year on Memorial Day C. A driver whose spouse and children all died as a result of his driving drunk D. An adult who insisted for many years that the adult hated the adult's deceased parent E. The parent of a child who died after the having left the child in a car on a hot day

A. The spouse of a person who died 7 years ago and visits the grave several times a day C. A driver whose spouse and children all died as a result of his driving drunk D. An adult who insisted for many years that the adult hated the adult's deceased parent E. The parent of a child who died after the having left the child in a car on a hot day

10. The bereaved client has worked through many processes of grief with the nurse. Which are eventual outcomes of the emotional dimension of grieving? Select all that apply. A. The survivor begins to reestablish a sense of personal identity, direction, and purpose for living .B. The survivor begins to gain independence and confidence. C. The survivor develops new ways of managing life and new relationships. D. The survivor's life returns to the same state as it was before the loss. E. The survivor forgets about the loss.

A. The survivor begins to reestablish a sense of personal identity, direction, and purpose for living. B. The survivor begins to gain independence and confidence. C. The survivor develops new ways of managing life and new relationships.

The nurse decides to place an aggressive and violent client in mechanical restraints. The nurse bases this decision on which of the following? A) Client's mood B) Client's safety C) Court order D) Physician's order

B) Client's safety

Whichpsychiatricdisordermakesapersonmostsusceptibletoangerattacksthatdo not result in physical aggression? A) Delusions B) Depression C) Dementia D) Delirium

B) Depression

A woman is in treatment for an anxiety disorder. Her history reveals that she was sexually abused repeatedly by her husband. Which of the following interventions would be appropriate in relation to this piece of data? A) Avoid discussing the abuse so as not to upset her. B) Encourage her to talk about feelings related to the abuse. C) Request an anxiolytic to reduce her anxiety levels. D) Help her explore her role in perpetuating the abuse.

B) Encourage her to talk about feelings related to the abuse.

Which of the following interventions would assist the client with the appropriate expression of anger? A) Encourage catharsis B) Encourage verbalization C) Improve self-esteem D) Isolate the client from others

B) Encourage verbalization

In the psychiatric setting, what is the most effective intervention in preventing the hostile client's behavior from escalating to physical aggression? A) Getting as far away from him or her as possible B) Engaging the hostile person in dialogue C) Yelling at the client to settle down now D) Ensuring that the client gets his or her

B) Engaging the hostile person in dialogue

A client is observed pacing the hall with clenched fists and swearing at others. The nurse intervenes immediately to prevent the client from moving to which phase of the aggressing cycle? A) Triggering B) Escalation C) Crisis D) Recovery

B) Escalation

The client's son is yelling and is hitting his hand with a rolled up newspaper. Which stage of aggression does the nurse identify that the client's son is exhibiting? A) Triggering B) Escalation C) Crisis D) Recovery

B) Escalation

Which of the following statements about post traumatic stress disorder is accurate? A) Estimates are that the disorder is very rare. B) Estimates are that up to 60% of people at risk develop PTSD. C) Only 20% of victims of rape develop PTSD. D) PTSD symptoms usually begin at the time of the trauma

B) Estimates are that up to 60% of people at risk develop PTSD.

The nurse is interviewing a client with a history of physical aggression. Which of the following should the nurse avoid? A) Anticipating that a loss of control is possible and planning accordingly B) Explaining the consequences the client will face if control is lost C) Interviewing the client with another staff member present D) Responding to verbal threats by terminating the interview and obtaining assistance

B) Explaining the consequences the client will face if control is lost

which of the following is the best explanation for why family violence tends to occur over multiple generations of families? A) A tendency toward violence is hereditary. B) Family violence may be perpetuated between generations of families by role modeling and social learning. C) All persons who have become victims of family violence will grow up to perpetrate family violence. D) Family violence does not tend to have an intergenerational transmission process

B) Family violence may be perpetuated between generations of families by role modeling and social learning.

The client identifies anger management as a problem. What is the next step in planning therapeutic interactions? A) Give the client a variety of choices on how to express anger. B) Give the client permission to be angry. C) Point out the senselessness of anger. D) Tell the client not to be angry all the time.

B) Give the client permission to be angry.

Which of the following might the nurse recognize as longer-term responses to trauma and stress? Select all that apply. A) Acute stress disorder B) Posttraumatic stress disorder C) Adjustment disorder D) Reactive attachment disorder E) Dissociative disorder

B) Posttraumatic stress disorder C) Adjustment disorder D) Reactive attachment disorder E) Dissociative disorder

Which of the following would the nurse know are the major elements of post traumatic stress disorder (PTSD)? Select all that apply. A) Trying to avoid any places or people or situations that may trigger memories of the trauma B) Reexperiencing the trauma through dreams or recurrent and intrusive thoughts C) Becoming increasingly more isolated D) Emotional numbing such as feeling detached from others E) Being on guard, irritable, or experiencing hyperarousal

B) Reexperiencing the

Which of the following would the nurse know are the major elements of post traumatic stress disorder (PTSD)? Select all that apply. A) Trying to avoid any places or people or situations that may trigger memories of the trauma B) Reexperiencing the trauma through dreams or recurrent and intrusive thoughts C) Becoming increasingly more isolated D) Emotional numbing such as feeling detached from others E) Being on guard, irritable, or experiencing hyperarousal

B) Reexperiencing the trauma through dreams or recurrent and intrusive thoughts D) Emotional numbing such as feeling detached from others E) Being on guard, irritable, or experiencing hyperarousal

The nurse is teaching a client to recognize early signs of anger and aggression. The nurse explores ways that the client can recognize which of the following? A) Decreased problem-solving ability B) Restlessness and irritability C) Remorse D) Severe muscle tension

B) Restlessness and irritability

A young female immigrant presents in the rural health clinic with facial bruising and a fractured nose. The client is reluctant to give details of the nature of her injuries. Which of the following should be a consideration in providing care for this client? A) Most views regarding domestic violence are universal across cultures. B) She may fear deportation if she seeks public assistance. C) Immigrants have expedited access to public legal services. D) The nurse should ignore the details and focus on treatment

B) She may fear deportation if she seeks public assistance.

Which of the following statements regarding the individual responses to trauma and stressors is a positive outcome? A) Many individuals are unable to cope with the event, manage their stress and emotions, or resume the daily activities of their lives. B) Some individuals may develop enhanced coping as a result of dealing with the stressor. C) These events are only significant in individuals who have risk for or actual mental health problems or issues. D) Large numbers or groups of people may be affected by a traumatic event.

B) Some individuals may develop enhanced coping as a result of dealing with the stressor.

Which is most likely to be the subject of an aggressive attack from a client with mental illness? A) Other people B) The client C) Animals D) Objects

B) The client

33. After the death of a client's spouse, the client tells the nurse, "I can never live without my spouse. They were my whole life." Which is the most therapeutic response from the nurse? A. "Remember, your spouse is no longer suffering." B. "Your spouse's death is a terrible loss for you." C. "Each day will get a little better." D. "Your friends will help you cope with this."

B. "Your spouse's death is a terrible loss for you."

16. The nurse is leading a support group for clients at the outpatient clinic that have experienced a loss. Which clients are most likely to experience disenfranchised grief? Select all that apply. A. A young adult whose spouse has just died suddenly B. A family whose long-time pet snake has just died C. A nurse who has just witnessed the death of a client D. A couple who has just experienced pregnancy loss E. The partner of a client who just died from AIDS

B. A family whose long-time pet snake has just died C. A nurse who has just witnessed the death of a client D. A couple who has just experienced pregnancy loss E. The partner of a client who just died from AIDS

1. A client with end-stage alcoholic cirrhosis of the liver is hesitant to talk about the illness and the impending loss of life from their alcohol use disorder. Which action by the nurse can promote the client's ability to express their feelings? A. Inform the client that since it is too late to change, acceptance is inevitable. B. Be an active listener and use silence to facilitate communication. C. Refer the client to the chaplain for religious counseling. D. Ask the client if they are in denial regarding the seriousness of their illness.

B. Be an active listener and use silence to facilitate communication.

19. The nurse is having an initial counseling session with a client that had a spontaneous abortion at 28-weeks' gestation. After establishing rapport, which is the priority nursing intervention? A. Assessing the client's support system B. Exploring what this loss means for the client C. Discussing helpful ways to cope with the loss D. Assessing what knowledge the client desires about the situation

B. Exploring what this loss means for the client

20. The nurse is assessing a client that is newly grieving a life partner. Which are critical components for the nurse to assess in this client? Select all that apply .A. Genetic risk B. Perception of the loss C. Support system D. Coping behaviors E. Spiritual and religious

B. Perception of the loss C. Support system D. Coping behaviors E. Spiritual and religious

32. A client states to a nurse, "They found a lump in my neck, and now they tell me I have an incurable disease." The client is young and appears to find this information hard to believe. Which pattern of response does the client's statement reflect? A. Restitution B. Shock and disbelief C. Physiologic grieving D. Recovery

B. Shock and disbelief

31. A client is scheduled for a mastectomy for breast cancer. The client is quiet, shows little emotion, and states that they have no questions. Which priority assessment will the nurse perform for this client? A. The client's plans for reconstructive surgery B. What the mastectomy means to the client C. Whether the client completely understands the surgery D. Why the client seems depressed

B. What the mastectomy means to the client

what a culture considers acceptable strongly influences the expression of anger. Which culture-bound syndrome is a dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at other people and objects? A) Hwa-Byung B) Hwabyeong C) Amok D) BouffÈe

C) Amok

Atwhichpointinthestagesofaggressiveincidentsisinterventionleastlikelyto be effective in preventing physically aggressive behavior? A) Triggering B) Escalation C) Crisis D) Postcrisis

C) Crisis

Which one of the following statements regarding intimate partner violence is true? A) Males are never the victim in intimate partner violence. B) It is common for abusers to use one type of abuse only. C) Intimate partner violence can exist with former partners. D) Psychological abuse is not as harmful as physical abuse.

C) Intimate partner violence can exist with former partners.

The nurse at a university health services clinic has been asked to meet with a freshman class of women about warning signs of relationship violence. The nurse points out which of the following danger signs the students should be alert for in a date? A) Dislikes your fiends B) Acts indifferent to your life choices C) Is excessively jealous D) Views you as superior to himself

C) Is excessively jealous

Which characteristic of the abuser should the nurse look for when completing the family assessment of a victim on intimate partner violence? A) Encourages the partner to have a life outside the intimate relationship B) An inflated sense of self-esteem C) Needy and possessive of the partner D) An ability to feel remorse for the abuse

C) Needy and possessive of the partner

A client is clenching his fists and yelling at another client on the unit. He appears to be close to losing control of his anger. Which of the following actions by the nurse is appropriate at this time? A) Clear others out of the immediate area. B) Prepare a PRN sedative. C) Tell the client to stop and take a time-out. D) Alert the security department of an impending aggressive outburst.

C) Tell the client to stop and take a time-out.

Which of the following behaviors would first alert the school nurse or teacher to suspect sexual abuse in a 7-year-old child? A) The child has a preference for associating with peers, rather than adults. B) The child has learning problems and shyness. C) The child tells sexually explicit stories to peers. D) The child wears dirty and threadbare clothing

C) The child tells sexually explicit stories to peers.

The pediatric nurse is caring for a 15-month-old child recently admitted tothe hospital for a fractured femur. Which of the following data obtained during the assessment would raise the nurse's suspicion that the child has suffered physical abuse? A) The parents appearing overprotective of the child B) Bruises over the child's bony prominences C) The injury occurring several days before the parents sought treatment D) Both parents reporting the exact same details pertaining to the injurious event

C) The injury occurring several days before the parents sought treatment

A client who has been physically aggressive arrives at the emergency room for a psychiatric assessment. Which would be the best approach for the nurse to use? A) Have a sense of humor to show a lack of fear. B) Provide close contact to increase the client's sense of safety. C) Use brief statements and questions to obtain information. D) Use open-ended questions, so the client can elaborate.

C) Use brief statements and questions to obtain information.

The client with a history of explosive outbursts becomes angry and states, ìI am really getting angry.î The nurse sees this as A) controlling. B) manipulation. C) progress. D) regression.

C) progress.

A married man expresses to the nurse that his wife's frequent nagging angers him. The nurse role-plays assertive communication techniques with the husband. Which of the following indicates the husband understands how to use assertive techniques effectively? A) ìI really wish you would stop nagging me.î B) ìYou are not perfect either.î C) ìI feel unappreciated when you criticize me.î D) ìAre you telling me you want me to change?

C) ìI feel unappreciated when you criticize me.î