Exam 4 Practice Questions
All treatment team members are seen as equally important in helping clients meet their treatment goals. This type of therapy approach is: a. Milieu therapy b. interpersonal therapy c. behavior modification d. rational emotive therapy
A
An agitated 80 year old patient states, "I'm having trouble with my bowels." Which response by the nurse incorporates the interviewing skill of reflection? a. "You seem distressed about your bowels." b. "You're having trouble with your bowels?" c. It's common to have problems with the bowels at your age." d. "When did you first notice having trouble with your bowels?"
A
An overweight 12-year old boy is brought to the clinic by his parents. The child tells the nurse that he dislikes school because his classmates tease him about his weight. He states rather sadly, "I'm always last when they choose up sides in gym." The nurse's most therapeutic response would be: a. "That hurts a lot when you want to be liked." b. "Have you tried letting them know how that makes you feel?" c. "Not everybody's a great athlete and you have other strengths." d. "Won't it be great when you lose weight and can do better in gym?"
A
Which comment best demonstrates agism. "He is 75 years old and: a. has outlived his usefulness." b. reads the newspaper with difficulty." c. reminisces about his past work experience." d. is most happy when working in his home workshop."
A
A nurse is reviewing therapeutic and nontherapeutic communication techniques with a student. Which of the following are therapeutic communication techniques? a. Restating b. Listening c. Asking the client, "Why?" d. Maintaining neutral responses e. giving advice, approval, or disapproval f. providing acknowledgement and feedback
A,D,E,F
A nurse is providing care to a client admitted to the hospital with a diagnosis of acute anxiety disorder. The client says to the nurse, "I have a secret that I want to tell you. You won't tell anyone about it, will you?" The appropriate nursing response would be which of the following? a. "No, I won't tell anyone." b. "I cannot promise to keep a secret." c. "If you tell me the secret, I will tell it to your doctor." d. "If you tell me the secret, I will need to document it in your record."
B
The following women should be screened for breast cancer? A. a 35yo F with 3 children and no family history of breast cancer B. a 59yo F with no children who still gets her period every month C. a 25yo F with one child whom she had as a teenager D. a 17yo with one child who started menstruating at 13yo
B
When a nurse revises a client's nursing care plan based on the client's responses that show evidence that goals were not attained, the phase of the nursing process being applied is: a. planning b. evaluation c. assessment d. implementation
B
a RN is reviewing the chart of a 31yo F who has been sexual active since the age of 12. which of the following would be of most concern? A. she does not preform self-breast exam B. she has never had a pap test C. she had one HIV test preformed at the age of 18 D. she does not use birth control pills
B
a high school student is referred to the schools nurse for suspected substance abuse. following the nurses assessment and interventions, what would be the most desirable outcome A. the student discusses conflicts over drug use B. the student accepts a referral to a substance abuse counselor C. The student agrees to inform his parents of the problem D. the student reports increased comfort with choices
B
an RN is planning a colorectal screening with the employees at the factory. which of the following would be an advantage of conducting this screening? A. allows for the beginning of a multiple test screening process B. provides an opportunity for health education C. allows for preliminary diagnosis of coronary artery disease D.provides the opportunity for referral to a physician
B
A community health nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse illustrates a therapeutic communication technique for this client? a. "That's normal." b. "Sleeping?" c. "You're having difficulty sleeping?" d. Sometimes, I have trouble sleeping too."
C
A nurse is discussing with parents how to prevent burns in a preschooler. Which of the following recommendations is the nurse most likely to give the parents? A. Do not read to the child while sitting on the sofa in front of the fireplace. B. Do not cook on a gas grill until the child is a teenager. C. Do not leave cigarettes and matches on the kitchen counter. D. Do not cook with the child in the kitchen.
C
A patient tells the nurse that she is worries about her 17 year old son who has been socializing with some friends she thinks are using drugs. the best response by the nurse to the patients concern is A. you need to stop his association with these friends to prevent him from using drugs B. most young people experiment with drugs, but very few become addicted to illegal substances C. you should learn about the early signs and symptoms of abuse and share your concerns with your son D. you need to make an appointment for your son with a drug counselor so he can be taught about the harmful effects of drugs
C
An 18-month-old toddler is being seen for a well-child visit. Which of the following strategies would the nurse use to enlist the toddler's cooperation? A. Ask the toddler if he wants to be examined today. B. Ask his mother leave the room while the nurse examines him. C.Have him hold the stethoscope diaphragm on his chest while the nurse listens to his chest. D. Have his mother hold him down while the nurse examines him.
C
The mother of a 16-month-old infant asks a nurse her opinion about holiday decorating. Which of the following recommendations should the nurse provide to the mother? a. Avoid hanging a wreath with holly and berries on the front door. b. Avoid hanging decorative pictures of a bearded Santa Claus on the window. c. Avoid placing poinsettia plants around the home. d. Avoid hanging stockings on the fireplace mantle.
C
The mother of a 4-month-old infant is concerned about the possibility of SIDS because her neighbor's daughter passed away last year as a result of SIDS. The mother reports she is so nervous that she has taken up smoking again. The mother informs you that the 4-month-old sleeps supine and takes a pacifier to help her fall asleep. Which of the following statements would be the best response from the nurse? A."You should place the infant in the bed with you until 6 months of age." B."You should never give the infant a pacifier while she is sleeping." C. "You should try to stop smoking." D. "You should place the infant on her stomach."
C
To screen for colorectal cancer, colonoscopy should be conducted every 10 years beginning at age: A. 30 B. 40 C. 50 D. 60
C
a client with a history of substance abuse has been attending AA meetings regularly . one afternoon, the client tells the nurse "Im not going to those meetings anymore. im not like the rest of those people. i am not a drunk. "what is the most appropriate response? A. if you arent an alcoholic, why do you keep drinking and ending up in the hospital B. its your decision , if you dont want to go, you dont have to go C. you seem upset about the meetings D. you have to go to meetings. its part of your treatment plan
C
A client scheduled for bowel surgery states to a nurse, "I'm not sure if I should have this surgery." Which response by the nurse is appropriate?" a. "It's your decision." b. "Don't worry. Everything will be fine." c. "Why don't you want to have this surgery?" d. "Tell me what concerns you have about the surgery."
D
A prenatal nurse is meeting with a newly pregnant 21 year old female to discuss her diet. what would the first step when providing nutritional counseling this client? A. teach her how to meet the needs of self and her family B. explain the changes in diet necessary for pregnant women C. providing handouts to her of how to use the food pyramid D. conduct a diet history to determine her normal eating routines
D
During a group therapy session occasionally silence will occur. To deal with this situation in a growth-promoting way, the leader should: a. Be willing to sit indefinitely to wait out the silence. b. Call on specific members to talk when silence occurs. c. Go around the group, requiring each member to talk in turn. d. Comment on the silence or nonverbal behavior related to the silence.
D
RNs at a colleges health fair are planning interventions to focus on health promotion for college students. which intervention is direction towards reducing the most common cause of death in YA? A. teach early warning signs of cancer B. encourage cardiovascular fitness C. teach principles of safer sex D. promote safe driving practices
D
which represents a disadvantage of screening? A. utilization of group screening methods B. utilization of multiple test screening C. utilization of a test with high specificity D. utilization of a test with low sensitivity
D
The parents of an autistic child begin family therapy with a nurse therapist. The father states that the family members wish to share their religion with the therapist. The nurse should: a. Limit the father's discussion of religion. b. Plan for a mutual discussion of religious beliefs. c. Invite the family's minister to a therapy session. d. Keep the sessions focused on the family's concerns.
D Rationale: If religion is a family concern, then the nurse should allow discussion of the family's thoughts and feelings on the subject.
The nurse is aware that in the working phase of the nurse-client relationship, clients: a. Often focus the conversation on the nurse b. Accept limits and initiate topics for discussion c. Commonly exhibit testing behaviors such as flirtation and lateness d. May repress emotionally charged material to avoid shocking the nurse.
b
The nurse understands that the stage of development that is most unstable and challenging with regard to the development of a personal identity is: a. toddlerhood b. adolescence c. childhood d. infancy
b
The patient appears tearful and is quiet and withdrawn. The nurse says, "you seem very sad today." What interviewing approach did the nurse use? a. Examining b. Reflecting c. Clarifying d. Orienting
b
Which age group should the nurse identify is reflected in the following statement. "More time is spent in bed but less time is spent asleep." a. 2 yr olds b. 40 yr olds c. 70 yr olds d. 14 yr olds
c
1. After a traumatic event, a client is extremely upset and exhibits pressure and rambling speech. A therapeutic technique that the nurse can use when a client's communication rambles is: a. Touch b. Silence c. Focusing d. Summarizing
c Rationale: Focusing is indicated when communication is vague; the nurse attempts to concentrate or focus the client's communication on one specific aspect.
The nurse can best handle the answering of personal questions asked by the client in any phase of the nurse-client relationships by: a. Reviewing the positive and negative aspects of the subject. b. Providing brief, truthful answers and redirecting the focus of the conversation. c. Offering an honest, brief expression of personal views on the subject raised. d. Reminding the client gently that the nurse's feelings are not the client's concern.
B
The nurse plans to use family therapy as a means of assisting a family to cope with their child's terminal illness. The nurse's basis for this choice is that: a.It is more time efficient to deal with the whole family together b.The entire family is involved and what happens to one member affects all c.The nurse can control manipulation and alliances better by using this mode of intervention d.It will prevent the parents from deceiving each other about the true nature of their child's condition
B Rationale: Family therapy views the whole within the context in which the emotional problems are occurring.
A client who has recently been diagnosed with AIDS comments to the nurse, "There are so many rotten people around. Why couldn't one of them get AIDS instead of me?" There could best respond: a. "It might be good if you speak with a minister." b. "It seems unfair that you should have this disease." c. "I'm sure you really don't wish this on someone else." d. "I'm sure you know that AIDS is now considered a chronic illness."
B Rationale: The client is in the anger or "why me" stage of grieving; encouraging the client to express feelings with help resolve them while moving toward acceptance.
In an attempt to remain objective and support a client during a crisis, the nurse uses imagination and determination to project the self into the client's emotions. The nurse accomplishes this by using the technique known as: a. empathy b. sympathy c. projection d. acceptance
a
The nurse identifies that an individual who nurtures, teaches and gives to others reflects which stages of Erikson's Stages of Development? a. generativity vs. stagnation ego integrity vs. despair c. industry vs. inferiority d. initiative vs. guilt
a
The nurse identifies that the patient in middle adulthood is experiencing a developmental crisis when there is an inability to: a. achieve a feeling of success b. develop peer relationships c. delay satisfaction d. face death
a
When the nurse assesses an adult, which behavior may indicate an unresolved developmental task of infancy? a. avoiding assistance from others b. rationalizing unacceptable behaviors c. being overly concerned about cleanliness d. apologizing constantly for small mistakes
a
When the nurse cares for individuals across the life span, which age group generally demonstrates an inefficiency of adaptation? a. 60 plus years b. 40-60 years c. 12-19 years d. 3-11 years
a
An older adult is admitted to the intensive care unit. For which common behavioral adaptation to sensory overload should the nurse monitor the patient? a. dementia b. confusion c. drowsiness d. bradycardia
b
When assessing the ability to age successfully the nurse understands that this is based on a person's ability to: a. cope with social isolation b. adjust to the change in social roles c. associate with members of every age group d. increase the number of meaningful relationships
b
A mother is concerned because her 22-month-old has been skipping meals lately. Which of the following actions should the nurse recommend to the mother? A. Put the child in time out whenever he skips a meal. B. Offer him foods he likes such as cookies and chips. C. Limit the child's consumption of juices and cookies. D. Talk to the child about how important it is to eat three meals a day.
c
During a home visit, the nurse finds a 9-month-old in a playpen with a couple of toys. Which of the following instructions would be most appropriate for the nurse to provide to the parent to encourage growth and development of the child? A. Encourage the addition of a few more toys to the playpen. B. Suggest keeping the infant in the playpen as much as possible to promote safe play. c. Encourage providing the infant with supervised time outside of the playpen. D. Suggest removing all toys from the playpen.
c
One afternoon the nurse on the unit overhears a young female client having an argument with her boyfriend. A while later the client complains to the nurse that dinner is always late and the meals are terrible. The nurse recognizes that the defense mechanism the client is using is: a. projection b. dissociation c. displacement d. intellectualization
c
The nurse identifies that the age group that is the greatest risk for constipation is: a. inactive school-aged children b. middle aged adults c. older adults d. bottle-fed infants
c
The nurse identifies that the person at greatest risk for problems with regulating body temperature is the: a. toddler b. teenager c. older adult d. school-age child
c
The nurse is providing dietary teaching to a group of adolescents recently diagnosed with diabetes mellitus. The nurse understands that many foods are ingested by the adolescent because of: a. taste b. routine c. pressure d. preference
c
The nurse understands that according to Erikson, establishing relationships based on commitment mainly occurs in which stage of psychosocial development? a. generativity vs. stagnation identify vs. role confusion c. intimacy vs. isolation d. trust vs. mistrust
c
The nurse understands that, according to Erikson, the person who becomes self-absorbed and obsessed with one's own needs is having difficulty resolving which stage of psychosocial development? a. industry vs. inferiority b. ego integrity vs. despair c. generativity vs. stagnation d. identity vs. role confusion
c
The goals of therapeutic communication mainly should depend on the: a. environment in which communication takes place b. role of the nurse in the particular clinical setting c. skill level of the nurse in the situation d. concerns of the patient
d
The nurse identifies that the behavior in an adult that indicates an unresolved developmental conflict associates with adolescence is: a. being overly concerned about following daily routines b. requiring excessive attention from others c. relying on oneself rather than others d. failing to set life goals
d
The nurse in the emergency department is assessing patients of various ages. The nurse understands that the age group that has the greatest individual differences in appearance and behavior is: a. children b. adolescents c. older adults d. middle-aged adults
d
The patient states, "I think that I am dying." The nurse responds, "You feel as though you are dying?" What interviewing approach did the nurse use? a. Focusing b. Reflecting c. Validating d. Paraphrasing
d
the nurse understands that an individual who is preoccupied with work and the drive to succeed at the expense of emotionally committing to others reflects a negative resolution of which stage of Erikson's Stages of Development? a. autonomy vs. shame and doubt b. identity vs. role confusion c. ego integrity vs. despair d. intimacy vs. isolation
d
