Adaptive set 2

A client is diagnosed with parathyroid dysfunction. Which serum calcium concentration in the client would support the diagnosis? Correct1 7.8 mg/dL 2 8.9 mg/dL 3 9.7 mg/dL 4 10.2 mg/dL

1

Which statements describe a mentally healthy person? Select all that apply. Correct1 One who accepts aging Correct2 One who engages available strengths Incorrect3 One who maintains minimum autonomy Correct4 One who sustains positive relationships Incorrect5 One who engages available weaknesses

1,2,4

What nursing intervention will be most effective in helping relieve the anxiety of a young school-aged child during the postoperative period? 1 Encouraging the child to talk about feelings 2 Having the child and a parent room together 3 Telling the child a story about a child with similar surgery Correct4 Providing the child with sterile dressing equipment and a doll

4

A nurse is caring for a client with Addison's disease. Upon assessment, which classic sign will the nurse find? 1 Ecchymosis 2 Hyperreflexia 3 Exophthalmos Correct4 Hyperpigmentation

4

A client is receiving total parenteral nutrition. The nurse assesses for which client response that indicates hyperglycemia? 1 Paralytic ileus 2 Respiratory rate below 16 Correct3 A fruity odor to the breath 4 Serum glucose of 105 mg/100 mL

3

Which of these cultural groups adopts a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness? 1 East Asian 2 Hispanic Correct3 Asian Indian 4 Native American

3

Which physical changes may cause longitudinal nail ridges? Incorrect1 Decreased rate of growth 2 Decreased cell division Correct3 Decreased blood flow 4 Decreased vitamin D production

3

Which sexually transmitted disease is treated with antiviral drugs? 1 Syphilis 2 Gonorrhea Correct3 Genital herpes 4 Chlamydial infection

3

Which surgery is used to treat excessive wrinkling or sagging of facial skin? 1 Rhinoplasty Correct2 Rhytidectomy 3 Dermabrasion 4 Blepharoplasty

2

Which life-threatening wounds are treated with hyperbaric oxygen therapy? Select all that apply. Correct1 Burns 2 Skin cancer Correct3 Osteomyelitis Correct4 Diabetic ulcers 5 Myocardial infarction

1,3,4

Which exogenous conditions are responsible for increased cortisol secretion? Select all that apply. Correct1 Asthma 2 Adrenal adenomas Correct3 Cancer chemotherapy Correct4 Organ transplantation 5 Carcinomas of the lung

1,3,4

A client is found to have a mood disorder, hypomanic episode. To support the diagnosis, the nurse should identify the signs and symptoms associated with this disorder. Select all that apply. Correct1 Distractibility Correct2 Flight of ideas 3 Low self-esteem 4 Increased need for sleep 5 Psychomotor retardation

1,2

A nurse in a hospice program cares for clients and family members who are coping with imminent loss. What is the most important factor in predicting a person's potential reaction to grief? 1 Family interactions 2 Social support system 3 Emotional relationships Correct4 Earlier experiences with grief

3,4

What factors put a client at risk for bacterial infections? Select all that apply. 1 Dry skin 2 Underweight Correct3 Atopic dermatitis Correct4 Diabetes mellitus Correct5 Systemic antibiotics

3,4,5

Which hormones does the nurse state are released by the hypothalamus? Select all that apply. 1 Follicle-stimulating hormone (FSH) 2 Thyroid-stimulating hormone (TSH) Correct3 Melanocyte-inhibiting hormone (MIH) Correct4 Corticotropin-releasing hormone (CRH) Correct5 Growth hormone-releasing hormone (GHRH)

3,4,5

What does a nurse consider the most significant influence on many clients' perception of pain when interpreting findings from a pain assessment? 1 Age and sex 2 Physical and physiological status 3 Intelligence and economic status Correct4 Previous experience and cultural values

4

What is the best drug of choice for treating obsessive-compulsive disorder? 1 Imipramine 2 Lithium salts 3 Amitriptyline Correct4 Clomipramine

4

Which drug can be prescribed to a 30-week-pregnant woman to promote maturity of the lungs in the fetus? 1 Methylergonovine 2 Clomiphene 3 Dinoprostone Correct4 Betamethasone

4

Which internal variable influences health beliefs and practices? 1 Family practices 2 Cultural background 3 Socioeconomic factors 4 Intellectual background

4

Which skin color in a client indicates an increased urochrome level? 1 Red 2 Blue 3 Reddish blue Correct4 Yellow-orange

4

A 30-year-old woman is scheduled for a total abdominal hysterectomy because of noninvasive endometrial cancer. The nurse anticipates the client may have difficulty adjusting emotionally to this type of surgery. What is the most common reason for this difficulty? Correct1 Loss of femininity 2 Body image changes 3 Diminished sexual desire 4 Slow postmenopausal recovery

1

A 5-year-old child who is newly arrived from Latin America attends a nursery school where everyone speaks English. The child's mother tells the nurse that her child is no longer outgoing and has become very passive in the classroom. What is the probable reason for the child's behavior? Correct1 Culture shock 2 Social immaturity 3 Experience of discrimination 4 Lack of interest in school activitie

1

A 65-inch (165 cm) tall 15-year-old girl weighing 80 lb (36.3 kg) is admitted to a mental health facility with a diagnosis of anorexia nervosa. The nurse recognizes that her problem most likely is caused by what? Correct1 A desire to control her life Incorrect2 The wish to be accepted by her peers 3 The media's emphasis on the beauty of thinness 4 A delusion in which she believes that she must be thin

1

A client with a prolonged history of chronic schizophrenia, paranoid type, shows the nurse a small plastic keychain and says that it provides protection from evil forces. The client then quickly hides the keychain, yelling, "Don't take it away from me; it's the only thing that protects me." How should the nurse respond? Correct1 "You may keep it, because I know it's important to you." 2 "You need to give it to me, because you may hurt yourself." 3 "You're safe without the keychain, because there are no evil forces here." 4 "You'd better put it away, because someone might take it away from you."

1

A client with the diagnosis of borderline personality disorder is manipulative and uses this behavior to get cigarettes from other clients. One day the client begins to badger another client. What should the nurse say while removing the client from the area? Correct1 "You must leave people alone; this behavior is unacceptable." 2 "There will be consequences if you do not stop annoying people." 3 "Tell me how you feel when you are exerting control over people." 4 "I'm surprised that you're still bothering people; you seemed to have improved lately."

1

A depressed client tells a nurse, "I want to die." What is the most therapeutic response by the nurse? Correct1 "You would rather not live." 2 "You're not alone in feeling this way." 3 "When was the last time you felt this way?" 4 "Do you believe that there's life after death?"

1

A mother brings her 9-month-old infant to the clinic. The nurse is familiar with the mother's culture and knows that belly binding to prevent extrusion of the umbilicus is a common practice. The nurse accepts the mother's cultural beliefs but is concerned for the infant's safety. What variation of belly binding does the nurse discourage? Correct1 Coin in the umbilicus 2 Tight diaper over the umbilicus 3 Binder that encircles the umbilicus 4 Adhesive tape across the umbilicus

1

A nonviolent client on the psychiatric unit suddenly refuses to take the prescribed antipsychotic medication. What should the nurse do? Correct1 Honor the client's decision and document the behavior and all interventions. 2 Use an authoritarian approach to induce the client to take the prescribed medication. 3 Call the primary healthcare provider and request that the client be discharged against medical advice. 4 Start proceedings to have the client declared incompetent and seek a court order permitting medication.

1

A nurse is working with a child who was physically abused by a parent. What is the most important goal for this family? Correct1 The child will live in a safe environment. 2 The parents will use verbal discipline effectively. 3 The family will feel comfortable in its relationship with the counselor. 4 The parents will gain an understanding of their abusive behavior patterns.

1

A nurse understands that value clarification is a technique useful in therapeutic communication because initially it helps clients do what? Correct1 Become aware of their personal values 2 Gain information related to their needs 3 Make correct decisions related to their health 4 Alter their value systems to make them more socially acceptable

1

A nurse, understanding the possible cause of alcohol-induced amnestic disorder, should take into consideration that the client is probably experiencing which imbalance? Correct1 Thiamine deficiency 2 A reduced iron intake 3 An increase in serotonin 4 Riboflavin malabsorption

1

An older adult resident of a nursing home who has the diagnosis of dementia of the Alzheimer type frequently talks about the good old days at the ranch. What is the most appropriate action by the nurse? Correct1 Allowing the resident to reminisce about the past and listening with interest 2 Involving the resident in interesting diversional activities with a small group 3 Reminding the resident that those "good old days" are past and that the client should focus on the present 4 Introducing the resident to other residents with the same diagnosis so that they can share their past experiences

1

Electroconvulsive therapy (ECT) is a mode of treatment that is used primarily to treat what? Correct1 Clinical depression 2 Substance abuse disorders 3 Antisocial personality disorder Incorrect4 Psychosis occurring in schizophrenia

1

In which situation does the nurse consider the family as context? Correct1 The nurse is caring for an individual with tonsillitis. 2 The nurse is caring for a dying client and all the family members. 3 The nurse is teaching young parents about caring for their toddler. Incorrect4 The nurse is assessing the needs of the family caregivers of a client.

1

The nurse is caring for a client with a diagnosis of diabetic ketoacidosis. Which arterial blood gas results are associated with this diagnosis? Correct1 pH: 7.28; PCO2: 28; HCO3: 18 2 pH: 7.30; PCO2: 54; HCO3: 28 3 pH: 7.50; PCO2: 49; HCO3: 32 4 pH: 7.52; PCO2: 26; HCO3: 20

1

The nurse is caring for an Asian client who had a laparoscopic cholecystectomy six hours ago. When asked whether there is pain, the client smiles and says, "No." What should the nurse do? Correct1 Monitor for nonverbal cues of pain 2 Check the pressure dressing for bleeding 3 Assist the client to ambulate around his room 4 Irrigate the client's nasogastric tube with sterile water

1

The nurse is interviewing a client admitted for uncontrolled diabetes after binging on alcohol for the past 2 weeks. The client states, "I am worried about how I am going to pay my bills for my family while I am hospitalized." Which statement by the nurse would best elicit information from the client? Correct1 "You are worried about paying your bills?" 2 "Don't worry; your bills will get paid eventually." 3 "When was the last time you were admitted for hyperglycemia?" 4 "You really shouldn't be drinking alcohol because of your diagnosis of diabetes."

1

The nurse is teaching a client newly diagnosed with diabetes about the importance of glucose monitoring. Which blood glucose levels should the nurse identify as hypoglycemia? Correct1 68 mg/dL (3.8 mmol/L) 2 78 mg/dL (4.3 mmol/L) 3 88 mg/dL (4.9 mmol/L) 4 98 mg/dL (5.4 mmol/L)

1

What does a nurse recall that language development in the autistic child resembles? Correct1 Echolalia 2 Stuttering 3 Scanning speech 4 Pressured speech

1

What is the most appropriate long-term goal for a client experiencing dysfunctional grieving after the death of a spouse? Correct1 Resuming previously enjoyed activities 2 Eating at least two meals a day with another person 3 Decreasing negativistic thinking about other people 4 Relocating to a state in which other family members reside

1

What is the most important nursing action involved in caring for a client using medications to manage disease? Correct1 Administering the medications 2 Teaching about the medications 3 Ensuring adherence to the medication regimen 4 Evaluating the client's ability to self-administer medications

1

What is the priority nursing intervention in the planning of nursing care for an adolescent client with anorexia nervosa? Correct1 Rewarding weight gain by increasing privileges 2 Discussing the importance of eating a balanced diet 3 Encouraging the client to include high-calorie foods in the diet 4 Family therapy focusing on the influence of the client's behavior on the family

1

What response from the nurse demonstrates an understanding of hallucinating behavior by a client? Correct1 Asking, "What are the voices telling you to do?" 2 Calmly noting that the "rat on the floor" is really a stuffed toy 3 Allowing the family to bring prepackaged foods from the store 4 Explaining to the family that the behavior will worsen during the night

1

Which behavior is seen in children at the undifferentiated stage of spiritual development, as propounded by Fowler? Correct1 Children have no concept of right or wrong to guide their behaviors. 2 Children imitate the religious behaviors without comprehending any meaning. 3 Children reason and question some of the established parental religious standards. 4 Children have a reverence for religious matters and are able to articulate their faith.

1

Which condition is characterized by hemorrhage after a pregnant female delivers? Correct1 Sheehan's syndrome 2 Cushing's syndrome 3 Addison's syndrome 4 Schwartz-Bartter syndrome

1

A client sustains a crushing injury to the lower left leg, and a below-the-knee amputation is performed. For which common clinical manifestations of a pulmonary embolus should the nurse assess this client? Select all that apply. Correct1 Sharp chest pain Correct2 Acute onset of dyspnea 3 Pain in the residual limb 4 Absence of the popliteal pulse 5 Blanching of the affected extremity

1,2

A client is admitted to the hospital with a diagnosis of restrictive airway disease. The nurse expects the client to exhibit which early signs of respiratory acidosis? Select all that apply. Correct1 Headache Correct2 Irritability Correct3 Restlessness 4 Hypertension 5 Lightheadedness

1,2,3

What are the functions of a client's subcutaneous layer of skin? Select all that apply. Correct1 It provides insulation. Correct2 It acts as an energy reservoir. 3 It prevents systemic dehydration. Incorrect4 It provides cells for wound healing. Correct5 It acts as a mechanical shock absorber.

1,2,5

Which does the nurse understand related to negative pressure wound therapy? Select all that apply. Correct1 Using a suction pump 2 Treating necrotizing infections 3 Administering oxygen under high pressure 4 Application of a low-voltage current to a wound area Correct5 Reducing chronic ulcers by removing fluids from the wound

1,5

A client with a history of atrial fibrillation has a stroke, and vascular dementia (multiinfarct dementia) is diagnosed. In a comparison of assessment findings in clients with vascular dementia and dementia of the Alzheimer type, which factor is unique to vascular dementia? 1 Memory impairment Correct2 Abrupt onset of symptoms 3 Difficulty making decisions 4 Inability to use words to communicate

2

A hyperactive, acting-out 9-year-old boy is started on a behavior modification program in which tokens are given for acceptable behavior. When he begins to lose a game he is playing with other children, he begins to kick the other children under the table and call them names. What is the most appropriate behavior modification technique for the nurse to use? 1 Ignoring the child's behavior Correct2 Placing the child in a time-out 3 Taking the child's daily allotment of tokens away 4 Engaging the child in a conversation about good sportsmanship

2

Obesity in children is an ever-worsening problem. What concept should a nurse consider when caring for school-aged children who are obese? 1 Enjoyment of specific foods is inherited. Correct2 There are familial influences on childhood eating habits. 3 Childhood obesity is usually not a predictor of adult obesity. 4 Children with obese parents are destined to become obese themselves.

2

A client is admitted to the psychiatric hospital after many self-inflicted nonlethal injuries over the preceding month. Of which level of suicidal behavior is the client's behavior reflective? 1 Threats 2 Ideation Correct3 Gestures 4 Attempts

3

A client who has a phobia about dogs is about to begin systematic desensitization. The client asks what the treatment will involve. What is the best response by the nurse? 1 "You'll be exposed to dogs until you no longer feel anxious." 2 "Rewards will be given when you don't become anxious around dogs." Correct3 "Your contact with dogs will be increased, and we'll teach you relaxation techniques." 4 "We'll be engaging in detailed discussions to help you identify what caused your phobia."

3

What should a nurse consider about the past experiences of clients who have immigrated to this country? 1 It affects all of their inherited traits. 2 There will be little impact on their lives today. Correct3 It is important that their values be assessed first. 4 How they will interact is permanently established.

3

1 Freedom from injury 2 Engaging independently in solitary craft activities 3 Identifying the consequences of acting-out behavior Correct4 Interacting appropriately with others in the therapeutic milieu

4

A Nitrazine test strip that turns deep blue indicates that the fluid being tested has a pH of what? 1 4.5 2 5.5 3 6.5 Correct4 7.5

4

A client who has been admitted with a diagnosis of schizophrenia says to the nurse, "Yes, it's March. March is Little Women. That's literal, you know." What do these statements illustrate? 1 Echolalia 2 Neologisms 3 Flight of ideas Correct4 Loosening of associations

4

A client who recently was diagnosed as having myelocytic leukemia discusses the diagnosis by referring to statistics, facts, and figures. The nurse determines that the client is using which defense mechanism? 1 Projection 2 Sublimation 3 Identification Correct4 Intellectualization

4

A client with cellulitis of the leg asks why bed rest has been prescribed to prevent sepsis. Which purpose will the nurse explain to the client? 1 This decreases catabolism to promote healing at the site of injury. 2 This lowers the metabolic rate in an attempt to help reduce the fever. 3 This reduces the energy demands on the body in the presence of infection. Correct4 This limits muscle contractions that may force causative organisms into the bloodstream.

4

A client with schizophrenia is speaking made-up words that have no meaning to other people. What term should the nurse use to document these verbalizations? 1 Avolition 2 Echolalia 3 Anhedonia Correct4 Neologisms

4

A nurse is caring for a client with vascular dementia. What does the nurse expect of this client's mental status? 1 Diminished remote memory resulting from anoxia 2 Loss of abstract thinking related to emotional state 3 Inability to concentrate related to decreased stimuli Correct4 Difficulty recalling recent events related to cerebral hypoxia

4

A nurse teaches a client about how to protect a skin area that has undergone radiation treatment. Which statement made by the client indicates the nurse needs to follow up? 1 "I should avoid swimming in saltwater." 2 "I should avoid using adhesive bandages." 3 "I should avoid wearing tight-fitting cloth." Correct4 "I should avoid rinsing the area with the saline solution."

4

A primigravida has just given birth. The nurse is aware that the client has type AB Rh-negative blood. Her newborn's blood type is B positive. What should the plan of care include? 1 Determining the father's blood type 2 Preparing for a maternal blood transfusion 3 Observing the newborn for signs of ABO incompatibility Correct4 Obtaining a prescription to administer Rho(D) immune globulin to the mother

4

An adolescent client with antisocial personality disorder plans to live with the parents after discharge. The parents request advice on how to respond to their child's unruly behavior. What is the most therapeutic response by the nurse? 1 "Discuss the behavior with your child and encourage the development of self-control." 2 "Avoid setting expectations for behavior and react to each situation as it arises." 3 "Help your child find new friends and encourage finding a job and assuming personal responsibility." Correct4 "Set clear limits, explain the consequences if your child disregards them, and firmly and consistently apply them."

4

The nurse is providing education to a client with calculi in the calyces of the right kidney. The client is scheduled to have the calculi removed. Which information should the nurse include in the teaching? 1 The surgery will be performed transurethrally. 2 During the surgery, the right ureter will be removed. 3 After surgery, a suprapubic catheter will be in place. Correct4 After surgery, there will be a small incision in the right flank area.

4

The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining? 1 Cultural diversity 2 Cultural sensitivity 3 Cultural imposition Correct4 Cultural competence

4

The parents of a preschooler tell the nurse that they try to inculcate good eating habits by asking the child to be at the table until the "plate is clean." What condition is the child at risk for? 1 Anorexia 2 Depression 3 Aggression Correct4 Poor eating habits

4

What should a nurse include in the initial plan of care for a client with the long-standing obsessive-compulsive behavior of handwashing? 1 Determining the purpose of the ritualistic behavior Incorrect2 Limiting the time allowed for the ritualistic behavior 3 Suggesting a symptom-substitution technique to refocus the ritualistic behavior Correct4 Developing a routine schedule of activities to reduce the need for the ritualistic behavior

4

Which technology would the nurse use to reduce chronic ulcers by removing fluids from the wound? 1 Electrical stimulation 2 Topical growth factors 3 Hyperbaric oxygen therapy Correct4 Negative pressure wound therapy

4

Which type of allergic skin condition in a client is associated with immunological irregularity, asthma, and allergic rhinitis? 1 Urticaria 2 Psoriasis 3 Acne vulgaris Correct4 Atopic dermatitis

4

While caring for a client with an intravenous cannula, the nurse assesses the site and finds that it red, swollen, and warm with purulent drainage near the insertion site. Which nursing intervention provides client comfort? 1 Slowing the infusion rate temporarily 2 Elevating the extremity slightly above level 3 Applying cold and warm compresses frequently Correct4 Cleaning the site with alcohol by expressing the drainage

4

While receiving betamimetic (tocolytic) therapy for preterm labor the client begins to experience muscle tremors and exhibit signs of nervousness. She reports, "My heart is racing." The nurse identifies that the client's pulse rate is 110 beats/min and regular. What should the nurse do next? 1 Discontinue the medication as per protocol. 2 Notify the primary healthcare provider that preterm labor has restarted. 3 Obtain the client's laboratory results for electrolyte levels. Correct4 Reassure the client that these are expected side effects of the medication.

4

An arterial blood gas report indicates the client's pH is 7.25, PCO2 is 35 mm Hg, and HCO3 is 20 mEq/L. Which disturbance should the nurse identify based on these results? Correct1 Metabolic acidosis 2 Metabolic alkalosis 3 Respiratory acidosis 4 Respiratory alkalosis

1

What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Select all that apply. Correct1 The RR intervals are relatively consistent. Correct2 One P wave precedes each QRS complex. 3 The ST segment is higher than the PR interval. 4 Four to eight complexes occur in a 6-second strip. 5 The QRS complex ranges from 0.12 to 0.2 seconds.

1,2

What are the primary causes of adrenal insufficiency? Select all that apply. Correct1 Hemorrhage Correct2 Tuberculosis 3 Pituitary tumors 4 Postpartum pituitary necrosis Correct5 Acquired immune deficiency syndrome

1,2,5

A client with the diagnosis of schizophrenia refuses to eat meals. Which nursing action is most beneficial for this client? 1 Directing the client repeatedly to eat the food 2 Explaining to the client the importance of eating 3 Waiting and allowing the client to eat whenever the client is ready Correct4 Having a staff member sit with the client in a quiet area during mealtimes

4

A client reports drinking two drinks per day every day with no negative consequences. How should this person be classified? Correct1 Daily drinker 2 Substance abuser 3 Functional alcoholic 4 Substance dependent

1

A nurse is caring for a client who had a nephrectomy because of cancer of the kidney. Which factor will influence the client's ability to deep breathe and cough postoperatively? Correct1 Location of the surgical incision 2 Increased anxiety about the prognosis 3 Inflammatory process associated with surgery 4 Pulmonary congestion from preoperative medications

1

A 54-year-old has demonstrated increasing forgetfulness, irritability, and antisocial behavior. After the person is found disoriented and semi-naked while walking down a street, the diagnosis of dementia of the Alzheimer type is made. The client expresses fear and anxiety upon admission to a long-term care facility. What is the best nursing intervention in light of the client's diagnosis? 1 Exploring the reasons for the concerns Correct2 Reassuring the client with the frequent presence of staff members 3 Providing the client with a written schedule of planned interactions 4 Explaining to the client why the admission to the facility is necessary

2

A client with the diagnosis of an antisocial personality disorder responds to limit-setting by a nurse by saying, "You sure do look messy today." What is the most appropriate response by the nurse? 1 "Don't you feel well today?" Correct2 "I get the feeling you're angry with me." 3 "I really didn't think anyone would notice." Incorrect4 "Do you think that was a nice thing to say to me?"

2

A 24-year-old woman states that she no longer enjoys any of the activities that she once found fun and pleasurable, such as socializing, sports, and hobbies. What term should the nurse use to describe this condition? 1 Anergia Correct2 Anhedonia 3 Grandiosity 4 Learned helplessness

2

A 5-year-old with attention deficit-hyperactivity disorder (ADHD) exhibits a short attention span and demonstrates intermittent head-banging and hair-pulling, as well as excessive motor activity. What is the priority nursing objective for this child? 1 Facilitating sleep Correct2 Maintaining safety 3 Promoting body image 4 Increasing nutritional intake

2

A 68-year-old client who has metastatic carcinoma is told by the practitioner that death will occur within a month or two. Later the nurse enters the client's room and finds the client crying. Before responding, which factor should the nurse consider? 1 Crying relieves depression and helps the client face reality. Correct2 Crying releases tension and frees psychic energy for coping. 3 Nurses should not interfere with a client's behavior and defenses. 4 Accepting a client's tears maintains and strengthens the nurse-client bond.

2

A Hispanic nurse is celebrating a quinceañera for her 15-year-old daughter. What is the appropriate action of the culturally competent nurse manager? 1 Make a joke about the cultural ritual. Correct2 Allow the nurse to take time off for this celebration. 3 Ask the nurse not to put so much value in cultural rituals. 4 Suggest that the nurse not invite other staff members to the occasion.

2

A client is admitted to the hospital and benazepril is prescribed for hypertension. Which is an appropriate nursing action for clients taking this medication? 1 Monitor the electroencephalogram (EEG). Correct2 Assess for dizziness. 3 Administer the drug after meals. 4 Assess for dark, tarry stools.

2

A client arrives at the clinic and tells the nurse about various aches and pains since her spouse's death 3 months ago. The client appears depressed and tense. What is the initial nursing intervention? Correct1 Facilitating a discussion of the spouse's death 2 Focusing on teaching the client relaxation exercises 3 Asking the practitioner for a psychiatric consultation 4 Helping the client recognize ambivalence toward the spouse

1

A client is admitted to the mental health clinic for treatment of an obsessive-compulsive disorder that impairs ability to work outside the home. What should the nurse consider about the client's behavior when developing a plan of care? Correct1 The client knows that the behavior is illogical but is unable to stop it. 2 The client is probably unaware that the behavior is inappropriately repetitious. 3 This behavior is partially determined by the culture to which the client belongs. 4 This behavior can be stopped by having the nursing staff gently encourage the client.

1

A client who only speaks Spanish is being cared for at a hospital in which nursing personnel only speak English. What communication technique would be appropriate for the nurse to use when discussing healthcare decisions with the client? Correct1 Contact an interpreter provided by the hospital. 2 Contact the client's family member to translate for the client. 3 Communicate with the client using Spanish phrases the nurse learned in a college course. 4 Communicate with the client with the use of a hospital-approved Spanish dictionary.

1

A client is scheduled for an adrenalectomy. What does the nurse expect that the plan of care will include? 1 Low-protein diet Correct2 Parenteral corticosteroids 3 Preoperative 24-hour urine specimen 4 Withholding all medications 48 hours before surgery

2

Which type of hormonal imbalance does the nurse infer through this image? old woman pic from 50's and current Correct1 Acromegaly 2 Exophthalmos 3 Addison's disease Incorrect4 Cushing's syndrome

1

Which type of laser is used in the treatment of vascular and other pigmented lesions? Correct1 Argon 2 Gold vapors Incorrect3 Neodymium 4 Carbon dioxide

1

A client who sustained a burn injury involving 36% of the body surface area is receiving hydrotherapy. Which is the best nursing intervention when providing wound care? Correct1 Use a consistent approach to care and encourage participation. 2 Prepare equipment while doing the procedure and explain the treatment to the client. 3 Rinse the burn area with 105° F (40.6° C) water to prevent loss of body temperature. 4 Arrange for a change of staff every 4 to 5 days and have the client select the time for the procedure to be done.

1

A client who uses a ritual of counting paper in the printer tells the nurse, "I'm spending 30 minutes counting each time I make copies, and my boss is getting very upset. What should I do?" What is the best response by the nurse? Correct1 "Limit photocopying by clustering it to two or three times a day." 2 "Arrive at work 30 minutes early to count the paper in the printer." 3 "Substitute another activity at home, such as counting shoes or other objects." 4 "Talk with the boss to ask for tolerance until the mental health treatments help."

1

A nurse is accompanying a client with a diagnosis of anxiety disorder who is pacing the halls and crying. When the client's pacing and crying worsen, the nurse suddenly feels uncomfortable and experiences a strong desire to leave. What is the most likely reason for what the nurse is experiencing? Correct1 An empathic communication of anxiety 2 A fear of the client becoming assaultive 3 A desire to go off duty after a busy workday 4 An inability to tolerate any more bizarre behavior

1

A nurse is working in a daycare center with clients who have cognitive impairments. What does the nurse expect of a client in the middle stages of dementia? Correct1 Ability to recall events from the past 2 Ability to cope effectively with anxiety 3 Ability to follow a simple schedule without help 4 Memory of what was eaten on the previous day

1

A psychiatric nurse is hired to work in the psychiatric emergency department of a large teaching hospital. While reviewing the manuals, the nurse reads, "People with mental health emergencies shall be triaged within 5 minutes of entering the emergency department." What does the nurse consider this statement to represent? Correct1 Hospital policy 2 Standard of care 3 Hospital procedure 4 Mental Health Bill of Rights

1

A resident in a nursing home recently immigrated to the United States (Canada) from Italy. How does the nurse plan to provide emotional support? Correct1 By offering choices consistent with the client's heritage 2 By assisting the client in adjusting to American culture 3 By ensuring that the client understands American beliefs 4 By correcting the client's misconceptions about appropriate health practices

1

After a child's visit to a healthcare provider, the parent tells the nurse, "I'm so upset! The doctor prescribed an antidepressant!" What is the best response by the nurse? Correct1 "Tell me more about what's bothering you." 2 "Weren't you told why your child needs an antidepressant?" 3 "You need to speak with the healthcare provider about your concerns." 4 "Are you sure it's an antidepressant and not a drug for attention deficit disorder?"

1

After flushing a client's left forearm saline lock (SL) with normal saline, the client begins to report a painful and burning sensation at the insertion site. Which is the most appropriate action for the nurse to take? Correct1 Remove the angiocatheter and saline lock and restart the SL in another site. 2 Document the findings per protocol and reassess the site in eight hours. 3 Flush the angiocatheter and saline lock again with sterile water. 4 Change the dressing and apply a new clean dressing.

1

An African man presents to the emergency department to obtain pain medication. The nurse behaves judgmentally and labels the client a drug abuser. What is the nurse demonstrating? Correct1 Ethnocentrism 2 Multiculturalism 3 Cultural encounter 4 Cultural imposition

1

An older depressed person at an independent living facility constantly complains about her health problems to anyone who will listen. One day the client says, "I'm not going to any more activities. All these old crabby people do is talk about their problems." What defense mechanism does the nurse conclude that the client is using? Correct1 Projection 2 Introjection 3 Somatization 4 Rationalization

1

The nurse is caring for a client 4 days after the client was admitted to the hospital with burns on the trunk and arms. The nurse collaborates with the dietician to develop a dietary plan for the following day. Which plan will the nurse follow? Correct1 High caloric intake, liberal potassium intake, and 3 g protein/kg/day 2 High caloric intake, restricted potassium intake, and 1 g protein/kg/day Incorrect3 Moderate caloric intake, liberal potassium intake, and 3 g protein/kg/day 4 Moderate caloric intake, restricted potassium intake, and 1 g protein/kg/day

1

The nurse is caring for the client posttranssphenoidal hypophysectomy. When assessing the client, the nurse observes clear drainage from the nares. What could be the cause of this drainage? Correct1 A cerebral spinal fluid leak from an opening to the brain. 2 A normal occurrence for this client's procedure. 3 The client is developing an infection. 4 The client may have had a cold preoperatively, and the nurse will continue to monitor

1

What is the color of a client's wound caused by skin tears? Correct1 Red 2 Gray 3 Black 4 Yellow

1

When leading the first session of a newly formed group of clients in a mental health clinic, the nurse notes that group members frequently assume self-serving roles. What does the nurse understand about this? Correct1 Early group development involves these behaviors. 2 Some group members will need to be placed in another group. Incorrect3 Certain group members may be emerging to control attention seekers. 4 The group is attempting to reconcile conflicting viewpoints among its members.

1

When the nurse is managing the care of an acutely depressed client, which intervention demonstrates that the nurse recognizes the client's fundamental mental health need? Correct1 Role modeling a hopeful attitude regarding life and the future 2 Sharing that life has presented depressing situations for all of us at times 3 Devoting time with the client and trying to focus on happy, positive memories Incorrect4 Identifying the client's personal weaknesses and designing interventions to strengthen them

1

Which statement should the nurse include when providing anticipatory guidance to the parents of a 3-year-old client? Correct1 "It is important to set limits with your child." 2 "Your child may begin to have more nightmares." 3 "It is important to enroll your child in swimming lessons." 4 "Your child may begin to exhibit more aggressive behavior."

1

A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications? Select all that apply. Correct1 Examine the feet daily Correct2 Wear well-fitting shoes Correct3 Perform regular exercise 4 Powder the feet after showering 5 Visit the primary healthcare provider weekly 6 Test bathwater with the toes before bathing

1,2,3

A client with a generalized anxiety disorder is hospitalized. The nurse determines that what environment would be conducive to reducing emotional stress and providing psychologic safety for this client? 1 One in which needs are met Correct2 One in which realistic limits and controls are set 3 One in which the client's requests are met promptly 4 One in which the client's environment is kept neat and orderly

2

A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait, tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What does the nurse remember when administering these medications together? 1 Both medications are cholinesterase inhibitors. Correct2 Both medications have a cholinergic-blocking action. 3 The antipsychotic effects of chlorpromazine will be decreased. 4 The synergistic effect of these medications will cause drooling.

2

A depressed, withdrawn client exhibits sadness through nonverbal behavior. What should the nurse plan to help the client to do? 1 Increase structured physical activity. Correct2 Cope with painful feelings by sharing them. 3 Decide which unit activities can be performed. 4 Improve ability to communicate with significant others.

2

A multigravida of Asian descent weighs 104 lb (47.2 kg), having gained 14 pounds (6.4 kg) during the pregnancy. On her second postpartum day, the client's temperature is 99.2° F (37.3° C). She has had poor dietary intake since admission. What should the nurse do? 1 Ask the nursing supervisor to discuss this with the healthcare provider. Correct2 Encourage the family to bring in special foods preferred in their culture. 3 Order a high-protein milkshake as a between-meal snack to stimulate her appetite. 4 Explain to the family that the dietitian plans nutritious meals that the client should eat.

2

A nurse identifies premature ventricular complexes (PVCs) on a client's cardiac monitor. What does the nurse conclude that these complexes are a sign of? 1 Atrial fibrillation Correct2 Cardiac irritability 3 Impending heart block Incorrect4 Ventricular tachycardia

2

A nurse in the mental health clinic concludes that a client is using confabulation when the client does what? 1 The flow of thoughts is interrupted. Correct2 Imagination is used to fill in memory gaps. 3 Speech flits from one topic to another with no apparent meaning. 4 Connections between statements are so loose that only the speaker understands them.

2

A nurse is assessing a client who has come to a walk-in mental health clinic. Which statement supports the assessment that the client is experiencing a crisis? 1 "I have these feelings of uneasiness. They come and go." Correct2 "Nothing I try works. Everything just keeps getting worse." 3 "Things have been building up slowly. I don't know what's causing it." 4 "I feel tense and irritable. When I concentrate on my work, I feel better."

2

A nurse is teaching parents of toddlers about why children receiving specific medications should not receive varicella vaccines. Which medication will be included in the discussion? 1 Insulin Correct2 Steroids Incorrect3 Antibiotics 4 Anticonvulsants

2

After reviewing the client's laboratory reports, the physician concludes that the client has primary hypofunction of the adrenal gland. Which clinical manifestation is likely to be observed in that client? 1 Edema at extremities Correct2 Uneven patches of pigment loss 3 Reddish-purple stretch marks on the abdomen 4 "Buffalo hump" between shoulders on the back

2

An Asian client arrives at the mental health clinic with symptoms of anxiety and panic. While speaking with the client, the nurse notes that the client makes very little eye contact. What does this assessment data suggest? 1 Shyness Correct2 Cultural variation 3 Symptom of depression 4 Shame regarding treatment

2

An older adult, accompanied by family members, is admitted to a long-term care facility with symptoms of dementia. What initial statement by the nurse during the admission procedure would be most helpful to this client? 1 "You're a little disoriented now, but don't worry. You'll be all right in a few days." Correct2 "Don't be afraid. I'm your nurse, and everyone here in the hospital is here to help you." 3 "I'm the nurse on duty today. You're in the hospital. Your family can stay with you for a while." Incorrect4 "Let me introduce you to the staff here first. In a little while I'll get you acquainted with our unit routine."

2

An older resident in a nursing home who has a diagnosis of dementia hoards leftover food from the meal tray and other seemingly valueless articles and stuffs them into pockets "so the others won't steal them." What should the nurse plan to do? 1 Remove the resident's unsafe and soiled articles during the night. Correct2 Give the resident a small bag in which to place selected personal articles and food. 3 Explain to the resident why the nursing home's policy for cleanliness and safety must be followed. 4 Explain to the resident that the staff is required to keep harmful objects out of reach in the resident's closet.

2

How should nurses provide effective nursing care to clients from different cultural backgrounds? 1 By advising clients that some cultural practices may be harmful to health Correct2 By providing care that fits the clients' cultural beliefs 3 By strictly adhering to organization policies regarding nursing care 4 By ignoring the cultural aspect and focusing on the medical aspect of care

2

Nurses on a psychiatric unit have secluded a client who has the diagnosis of bipolar I disorder, manic episode, and who has been losing control and throwing objects while in the dayroom. What is the most important intervention for the client who is given an as-needed (PRN) medication and confined to involuntary seclusion? 1 Continue intensive nursing interactions. Correct2 Evaluate the client's progress toward self-control. 3 Determine whether any staff member has been injured. Incorrect4 Observe the client for side effects of the medication given to the client.

2

The nurse is caring for a client with vascular dementia. What does the nurse identify as the cause of this problem? 1 A long history of inadequate nutrition Correct2 Disruptions in cerebral blood flow, resulting in thrombi or emboli 3 A delayed response to severe emotional trauma in early adulthood 4 Anatomical changes in the brain that produce acute, transient symptoms

2

The nurse should understand the effects of internal and external variables to plan and deliver individualized care. Which variable is an internal variable? 1 Family practices Correct2 Emotional factors 3 Cultural background 4 Socioeconomic factors

2

The nurse teaches a client methods of coping with anger. The nurse concludes that the client has learned the most effective method when the client states that the client will do what when angry? 1 Go for a long jog. Correct2 Talk about the anger. 3 Go to the basement to scream. 4 Concentrate on what caused the anger.

2

The primary healthcare provider prescribed a diagnostic study with contrast medium for an older adult who has an endocrine disorder. Which assessment result should the nurse check before the study? 1 Urinary pH Correct2 Serum creatinine 3 Urinary creatinine Incorrect4 Creatinine clearance

2

The serum potassium level of a client who has diabetic ketoacidosis is 5.4 mEq/L (5.4 mmol/L). What would the nurse expect to see on the ECG tracing monitor? 1 Abnormal P waves and depressed T waves Correct2 Peaked T waves and widened QRS complexes 3 Abnormal Q waves and prolonged ST segments 4 Peaked P waves and an increased number of T waves

2

Which change in the epidermis causes increased risk of sunburn? 1 Decreased cell division Correct2 Decreased melanocyte activity 3 Decreased vitamin D production 4 Decreased immune system cells

2

Which drug is a newer treatment option for treating metastatic melanoma? 1 Lomustin Correct2 Ipilimumab 3 Carmustine 4 Temozolomide

2

Which hormonal deficiency causes breast atrophy in female clients? 1 Growth hormone Correct2 Luteinizing hormone 3 Thyroid-stimulating hormone 4 Adrenocorticotropic hormone

2

Which statement related to breast-feeding is correct? Incorrect1 Protein soluble drugs can enter breast milk. Correct2 Drugs with a long half-life should be avoided. 3 Mothers should take drugs prior to breast-feeding. 4 Drug usage during lactation is safe because the drugs will not harm the baby

2

An adolescent female suffering from severe cystic acne is placed on isotretinoin. What important facts should the nurse tell the client about isotretinoin? Select all that apply. 1 Inform the client to use vinyl helmet straps. Correct2 Inform the client about the risk of teratogenicity. Correct3 Inform the client that skin improvement may take time. 4 Inform the client to scrub vigorously to remove blackheads. 5 Inform the client to use abrasive cleansers to remove blackheads.

2,3

Which questions will allow the nurse to assess a preschool-age child diagnosed with asthma for delayed peer relationships? Select all that apply. 1 "Can your child independently dress each day?" Correct2 "Does your child use 'baby-like' terms when talking?" Correct3 "Does your child play with the other children in the playroom?" 4 "Has your child ever thought that the asthma is a punishment?" 5 "Does your child become anxious before respiratory treatments?"

2,3

A nurse is managing the care of a client with recently diagnosed schizophrenia. Effective therapeutic communication will directly affect which client-focused outcomes? Select all that apply. 1 The client will become capable of part-time employment. Correct2 The client will effectively express emotional and physical needs. 3 The client will demonstrate wellness reflective of physical potential. Correct4 The client will demonstrate an understanding of the mental health disorder. Correct5 The client will recognize the issues most important to managing this disorder.

2,4,5

A client has been diagnosed with generalized anxiety disorder (GAD). Which behavior supports this diagnosis? 1 Making huge efforts to avoid "any kind of bug or spider" 2 Experiencing flashbacks to an event that involved a sexual attack Correct3 Spending hours each day worrying about something "bad happening" 4 Becoming suddenly tachycardic and diaphoretic for no apparent reason

3

A client is presented with the treatment option of electroconvulsive therapy (ECT). After discussion with staff members, the client requests that a family member be called to help make the decision about this treatment. What ethical principle does the nurse consider when supporting the client's request? 1 Justice 2 Veracity Correct3 Autonomy 4 Beneficence

3

A client is receiving whole-body radiation for Hodgkin disease. Which side effect should the nurse expect as a result of this therapy? 1 Increased tendency to bleed 2 Increased tendency for fractures Correct3 Decreased number of erythrocytes 4 Decreased susceptibility to infection

3

A client who had a femoropopliteal bypass graft is receiving clopidogrel postoperatively. What should the nurse teach the client related to the medication? 1 Eliminate grapefruit from the diet 2 Eat more roughage if constipation occurs Correct3 Report any occurrence of multiple bruises 4 Take the medication on an empty stomach

3

A client who has a hemoglobin of 6 gm/dL (60 mmol/L) is refusing blood because of religious reasons. What is the most appropriate action by the nurse? 1 Call the chaplain to convince the client to receive the blood transfusion. 2 Discuss the case with coworkers. Correct3 Notify the primary healthcare provider of the client's refusal of blood products. 4 Explain to the client that they will die without the blood transfusion.

3

A client who has had a subtotal thyroidectomy does not understand how hypothyroidism can develop when the problem was initially hyperthyroidism. On what fact should the nurse base her response? 1 Hypothyroidism is a gradual slowing of the body's function. 2 There will be a decrease in pituitary thyroid-stimulating hormone (TSH). Correct3 There may not be enough thyroid tissue to supply adequate thyroid hormone. 4 Atrophy of tissue remaining after surgery reduces secretion of thyroid hormones.

3

A client with a history of chronic alcoholism is admitted to the mental health unit. What does the nurse identify as the cause of a client's use of confabulation? 1 Ideas of grandeur 2 Need to get attention Correct3 Marked loss of memory 4 Difficulty accepting the truth

3

A client with a history of gambling is experiencing legal difficulties for embezzling money and has been required to obtain counseling. During an intake interview the client says, "I never would have done this if I'd been paid what I am worth." What factor will create the greatest difficulty in helping this client develop insight? 1 Feelings of boredom and emptiness 2 Grandiosity related to personal abilities Correct3 Projection of reasons for difficulties onto others 4 Anger toward those who are in authority positions

3

A client with a long history of alcohol abuse who has been hospitalized for 1 week tells the nurse, "I feel much better and probably won't need any more treatment." What does the nurse conclude when evaluating the client's progress? 1 The client has accepted the illness and now must use willpower to resist alcohol. 2 The client will probably not use alcohol again as long as the client's family remains supportive. Correct3 The client's lack of insight into the emotional aspects of the illness indicates the need for continued supervision. 4 The client's statement should be communicated to the practitioner so aversion therapy can be started before the client's discharge.

3

A healthcare provider prescribes a diuretic for a client with hypertension. What should the nurse include in the teaching when explaining how diuretics reduce blood pressure? 1 Facilitates vasodilation 2 Promotes smooth muscle relaxation Correct3 Reduces the circulating blood volume 4 Blocks the sympathetic nervous system

3

A married woman is brought to the emergency department of a local hospital. Her eyes are swollen shut, and she has a bruise on her neck. She reports that she is being beaten by her husband. How does the nurse expect the husband to behave when he arrives at the emergency department? 1 Fearful 2 Confused Correct3 Charming 4 Indifferent

3

A mother brings her 7-year-old son into an outpatient clinic for a follow-up appointment. The mother appears angry and agitated with the boy. Looking at the boy's medical chart, the nurse notes that the boy has a diagnosis of encopresis. What is the primary symptom of encopresis? 1 Practicing self-mutilation 2 Practicing self-induced vomiting Correct3 Passing feces either voluntarily or involuntarily into inappropriate places 4 Passing urine either voluntarily or involuntarily into inappropriate places

3

A nurse has just finished reviewing how anesthesia will be used during a vaginal birth for a client with class I heart disease. What type of anesthesia does the client discuss that indicates to the nurse that the teaching was effective? 1 Spinal 2 General Correct3 Epidural 4 Perinea

3

A nurse hired to work in a metropolitan hospital provides services for a culturally diverse population. One of the nurses on the unit says it is the nurses' responsibility to discourage "these people" from bringing all that "home medicine stuff" to their family members. Which response by the recently hired nurse is most appropriate? 1 "Hospital policies should put a stop to this." 2 "Everyone should conform to the prevailing culture." Correct3 "Nontraditional approaches to health care can be beneficial." 4 "You are right because they may have a negative impact on people's health."

3

A nurse is assessing a client who has come to a walk-in mental health clinic. Which statement supports the assessment that the client is experiencing a crisis? 1 "I have these feelings of uneasiness. They come and go." Correct2 "Nothing I try works. Everything just keeps getting worse." 3 "Things have been building up slowly. I don't know what's causing it." 4 "I feel tense and irritable. When I concentrate on my work, I feel better."

3

A nurse is speaking with a client who was sexually abused as a child. The client does not know what constitutes inappropriate touch by another person. What issue will have to be addressed with this client? 1 Increased libido 2 Phobic behavior Correct3 Boundary violations 4 Excessive aggression

3

A nurse needs to educate a parent about the playing behavior of preschoolers. What information should the nurse provide to the parent? 1 "Your child will avoid playing different roles." 2 "Your child will dislike having a leader for any activity." Correct3 "Your child will cooperate while playing with another child." 4 "Your child will often like to play with a group of 7-9 children."

3

A nurse on a psychiatric unit has been working with a suicidal college student for 2 days. What comment by the student indicates relief from suicidal thinking? 1 "I can be a burden to others." 2 "I feel very alone sometimes." Correct3 "I plan to go to school next semester." 4 "I don't know whether I can talk about my feelings."

3

As the nurse is discussing psychiatric care with an older adult client, the client says, "When I was growing up I was taught to accept my lot in life and not complain. I'm proud of the fact that despite my issues I can still function independently. I don't want to be just put away." The nurse understands that the factors that influence the client's mental health are examples of what? 1 Setting of care 2 Anxiety disorder Correct3 Attitudes and beliefs 4 Cultural and ethnic disparities

3

At times a client's anxiety level is so high that it blocks attempts at communication and the nurse is unsure of what is being said. To clarify understanding, the nurse says, "Let's see whether we mean the same thing." What communication technique is being used by the nurse? 1 Reflecting feelings 2 Making observations Correct3 Seeking consensual validation 4 Attempting to place events in sequence

3

During a group therapy session some members accuse another client of intellectualizing to avoid discussing feelings. The client asks whether the nurse agrees with the others. What is the best response by the nurse? 1 "It seems that way to me, too." 2 "What's your perception of my behavior?" Correct3 "Are you uncomfortable with what you were told?" 4 "I'd rather not give my personal opinion at this time."

3

During data collection, the nurse inspects the client's nose and concludes that the client has an infection. Which finding supports the nurse's conclusion? 1 Bloody discharge 2 Watery discharge Correct3 Thick mucosal discharge Incorrect4 Purulent and malodorous discharge

3

How can a nurse minimize agitation in a disturbed client? 1 By ensuring constant staff contact 2 By increasing environmental sensory stimulation Correct3 By limiting unnecessary interactions with the client 4 By discussing the reasons for the client's suspicions

3

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 identifies the defense mechanism that the client is using as what? 1 Projection 2 Dissociation Correct3 Displacement 4 Intellectualization

3

Three days after a stressful incident a client can no longer remember why it was stressful. The nurse, in relating to this client, can be most therapeutic by identifying that the inability to recall the situation is an example of what defense mechanism? 1 Denial 2 Regression Correct3 Repression 4 Dissociation

3

To provide appropriate psychosocial support to clients, a nurse must understand development across the life span. What theory is the nurse using in considering relationships and resulting behaviors as the central factors that influence development? 1 Cognitive theory 2 Psychosocial theory Correct3 Interpersonal theory 4 Psychosexual theory

3

When talking with one of the day nurses, a client with the diagnosis of anorexia nervosa states that the day nurses give better care and are nicer than the night nurses. The client also asks a question that the day nurse knows was already answered by one of the night nurses. What conclusion should the nurse make about the client? 1 The client needs assistance in exploring and verbalizing feelings about the night nurses. 2 The client is trying to develop a bond of trust with a staff member that should be supported. Correct3 The client is trying to divide the staff, and the behavior should be reported to the other staff members. 4 The client has negative feelings about the night nurses, and the nurses should be informed of these feelings.

3

Which characteristic does the nurse associate with a punch biopsy? 1 It is usually indicated for superficial or raised lesions. 2 It is more uncomfortable than other biopsies while healing. Correct3 It is performed using a circular cutting instrument 2 to 6 mm in diameter. 4 It removes only the portion of the skin that rises above the surrounding tissue.

3

Which drug would be effective for the treatment of pituitary Cushing's syndrome? Incorrect1 Mitotane 2 Cabergoline Correct3 Cyproheptadine 4 Bromocriptine mesylate

3

Which nursing intervention is most important for a client who has the diagnosis of antisocial personality disorder? 1 Teaching and modeling assertiveness 2 Using a gentle and reassuring approach Correct3 Providing clear boundaries and consequences 4 Presenting an empathetic and democratic approach

3

Which drugs may cause an increase in the serum clozapine level? Select all that apply. 1 Rifampin 2 Phenytoin Correct3 Ketoconazole Correct4 Erythromycin 5 Bromocriptine

3,4

A 3-year-old child is found to have a pervasive developmental disorder not otherwise specified. What should the nurse consider most unusual for the child to demonstrate? 1 Interest in music 2 Ritualistic behavior 3 Attachment to odd objects Correct4 Responsiveness to the parents

4

A client experiencing a tremendously stressful situation says, "My baby was diagnosed with terminal cancer 2 months ago. I'm either crying or walking around like I'm in a dream. I can't believe this is happening. What did we do to deserve something so horrible? The doctors can transplant almost every human organ, but they can't stop my baby from dying. I'm so angry. Most days I just want to take my child and run away." The nurse determines that the client is mainly expressing what? 1 Anger 2 Denial 3 Avoidance Correct4 Anticipatory grief

4

A client had a colostomy surgery and is learning how to care for the skin around the stoma. Which information should the nurse include in the teaching plan for this client? Incorrect1 "Cut an opening about ⅓ inch (0.85 cm) larger than the stomal pattern." 2 "Avoid the use of soap and other irritating agents." 3 "Eat yogurt and drink buttermilk and parsley." Correct4 "Empty the pouch before it is one-third full."

4

A client in the mental health clinic who has concerns about getting married says to the nurse, "I guess I'd better get married. All the plans are made and paid for, and the invitations have all been mailed." What defense mechanism is the client using? 1 Introjection 2 Identification 3 Compensation Correct4 Rationalization

4

A client is admitted to the hospital for replacement of the mitral valve. The primary purpose of the nurse checking the pulses in the client's legs frequently after surgery is detection of what? 1 Atrial fibrillation 2 Postsurgical bleeding Incorrect3 Arteriovenous shunting Correct4 Peripheral thrombophlebitis

4

A client was recently given a diagnosis of a manic episode of bipolar I disorder. What activity is most therapeutic for this client at this time? 1 Doing a craft project 2 Playing a game of table tennis 3 Playing cards with another patient Correct4 Walking around the unit with a nurse

4

A male client with the diagnosis of schizophrenia, paranoid type, often displays overt sexual behavior toward female clients and nurses. What is the nurse's best response when the client engages in sexually explicit behavior? 1 Refusing to speak with the client until he stops the behavior 2 Sending the client to his room when the behavior is observed 3 Ignoring this behavior until the client is more in control of his responses Correct4 Telling the client in a matter-of-fact manner that his behavior is unacceptable

4

A nurse at the mental health center has been counseling the family of an adolescent client with anorexia about nutrition. Which statement made by a family member demonstrates an adequate understanding of the needs of the client? 1 "We won't have to worry about this passing fad for long." 2 "We'll monitor both of our teenagers' exercise habits closely." 3 "We need to watch more closely when we're all eating together." Correct4 "We should give our child more input into our meal planning."

4

A nurse in a hospice program cares for clients and family members who are coping with imminent loss. What is the most important factor in predicting a person's potential reaction to grief? 1 Family interactions 2 Social support system 3 Emotional relationships Correct4 Earlier experiences with grief

4

A nurse is caring for a newly admitted client with obsessive-compulsive disorder. When should the nurse anticipate that the client's anxiety level will increase? 1 As the day progresses 2 When family members visit 3 During a physical assessment by the nurse Correct4 When limits are set on the performance of a ritual

4

A nurse is with the parents of a 3-year-old child who has just died. What is the most therapeutic question for the nurse to ask the parents? 1 "Do you feel ready to consent to an autopsy?" 2 "Have you made a decision about organ donation?" 3 "Would you like to talk about how you'll tell your other children?" Correct4 "Can I be of any help with traditional practices that are important to you?"

4

A nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. How should the nurse manager address this situation? 1 Assign articles about various cultures so that they can become more knowledgeable. 2 Relocate the nurses to units where they will not have to care for clients from a variety of cultures. 3 Rotate the nurses' assignments so they have an equal opportunity to care for clients from other cultures. Correct4 Plan a workshop that offers opportunities to learn about the cultures they might encounter while at work.

4

A registered nurse is explaining the term "just culture" to the student nurse. Which explanation provided by the registered nurse is accurate? 1 "It refers to the agreement to keep promises." 2 "It refers to taking positive actions to help others." 3 "It refers to the ability to answer for one's actions." Correct4 "It refers to promoting open discussion whenever error occurs without fear of recrimination."

4

A woman with bipolar disorder, manic episode, has been spending thousands of dollars on clothing and makeup. She has been partying in bars every night and rarely sleeps or eats. The nurse in the outpatient clinic, knowing that this client rarely eats, recognizes that her eating problems most likely result from what? 1 Feelings of guilt 2 Need to control others 3 Desire for punishment Correct4 Excessive physical activity

4

After determining that the nurses on the psychiatric unit are uncomfortable caring for clients who are from different cultures than their own, the nurse manager establishes a unit goal that by the next annual review the unit will have achieved what? 1 Increased cultural sensitivity 2 Decreased cultural imposition 3 Decreased cultural dissonance Correct4 Increased cultural competence

4

An autistic toddler is sitting in a corner, rocking and spinning a top. How can the nurse be most therapeutic when approaching this toddler? 1 Holding the toddler to provide a sense of security 2 Stroking the toddler's arm gently to gain the child's attention 3 Waiting for the toddler to make the initial contact before moving close Correct4 Sitting with the toddler while watching the spinning top to provide a nonintrusive presence

4

An older adult is admitted for evaluation of anemia and unsteady gait. While obtaining a health history, the nurse notes that the client seems to make up stories to fill in for memory lapses. How should the nurse document what the client is doing? 1 Lying 2 Denying 3 Fantasizing Correct4 Confabulating

4

Before effectively responding to a sexually abused victim on the phone, it is essential that the nurse in the rape crisis center do what? 1 Get the client's full name and address. 2 Call for assistance from the psychiatrist. 3 Know some myths and facts about sexual assault. Correct4 Be aware of any personal bias about sexual assault.

4

Imipramine, 75 mg three times per day, is prescribed for a client. What nursing action is appropriate when this medication is being administered? 1 Telling the client that barbiturates and steroids will not be prescribed 2 Warning the client not to eat cheese, fermented products, and chicken liver 3 Monitoring the client for increased tolerance and reporting when the dosage is no longer effective Correct4 Having the client checked for increased intraocular pressure and teaching about symptoms of glaucoma

4

Obesity in children is an ever-increasing problem. What should a nurse consider before confronting the problem with individual children? 1 Enjoyment of specific foods is inherited. 2 Childhood obesity is not usually a predictor of adult obesity. 3 Children with obese parents and siblings are destined for obesity. Correct4 Familial and cultural influences are deciding factors in eating habits.

4

The nurse determines that the plan for bolstering an overweight adolescent's self-esteem has been effective when, 3 months later, the adolescent's mother reports that the adolescent is doing what? 1 Seems to be doing average work in school 2 Has asked her how to bake bread and cookies 3 Imitates a sibling's manner of speech and dress Correct4 Joined a dirt bike group that meets at the school

4

Which client has a primary lesion? Incorrect1 One with scales 2 One with ulcers 3 One with fissures Correct4 One with erosions

4