Fundamentals - Basic Psychosocial Needs

The nurse is caring for a client with a terminal illness who is awaiting transfer to hospice. The client states, "It is all out of my hands now." How should the nurse respond? "Are you feeling like you do not have control? Would you like to discuss the planned transfer to hospice?" "I hear you saying things are out of your hands. Can you tell me more about what has you feeling this way?" "Change and transition can be challenging. We are here to support you. What can I do now to help?" "I hear you saying you do not feel in control. What coping technique do you usually use when feeling this way?"

"I hear you saying things are out of your hands. Can you tell me more about what has you feeling this way?"

A client has identified to the community mental health nurse that an inability to be assertive with the client's boss has contributed to long work hours and increased stress and anxiety. Which question would be appropriate for the nurse to ask to assist the client? "When is the best time of day to approach your boss?" "How is it best for you to approach your boss?" "What have you done so far to try to solve this problem?" "What are your alternative plans at this time?"

"What have you done so far to try to solve this problem?"

The nurse is caring for a client who recently lost an infant to sudden infant death syndrome (SIDS). The client talks about how going back to work last week and that the couple want to become pregnant again soon to have another baby. The client reports feeling sad sometimes, but also feeling happy sometimes. What stage of grief does this client demonstrate? Denial Delusion Acceptance Bargaining

Acceptance

The parents of an infant who just died from sudden infant death syndrome (SIDS) are angry at God and refuse to see any members of the clergy. How would the nurse respond? "Faith can be a wonderful support after such a devastating event." "I respect your choice not to seek spiritual support at this time." "Is there anyone else I can call to support you at this time?" "Can you tell me more about your spiritual beliefs and practices?"

"Is there anyone else I can call to support you at this time?"

An older adult client shares with the nurse having never gotten over the grief of losing a parent 22 years ago. The client states that the parent completed suicide and the client found the parent and called for emergency assistance. The nurse assesses that the client is experiencing which type of grief? Anticipatory Uncomplicated Disenfranchised Dysfunctional

Dysfunctional

A client tells the nurse on admission that she is uneasy about having to leave her children with a relative while being in the hospital for surgery. What should the nurse do? Reassure the client that her children will be fine and she should stop worrying. Contact the relative to determine their capacity to be an adequate care provider. Encourage the client to call the children to make sure they are doing well. Gather more information about the client's feelings about the childcare arrangements.

Gather more information about the client's feelings about the childcare arrangements.

An elderly client with primary degenerative dementia is slow in following simple directions and is indecisive selecting clothes to be worn for the day. What is the best approach for the nurse to take? Allow the client to select from the outfits and minimize other distractions in the environment. Give the client the opportunity to select from two outfits and cue follow-through instructions. Pick an outfit and assist with dressing because the client is too distracted to complete this activity without help. Time limit the indecision and let the client know that activities of daily living need to be completed faster.

Give the client the opportunity to select from two outfits and cue follow-through instructions.

The family of a client who died unexpectedly arrives to the care area. In which way should the nurse support the family at this time? Select all that apply. Provide emotional support. Serve as an attentive listener. Expect the family to express grief. Arrange for the family to view the body. Direct the family to the funeral home.

Provide emotional support. Serve as an attentive listener. Expect the family to express grief. Arrange for the family to view the body.

Which statement about religion and spirituality is most accurate? Religion is an organized system of spiritual beliefs. Religion and spirituality are synonymous. Spirituality is the behavioral manifestation of religious beliefs. Spirituality is a recently developed alternative to traditional religious belief.

Religion is an organized system of spiritual beliefs.

The nurse provides care to a verbally unresponsive client diagnosed with terminal cancer. The client's family refuses palliation on religious grounds. The nurse experiences great anxiety and distress when caring for the client due to the level of suffering perceived. What action should the nurse take? Accept that this is the client's and family's wish. File a complaint with the facility's client advocate. Discuss the plan of care with the client's healthcare provider. Speak to the charge nurse about the nurse's moral conflict.

Speak to the charge nurse about the nurse's moral conflict.

A client, age 22, is admitted in a psychotic episode. The client's frequent requests to speak with the hospital chaplain are interspersed with profanities regarding God and the devil. The most therapeutic nursing intervention would be to immediately call the chaplain because you realize symptoms may resolve with spiritual counseling. continue providing safe, effective care and give anti-psychotic medications as ordered to reduce symptoms of psychosis. ask a chaplain to meet with you and the client on the unit so you can monitor the exchange. tell the client you are not allowed to call the chaplain when a client is this disturbed.

continue providing safe, effective care and give anti-psychotic medications as ordered to reduce symptoms of psychosis.

A group of nursing students are reviewing current nursing codes of ethics. Such a code is important in the nursing profession because: nurses are highly vulnerable to criminal and civil prosecution in the course of their work nurses interact with clients and families from diverse cultural and religious backgrounds nursing practice involves numerous interactions between laws and individual values nurses are responsible for carrying out actions that have been ordered by other individuals

nursing practice involves numerous interactions between laws and individual values

The nurse is counseling the family of an older adult who died today. Which factor facilitates attainment of a positive bereavement outcome? being a teenager having a history of anxiety being a spouse possessing adequate financial resources

possessing adequate financial resources

Six months after undergoing a radical modified mastectomy to treat breast cancer, a client is admitted for chemotherapy. When the nurse enters the client's room, the client is sobbing and states, "I thought the chemotherapy would help, but now I feel worse." Which response by the nurse is most appropriate? "You sound discouraged. Chemotherapy commonly makes people feel worse." "Can you tell me more about how you are feeling right now about your treatment?" "Can you tell me what side effects of the chemotherapy are most troubling for you?" "It can be discouraging to feel worse after treatment. How can I help you feel better?"

"Can you tell me more about how you are feeling right now about your treatment?"

A client gives birth to a neonate at 30 weeks' gestation. The neonate is stable on minimal ventilator settings. The client's previous infant, who was born at 24 weeks gestation, did not survive. The family is Roman Catholic and requests that neonate be baptized as soon as possible. What response by the nurse is most appropriate? "What would you like me to do to help arrange the baptism?" "Are you requesting the baptism because you are concerned that your infant might die?" "We have a unit chaplain who rounds daily and can perform the baptism." "Your baby is much older and much more stable than the baby you lost."

"What would you like me to do to help arrange the baptism?"

A nurse is assessing a client's spiritual needs when the client becomes angry and defensive about the questions being asked. What would the nurse say to make the client comfortable? "We ask everyone these questions. It's nothing personal." "You appear upset about these questions. Is this true?" "We ask because having a spiritual connection can really help you during this time." "Many clients get uncomfortable when asked about their spiritual beliefs."

"You appear upset about these questions. Is this true?"

The nurse is caring for a client who reports that the common-law spouse sexually assaulted the client. Which statement by the nurse would hinder the therapeutic relationship between the nurse and this client? "You handled the attack as well as you could because you survived." "You may feel anger, guilt, fear, or embarrassment, but these are very normal reactions." "You didn't do anything to cause the attack, and it's not your fault that you were raped." "You may want to have an abortion if you find out you are pregnant."

"You may want to have an abortion if you find out you are pregnant."

A medical-surgical nurse is caring for a client with end-stage kidney disease. The client asks the nurse, "Will I die soon?" What would be the most appropriate response(s) by the nurse? Select all that apply. "I can't discuss that, but the health care provider will come by later and can discuss the prognosis with you." "We are doing everything medically possible, and you will be fine." "You're in the final stage of illness, so you may have little time remaining." "Do you want me to call the local clergy for you to obtain last rites?" "Do you want to talk about how you are feeling about your prognosis?"

"You're in the final stage of illness, so you may have little time remaining." "Do you want to talk about how you are feeling about your prognosis?"

A nurse is working in the emergency department when a woman comes in reporting that she was notified that her husband was just admitted following an accident. The woman is pacing, tearful, and her attention span seems poor. The nurse recognizes that the woman is having moderate anxiety. What should be the nurse's first response? "Hi! I'm really glad you are here. I work on this unit and was here when your husband came in. He was in really bad shape." "Your husband is awake and stable right now. I'll take you to his room." "Your husband had an X-ray, and he might have a fractured femur. His hemoglobin and hematocrit are stable. He is diaphoretic. He has had an analgesic while awaiting an orthopedic consultation." "You seem really nervous about all of this. Maybe you should complete the admission paperwork before seeing your husband."

"Your husband is awake and stable right now. I'll take you to his room."

A nurse is caring for multiple grieving clients. Which client is most likely to experience disenfranchised grief? A 50-year-old client whose ex-spouse died suddenly in a motor vehicle accident A 60-year-old client whose child has been diagnosed with terminal cancer A 70-year-old client whose best friend died from a heart attack An 80-year-old client whose spouse died from Alzheimer disease

A 50-year-old client whose ex-spouse died suddenly in a motor vehicle accident

A client has been diagnosed with colon cancer with metastasis to the lymph nodes. When the nurse enters the room, the client says life is "not worth living." What is the nurse's best therapeutic response? Assure the client that everything will work out fine. Explain that the condition is complicated and ask a physician to come speak with the client. Approach the client and ask if there are questions about the condition. Ask the client if calling the family would be helpful.

Approach the client and ask if there are questions about the condition.The nurse is counseling the family of an older adult who died today. Which factor facilitates attainment of a positive bereavement outcome? being a teenager having a history of anxiety being a spouse possessing adequate financial resources

The nurse is caring for a critically ill client who informs the nurse that there is a conflict between the client's spiritual beliefs and a proposed health option. What is the nurse's role in this situation? Assist the client in obtaining information to make an informed decision. Encourage the client to pray for clarity on the matter and offer support. Inform the client's healthcare provider of the client's concerns. Provide examples of ways clients handle spiritual and care planning conflicts.

Assist the client in obtaining information to make an informed decision.

A mother reports she cannot afford the antibiotic azithromycin, which was prescribed by the health care provider (HCP) for her toddler's otitis media. What is the nurse's best response? Instruct the mother on the importance of the medication. Ask the mother if she has considered using any medical assistance programs in her community. Confer with the HCP about whether a less expensive drug could be prescribed. Consult with the social worker.

Confer with the HCP about whether a less expensive drug could be prescribed.

A client at a mental health clinic who has recently emigrated from another country identifies isolation and loneliness as current stressors. The client describes being withdrawn but does not know how to change the situation. Which is the most appropriate step for the nurse to take to help the client? Refer the client to special interest clubs for newcomers. Model culturally appropriate interactional skills. Support the client in developing attainable socialization goals. Have the client plan a social activity for the upcoming weekend.

Support the client in developing attainable socialization goals.

A nurse is performing an admission assessment on a client newly admitted to the hospital and has documented the client as being a member of the Native American subculture. Which of these best describes a subculture? a cultural group with fewer than 5 million members in the United States a unique cultural group with unspecified geographic origins a cultural group with values that are incongruent with those of the dominant culture a unique cultural group that exists within the larger culture

a unique cultural group that exists within the larger culture

Which factors should be the primary factor in a nurse's decision whether to pray with a client? the client's openness to being prayed for the nurse's familiarity with the prayer traditions of different faiths the nature and course of the client's current diagnosis the availability of a hospital chaplain or other spiritual counselor

the client's openness to being prayed for

Arrangements are made for a member of the colostomy support group to meet with a client before bowel surgery. What is accomplished by having a representative from the group meet the client preoperatively? letting the client know that there are resources in the community that can help providing support for the health care provider's (HCP's) plan of therapy for the client providing the client with support and realistic information on the colostomy explaining that the surgery will not be disfiguring and that the client can lead a full life

providing the client with support and realistic information on the colostomy

Two days after undergoing a modified radical mastectomy, a client tells the nurse, "Now I won't be sexually attractive to my spouse." How should the nurse respond? "I am sure your spouse loves you very much and will still find you attractive." "Can you tell me more about what your goals for a sexual relationship with your spouse are?" "There are really good reconstructions that can be perfumed once your surgical site is healed." "I hear you are concerned. I can arrange to speak with you and your spouse about your sexual relationship."

"Can you tell me more about what your goals for a sexual relationship with your spouse are?"

The nurse who cared for a client in the home environment for several months learns that the client has died. What should the nurse do to support the family at this time? Send flowers. Attend the funeral. Remove the client's name from the care list. Avoid phoning the family to permit the family to grieve.

Attend the funeral.

A 42-year-old client was admitted from a homeless shelter with a diagnosis of tuberculosis and alcoholism. It is essential that which health care team member attends the care conference to discuss discharge planning and community resources? dietitian pharmacist social worker infection control nurse

social worker

Which would be most helpful when coaching a client to stop smoking? Review the negative effects of smoking on the body. Discuss the effects of passive smoking on environmental pollution. Establish the client's daily smoking pattern. Explain how smoking worsens high blood pressure.

Establish the client's daily smoking pattern.

Which philosophy should the nurse integrate into the plan of care for a client and family to help them best cope during the final stages of the client's illness? living each day as it comes as fully as possible reliving the pleasant memories of days gone by expecting the worst and being grateful when it does not happen planning ahead for the remaining good times that will be spent together

living each day as it comes as fully as possible

A an adolescent client has undergone an examination and had evidence collected after being sexually assaulted. Her father is overheard yelling at his daughter, "You're going to tell me who did this to you. What's his name?" Which is the nurse's best response? "Please come with me, sir. I need some important information." "Stop yelling. You're being inappropriate." "Please be quiet. You're not helping your daughter this way." "If you don't stop yelling, I'll have to call Security."

"Please come with me, sir. I need some important information."

The client with recurrent depression and suicidal ideation tells the nurse, "I can't afford this medicine anymore. I know I'll be okay without it." What should the nurse do next? Inform the health care provider (HCP) of the client's statement. Ask the social worker to find financial assistance for the client. Schedule a follow-up appointment in 48 hours. Ask the client whether a family member could help.

Ask the social worker to find financial assistance for the client.

The nurse manager has employed three nurses from a culture that is different from that of most of the nurses who currently work on this unit. Which strategy would help the newly employed nurses socialize into the team and promote the cultural competence of all of the nurses? Create a staffing plan placing one of the newly employed nurses on each shift. Require newly employed nurses to speak English only when working. Hold a culture sharing session at monthly meetings. Encourage the staff to invite the new nurses to meet their families.

Hold a culture sharing session at monthly meetings.

The nurse is meeting with a community group to discuss the changes that need to be made to meet their health needs after a community assessment has been done. One cultural group is insisting their views need to be implemented because they are in the majority in that community. What is the best action by the nurse? Support the implementation of the ideas of the majority. Seek input from all groups and strive for consensus on what would benefit most or all of these people. Seek to promote homogeneity and common views rather than focus on differences. Make decisions based on findings from the community assessment.

Seek input from all groups and strive for consensus on what would benefit most or all of these people.

A client expresses experiencing stress when working but enjoys the challenges this work presents. What would the nurse suggest? Find ways to make work fun. Take stress-management classes. Spend more time with the family. Leave work at work.

Take stress-management classes.

An overweight adolescent has been diagnosed with type 2 diabetes. What should the nurse do to increase the client's self-efficacy to manage the disease? Provide the client with a written daily food and exercise plan. Discuss eliminating junk food in the home with the parents. Arrange for the school nurse to weigh the child weekly. Utilize a peer with type 2 diabetes to role model lifestyle changes.

Utilize a peer with type 2 diabetes to role model lifestyle changes.

A North American nurse is caring for a Chinese client. How can the nurse better understand the client's cultural values and beliefs? long-term contact careful observation inquiry about behavior patterns nursing and medical journals

nursing and medical journals

A male nurse is assigned to care for a female client with a new colostomy. Upon entering the room, the spouse tells the nurse that it is considered immodest for a woman's body to be seen by any male that is not her husband in their Muslim culture. Which actions demonstrate culturally competent nursing care in this situation? Select all that apply. Explore the possibility of a female nurse being willing to swap clients. Explain that it is discriminatory to not accept male nursing care. Report to the charge nurse to make them aware of the situation. Notify the facility patient-advocate to make them aware of the situation. Explain that the unit is made up of mostly male nurses so it may not be possible.

Explore the possibility of a female nurse being willing to swap clients. Report to the charge nurse to make them aware of the situation. Notify the facility patient-advocate to make them aware of the situation.

A client with multiple serious chronic illnesses says to the nurse, "I would like to strengthen my faith, but I am struggling." What action(s) by the nurse would assist the client in strengthening faith? Select all that apply. asking the client about original spiritual beliefs identifying current or past spiritual supports exploring factors that are creating conflict with client's beliefs reading aloud Bible passages that relate to the client's needs offering to pray with the client to help resolve the conflict

asking the client about original spiritual beliefs identifying current or past spiritual supports exploring factors that are creating conflict with client's beliefs