Pam Practice Questions

18. A nurse is coaching four clients in the use of relaxation techniques to manage stress. Which of the following findings indicate the techniques are effective? (Select all that apply.) A. Arousal reduction B. Decreased blood pressure C. Decreased heart rate D. Increased oxygen consumption E. Increased peripheral skin temperature

ANS:A,B,C,E

3. A nurse is caring for a client who is experiencing a normal grief reaction foterm-1llowing the loss of her spouse. Which of the following findings should the nurse expect? A. Chest pain B. Insomnia C. Hypertension D. Dry mouth

ANS:B

9. A client is admitted with post-traumatic stress disorder following a fire in his home in which family members died. Which of the following should the nurse recognize as an adaptive defense mechanism? A. The client begins reading a book when he experiences hand tremors in response to loud noise. B. The client makes a decision to postpone a needed surgery. C. The client focuses on discussing his daily routine when asked about the fire. D. The client develops stomach pains when fire is seen on television.

ANS:A

A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and finds that the client demonstrates constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following? A. Decrease anxiety. B. Prevent aggressive and impulsive behaviors. C. Manipulate others. D. Decrease the time available for interaction with people.

ANS:A

8. A home health nurse is reinforcing coping strategies with the family caregiver of a client who has Alzheimer's disease. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Actions to reduce stress B. Identification of a social support system C. Referral to available community resources D. Instruction on client medication administration E. Expected physiological changes of the disease

ANS: A,B,C,E

15. A nurse is caring for a 2-year-old child who is hospitalized and throws a tantrum when his parent leaves. Which of the following toys should the nurse provide to alleviate the child's stress? A. Set of building blocks B. Toy hammer and pounding board C. Picture book about hospitals D. Stuffed animal

ANS: B

A nurse is assessing a client who is experiencing chronic stress. Which of the following findings should the nurse expect? A. Hypotension B. Viral infection C. Increased energy D. Increased cognitive awareness

ANS: B

19. A nurse is caring for a young adult client who says he is experiencing increased anxiety and an inability to concentrate. Which of the following responses should the nurse make? A. "It sounds like you're having a difficult time." B. "Have you talked to your parents about this yet?" C. "Why do you think you are so anxious?" D. "How long has this been going on?"

ANS:A

21. A nurse is performing an admission assessment for a client who is receiving treatment following a situational crisis. Which of the following assessments by the nurse is the highest priority? A. Determining if the client has psychotic thinking B. Asking the client to identify the cause of the crisis C. Identifying the client's coping skills D. Identifying the client's support systems

ANS:A

4. A nurse is caring for a client whose partner died five years ago. Which of the following findings indicates that the client is experiencing maladaptive grief? A. The client joined a bowling league 2 months ago. B. The client has kept his partner's closet untouched since her death. C. The client exercises at a local health facility 3 days each week. D. The client meets his daughter for dinner every week.

ANS:B

13. A nurse is counseling a client for the management of anxiety. The client is consistently late for appointments and ignores household chores. The client states, "I'm just too stressed. I need someone to take care of me." The nurse identifies this behavior as an example of which of the following defense mechanisms? A. Dissociation B. Introjection C. Regression D. Repression

ANS:C

25. A nurse is planning care for a client who has generalized anxiety disorder. Which of the following intervention should the nurse implement to promote relaxation? A. Assist the client in practicing meditation. B. Recognize the client's spiritual preferences. C. Encourage the client to identify his positive qualities. D. Help the client to identify his previous accomplishments.

ANS:A

7. A nurse is attending a group therapy session and is listening to clients who have bipolar disorder discuss coping strategies. Which of the following statements by the clients indicate adaptive coping? (Select all that apply.) A. "I exercise aerobically three times a day for 30 minutes at a time." B. "I get 7 hours of sleep at night by skipping afternoon naps." C. "I think about being on my favorite beach vacation when I get anxious." D. "I tense and release my muscles, starting with my feet." E. "I see the glass as half-full when it starts looking empty."

ANS:B,C,D,E

17. A nurse is discussing stress management techniques with a group of clients. Which of the following techniques mentioned by a client should the nurse recognize as the least effective? A. "I journal when I find it difficult to talk." B. "I pray when I begin to breathe fast." C. "I fix myself a pot of coffee when I get anxious." D. "I exercise when my neck is tense."

ANS:C

24. A nurse is evaluating the outcomes for an outpatient client who has depression. Which of the following client statements indicates a need for further evaluation? A. "I had a great trip to the Smokey Mountains." B. "Going back to work has been okay." C. "I just don't like going to the movies like I used to." D. "I can't wait to have my family together next weekend."

ANS:C

A nurse is caring for a client in the emergency department who had a traumatic amputation of his left arm in an industrial accident. The nurse should expect the client to be experiencing which of the following of Kubler-Ross's stages of grief? A. Bargaining B. Depression C. Denial D. Acceptance

ANS:C

1. A nurse manager is discussing the differences between normal and maladaptive grief with nursing staff. Which of the following findings should the nurse manager identify as being a unique component of the maladaptive grieving process? A. Anorexia B. Sleep disturbances C. Anergia D. Low self-esteem

ANS:D

10. A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding? A. Sleeping 12 hr or more each day. B. Increasing sense of attachment to others. C. Constant need to talk about the event. D. Increasing feelings of anger.

ANS:D

11. A nurse is caring for a client who is discussing his post-traumatic stress disorder and states: "Everyone thinks you should be able to put it out of your mind. It happened so long ago - just get over it!" The nurse responds, "It must be very frustrating to encounter this kind of attitude." The nurse is using which of the following therapeutic communication techniques? A. Clarifying B. Focusing C. Paraphrasing D. Reflection

ANS:D

12. A nurse is admitting a client who is exhibiting manic behavior. The client reports recent personal stressors including the loss of her mother and a divorce. Which of the following is the priority nursing action? A. Identifying support systems. B. Assisting the client in identifying coping behaviors. C. Encouraging self-care D. Preventing self-directed violence.

ANS:D

16. A nurse is caring for a client who was involved in heavy combat and observed war casualties. The nurse should suspect that the client is suffering from posttraumatic stress disorder (PTSD) if the client makes which of the following statements? A. "I check any room I enter because the enemy is still after me and could be hiding anywhere." B. "My child was born with a birth defect due to an exposure I had overseas." C. "I killed four enemy soldiers with my bare hands and saved my entire battalion." D. "In my dreams, all I can see are the wounded reaching out and trying to grab me."

ANS:D

2. A nurse is caring for a client who is experiencing grief following the unexpected death of his spouse. Which of the following statements by the client indicates he is experiencing maladaptive grieving? A. I am only able to sleep 2 or 3 hours a night." B. "It's impossible for me to focus on my job." C. "I have lost 15 pounds since my wife died." D. "I have started smoking again."

ANS:D

20. A nurse is caring for a client who has been diagnosed with obsessive compulsive disorder (OCD) and is constantly picking up after others in the day room. The nurse should recognize that the client uses this behavior to do which of the following? A. Limit the amount of time available to interact with others. B. Focus attention on meaningful tasks. C. Manipulate and control others' behaviors. D. Decrease anxiety to a tolerable level.

ANS:D

23. A nurse is caring for a client who lost all his possessions in a house fire and states, "I have no idea what I am going to do. I cannot think right now." Which of the following actions should the nurse take? A. Identify other housing options and sources of transportation. B. Notify the facility chaplain to request scheduling an appointment. C. Confirm that everything will be all right because belongings can be replaced. D. Maintain eye contact with client and summarize the client's feelings.

ANS:D

A nurse is caring for a client in the emergency department who had a traumatic amputation of his left arm in an industrial accident. The nurse should expect the client to be experiencing which of the following of Kubler-Ross's stages of grief? A. Bargaining B. Depression C. Denial D. Acceptance

ANS:D