Psychosocial Integrity

A client of Anglo-Saxon descent (e.g., Anglo-American or English Canadian) reports to the primary health care facility with symptoms of fever, cough, and running nose. While interviewing the client, which of the following points should the nurse keep in mind?

While interviewing a client of Anglo descent, the nurse should maintain eye contact, because it indicates openness and sincerity.

A nurse may use self-disclosure with a client if

it achieves a specific therapeutic goal

A client with schizophrenia states, "I hear the voice of King Tut." Which response by the nurse is therapeutic?

"I don't hear the voice, but I know you hear what sounds like a voice.This response makes a factual statement about the client's hallucination.

Methadone

It can treat moderate to severe pain. It can also treat narcotic drug addiction.

The nurse is aware that clients in the initial stages of a terminal diagnosis may present with which of the following behaviors?

Seeking other opinions to disprove the inevitable is a form of denial used by individuals with illnesses that have a poor prognosis.

What is a generally accepted criterion of mental health?

Self-acceptance is a generally accepted criterion of mental health and serves as the basis for healthy relationships with others.

A woman has become increasingly afraid to ride in elevators. While in an elevator one morning, she experiences shortness of breath, palpitations, dizziness, and trembling. A physician can find no physiological basis for these symptoms and refers her to a psychiatric clinical nurse specialist for outpatient counseling sessions. Which type of therapy is most likely to reduce the client's anxiety level?

Systematic desensitization, a form of behavior modification, attempts to reduce anxiety, and thereby eradicate the phobia, through gradual exposure to anxiety-producing stimuli.

Despite education and role-play practice of restraint procedures, a staff member is injured when actually restraining a client. When helping the uninjured staff deal with the incident, the nurse should address which factor?

The emotional responses may be similar to those of other crime victims.

A client with severe chest pain is brought to the emergency department. The client tells the nurse, "I just have a little indigestion." How should the nurse respond?

"You seem concerned about your chest pain.During a crisis, it's common for a client to use denial, a coping mechanism exhibited by minimizing symptoms or avoiding discussion. The nurse must respond therapeutically to the client.

The mother tells the nurse that the diagnosis of colic upsets her because she knows her infant will continue to have colicky pain. Which response by the nurse would be most appropriate?

"It can be difficult to listen to your baby cry so loud and so long, so try to make sure that you get some free time.The nurse needs to provide the parents with support because of the infant's crying. The parents are stressed and need to be encouraged to get out of the house and arrange for some free time.

A woman who was raped in her home was brought to the emergency department by her husband. After being interviewed by the police, the husband talks to the nurse. "I do not know why she did not keep the doors locked like I told her. I cannot believe she has had sex with another man now." The nurse should respond by saying:

"Let us talk about how you feel. Maybe it would help to talk to other men who have been through this."The nurse should respond to the husband's needs and concerns and should offer support. Protecting or defending the wife against his criticism ignores the husband's needs.

A mother of three young children has been diagnosed with stage III breast cancer and is distraught. Which statement best communicates a spirit of hopefulness to this client?

"Let's take this one day at a time; remember you have your daughter's dance recital next month.Helping a client to find reasons to live and look forward to events promotes positive attitudes and ability to live for the moment, which in turn communicates a spirit of hopefulness.

A client tells a nurse that people from Mars are going to invade the Earth. Which response by the nurse would be therapeutic?

"That must be frightening to you. Can you tell me how you feel about it?"This response addresses the client's underlying fears without feeding the delusion. Refuting the client's delusion would increase his anxiety and reinforce his delusion.

A hospitalized client craves a drink after withdrawing from alcohol. Which measure is the best way to help the client resist the urge to drink?

Group support has proved more successful than individual attention from the staff in influencing positive behavior in alcoholics.

When doing discharge planning for a hospitalized client with impulse control disorder, a nurse explains how family members can participate effectively in the client's ongoing care. What instruction should the nurse include?

Consistency in rewarding positive behavior and reinforcing consequences of negative behavior

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?

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

A client changes topics quickly while relating past psychiatric history. This client's pattern of thinking is called

Flight of ideas describes a thought pattern in which a client moves rapidly from one topic to the next with some connection.

Which assessment finding by the nurse and statement by an older adult would require the nurse to report suspected elder abuse?

Stage II decubitus ulcer on coccyx; "No one is able to turn or lift me anymore."Neglect is the most common form of elder abuse. The inability of an older adult to obtain basic care is considered neglect. If a client is not being turned or repositioned to prevent skin breakdown, then neglect is happening.

Which of the following would be the priority when providing care to a client with posttraumatic stress disorder (PTSD)?

The first step in caring for a client with PTSD is to develop a trusting nurse-client relationship because the patient is physically compromised and struggling emotionally with a situation that is outside the norm.

A client who is to have a vaginal radium implant tells the nurse she is concerned about being radioactive. The nurse should tell the client

The radioactivity comes from a radioactive material such as radium or cesium. Radioactivity affects tissues but does not make them radioactive. Once the radioactive source is removed, no radioactivity remains. Accurate information can help alleviate ungrounded fears.

most effective means of minimizing the child's anxiety during hospitalization

have the parents stay. Having a familiar toy helps the child to deal with the anxiety of unfamiliar surroundings. Sibling visitation can also help to ease the child's anxiety.

Dementia

impairment of abstract thinking and in decision making.

A client diagnosed with paranoid personality disorder is hospitalized for physically threatening his wife because he suspects her of having an affair with a coworker. What approach should the nurse employ with this client?

matter-of-fact approach to create a nonthreatening and secure environment because the client is experiencing problems with suspiciousness and trust.

A client with suspected abuse describes her husband as a good man who works hard and provides well for his family. She does not work outside the home and states that she is proud to be a wife and mother just like her own mother. The nurse interprets the family pattern described by the client as best illustrating which characteristic of abusive families?

role stereotyping