HC3B Exam 1

A client, being cared for in the ED after a sexual assault, asks that a friend be allowed to stay in the examination room while waiting for the SANE nurse to arrive. The client is observably anxious and states, "I don't want to be alone." What response will the ED nurse make in order to best assure the client's safety and emotional health? A) "Certainly; whatever makes you feel safe." B) "Are you thinking about hurting yourself?" C) "I understand. I'll stay with you." D) "Do you want to talk to a psychiatrist?"

A) "Certainly; whatever makes you feel safe."

A patient tells the nurse, "I was raped 8 years ago but never told anyone. Nevertheless, the memories haunt me every day. I should be over it by now." Which comment should the nurse offer next? A) "It sounds like you're judging yourself for continuing to struggle with your reaction." B) "Rape is criminal behavior. You should have reported the incident to law enforcement." C) "Are you now ready to engage in counseling to deal with your reactions to this experience?" D) "Although it's important to learn from such life events, it's more important to put things in the past."

A) "It sounds like you're judging yourself for continuing to struggle with your reaction."

A preschool-age child with a history of being abused has blood drawn. The child lies very still and makes no sound during the procedure. Which comment by the nurse would be most appropriate? A) "It's okay to cry when something hurts." B) "That really didn't hurt, did it?" C) "We must seem mean to hurt you that way." D) "You were very good not to cry with the needle."

A) "It's okay to cry when something hurts."

A woman who was raped in her home was brought to the ED by her husband. After being interviewed by the police, the husband talks to the nurse. "I don't know why she didn't keep the doors locked like I told her. I can't believe she's had sex with another man now." How should the nurse respond? A) "Let's talk about how you feel. Maybe it would help to talk to other men who have been through this." B) "Maybe the doors were locked, but the man broke in anyway." C) "Your wife needs your support right now, not your criticism." D) "It wasn't consensual sex. Let's see if your wife was physically injured."

A) "Let's talk about how you feel. Maybe it would help to talk to other men who have been through this."

The nurse is caring for four clients who have been recommended to consider bariatric surgery. Which assessment data require immediate nursing intervention? A) BMI of 23 with gastrointestinal reflux B) BMI of 36 with hypertension C) BMI of 40 with type II diabetes D) BMI of 43 with sleep apnea

A) BMI of 23 with gastrointestinal reflux

A nurse is working with a client with bulimia. Which goals should be included in the care plan? SATA. A) The client will maintain normal weight B) The client will comply with medication therapy C) The client will achieve a positive self-concept D) The client will acknowledge the disorder E) The client will never have the desire to purge again

A, B, C

A client with obesity tells the nurse, "My genes are the only thing that have made me obese." What is the appropriate nursing response? SATA. A) "Genes can contribute to obesity." B) "Tell me about your family history." C) "Let's talk about your nutrition intake." D) "Have you considered bariatric surgery?" E) "How do you feel about physical activity?" F) "What lifestyle modifications have you tried?"

A, B, C, E, F

Which response would the nurse make to a client who says, "I used to believe that I was God, but now I know that's not true."? A) "You really believed that?" B) "Many people have this delusion." C) "This is a sign you are getting better." D) "What caused you to think you were God?"

C) "This is a sign you are getting better."

Which response would the nurse make to a confused, hallucinating client who says, "My arms are turning to stone."? A) "May I examine your arms?" B) "When did this feeling first start?" C) "That's a rather unusual sensation." D) "It can be frightening to feel that way."

D) "It can be frightening to feel that way."

Abuse categories include all of the following, except: A) Emotional B) Physical C) Sexual D) Spiritual

D) Spiritual

A nurse is not obligated to report suspected child abuse unless proof is actually found. True or False?

False

Elder abuse does not need to be reported since it is happening to an adult. True or False?

False

A patient in the refeeding stage of an anorexia diagnosis does not have any risks or potential complications. True or False?

False

Ignoring a visitor who is yelling and cussing at the patient and staff is an appropriate intervention. True or False?

False

Victims of intimate partner violence do not need to have safety plans in place. True or False?

False

When caring for patients with mental health disorders, safety is not typically a concern. True or False?

False

A client became angry with a staff member and began throwing objects at others in the unit. Which question will the nurse manager ask the staff in order to address the goals of the debriefing of the incident that focuses on client care? A) "Were the unit's policies on managing violence followed?" B) "What injuries resulted from the violence?" C) "When did the violence begin?" D) "What was the client's reasoning for the violent behaviors?"

A) "Were the unit's policies on managing violence followed?"

Adolescents and adults who were sexually abused as children commonly mutilate themselves. The nurse interprets this behavior as: A) The need to make themselves less sexually attractive B) An alternative to bingeing and purging C) Use of physical pain to avoid dealing with emotional pain D) An alternative to getting high on drugs

C) Use of physical pain to avoid dealing with emotional pain

When teaching a group of adolescents about anorexia nervosa, the nurse should describe this disorder as being characterized by which factors? A) Excessive fear of becoming obese, near-normal weight, and a self-critical body image B) Obsession with the weight of others, chronic dieting, and an altered body image C) Extreme concern about dieting, calorie counting, and an unrealistic body image D) Intense fear of becoming obese, emaciation, and a disturbed body image

D) Intense fear of becoming obese, emaciation, and a disturbed body image

Which conclusion would the school nurse make about a female teenager who has anorexia nervosa and states that she thinks she is pregnant even though she has had intercourse only once, more than a year ago? A) Is using magical thinking B) Is submitting to peer pressure C) Is lying about the last time she had intercourse D) Is lacking knowledge that the disease can cause amenorrhea

D) Is lacking knowledge that the disease can cause amenorrhea

The nurse hears a child who was not invited to a sleepover say, "I have better things to do than go that sleepover." Which defense mechanism would the nurse conclude the child is using? A) Denial B) Projection C) Regression D) Rationalization

D) Rationalization

All of the following factors could predispose an individual to an eating disorder, except: A) Genetics B) Traumatic life events C) Cultural pressures D) Healthy coping mechanisms

D) Healthy coping mechanisms

A young adult female client is brought to the ED by her roommate to seek treatment for GI problems. The client reveals that she attends college and works at a coffee shop each evening. A diet history indicates that the client has unhealthy eating habits, commonly eating large amounts of carbohydrates and junk food with few fruits and vegetables. "Her stomach is upset a lot," the roommate says. She further reports that the client is "in the bathroom all the time." Which referral is most important for the nurse to make for the client? A) A mental health clinic B) A weight loss program C) An overeating support group D) The client's health care provider

A) A mental health clinic

When interviewing a child of suspected abuse, an appropriate technique to gather information would be: A) Allow child to draw their feelings about the experience B) Tell the child the only way to get help is to talk about the situation C) Promise the child that everything will be fine and kept confidential D) Suggest potential answers to questions to alleviate the stress to the child

A) Allow child to draw their feelings about the experience

A young child who has been sexually abused has difficulty putting feelings into words. Which approach should the nurse employ with the child? A) Engaging in play therapy B) Role-playing C) Giving the child's drawings to the abuser D) Reporting the abuse to a prosecutor

A) Engaging in play therapy

During the clinical interview, the nurse should do which of the following when establishing a plan of care with a patient? A) Establish boundaries B) Give advice of what the patient should do C) Tell patient about personal experiences D) Avoid speaking to the patient

A) Establish boundaries

Identify an appropriate goal for a patient with anorexia nervosa: A) Patient will gain 1 lb a week B) Patient will gain weight C) Patient will eat all of the three meals a day offered D) Patient will weigh themselves every morning

A) Patient will gain 1 lb a week

During an initial assessment of a patient with anorexia, which of the following components would be most pertinent to care: A) Severely abnormal lab values B) Acknowledgement of previous traumatic events C) Poor self-esteem D) The need for nutritional counseling

A) Severely abnormal lab values

The nurse is planning an eating disorder protocol for hospitalized clients experiencing bulimia and anorexia. Which elements should be included in the protocol? SATA. A) Clients must eat within view of a staff member B) Clients are not told their weight and cannot see their weight while being weighed C) Clients must rest within view of a staff member for one-half hour to an hour after eating D) Clients may not go to the bathroom for one-half hour to an hour after eating E) Clients cannot participate in any groups for admission until they gain 1 lb

A, B, C, D

What discharge teaching will the nurse provide to a client who had gastric bypass surgery? SATA. A) Be certain to stay hydrated by drinking water B) Solid food can be introduced back into the diet in a week C) Report any back, shoulder, or abdominal pain to the surgeon D) You are likely to have little urine output for the first few weeks E) Each of your meals should initially contain about 5 tablespoons of food

A, C, E

In a hostile voice, a patient experiencing mania yells at the nurse: "You will listen to me and not interrupt. I have some really important stuff to say. I'm tired of you nurses and doctors acting like you have all the answers." To facilitate effective communication, which initial response should the nurse provide? A) "You are our patient, so we always listen to you." B) "I can talk with you better if you use a calm voice." C) "It's our job to help you get through this manic episode." D) "Patients have an important role in treatment planning."

B) "I can talk with you better if you use a calm voice."

A client diagnosed with bulimia tells the nurse she only eats excessively when upset with her best friend, and then she vomits to avoid gaining a lot of weight. What should the nurse do next? A) Schedule daily family therapy sessions B) Enroll client in a coping skills group C) Work with the client to limit her purging D) Obtain a PRN prescription for lorazepam to reduce binge eating urges

B) Enroll client in a coping skills group

The nurse discovers that an adolescent client with anorexia nervosa is taking diet pills rather than complying with the diet. What should the nurse do first? A) Explain to the client how diet pills can jeopardize health B) Listen to the client discuss fears of losing control of eating while being treated C) Talk with the client about how weight loss worry the HCP D) Inquire about worries of the client's family concerning the client's health

B) Listen to the client discuss fears of losing control of eating while being treated

Which instruction would the nurse suggest to a 14-year-old girl who suspects her friend is using self-induced vomiting to keep weight down? A) Confront her friend with her suspicions B) Talk to the school nurse about her concerns C) Inform the girl's mother about her daughter's behavior D) Watch a while longer before doing anything that might ruin the friendship

B) Talk to the school nurse about her concerns

A preadolescent child is suspected of being sexually abused because he demonstrates the self-destructive behaviors of self-mutilation and attempted suicide. Which common behavior should the nurse also expect to assess? A) Inability to play B) Truancy and running away C) Headbanging D) Over-control of anger

B) Truancy and running away

A client who has been sexually assaulted is admitted to the ED. Which is the most important initial statement by the nurse? A) "Did you know the person who did this to you?" B) "I'll get the emergency rape kit." C) "I'll stay with you while you're here." D) "Don't worry, trained responders are coming."

C) "I'll stay with you while you're here."

While interviewing a preschool-age-girl who has been sexually abused about the event, which approach would be most effective? A) Describe what happened during the abusive act B) Draw a picture and explain what it means C) "Play out" the event using anatomically correct dolls D) Name the perpetrator

C) "Play out" the event using anatomically correct dolls

The parents of an adolescent client newly diagnosed with anorexia nervosa are meeting with the nurse during the admission process. Which remarks should the nurse interpret as typical for parents of a client with anorexia nervosa? A) "We've given her everything, and look how she repays us!" B) "She's had behavior problems for the past year both at home and at school." C) "She's been a model child. We've never had any problems with her." D) "We have five children, all normal kids with some problems at times."

C) "She's been a model child. We've never had any problems with her."

A client newly diagnosed with bulimia is attending the nurse-led group at the mental health center. She tells the group that she came only because her husband said he would divorce her if she did not get help. Which response by the nurse is appropriate? A) "You sound angry with your husband. Is that correct?" B) "You'll find that you'll like coming to group. These people are a lot of fun." C) "Tell me more about why you're here and how you feel about that?" D) "Tell me something about what has caused you to be bulimic."

C) "Tell me more about why you're here and how you feel about that?"

A hospitalized adolescent diagnosed with anorexia nervosa refuses to comply with her daily before-breakfast weigh-in. She states that she just drank a glass of water, which she feels will unfairly increase her weight. What is the nurse's best response? A) "You're here to gain weight so that will work in your favor." B) "Don't drink or eat for 2 hours, and then I'll weight you." C) "You must weigh in every day at this time. Please step on the scale." D) "If you don't get on the scale, I'll be forced to call your health care provider."

C) "You must weigh in every day at this time. Please step on the scale."

An adolescent client is being admitted with an eating disorder. Which initial assessment finding is of greatest concern for the nurse? A) A systolic blood pressure of 100 mmHg B) A weight loss of 10% over 6 months C) A potassium level of 2.5 mEq/L D) A heart rate of 57 bpm

C) A potassium level of 2.5 mEq/L

One of the myths about sexual abuse of young children is that it usually involves physically violent acts. Which of the following behaviors is more likely to be used by the abusers? A) Tying the child down B) Bribery with money C) Coercion as a result of the trusting relationship D) Asking for the child's consent for sex

C) Coercion as a result of the trusting relationship

In the care of a sexual violence victim, the nurse should do all of the following, except: A) Do not leave the victim alone B) Be supportive and empathetic during this time C) Make the patient wait in the triage area since it isn't a life-threatening issue D) Provide privacy to the patient

C) Make the patient wait in the triage area since it isn't a life threatening issue

A nurse works with a client diagnosed with bulimia. What is the most appropriate long-term client goal for this client? A) Eat meals at home without binging or purging B) Be able to eat out without binging or purging C) Manage stresses in life without binging or purging D) Be able to attend college without binging or purging

C) Manage stresses in life without binging or purging

In working with a rape victim, which of the following is most important? A) Continuing to encourage the client to report the rape to the legal authorities B) Recommending that the client resume sexual relations with her partner as soon as possible C) Periodically reminding the client that she did not deserve and did not cause the rape D) Telling the client that the rapist will eventually be caught, put on trial, and jailed

C) Periodically reminding the client that she did not deserve and did not cause the rape

A client is admitted to the psychiatric hospital for evaluation after numerous incidents of threatening others, and two episodes of hitting a coworker at the client's place of employment. The client is very anxious and tells the nurse, "I didn't mean to hit him. He made me so mad that I just couldn't help it. I hope I don't hit anyone here." To ensure a safe environment, what should the nurse do first? A) Let other clients know that the client has a history of hitting others so that they will not provoke the client B) Put the client in a private room to when staff can be with the client C) Tell the client that hitting others is unacceptable behavior, and ask the client to tell a staff member when feeling angry D) Obtain a prescription for a medication to be administered to decrease the client's anxiety and threatening behavior

C) Tell the client that hitting others is unacceptable behavior, and ask the client to tell a staff member when feeling angry

Which observation by the nurse should suggest that a 15-month-old toddler has been abused? A) The child appears happy when personnel work with him B) The child plays alongside others contentedly C) The child is underdeveloped for his age D) The child sucks his thumb

C) The child is underdeveloped for his age

When obtaining a nursing history from parents who are suspected of abusing their child, which characteristic about the parents should the nurse particularly assess? A) Attentiveness to the child's needs B) Self-blame for the injury to the child C) Ability to relate the child's developmental achievements D) Difficulty with controlling aggression

D) Difficulty with controlling aggression

After a client reveals a history of childhood sexual abuse, the nurse should ask which of the following questions first? A) "What other forms of abuse did you experience?" B) "How long did the abuse go on?" C) "Was there a time when you did not remember the abuse?" D) "Does your abuser still have contact with young children?"

D) "Does your abuser still have contact with young children?"

In the process of dealing with the intense feelings about being raped, victims commonly verbalize that they were afraid they would be killed during the rape and wish that they had been. The nurse should decide that further counseling is needed if the client voices which of the following? A) "I didn't fight him, but I guess I did the right thing because I'm alive." B) "Suicide would be an easy escape from all this pain, but I couldn't do it to myself." C) "I wish they gave the death penalty to all rapists and other sexual predators." D) "I get so angry at times that I have to have a couple of drinks before I sleep."

D) "I get so angry at times that I have to have a couple of drinks before I sleep."

This type of communication style is deemed therapeutic to gather information: A) Falsely reassuring B) Asking excessive questions C) Changing the subject D) Giving broad openings

D) Giving broad openings

A client loses control and throws two chairs toward another client. What should the nurse do next? A) Ask the client to go to the quiet area and talk about the behavior B) Administer an oral PRN tranquilizer and prepare for a show of determination C) Process the incident with the client and discuss alternative behaviors D) Call for assistance to restrain the client, and administer a PRN intramuscular tranquilizer

D) Call for assistance to restrain the client, and administer a PRN intramuscular tranquilizer

When planning the care for a client who is being abused, which measure is most important to include? A) Being compassionate and empathetic B) Teaching the client about abuse and the cycle of violence C) Explaining to the client about the client's personal and legal rights D) Helping the client develop a safety plan

D) Helping the client develop a safety plan

A community health nurse working with a group of fifth-grade girls is planning a primary prevention to help the girls avoid developing eating disorders during their teen years. The nurse should focus on which factor? A) Working with the school nurse to closely monitor the girls' weight during middle school B) Limiting the girls' access to media images of very thin models and celebrities C) Telling the girls' parents to monitor their daughter's weight and media access D) Helping the girls accept and appreciate their bodies and feel good about themselves

D) Helping the girls accept and appreciate their bodies and feel good about themselves

All of the following are potential signs/symptoms of bulimia, except: A) Dental decay B) Possible dehydration C) Enlarged parotid glands D) Improved self-esteem

D) Improved self-esteem

The nurse would determine 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 performing which behavior? A) Seems to be doing average work in school B) Has asked the mother how to bake bread C) Imitates a sibling's manner of speech and dress D) Joins a dirt bike group that meets at the school

D) Joins a dirt bike group that meets at the school

Based on a client's history of violence toward others and inability to cope with anger, which of the following should the nurse use as the most important indicator of goal achievement before discharge? A) Acknowledgment of the client's angry feelings B) Ability to describe situations that provoke angry feelings C) Development of a list of how anger has been handled in the past D) Verbalization of feelings in an appropriate manner

D) Verbalization of feelings in an appropriate manner

Which response would the nurse make to a cocaine addict remanded for rehabilitation by the court who curses at his or her spouse and tell the spouse to go home, causing the spouse to leave in tears? A) "You are very angry right now." B) "Let's talk about what just happened." C) "Let's go to your next scheduled activity." D) "You should go to the gym to use the punching bag."

B) "Let's talk about what just happened."

Which response would the nurse make to a client who says, "Please let me go. I trust you. The Mafia is going to kill me tonight."? A) "You're frightened. Come with me to your room, and we can talk about it." B) "Come with me to your room. I'll lock the door and no one will get in to harm you." C) "Nobody here wants to harm you, and you know that. I'll come with you to your room." D) "Thank you for trusting me. Maybe you can trust me when I tell you that no one will kill you here."

A) "You're frightened. Come with me to your room, and we can talk about it."

A patient has been out of work for 3 weeks with a major illness and anticipates another month of recovery. The patient tells the nurse, "I'm trying to keep up with my work email from home. They hired a new person in my department, but that person has no experience." Select the nurse's therapeutic response. A) "It sounds like you're saying you are worried about your job security." B) "No one expects you to keep pace with your job while you're recovering." C) "Your employer is required to hold your job for you while you're on sick leave." D) "Don't worry about your job right now. It's more important for you to recover."

A) "It sounds like you're saying you are worried about your job security."

Which statement by the nurse demonstrates a blurring of boundaries with a client diagnosed with depression? A) "The client is just too depressed to shower and dress today." B) "Today we discussed the impact of depression on family members." C) "The client talked about an uncle who was depressed and committed suicide." D) "I'm concerned that the client's depression has been the cause of marital problems."

A) "The client is just too depressed to shower and dress today." Rationale: The nurse is demonstrating over-helping by determining the client doesn't need to shower because of the depression. This, along with controlling and narcissism on the part of the nurse, is an indicator of blurring boundaries.

The client comes to the local clinic reporting dizziness and a "racing heart." The client's physical exam is normal. The client reports the client's company recently lost a large sum of money and the client feels responsible. The client tells the nurse of being extremely anxious. Which response by the nurse is best? A) "When did you first notice that you were feeling anxious?" B) "Have you shared this information with a loved one?" C) "Are you worried about having to visit the health care provider?" D) "Would you like to discuss your anxiety with me?"

A) "When did you first notice that you were feeling anxious?"

An ED nurse talks with a newly admitted victim of reported rape. Which communication should the nurse offer to comfort the patient? A) "You are safe now. I will stay with you in this private room." B) "Would you like your friend to stay with you during your examination?" C) "You made a good decision to come to the hospital after you were raped." D) "What questions do you have about your examination by the sexual assault nurse examiner?"

A) "You are safe now. I will stay with you in this private room."

Which response would the nurse make to a depressed client who tells the nurse, "I want to die." A) "You would rather not live." B) "You're not alone in feeling this way." C) "When was the last time you felt this way." D) "Do you believe that there's a life after death?"

A) "You would rather not live."

Which response would the nurse make to a depressed, crying client on the evening of admission? A) "You're crying. Let's talk about it." B) "Let me get a cup of coffee; then we can talk." C) "Visitors will be here soon; you'd better get ready." D) "You'll feel better soon. Come to the sitting room with me."

A) "You're crying. Let's talk about it."

Which response would the nurse make to a client who has been acting out for several weeks and says, I'm really sorry about how I've acted. I'll bet everyone thinks I'm an idiot."? A) "You're wondering how others will react to you now." B) "Some clients are concerned that you might lose control again." C) "Everyone feels foolish sometimes; you didn't deliberately act that way." D) "Nobody thinks you're a fool; everyone recognized that you were really struggling to keep control."

A) "You're wondering how others will react to you now."

Which client-focused change will the nurse identify as a sign of possible escalation of anger? A) A client that had been calm and quiet becomes talkative and loud B) A manic client becomes withdrawn C) An impulsive client demonstrates introspection D) A depressed client begins to cry

A) A client that had been calm and quiet becomes talkative and loud

Which reason would likely be the cause for a 65-inch tall 15-year-old girl weighing 80 lb being admitted to a mental health facility? A) A desire to control her life B) The wish to be accepted by her peers C) The media's emphasis on the beauty of thinness D) A delusion in which she believes that she must be thin

A) A desire to control her life

The client is told by the HCP that the client's cancer is inoperable. The nurse enters the room a short time later and finds the client crying. Which action does the nurse take first? A) Acknowledges this is a sad time B) Quietly leaves the room C) Calls the chaplain or spiritual leader at the hospital D) Stresses what can be done in the time remaining

A) Acknowledges this is a sad time

A university football coach invites the campus nurse to talk to the team about healthy relationships in the community. Which topic has priority for the nurse to include? A) Appropriate behavior with intimate partners B) University resources for counseling and support C) The importance of role modeling for children and teens D) Public recognition of children with life-threatening illnesses

A) Appropriate behavior with intimate partners

Which action would the nurse take to establish a trusting relationship with a client who is using paranoid ideation? A) Being available on the unit but waiting for the client to approach B) Seeking the client out frequently to spend long blocks of time together C) Sitting on the unit and observing the client's behavior throughout the day D) Calling the client into the office to establish a contract for regular therapy sessions

A) Being available on the unit but waiting for the client to approach

Which initial approach would the nurse use to establish a therapeutic one-on-one relationship with a guarded, suspicious client diagnosed with schizophrenia? A) Casual and honest B) Warm and friendly C) Permissive and distant D) Undemanding and watchful

A) Casual and honest

Which nursing intervention would be essential for a newly admitted client with bulimia nervosa? A) Check on the client continually B) Observe the client during meals C) Teach the client to measure intake and output D) Involve the client in developing a daily meal plan

A) Check on the client continually

A nurse prepares a patient in a rural community for an initial telehealth visit with the HCP. Select the nurse's priority action. A) Ensure that the patient's rights to privacy are respected B) Ask the patient, "How much do you know about the Internet?" C) Inform the patient, "This experience will be like appearing on a television." D) Advise the patient, "You will be able to hear, but not see, your health care provider."

A) Ensure that the patient's rights to privacy are respected

Which action would the nurse take when interacting with an adolescent who has anorexia nervosa? A) Follow unit guidelines B) Maintain constant contact C) Demonstrate sympathy D) Focus on a healthy intake

A) Follow unit guidelines

Which initial action would the nurse take to provide a therapeutic environment for a client who is withdrawn and reclusive? A) Foster a trusting relationship B) Administer medications on time C) Involve the client in a group with peers D) Remove the client from the family home

A) Foster a trusting relationship

After the admission interview and assessment, the ED nurse has reason to believe that a child is being abused physically. Which intervention will the nurse implement to best determine if the child has been abused?" A) Insist that the child be further assessed without the parents being present B) Provide the child with suggestions of other possible examples of abuse C) Allow the child to pick one parent to be present during the remaining examination D) Delay the assessment until the appropriate child protection authorities are present

A) Insist that the child be further assessed without the parents being present

Which primary gain would an adolescent with anorexia nervosa achieve from this disorder? A) Reduction of anxiety through control over food B) Separation from parents secondary to hospitalization C) Release from school responsibilities because of illness D) Increased parental attentiveness related to massive weight loss

A) Reduction of anxiety through control over food

Which action would the nurse take for an adolescent client with anorexia nervosa? A) Reward weight gain by increasing privileges B) Discuss the importance of eating a balanced diet C) Encourage the client to include high-calorie foods in the diet D) Suggest family therapy to focus on the client's behavior

A) Reward weight gain by increasing privileges

Which behavior is an early sign of an abusive personality? SATA. A) Verbally abusive B) Jealous, controlling C) Enforces rigid sex roles D) Hypersensitive, easily insulted E) Isolates partner from family and friends F) Makes others responsible for their feelings

A, B, C, D, E, F

An adult experiencing a recent exacerbation of ulcerative colitis tells the nurse, "I had an accident while I was at the grocery store. It was so embarrassing." Select the nurse's therapeutic response. A) "Most grocery stores have public restrooms available." B) "Tell me more about how you felt when that happened." C) "People usually have compassion about those types of events." D) "Your disease is now in remission so that is not likely to happen again."

B) "Tell me more about how you felt when that happened."

An older client is terminally ill. The client says to the nurse, "Why do you bother me?" Which response is best? A) "Would you prefer to be alone right now?" B) "I care about you and how you are doing." C) "I understand how you feel." D) "This is difficult disease, isn't it?"

B) "I care about you and how you are doing."

The school nurse assesses four adolescents who appear to have a healthy weight. Which comment would lead the nurse to explore further for an eating disorder? A) "I usually try to exercise 30 minutes a day." B) "I know everything in my life will be better once I lose 15 more pounds." C) "I forgot my lunch today, so I will only be eating an apple." D) "I know I shouldn't eat potato chips, but I just love them."

B) "I know everything in my life will be better once I lose 15 more pounds."

A female nurse is appointed to a committee with seven men. At the beginning of the meeting, the chairman asks the nurse to be the secretary. The nurse responds, "No. You're just asking me to be secretary because I'm the only woman here." Which response would have been more effective? A) "There are others more qualified than I am to be secretary." B) "I would be glad to perform another role for our committee." C) "I'm probably overreacting, but I find your request offensive." D) "Thank you for asking, but your request is sexually discriminatory."

B) "I would be glad to perform another role for our committee."

An ED nurse assesses a child with a fractured ulna. The nurse also observes yellow and purple bruises across the child's back and shoulders. Which comment by the parents should prompt the nurse to consider making a report to Child Protective Services? A) "We do not believe in the immunization of our children." B) "This child is always creating problems for the family." C) "Our child would rather play alone than with other children." D) "We homeschool our children in order to include religious education."

B) "This child is always creating problems for the family."

A client has expressed great concern over "feeling like I'm going crazy" since experiencing anxiety, depression, and nightmares after being sexually assaulted. What response will the nurse make initially to address the client's concerns? A) "Let's talk about how these symptoms are making you feel and especially how they are making you feel crazy." B) "What you are experiencing must be frightening. These symptoms are shared by many who have been sexually assaulted." C) These are common feelings after being assaulted. Fortunately, you are not going crazy so try not to worry about that." D) "What you are experiencing is common among sexual assault victims. It's not a result of going crazy."

B) "What you are experiencing must be frightening. These symptoms are shared by many who have been sexually assaulted."

Which nursing intervention would be priority in the period immediately after an emaciated young teenager with anorexia nervosa is admitted to the hospital for starvation? A) Ensuring that the child's rest and nutrition needs are met B) Correcting the child's fluid and electrolyte imbalances C) Obtaining more data about the child's diet and exercise program D) Completing an assessment of the child's physical and family status

B) Correcting the child's fluid and electrolyte imbalances

A client tells the nurse that she has been raped but has not reported it to the police. After determining whether the client was injured, whether it is still possible to collect evidence, and whether the client wants to file a report, the nurse's next priority is to offer which intervention to the client? A) Legal assistance B) Crisis intervention C) A rape support group D) Medication for disturbed sleep

B) Crisis intervention

After months of counseling, a client abused by her husband tells the nurse that she has decided to stop treatment. There has been no abuse during this time, and she feels better able to cope with the needs of her husband and children. In discussing this decision with the client, the nurse should: A) Tell the client that this is a bad decision that she will regret in the future B) Find out more about the client's rationale for her decision to stop treatment C) Warn the client that abuse commonly stops when one partner is in treatment, only to begin again later D) Remind the client of her duty to protect her children by continuing treatment

B) Find out more about the client's rationale for her decision to stop treatment

An ED nurse assesses a woman suspected of being abused by an intimate partner. Which assessment finding most clearly confirms the suspicion? A) Leathery facial tone B) Injuries in a bikini pattern C) Reluctance to be examined D) Lack of eye contact with the nurse

B) Injuries in a bikini pattern

Which assessment data would the nurse find in a client who was recently admitted with a diagnosis of bulimia nervosa? A) Amenorrhea in postmenarchal female B) Lack of control over bing-eating episodes C) Body weight less than 85% of that expected D) Inability to purge in public places after eating

B) Lack of control over bing-eating episodes

A woman in a relationship characterized by a long history of battering and abuse tells the nurse, "We've had a rough time lately. I admit it: He beat me last night but then said he was sorry." Which event would the nurse expect to occur next in this relationship? A) Another beating by the abusive partner B) Love, gifts, and praise from the abusive partner C) A brief period during which the partners ignore each other D) The abusive partner leaves the relationship for a short time

B) Love, gifts, and praise from the abusive partner

Which approach would the nurse use for the involved parent who has a child diagnosed with Munchausen syndrome by proxy? A) Confrontation B) Open communication C) Health teaching about childrearing D) Validation of the child's physical status

B) Open communication

Which intervention would the nurse include in the plan of care for an adolescent with anorexia nervosa who is admitted to the psychiatric unit? A) Limit opportunities for decision-making B) Provide supervision during and after mealtimes C) Arrange for a physical exercise program with time to complete it D) Request that parents keep their visits to a minimum early in treatment

B) Provide supervision during and after mealtimes

Which instructions would the nurse share with a housekeeping staff member who reports that the client with anorexia nervosa has food hidden in the room? A) Point this out to the client and remove the food B) Report it to the nursing staff if it happens again C) Disregard this finding because it's a common behavior in clients with anorexia D) Keep a record of when this happens and report it to the nursing staff weekly

B) Report it to the nursing staff if it happens again

A neighbor telephones the nurse daily, giving lengthy details about multiple somatic complaints and relationship problems. Which limit-setting strategy should the nurse employ? A) Suggest the neighbor call other people in the community B) Say to the neighbor, "I can talk to you for 15 minutes twice a week." C) Use the telephone's caller ID to screen calls from the neighbor D) Tell the neighbor, "You should discuss these concerns with your personal physician rather than me."

B) Say to the neighbor, "I can talk to you for 15 minutes twice a week."

Which response would the nurse make during the admission procedure for a client who cries out at intervals, "No, no! I didn't kill him! You know the truth-tell that police officer! Please help me!"? A) Listening attentively and assuming an expression of disbelief B) Saying, "I want to help you. I realize that you must be very frightened." C) Sitting quietly and refraining from responding to the client's statements D) Replying, "Don't be so upset. No one is talking to you; those voices are part of your illness."

B) Saying, "I want to help you. I realize that you must be very frightened."

A woman experienced a double mastectomy yesterday. Now she cheerfully says to the nurse, "I didn't need those things anyway. No more wet T-shirt contests for me!" How should the nurse interpret this comment? A) The patient is realistically accepting her loss B) The comment is sarcastic, which may reflect anger C) The patient is experiencing a distorted body image D) The comment suggests guilt regarding prior behavior

B) The comment is sarcastic, which may reflect anger

A married female client has been referred to the mental health center because she is depressed. The nurse notices bruises on her upper arms and asks about them. After denying any problems, the client starts to cry and says, "He did not really mean to hurt me, but I hate for the kids to this. I am so worried about them." What is the most crucial information for the nurse to determine? A) The type and extent of abuse occurring in the family B) The potential of immediate danger to the client and her children C) The resources available to the client D) Whether the client wants to be separated from her husband

B) The potential of immediate danger to the client and her children

A nurse assesses four adolescents diagnosed with various eating disorders. Which comment would the nurse expect from the adolescent diagnosed with anorexia nervosa? A) "I look good because whenever I overeat, I purge myself." B) "I love sweets. I make myself throw up so I can eat more." C) "I've lost 60 pounds, but I'm still a size 2. I want to be a size 0." D) "I've hidden my eating disorder from everyone, even my parents."

C) "I've lost 60 pounds, but I'm still a size 2. I want to be a size 0."

An ED nurse prepares to discharge a victim of reported rape. Which comment by the victim indicates that the nurse's teaching was effective? A) "I should bathe frequently over the next week." B) "I am required to follow up with law enforcement." C) "It's important for me to follow up with counseling." D) "I should delay any sexual activity for at least 3 months."

C) "It's important for me to follow up with counseling."

Which statement made by the nurse best demonstrates a core concept of patient- and family-centered care? A) "Would you prefer I call you by your first name?" B) "Would you like to go with the group today to see a movie?" C) "Let me see if I understood your concerns about your medications." D) "Today I'll plan to spend time with you discussing your treatment plan."

C) "Let me see if I understood your concerns about your medications." Rationale: The core concepts of patient- and family-centered care consist of (A) dignity and respect, (B) information sharing, (C) patient and family participation, and (D) the feeling of being heard and understood by patients. While all the options demonstrate a component of this form of care, clarifying an understanding of the client's concerns demonstrates the best and most basic form of patient centered care.

A few nurses are privately discussing patients under their care. Which nurse's comment indicates the need for clinical supervision regarding countertransference? A) "My patient is always asking my permission to do something, just like a child." B) "When our unit is understaffed, it seems like we have more incidents of disruptive behavior." C) "My patient tries to tell me what to do all the time. I got a divorce because my spouse used to do that." D) "Our patients have had so many life experiences. I find myself feeling sympathetic sometimes."

C) "My patient tries to tell me what to do all the time. I got a divorce because my spouse used to do that."

Shortly after hospitalization, an adolescent diagnosed with anorexia nervosa says to the nurse, "Being fat is the worst thing in the world. I hope it never happens to me." Which response by the nurse is appropriate? A) "You need to gain weight to become healthier." B) "Your world would not change if you gained a few pounds." C) "Tell me how your world would be different if your were fat." D) "Your attractiveness is not defined by a number on the scale."

C) "Tell me how your world would be different if your were fat."

Which response would the nurse make to help a depressed client who is crying? A) "Does crying help?" B) "I know that you're upset." C) "Tell me what you're feeling now." D) "Do you want to tell me why you're crying?"

C) "Tell me what you're feeling now."

Which response would the nurse make to a client who says, "I'm a terrible, evil person. The voices are telling me that God needs to punish me."? A) "God is loving and won't punish you." B) "Those voices you're hearing are a fantasy." C) "Tell me what you're thinking about yourself." D) "You aren't wicked-both God and I love you."

C) "Tell me what you're thinking about yourself."

A nurse counsels a widow whose husband died 5 years ago. The widow says, If I'd done more, he would still be alive." Select the nurse's therapeutic response. A) "I understand how you feel after such a terrible loss." B) "That was a long time ago. Now it's time to move on with your life." C) "You did a very good job of caring for him, especially because he was sick for so long." D) "Your husband was 82 years old with severe chronic obstructive pulmonary disease."

C) "You did a very good job of caring for him, especially because he was sick for so long."

A school-aged child is referred to the mental health clinic by the school nurse because he is fearful, anxious, and socially isolated. After meeting with the client, the nurse talks with his mother, who says, "It's that school nurse again. She's done nothing but try to make trouble for our family since my son started school. And now you're in on it." What is the nurse's most appropriate response? A) "The school nurse is concerned about your son and is only doing her job." B) "You don't need to feel singled out. We wee a number of children who go to your son's school." C) "You sound pretty angry with the school nurse. Tell me what's happened." D) "Let me tell you why your son was referred, and then you can tell me about your concerns."

C) "You sound pretty angry with the school nurse. Tell me what's happened."

A nurse participating in a community health fair interviews an adult who has had no interaction with a health care professional for more than 10 years. The adult says, "I like to keep to myself. Crowds make me nervous." Which action should the nurse employ? A) Refer the adult for a full health assessment B) Explore the adult's family and social relationships C) Ask the adult, "How do you feel about the quality of your life?" D) Explain to the adult, "We can help you feel better about yourself."

C) Ask the adult, "How do you feel about the quality of your life?"

An 8-year-old tells a parent, "I like to scare kids at school by showing them pictures of clowns. Some kids are terrified." How should the nurse counsel the parents regarding this behavior? A) Recommend family therapy for the child, siblings, and parents B) Suggest the parents enroll the child in an anger management program C) Educate both parents about bullying, including possible origins and long-term effects D) Teach the parents about the developmental phase and tasks for an 8-year-old child.

C) Educate both parents about bullying, including possible origins and long-term effects

Which client finding would indicate that the therapy is beginning to be effective in a client with anorexia nervosa? A) Hides food in clothes pockets B) States that the hospitalization has been helpful C) Has gained 6 lb since admission 3 weeks ago D) Remains in the dining room eating for 1 hour after others have left

C) Has gained 6 lb since admission 3 weeks ago

Which conclusion would likely be true about a young adolescent client hospitalized with anorexia nervosa? A) Is somewhat concerned that the eating behavior may threaten life B) Has some understanding of anorexia nervosa because of media publicity C) Has minimal awareness that reduced caloric intake has lethal implication D) Is demonstrating an unconscious desire for death by refusing food

C) Has minimal awareness that reduced caloric intake has lethal implication

Select the completion of the following sentence that demonstrates that an adult is coping in a healthy way: "I am feeling so angry right now ... A) I'm afraid I'm going to cry." B) I would like to punch something." C) I want to talk to someone about it." D) I want to curl up and sleep for a long time."

C) I want to talk to someone about it."

Which rationale describes the reason the nurse would ask a client who has been raped to describe what happened? A) This information will help the nursing staff give legal advice and provide counseling B) Talking about the assault will help the client see how actions have led to the event C) It will let the client put the event in better perspective and help begin the resolution process D) Discussing the details will keep the client from concealing the intimate happenings during the assault

C) It will let the client put the event in better perspective and help begin the resolution process

An elderly widow tells the nurse, "Since my sister-in-law's death, her husband has been making advances toward me. He tried to come into my home with a bottle of wine. Even though he's family, I'm afraid of what might happen if I let him in." Which action should the nurse take first? A) Support the widow to clarify her thoughts and feelings about the situation B) Explain to the widow how to obtain an order of protection (restraining order) C) Positively reinforce the widow for addressing the problem with a caring professional D) Educate the widow about sexual assault and violence, including the importance of prevention

C) Positively reinforce the widow for addressing the problem with a caring professional

While weighing patients on an eating disorders unit, the nurse overhears a psychiatric technician say, "I wish I had an eating disorder; maybe I'd lose a little weight." What is the nurse's best action? A) Report the clinical observation to the nursing supervisor B) Ask the psychiatric technician, "What did you mean by that comment?" C) Privately discuss the importance of sensitivity with the psychiatric technician D) Immediately interrupt the interaction between the patient and psychiatric technician

C) Privately discuss the importance of sensitivity with the psychiatric technician

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? A) Tight, impermeable boundaries B) Unbalanced power ratio C) Role stereotyping D) Dysfunctional feeling tone

C) Role stereotyping

Which communication technique would the nurse be using when he or she states, "Let's see whether we mean the same thing." to a client who is not making sense? A) Reflecting feelings B) Making observations C) Seeking consensual validation D) Attempting to place events in sequence

C) Seeking consensual validation

When interacting with an adolescent client who has anorexia nervosa, which action would be important for the nurse to take? A) Show empathy B) Maintain control C) Set and maintain limits D) Focus on food and nutrition

C) Set and maintain limits

In which nurse-patient interaction would it be appropriate for the nurse to consider using touch? A) Comforting a tearful patient of Japanese heritage B) Counseling a child who was physically abused by a parent C) Welcoming a person of Hispanic heritage to a new group session D) Interacting with a Native American who has a hearing impairment

C) Welcoming a person of Hispanic heritage to a new group session

Which statement by the nurse best confirms the relationship being maintained with the client is a therapeutic one? A) "Do you agree with me that we need to focus on your anger issues?" B) "I'll plan to meet with you again tomorrow at our regular time." C) "I'm sure you will get significant benefit from attending the group I suggested." D) "Can you give me some examples of how your coping skills have improved?"

D) "Can you give me some examples of how your coping skills have improved?" Rationale: The focus of the therapeutic relationship needs to be on the patient's ideas, experiences, and feelings. Inherent in a therapeutic relationship is the nurse's focus on significant personal issues introduced by the patient during the clinical interview.

During group therapy on the unit, one client seldom speaks. One morning, the quiet client listens intensely and maintains eye contact with another client who speaks about depression, but the quiet client still does not speak. Which response by the nurse is most appropriate? A) "You are both sad now, but it is better to have a positive view to share." B) "Why are you looking that way? You seem very upset." C) "Express yourself verbally, so the group understands you." D) "Do you have some feelings about what's being said?"

D) "Do you have some feelings about what's being said?"

Which question would the nurse ask to obtain information about a bulimic client's intake habits and patterns? A) "Are you trying to control other people through the use of food?" B) "When you socialize, do you find that you eat more than when you eat by yourself?" C) "Do you find yourself eating more right before the beginning of your menstrual cycle?" D) "How often are you eating in response to your feelings rather than because you're hungry?"

D) "How often are you eating in response to your feelings rather than because you're hungry?"

The nurse assessed an elderly person who was abused by the caregiver. Afterward, which internal dialogue should prompt the nurse to seek guidance? A) "Sometimes I get so discouraged and frustrated with my job." B) "It's incredible that anyone could hurt a child or elderly person." C) "The abuser was probably a victim of abuse at some point in life." D) "I hope the abuser gets victimized so they know what it feels like."

D) "I hope the abuser gets victimized so they know what it feels like."

Which response would the nurse make to a client who has been attending a day treatment facility for 1 month with depressive disorder and is to be discharged in a week? A) "We have just a few sessions left. I'm really pleased with your progress." B) "Your discharge date has been set for next week. That's wonderful news." C) "There are 5 sessions remaining. We need to start making plans to end our sessions." D) "I understand that your discharge is set for next week. I'm wondering how you feel about that?"

D) "I understand that your discharge is set for next week. I'm wondering how you feel about that?"

A victim of reported sexual assault tells the nurse, "This was entirely my fault. I should have never gone to that party alone." Which response by the nurse is most therapeutic? A) "This was a frightening experience for you." B) "What do you think you should have done differently." C) "Would you like to tell me more about what happened?" D) "It sounds like you're blaming yourself for the assailant's behavior."

D) "It sounds like you're blaming yourself for the assailant's behavior."

Which response would the nurse make to a client who tells the nurse, "A man is speaking to me from the corner of the room. Can you hear him?" A) "What's he saying to you? Does it make any sense?" B) "Yes, I hear him, but I can't understand what he's saying." C) "I don't hear him. There's no one in the corner of the room." D) "No, I don't hear him, but is it making you uncomfortable to hear him?"

D) "No, I don't hear him, but is it making you uncomfortable to hear him?"

Which response would the nurse make during the last interview before discharge, when the client who has follow-up therapy sessions says, "There are a few things that bother me that I've told no one."? A) "The purpose of our getting together is to discuss your problems." B) "Do you want to work on those things during the few minutes we have left?" C) "What kind of problems have you not shared with me during our time together?" D) "One purpose of continuing counseling is to allow you to discuss things that bother you."

D) "One purpose of continuing counseling is to allow you to discuss things that bother you."

Which comment by the nurse would be appropriate to begin a new nurse-patient relationship? A) "Which of your problems is most serious?" B) "I want you to tell me about your problems." C) "I'm an experienced nurse. You can trust me." D) "What would you like to tell me about yourself?"

D) "What would you like to tell me about yourself?"

Which response would the nurse make when obtaining a health history from a client who is known to be verbally abusive and says, "You're ugly, and you're probably stupid, too. Why am I stuck with you?" A) "It doesn't matter what you think, because I know I'm a capable nurse." B) "Tell me more about why my caring for you today is so upsetting to you." C) "If you like, I will arrange to switch assignments so you can have another nurse." D) "You are talking inappropriately, so I'm going to leave and will come back when you stop being verbally abusive."

D) "You are talking inappropriately, so I'm going to leave and will come back when you stop being verbally abusive."

A nurse who is comfortable and confident with the interviewing process will effectively use which communication technique? A) Avoiding topics that could possibly be embarrassing B) Relying on verbal rather than nonverbal communication C) Personally fills each void in the conversation D) Allowing for moments of uninterrupted silence

D) Allowing for moments of uninterrupted silence

Which nursing intervention would help a client who exhibits physical symptoms when stressed? A) Limiting discussion about the problem B) Providing information regarding medical care C) Teaching the client how to eliminate stress at home D) Assisting the client in developing new coping mechanisms

D) Assisting the client in developing new coping mechanisms

Which initial approach would the nurse use for an adolescent with anorexia nervosa who has lost 20 lb in 6 weeks and is very thin but is excessively concerned about being overweight? A) Complimenting the physical appearance of the adolescent B) Explaining the value of adequate nutrition to the adolescent C) Exploring the reasons that the adolescent does not want to eat D) Attempting to establish a trusting relationship with the adolescent

D) Attempting to establish a trusting relationship with the adolescent

A patient is hospitalized with a diagnosis of anorexia nervosa. The nurse reviews the patient's lab results, as follows: - Sodium: 143 mEq/L - Potassium: 3.1 mEq/L - Chloride: 102 mEq/L - Magnesium: 2.2 mEq/L - Calcium: 8.4 mg/dL - Phosphate: 3.0 mg/dL The nurse should take which action next? A) Measure the patient's body temperature B) Inspect the patient's skin and sclera for jaundice C) Assess the patient's mucous membranes for erosion D) Auscultate the patient's heart rate, rhythm, and sounds

D) Auscultate the patient's heart rate, rhythm, and sounds

Which condition would be the priority to assess for during the initial appointment for a client with bulimia nervosa? A) Insight B) Boredom C) Loneliness D) Depression

D) Depression

Which action would the nurse take for an adolescent who has been admitted to the psychiatric hospital with a diagnosis of anorexia nervosa? A) Schedule an endocrinology consult because of amenorrhea B) Confront those behaviors that reflect an inflated self-importance C) Arrange for psychotherapy sessions to help develop a desire to accommodate others D) Develop a contract to achieve a weekly weight gain, with consequences for non-achievement

D) Develop a contract to achieve a weekly weight gain, with consequences for non-achievement

A client is seeking treatment in the ED after a sexual assault. Which notation made by the ED nurse demonstrates appropriate nonjudgmental documentation? A) An alleged sexual assault inside a local parking garage was made by the client B) No acute emotional distress during assessment was noted C) Treatment for facial abrasions was refused D) Physical evidence supports that vaginal penetration occurred

D) Physical evidence supports that vaginal penetration occurred

When caring for a client who was a victim of a crime, the nurse is aware that recovery from any crime can be a long and difficult process depending on the meaning it has for the client. What should the nurse establish as a victim's ultimate goal in reconstructing his or her life? A) Getting through the shock and confusion B) Carrying out home and work routines C) Resolving grief over any losses D) Regaining a sense of security and safety

D) Regaining a sense of security and safety

Which initial action would the nurse take for a young client with anorexia nervosa who phones home just before each mealtime and then refuses to eat food that has gotten cold? A) Insist that the client eat the food B) Revoke the client's phone privileges C) Hang up the phone when meals are served D) Schedule a family meeting to discuss the problem

D) Schedule a family meeting to discuss the problem

The parent of a school-age child tell the nurse that, "For most of the past year, my husband was unemployed, and I worked a second job. Twice during the year I spanked my son repeatedly when he refused to obey. It hasn't happened again. Our family is back to normal." After assessing the family, the nurse decides that the child is still at risk for abuse. Which observation best supports this conclusion? A) The parents say they are taking away privileges when their son refuses to obey B) The child has talked about family activities with the nurse C) The parents are less negative towards the nurse D) The child wears long-sleeved shirts and long pants, even in warm weather

D) The child wears long-sleeved shirts and long pants, even in warm weather

During the second session of individual therapy, a client sits quietly with arms folded and eyes cast down. Which approach by the nurse is best? A) Use small talk to keep the conversation going B) Ask the client why the client is having difficulty talking C) Ask concrete, direct questions that require simple answers D) Use broad openings and leads to encourage the discussion

D) Use broad openings and leads to encourage the discussion

Which short-term outcome would the nurse use for a client with bulimia nervosa who at times feels helpless in regard to the eating disorder? A) Practices effective socialization skills B) Perceives the body shape as acceptable C) Decreases preoccupation with delusional thoughts D) Verbalizes the desire to increase control over stressful situations

D) Verbalizes the desire to increase control over stressful situations

Which client behavior would the nurse anticipate after a client with bulimia nervosa eats 2 sandwiches, 2 salads, and 4 desserts for lunch? A) Exercising excessively B) Hoarding of more food for a later binge C) Active socializing with small groups of clients D) Withdrawing from the group to go to the bathroom

D) Withdrawing from the group to go to the bathroom

A patient has been oppositional, demanding, and resistant to working on goals. A mental health nurse tells the nursing supervisor, "We finally had a serious talk. I let that patient know it's time to get right with God and stop this behavior." Recognizing the nurse's actions were not acceptable, select the supervisor's responding action. A) Review the facility policies regarding patient's rights with the nurse B) Ask the nurse about documentation related to this patient interaction C) Schedule the nurse for a staff development activity on cultural sensitivity D) Work with the nurse to prepare and analyze a process recording of the interaction

D) Work with the nurse to prepare and analyze a process recording of the interaction