NMNC 1110 EAQ 8: Stress

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A teenager is being discharged with a cast. Which would the nurse recommend if the client experiences pruritus around the cast edges?

"Put an ice pack on the affected area."

A girl arrives at the school health office in tears, telling the nurse that several of her classmates have been teasing her. Which is the most therapeutic response by the nurse?

"Tell me more about it."

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops an infection with anorexia. Which advice will the nurse provide to the client? Select all that apply. One, some, or all responses may be correct.

- Continue to take the oral medication. - Drink fluids throughout the day. - Monitor capillary glucose levels.

Which would be treatment goals in anorexia nervosa? Select all that apply. One, some, or all responses may be correct.

- The repairing of family interactions - The reinstitution of normal nutrition to counteract a state of malnutrition - The correction of deficits and distortions in psychological functioning via psychotherapy

The nurse is helping a depressed client cope after a bilateral mastectomy. Which theoretical care focus is the nurse using?

Adaptation

A recently widowed client says, "His death has complicated my life even more than the hassles he caused when he was alive!" Which term would best describe the marital relationship?

Ambivalent

Which feelings would be the basis for the ritualistic behavior seen in clients with obsessive-compulsive disorder?

Anxiety and guilt

The nurse is assessing the needs of a client who just learned that a tumor is malignant and has metastasized to several organs and that the illness is terminal. Which behavior would the nurse expect the client to exhibit during the initial stage of grieving?

Asking for a second opinion

Although the health care provider has explained the scheduled head and neck surgery, the client still has moderate to severe anxiety. Which action would the nurse take?

Attempt to discover the client's concerns.

Which source of stress would the nurse anticipate in a 4-year-old child?

Attention

Which definition describes the defense mechanism of sublimation?

Channeling unacceptable impulses into socially appropriate behavior

A client who recently was told by her primary health care provider that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. Which stage of death and dying is the client experiencing?

Denial

A community health nurse makes a home visit to a disabled 13-year-old client who has a 6-month-old infant sister. The infant lies quietly in her crib and rarely smiles or vocalizes; it appears that the infant barely has her basic needs met. Which is the nurse's most appropriate action?

Determine whether there is anyone who can help with chores and the infant's care.

Which intervention is most helpful for parents who just learned that their newborn baby has a heart defect?

Encourage the expression of their feelings.

Which guideline would the nurse consider when caring for clients who are at risk for suicide?

Formal suicide plans increase the likelihood that a client will attempt suicide.

Which benefit would a client expect from joining a self-help group after being discharged from a mental health facility?

Getting support from group members

Which reason would be likely for a client's anger and acting out when the nurse interrupts the hand-washing ritual of a client with obsessive-compulsive disorder?

Has overwhelming feelings of anxiety

A 13-year-old client is found to have idiopathic scoliosis. The client is upset about the treatment regimen and is worried about being different from peers. Which would the nurse provide to maintain a positive self-image during treatment?

Help investigate appropriate clothing to minimize appearance of the brace.

A client who receives NPH insulin every morning reports feeling nervous at 4:30 PM. The nurse observes that the client's skin is moist and cool. Which condition is the client likely experiencing?

Hypoglycemia

An adolescent diagnosed with new-onset type 1 diabetes mellitus has stress and reports not having a menstrual cycle for a long time. Which condition is the adolescent experiencing?

Hypogonadotropic amenorrhea

Which behavioral response to a disaster would the nurse treat first, in an attempt to avoid mass hysteria?

Panic

A parent asks the nurse what to do when the toddler has temper tantrums. Which play materials would the nurse suggest that the child be offered as another means of expressing anger?

Pegs and pounding board

Which key factor would the nurse consider when assessing how a client will cope with body image changes?

Perception of the change

Which initial action would the nurse take for a newly admitted client who reports memory loss, nervousness, insomnia, and fear of leaving the house?

Provide the client with a sense of security and safety.

A client has terminal cancer after 7 years of chemotherapy and surgeries. The nurse enters the client's room and finds the client crying. Which is the correct intervention by the nurse?

Sit down quietly next to the bed and allow her or him to cry.

Which member of the interprofessional team is appropriate for the nurse to ask for support in informing and consoling the family of a terminally ill client who has died?

Social worker

Which intervention would provide comfort to the client experiencing alcohol toxicity?

Stay with the client.

Which is true about the effect of grief and loss in toddlers?

They express a sense of change in sleeping.

Which action would the nurse identify as a potential contributor to staff post-traumatic stress disorder (PTSD) during a mass casualty assessment?

Working continuously without any breaks

The nurse is assessing a middle-aged client whose children have left home in search of work. The client is trying to adjust to these family changes. Which family life-cycle stage is the client going through?

Launching children and moving on


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