NU 326 Final Exam Review Questions

~A recently discharged veteran who served in active combat reports symptoms of recurring intrusive thoughts and hypervigilance. Which question would be most helpful in establishing a treatment plan?

"Are you also having nightmares when you do sleep?"

~The nurse is conducting a health history for a client and wants to determine the client's alcohol use. What question from the nurse will provide the greatest amount of information?

"How many alcoholic beverages do you drink each day?"

~A nurse is caring for an adolescent who has a history of violent behavior and has asked the nurse to keep confidential information about the desire to kill several classmates and a teacher. Which of the following responses by the nurse is appropriate to give?

"I cannot promise that. I must share this information with other members of the team who are responsible for planning your care."

~A new nurse is caring for a client recently diagnosed with dissociative identity disorder (DID). The nurse asks the preceptor about discussing the client's traumatic events with the client. Which response by the preceptor is best?

"If the client begins talking about it, just listen and be supportive."

~During the admission interview, the client reports that she has nightmares and memories of a rape that occurred 3 years earlier. She feels depressed and asks the nurse, "Do you think I will ever get better? I don't know what is wrong with me." The nurse's most supportive response would be:

"It sounds like you have some unresolved feelings about the traumatic experience. Tell me more about it."

~A school nurse is talking with a 13-year-old female at her annual health-screening visit. Which of the following comments made by the adolescent should be the nurse's priority to address?

"None of the kids at this school like me, and I don't like them either."

~A nurse is reviewing results of diagnostic studies with the family of an adolescent with anorexia nervosa. What explanation should the nurse give the family about the client's abnormal BUN value?

"The BUN is elevated because your daughter is dehydrated."

During a session, the nurse finds that the client who has posttraumatic stress disorder (PTSD) is unable to identify the intensity of his emotions. The client states extreme emotions appear out of nowhere and with no warning. What suggestion should the nurse provide to help the client get in touch with his emotions?

"Use a journal or log to write down feelings."

~Which response demonstrates that the parents of a child with newly diagnosed schizophrenia understand their child's diagnosis?

"We will watch him swallow his daily pills."

~A client struggling with a binge eating disorder tells a nurse, "I don't know why I eat the way I do each night." What question would be most helpful for the nurse to ask this client?

"What do you do when you feel stressed or upset?"

~An adolescent with a history of conflicts and acting out in a behavioral health unit lacerates her wrists. She asks the nurse, "I did a good job, didn't I?" Which response by the nurse is best?

"What were you feeling before you hurt yourself?"

~A nurse is caring for a client with antisocial personality disorder. Which statement is most appropriate for the nurse to make when explaining unit rules and expectations to the client?

"You will be expected to attend group therapy each day."

~A client says to the nurse, "Ever since my wife passed on, my life is empty and has no meaning." What is the appropriate nursing response?

"Your life has no meaning?"

~A nurse is assessing a client who has experienced trauma. The nurse determines that the client is experiencing physiologic hyperarousal based on which finding? Select all that apply.

-startles easily -overreacts to others

~Knowing Maslow's hierarchy of needs can assist a nurse in understanding a client's behavior. Place the stages of Maslow's hierarchy of needs in order from basic to most complex.

1. Physiologic needs 2. Safety and Security 3. Love and belonging 4. Self-esteem 5. Self-actualization

~The nurse should include which of the following in the plan of care for someone with dependent personality disorder?

Acknowledge the client's situation but encourage independence

~A nurse is planning discharge for a client who has borderline personality disorder. Which of the following interventions should be included for this client?

Dialectical behavior therapy

~The client with a history of alcohol abuse is being discharged to a treatment facility. Which prescription does the nurse anticipate for this client?

Disulfiram

~A nurse is caring for a client diagnosed with an eating disorder. When the client verbalizes disapproval of her own physical features, the nurse should:

Encourage the client to talk about her fears and stressful life situations

~A client visits the clinic after the death of a parent. Which statement made by the client's sister signifies abnormal grieving?

My sister has not been sad about Daddy's death, she's acting like nothing happened

~A client has been diagnosed with a dissociative fugue and has been admitted to the inpatient care unit. Which behavior best illustrates this diagnosis?

Sudden unexpected travel away from home

~A young client admitted to the surgical unit rapidly deteriorates, and despite efforts by staff, the client dies. After the client's death, the nursing staff displays many emotions. With whom should the nurse-manager consult to help the staff cope with this unexpected death?

The chaplain because his background includes grief counseling

~A nurse us administering total parenteral nutrition to a client hospitalized with severe anorexia nervosa. Which lab finding would alert the nurse to a potential problem?

decreased magnesium levels

~An adolescent client becomes angry and belligerent toward the nurse after speaking on the phone with his mother. The nurse recognizes this as what defense mechanism?

displacement

~During visiting hours on the unit, the nurse is observing the family dynamics of an adolescent client who has an addiction problem and recognizes that the family is experiencing behaviors consistent with codependence. Based on this data, which manifestation does the nurse anticipate from the client's family?

enabling

~A nurse is using drawing, puppetry, and other forms of play therapy while treating a school-age child diagnosed with a depressive disorder. The purpose of these techniques is to help the child:

express feelings he cannot articulate

~The nurse is planning to implement addiction treatment groups at a clinic. Which knowledge regarding addictions and its related therapies will facilitate implementation of the groups?

hereditary, as well as complex environmental influences, predisposes one to substance dependence

~A nurse is caring for a client diagnosed with antisocial personality disorder. The client has a history of fighting, cruelty to animals, and stealing. Which trait is the nurse likely to uncover during the assessment?

low tolerance for frustration

~A client is admitted to the emergency department with signs of drug use. The client reports having ingested Percocet and is experiencing respiratory depression. Based on this data, which prescription does the nurse anticipate for this client?

naloxone

~An important intervention in monitoring the dietary compliance of a client with bulimia is:

observing the client for 1-2 hours after meals

~A client with borderline personality disorder dramatically expresses feelings about each nurse on the unit, stating that her nurse today is the only one who is understanding and trustworthy. This client is demonstrating which behavior?

splitting

~A nurse performing an assessment determines that a client with anorexia nervosa is currently unemployed and has a family history of mental health disorders, obesity, and infertility. Based on this information, the nurse should monitor the client for which health concern?

suicide potential

~A teenager was driving a car that slid off an icy road, killing two of his friends. He repeatedly tells the nurse that he should be dead instead of his friends. The client's behavior is an example of:

survivor's guilt

~A nurse is reviewing the history and physicality of an adolescent client who has conduct disorder. Which of the following is an expected finding?

suspended from school several times in the past year

~The employee health nurse is providing care to an employee who was injured on the job. The client has a history of drug addiction and is currently enrolled in a 12-step recovery program. In order to determine whether the employee was impaired at the time of the accident, which diagnostic tool will the nurse use?

urine toxicology testing