Quiz 3

Which statement made by a client diagnosed with posttraumatic stress disorder (PTSD) leads the nurse to believe the client is experiencing dissociative symptoms?

"I describe my feelings like I'm having an out-of-body experience."

A nursing instructor lecturing about death and grief realizes a need for further instruction when a student states what?

"The grieving process is the same for children and adults."

A nurse is teaching a group of nursing students about the concept that long term stress causes an increase in the wear and tear on the brain and body. Which statement by the nursing student indicates understanding of this concept?

"The increase in the wear and tear on the body from stress is allostatic load."

The nurse is working with a client who lost a life partner nearly 3 weeks ago. The client has recently become less emotional and expressed an interest in possibly returning to work. Which response by the nurse is most appropriate at this time?

"You are just starting to accept that this loss is real."

Which clients in the psychiatric inpatient unit should the nurse watch closely for risk of aggressive behavior? Select all that apply.

A client with a history of violence. A client with history of being personally victimized. A client with a history of substance abuse.

A client diagnosed with terminal cancer is making plans to take flying lessons because that has always been the client's personal goal and it will allow the client to visit the client's elderly parents. What stage of death and dying according to Kübler-Ross is best illustrated in this description?

Acceptance

A client is arranging a funeral ceremony for the client's child. According to the Worden's tasks of grieving, which task is being accomplished?

Acceptance of the reality of the loss

Which factor is likely to have the greatest impact on how a client responds to grief?

Cultural influences

The nurse is planning to give health-related education to adolescents with posttraumatic stress disorder (PTSD). What topics should the nurse discuss specifically for these clients? Select all that apply.

Have a healthy, balanced diet Set small, specific, achievable goals Abuse of alcohol and drugs can cause ill effects

The nurse is performing an initial psychological assessment on a client who has been rescued from a flood. Which question would be most important in helping determine the amount of support needed by the client?

Have you thought about where you can stay right now?"

A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when they state:

Bereavement is the process of mourning and grief is the emotional reaction.

The spouse of a client who died of breast cancer is still grieving 2 years later. What type of grief is the spouse experiencing?

Complicated

A nurse is caring for a client in the hospital who was admitted for injuries sustained from an abusive spouse. The client says she's scared to leave her husband for fear he will hurt her. Which actions should the nurse plan to include in the plan of care for this client? Select all that apply.

Consult social services. Plan an interdisciplinary team meeting regarding this situation. educate the client on resources available to her

The nurse is counseling a client couple who are trying to reconcile and hold their marriage together. During therapy the wife states, "He makes me so mad when he spends all his weekend time with his friends instead of us. He makes me want to hurt him back." Using concepts from assertiveness training and effective communication techniques, the nurse implements which intervention after hearing the wife's remarks?

Teach the client to make "I" statements.

The nurse is caring for a client who has recently lost a sibling due to suicide. Which type of grief does the nurse anticipate the client is experiencing?

traumatic grief

An adult male client with a history of PTSD is brought to the emergency department (ED). The client was startled by a dog while out for a walk and kicked it. He was calm and apologetic when he presented to the triage nurse. Which is a priority nursing intervention?

Identify risks for self-harm and aggression

Which factor does not influence the grieving person's return to homeostasis?

Adequate self-awareness on the part of the nurse

A nurse is assessing an adult client in a psychology clinic. On obtaining the history, the nurse finds that the client has lost the client's job and is thus not able to meet the financial demands of the family. In the absence of other symptoms, which is the most appropriate diagnosis for this client?

Adjustment disorder

The nurse is assessing a client who is recently divorced. The client tells the nurse that the memories of the client's former spouse are interfering with an ability to concentrate at work. According to Horowitz's stages of loss and adaptation, this is indicative of which stage?

Denial and intrusion

A nurse is beginning the process of providing therapy to a client with anger management problems. When implementing this therapy, which should occur first to promote optimal effectiveness?

Development of a therapeutic relationship

Which term is used to describe an activity used to release anger?

Catharsis

In clients with posttraumatic stress disorder (PTSD), there is marked alteration in arousal and reactivity associated with the traumatic event. Knowing this, which behaviors of a client would the nurse interpret as characteristic of PTSD? Select all that apply.

Causing self-injury Inability to concentrate on studies Shouting and throwing objects out of anger

A client has lost emotional and physical control. The client is shouting, screaming, hitting others, and throwing objects. Which phase of the aggression cycle is this client expressing?

Crisis

In which phase of the aggression cycle can techniques of seclusion or restraint be used to deal with the aggression quickly?

Crisis

Recollect and reexperience

Divorce

A client is exhibiting a behavioral response to grief. When obtaining a health history, the nurse would expect which assessment finding to be noted?

Hostility

A client has just been diagnosed with terminal brain cancer and given approximately 2 months to live. The client wishes to visit the client's mother soon to "say goodbye." The nurse acknowledges this reaction as what?

Anticipatory

A client is diagnosed with terminal kidney failure. The client's spouse demonstrates loss and grief behaviors. Which term accurately describes the spouse's experience?

Anticipatory grief

A nurse is working in a psychiatric-mental health facility. The nurse observes a client pacing and punching the wall. Which measure can the nurse take for personal safety?

Avoid being alone with the client.

Which term describes the process by which a person experiences grief?

Bereavement

Which statement regarding posttraumatic stress disorder (PTSD) and children is accurate?

Best practices demonstrate that adolescents who have PTSD are at increased risk of drug

Which occurs in the second phase of Bowlby's grieving process?

Emotional yearning for the loved one

The nurse is speaking to the caregivers of a client who is experiencing complicated grief. The nurse is explaining some of the consequences of complicated grief. What are the health-related consequences associated with this type of grieving? Select all that apply.

Panic disorder Psychosomatic disorder Precipitation of a cardiac disease

During which phase of the aggression cycle does the client regain physical and emotional control?

Recovery

The nurse has been working on anger management with the client. The client yells during dinner, "Give me that salt shaker!" What is the best nursing intervention at this time?

Remind the client about communication skills discussed earlier

What action by a 6-year-old child would most strongly suggest a diagnosis of disinhibited social engagement disorder?

The child gives adults enthusiastic hugs immediately after meeting them

The nurse is assessing a client who is deeply upset and is not expressing feelings. At the end of the assessment, the nurse concludes that the client is extremely depressed because of the death of a loved one. The client has disenfranchised grief. What is the most likely reason for the client not being willing to speak about it to the nurse?

The client feels uncomfortable speaking about the relationship with the deceased.

A community mental health nurse has come to know that the mother of a long-term client has passed away. What are ways for the nurse to determine if the client will be at risk for complicated grief? Select all that apply.

The client has low self-esteem. The client is unable to trust others. The client has attempted suicide in the past.

A client with posttraumatic stress disorder (PTSD) is treated with psychotherapy. Which behaviors would indicate that the client is well stabilized? Select all that apply.

The client is able to express grief in a nondestructive manner. The client demonstrates an increased ability to cope with stress. The client voluntarily establishes contact with friends and family. Explanation:

A nurse observes that a client who has posttraumatic stress disorder (PTSD) is startled even by small noises. What is this behavior indicative of?

The client is hypervigilant.

Following an assessment of a client with posttraumatic stress disorder (PTSD), the nurse concludes that the client is at risk for suicide. What would be the immediate goals of management for this client?

The client will be physically safe.

A client is becoming increasingly angry while talking with the nurse. Which statement reflects the nurses's appropriate use of de-escalation with the client?

You look like you are upset and I want to understand why."

A client with aggressive behavior shows no psychotic symptoms. Which medication should the nurse expect to be ordered for this client?

Lorazepam

Which characteristics should a nurse observe a client for that may be predictive of aggression and violence? Select all that apply.

being suspicious breaking unit rules acting impulsive

The nurse is assessing a client who is grieving the loss of a spouse. According to Kubler-Ross's stages of grieving, which statement indicates that the client is in the depression stage?

My spouse is gone. I am having a really hard time finding a reason to keep going."

A nurse is interviewing several clients who survived a school shooting ten years ago when they were in high school. Which clients should the nurse identify as having achieved adaptation following this event? Select all that apply.

Nurse manager for the local hospital. Married, mother of three, who is a stay at home mother. Father of two who works in a tire store and has a second job as a mechanic.

A nurse is working in a mental health clinic and cares for various clients. Which client should the nurse recognize as having the greatest risk for the development of drug dependence?

a 12 year old girl who was raped by a family friend

The nurse is counseling a female client who is the primary caregiver for her older adult mother who requires total care due to stroke. The client reports having difficulty "recovering from the flu." She tells the nurse she has been experiecing flu-like symptoms for over two weeks. The client is most likely experiencing which consequence of chronic stress?

a reduction in lymphocyte function

A client's roommate yells at the client and the client acts as if nothing has occurred and ignores the roommate. The nurse identifies that the client may have which style of anger expression related to this incident?

anger suppression

Considering the spiritual response to grief, which nursing intervention has the potential of providing the most support to a grieving client?

asking, "Do you find comfort in your religion at times like this?"

With a client who is aggressive with a potential for violence, which item would the nurse want to limit or remove from the breakfast tray?

coffee

The nurse is providing individual support to a female client who attends a group for people who have experienced loss of a family member to suicide. The client's son committed suicide one month ago. The client was not aware that her son experienced depression. Which risk factors for complicated grief are most likely for this client? (Select all that apply.)

death of a child sudden, unexpected death death by suicide

A client has experienced a physcial assault and states "I keep having nightmares about it." Which intervention may be most helpful for the nurse to explore with the client at this time?

debriefing about the event

A client who has recently lost his same-sex partner in a motor vehicle accident tells the nurse, "My family doesn't speak to me because of my lifestyle. I feel like I have no one to talk to about my loss." The client is experiencing:

disenfranchised grief.

A client is assessed for recurring episodes of fainting and blurred vision. A diagnostic scan reveals the client has an ominous mass in the brain. When the client is told this news, the client appears stoic and does not cry. According to Horowitz's stages of loss and adaptation, this client is in which stage?

outcry

A client tells the nurse the client been dating someone for three months after finalizing divorce one year ago. According to Rando (1984), the client is engaging in which grieving task?

re-investing

A client is crying uncontrollably after having experienced an assault by a family member. The nurse is aware that the client is experiencing which type of crisis?

traumatic

A client with posttraumatic stress disorder (PTSD) is having a flashback experience of a traumatic event. The client asks the nurse if the client can hold the nurse's hand. What should the nurse interpret from this behavior?

The client benefits from supportive touch.

A client with posttraumatic stress disorder (PTSD) is treated with psychotherapy. Which behaviors would indicate that the client is well stabilized? Select all that apply.

The client is able to express grief in a nondestructive manner. The client demonstrates an increased ability to cope with stress. The client voluntarily establishes contact with friends and family.

A client with dissociative disorder is referred for psychotherapy. What would be the main focus of therapy for this client?

To reassociate with conciousness

The nurse is asking a client who has developed aggressive behavior about medical history. Which risk factors would the nurse want to explore related to aggression? Select all that apply.

history of schizophrenia history of substance abuse history of noncompliance with medications

Which statement by a client would alert the nurse that the client is experiencing complicated grief?

"I am still so angry about my grandmother's death even after a year."

A female client with post-traumatic stress disorder (PTSD) has just completed a session of eye movement, desensitization, and reprocessing (EMDR) therapy and exposure therapy. The client states that she is exhausted because she has been:

imagining the details of the traumatic event with the therapist.

The nurse is performing a physical assessment on a 3-year-old client. During the assessment, the child starts screaming and kicking. The nurse suspects this child:

is acting out.

The nurse is working with a client who has the tendency to "tend and befriend." The nurse identifies this is characteristic of:

the female response to stress.

The nurse states "I know this must be frightening for you" to a client who is angry and has a potential for violence. Which communication technique is the nurse utilizing with this statement?

validation

The nurse is assessing a client who is grieving the loss of a spouse. According to Kubler-Ross's stages of grieving, which statement indicates that the client is in the depression stage?

"My spouse is gone. I am having a really hard time finding a reason to keep going."

The nurse is working with a client who has been experiencing nightmares, hyperarousal and negative thoughts following a bomb threat at the client's workplace. The nurse's colleague states, "It turned out to be just a threat, not a bombing, so technically she can't have posttraumatic stress disorder (PTSD)." What is the nurse's best response?

"PTSD is a real possibility, even though the bombing never actually took place."

A nurse is assessing a 7-year-old child in a school. The nurse suspects that the child has an insecure relationship with the parents. Which statement said by the child would have led the nurse to this conclusion?

"Please don't tell my mom anything we've talked about."

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

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

A client states to the nurse "I was just diagnosed with a terminal illness." What is the nurse's best response?

"What does that mean to you?"

A nurse's colleague expresses sympathy for a client who is traumatized following a terrorist attack 1 week earlier. The colleague states, "I'm certain that the client has posttraumatic stress disorder (PTSD)." What is the nurse's best response?

"Acute stress disorder is a possibility, which might develop into PTSD."

The client is scheduled to undergo an amputation of the lower right limb. The client is experiencing grief over the pending procedure. Which question should the nurse ask while assessing the client's perception of loss?

"How do you feel about the news?"

The nurse is working with a client who has experienced the death of a spouse. The nurse is aware that the client is in the acute mourning stage of grief with which client statement?

"I just want to be left alone by my family and friends."

The nurse is seeing a male client who is experiencing anxiety and having difficulty managing anger. The client tells the nurse he received an email last week in which a co-worker was insulting and dismissive. The client states he had difficulty sleeping after receiving the email. Select the nurse's best response.

"Is there any other way in which can you interpret what the co-worker said in the email?"

A client is attending anger management class and wants to know how the class will help. What is the nurse's best response?

"It will help you to learn how to control the arousal of anger."

n adult client is pacing and yelling. Which is the best response by the nurse?

"When did these feelings begin?"

Which statement, made by the nurse, focuses on the purposeful assessment of a client coping with a terminal diagnosis?

"Who do you want to share information about your prognosis with?"

The psychiatric mental health nurse is assessing a client who was diagnosed with posttraumatic stress disorder (PTSD) after the death of the client's child from a medical error. What assessment finding would most warrant interventions aimed at addressing the client's dissociation?

A client with posttraumatic stress disorder (PTSD) tells the nurse that the client's recent cognitive behavioral therapy has been difficult. The client states that the client's therapist has the client visualize the sights and sounds from the time that the client was assaulted. This client is likely receiving:

A nurse suggests that the client explores new ideas about a particular problem and considers other possibilities to reflect:

A cognitive intervention.

The nurse in an occupational health setting assesses an employee's capacity to withstand the stress of working in a country affected by famine and civil war. Which are factors that support the client's resiliency? Select all that apply.

Adaptive problem-solving ability Supportive family and community Parenting with authoritative versus permissive or indifferent style

Which is an example of a perceived loss?

An older client grieves for the loss of independence

Which is a cognitive response to grief?

Attempting to keep the lost one present

Which likely takes place in the fourth stage of Kubler-Ross's stages of grieving?

Depression

Which experience could be the possible cause of grief due the loss of security and belonging for the client?

Divorce

When working with a grieving client, which is the most effective intervention a nurse can use?

Encourages the client to express grief verbally

Which staff behaviors are most likely to trigger clients who are predisposed to aggressive or violent behavior?

Engaging in disputes over medication, supplies, or rules on the unit

A group of at-risk teenagers have successfully completed an outdoor training program in which they had to collaborate and conquer a number of challenges. The nurse should identify what likely outcome of this program?

Enhanced resilience for the participants

A nurse must assess for characteristics that are predictive of violent behavior. Research suggests violent behavior is influenced by possession of which attribute?

Low self-esteem

A nurse is talking to a client who has been told the client has a terminal illness and is responding in an angry manner. What statement by the nurse would best facilitate the best possible client outcomes?

How much do you know and what do you want to know?"

When determining a client's potential for aggression and violence prior to engaging in a detailed psychosocial assessment, which would be most important for the nurse to do?

Obtain a thorough client history

A nurse is developing a care plan for a client who has post-traumatic stress disorder. Which intervention by the nurse is a priority?

Promote discussion of the client's thoughts and feelings about the stressful event.

The nurse is caring for a client who has been placed in palliative care. The nurse observes the client constantly looking at photographs from youth. According to the tasks of grieving by Rando, which task is being accomplished here?

Recollect

Which is the most frequent and persistent bereavement-associated symptom?

Sleep disturbances

The pediatric nurse is caring for a child who comes from an abusive background and who has been diagnosed with reactive attachment disorder. What behavior should the nurse anticipate when planning this child's care?

The child will be reluctant to engage with the nurse

A client has recovered from an episode of aggressive and hostile behavior. Which behaviors in the client indicate that the client is in the post-crisis stage of the aggression cycle? Select all that apply.

The client apologizes for the hostile behavior. The client cries and is remorseful for the event. The client remains withdrawn from others.

A nurse is performing a follow-up assessment of a client who had been treated for posttraumatic stress disorder (PTSD) a year ago. The client tells the nurse that the client is not able to maintain relationships and that the relationships last for a very short time. What is the most likely reason for this problem?

The client has issues with developing trust.

The nurse is interviewing a client who witnessed a fatal accident at the workplace and was unable to save a colleague. What assessment findings would support a diagnosis of posttraumatic stress disorder (PTSD)? Select all that apply.

The client has nightmares about the accident The client says the client is "unable to face that place again" The client says the client's family describes the client now as "edgy" and "irritable"

A 74-year-old is being seen in the mental health clinic. The client has never fully regained the level of activity the client had prior to the death of the client's spouse. The client continues to have symptoms of depression and has not been able to work or volunteer. In addition, the client complains of "anxiety attacks" that occur nearly every night. What type of grief reaction is this client exhibiting?

The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.

The nurse is interviewing a client who has been diagnosed with posttraumatic stress disorder (PTSD) after being randomly attacked with a gun. The client describes a recent event where the client panicked and jumped for cover when a car backfired on the street. How should the nurse best interpret this event?

The client is experiencing hyperarousal

A nurse is assessing a young client who has recently witnessed a murder. Despite directly witnessing the crime, the client has been unable to provide proper information about the event to the police. The client tells the nurse that the client does not remember anything related to the crime scene. What is the most likely cause for the inability to remember the events related to the scene?

The client may have dissociative amnesia.

The nurse is assigned to care for a client with posttraumatic stress disorder (PTSD). Which is the most appropriate reason for the nurse to be nonjudgmental while interacting with the client?

The client may have negative feelings about the self.

A nurse is caring for a client with dissociative disorder. The nurse tells the client, "Hello, I'm Robin, your nurse. It is 9 o'clock in the morning now. You are in room number 303. My name is Robin, I'm your nurse." What is the most appropriate reason for the nurse to repeat this statement?

The client may need to be reoriented.

The nurse is assessing a client who was diagnosed with posttraumatic stress disorder (PTSD) several months ago. During a comprehensive follow-up assessment, what areas should the nurse assess? Select all that apply.

The client's use of alcohol or other drugs Characteristics of the client's sleep The effect of the client's PTSD on the family

A nurse is counseling a client who was diagnosed with posttraumatic stress disorder (PTSD). During the session, the client states that the client feels worthless and starts crying. The nurse reassures the client that the client is a survivor rather than a victim. What intervention is the nurse using?

The nurse is promoting the client's self-esteem.

A nurse is considering using restraint and seclusion for a client who is acting out. Which is the primary guideline for the use of restraint and seclusion?

Use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent.

Under which circumstances can an expression of anger be considered a normal and healthy reaction? Select all that apply.

When facing an unjust situation. When personal rights are not respected. When realistic expectations are not met.

The nurse is orienting a new staff member in an inpatient mental health unit when a client begins to act in a violent manner. The nurse should explain to the new staff member that some clients use violence and aggression to ...

have their needs met.

The nurse is providing discharge instructions for a client who has received a prescription for lorazepam after the death of a loved one. Which phase of psychopharmacologic treatment does this describe?

stabilization

The nurses on a mental health unit are reviewing aspects of the unit environment in a staff meeting. Which factor would be predictive of a client becoming aggressive or violent?

strict hierarchy of authority

The nurse is utilizing the general aggression model to determine what may have contributed to one client's violence toward a roommate. Which would be considered a situational factor?

the client being called lazy by the roommate

The nurse is performing an initial psychological assessment on a client who has been rescued from a flood. Which question would be most important in helping determine the amount of support needed by the client?

"Have you thought about where you can stay right now?"

The nurse is performing an assessment of a client who has experienced a traumatic event. In understanding the client's ability to cope with the event, what question would the nurse ask first?

"How have you managed a stressful event before?"

A nurse is talking to a client who has been told the client has a terminal illness and is responding in an angry manner. What statement by the nurse would best facilitate the best possible client outcomes?

"How much do you know and what do you want to know?"

Kübler-Ross defines five stages of psychosocial responses to dying and death. Which statement is characteristic of the bargaining stage?

"Just let me live to see my grandson born."

Which phrase can do much to instill hope in the dying client?

"Let me tell you about your illness."

Which statement is typical of the first stage of grieving described by Engel?

"No, not me."

A nurse is teaching a class on type D personalites. Which statement by a student indicates an understanding of this instruction?

"Pessimism is a key quality with this personality."

The nurse is assessing a client of an Eastern culture who is admitted due to the need for anger management. What question should the nurse ask to determine the effect of culture on the client's expression of anger?

"What did you learn about anger when growing up?"

A new nurse asks the nurse manager about the best intervention to use when trying to de-escalate a potentially violent client. Which response would be most appropriate?

"What works best is what fits the client and the situation."

The nurse is counseling a client who has lost a spouse. According to the dual-process model, which of the client's statements to the nurse relate to restoration-oriented coping?

"With my spouse gone, I don't know how I can pay the bills."

The nurse is demonstrating de-escalation techniques on an aggressive client in a forensic setting. Which is the best explanation of this technique?

Resolution of anger in nonviolent ways

Aggression control can be measured by the nurse's observation of a client's ability to do what?

Show an increased tolerance for frustration

The nurse is seeing a male client who has experienced difficulty initiating sleep three months after his mother's funeral. The client states he has begun drinking one glass of wine each evening and finds this helpful with his sleep. The nurse recognizes the client is in which stage of general adaptation syndrome?

Stage of resistance

A hospice nurse is providing emotional care and support for a family who lost a child. The nurse will provide care on the basis of what knowledge?

Stages of grief reactions may overlap and are individualized

A client tells the nurse that the client has strong urges to damage property as a result of feelings of hostility and anger. Which is an appropriate nursing action?

Take the client to the gym for exercise.

A 14-year-old survived a house fire in which a younger sibling died. What assessment finding would support a diagnosis of posttraumatic stress disorder (PTSD)?

The adolescent expresses intense guilt for the inability to save the sibling

A nurse is assessing a client who is depressed but unwilling to discuss the client's feelings. After speaking with the client's caregiver, the nurse learns that the client's pet died recently. Which is the most likely reason the client has hesitated to express the client's feelings?

The client feels that the nurse would not consider the grief as significant.

The nurse is assessing a client who has lost the client's family in an accident. According to George Engel's stages of grieving, which behavior indicates that the client is in the stage of resolution of the loss?

The client repeatedly views family photos.

A client with a history of angry outbursts that have caused interpersonal and work problems has been in counseling for several months. The nurse judges the plan of care to be effective when which outcome is met?

The client uses adaptive coping to manage anger impulses.

Which outcome will the nurse evaluate to determine whether a client has successfully stabilized when engaged in the grieving process?

The client will verbalize acceptance of his or her terminal diagnosis.

A psychiatric nurse has assessed a client with posttraumatic stress disorder (PTSD). Before referring the client to psychotherapy, the nurse refers the client to a substance dependence treatment program. Why does the nurse refer the client to an addiction treatment program before referring for psychotherapy? Select all that apply.

The nurse believes that addiction can decrease the effectiveness of the psychotherapy. The nurse believes that the client is not expressing feelings because of the effect of the addiction.

The nurse is caring for a client who is extremely depressed after receiving a diagnosis of cancer. Which body language should the nurse adopt while speaking to the client in order to demonstrate an attentive presence? Select all that apply.

The nurse should stand facing the client. The nurse should lean slightly toward the client. The nurse should maintain moderate eye contact while the client speaks.

A nurse is caring for a Jewish client with a terminal illness who is on a ventilator. The spouse of the client intends to stay near the client when the ventilator is removed. What is the reason for such a request, according to the Jewish culture? Choose the best answer.

The soul of the deceased should not be alone while leaving the body.

Which type of grief occurs when a person is stuck in a state of chronic grieving?

complicated grief

A client who is in the process of divorce tells the nurse the client will require some time off from work due to the inability to concentrate. According to Bowlby's phases of grieving, which phase best reflects this client's current experience?

disorganization and despair

A client is experiencing a high level of stimulation after a terrorist attack. In providing psychological first aid to the client, which intervention would be best for the nurse to select?

explaining to the client that the client is safe

A client with poorly controlled type 1 diabetes has just been informed that an amputation of the lower leg is required. The nurse can anticipate that the client will experience a reaction to the loss of which human need according to Maslow's hierarchy?

physiologic

The nurse is seeing a male client who is obese and wants to lose weight. The client discusses why he wants to lose weight, how he recognizes that being obese is unhealthy, and that he plans to remain committed to a healthy lifestyle. The nurse recognizes that the client is engaging in which activity?

primary appraisal

A female client tells the nurse she has had low appetite and motivation since the recent breakup of a long-term relationship. The client states, "I just can't stand not having her around. I need her back." The client is experiencing which of Bowlby's phases of grieving?

yearning

What question should nurses ask themselves to determine if the care they provide to the grieving client has been both therapeutic and client focused?

"Do I have the strength to be present and to facilitate the client who is grieving?"

The nurse is working with a client who is experiencing a crisis due to a divorce. Which statement would alert the nurse to the client's need for referral for further mental health counseling?

"I am trying to work through this but have had to cut myself a few times."

The advanced practice psychiatric mental health registered nurse is leading a support group for adolescents who have recently experienced disruptions in their life. What participant most warrants further assessment for posttraumatic stress disorder?

An adolescent who has committed uncharacteristic acts of violence since the death of the adolescent's mother

After receiving word from the oncologist that the client's tumor is malignant, the client says to the nurse, "If you people had the faintest clue what you were doing, I wouldn't be like this." The nurse should recognize that the client may be experiencing which stage of grief?

Anger

According to Mardi Horowitz (2001), life begins to feel "normal" again in which stage?

Completion

The nurse is planning the environment for a newly-admitted client with a history of violence toward others. Which modification would the nurse implement?

Confirm that the utility and storage rooms are kept locked.

A client has been diagnosed with posttraumatic stress disorder (PTSD) after a house fire. Which nursing intervention is most appropriate?

Facilitate the client's introduction to a support group of other people recovering from PTSD

The nurse is providing care for a client whose history of intimate partner violence has resulted in posttraumatic stress disorder (PTSD). The client has few friends and states that the client is estranged from the client's family. How can the nurse best enhance the client's social support?

Facilitate the client's participation in a support group

A client with posttraumatic stress disorder (PTSD) holds strong Christian beliefs. The nurse refers the client to an individual from the clergy as a part of treatment. What would be the most appropriate reason for the nurse to take this action?

It fosters resilience through allegiance to religious beliefs.

Which explanation would be the nurse's best response when asked about the denial stage of grief?

It provides the individual with a temporary escape from the reality of dying

A woman has had a breast removed to treat cancer. What type of loss will she most likely experience?

Physiologic loss

A client is crying continuously from having lost a friend in an accident. According to the tasks of grieving by Rando, which task of grief is expected to be accomplished next?

Recollect and reexperience

Which client is most at risk for experiencing anticipatory grief?

61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer

The nurse is facilitating a wellness group which includes a client who was suspended from work for an angry outburst. The client most likely has the characteristics of which personality type?

A

Which individual is exhibiting signs or symptoms that are characteristic of posttraumatic stress disorder (PTSD)? Select all that apply.

A client who has frequent nightmares about the time a fellow soldier died from an improvised explosive device A client who is unable to relax without first barricading the client's home after a violent home invasion and assault A client who has quit the client's job so that the client no longer has to go to the client's old office where the client was attacked and robbed A police officer who experiences panic attacks when thinking about the time the police officer was forced to shoot a violent suspect

When lecturing about dissociative disorders to a group of nursing students, a nurse states that an essential feature of these disorders involves what?

Failure to integrate identity, memory, and consciousness

A nurse is assessing a Haitian client. The caregiver of the client tells the nurse that the client is having an episode of Bouffée delirante. What symptoms would the nurse expect to find in this client? Select all that apply.

Confusion Hallucinations Extreme aggression

Which client should the nurse anticipate will be at greatest risk for alteration in quality of life as a result of loss?

45-year-old with severe depression