Basic Psychosocial Needs

A client states, "I am stressed by my job but enjoy the challenge. What is the best response by the nurse? "Don't take your work home." "Spend more time with your family." "Switch job positions." "Take stress management classes."

"Take stress management classes."

A nurse is caring for a client with a terminal illness. The nurse determines that a client has entered the first stage of the grieving process when the client makes which statement? "I think they mixed up my test results." "I can go in peace. I saw the wedding." "I just want to see my daughter get married. Then, I can go." "I did everything I was supposed to do and what good did that do?"

"I think they mixed up my test results."

Which statement indicates that a newly hired nurse understands confidentiality? "I understand your need for the health record since you are a representative of the insurance company. I can make it available." "Thank you for stopping by to see your mother. She's in surgery right now, but I'd be glad to update you on how she has been doing." "I can't discuss your client's condition in the hallway, doctor. Let's move to the client's room to speak." "I'd be happy to discuss your care plan with your daughter, but first I need your signature giving me permission to do so."

"I'd be happy to discuss your care plan with your daughter, but first I need your signature giving me permission to do so."

A client receiving chemotherapy reports decreased energy leading to boredom from a lack of activity. Which statement by the client indicates an understanding of appropriate ways to deal with this lack of diversional activity? "I'll play card games with my friends." "I'll take a long trip to visit my aunt." "I'll bowl with my team after discharge." "I'll eat lunch in a restaurant every day."

"I'll play card games with my friends."

Six months after undergoing a radical modified mastectomy to treat breast cancer, a client is admitted for chemotherapy. When the nurse enters the client's room, the client is sobbing and states, "I thought the chemotherapy would help, but now I feel worse." Which response by the nurse would be most therapeutic? Select all that apply. "I'll bring you a sedative to calm you down." "You're feeling worse since chemotherapy started?" "Don't worry. I'm sure everything will be okay if you just give it time." "You probably should have had surgery sooner so the tumor could have been caught earlier." "I'll sit here with you for a while. Would it help you to talk about it?"

"I'll sit here with you for a while. Would it help you to talk about it?" "You're feeling worse since chemotherapy started?"

A pregnant client with vaginal bleeding asks a nurse how the fetus is doing. Which response is best? "I'll tell you what the monitors show." "I can't answer that question." "It's too early to tell anything." "I don't know for sure."

"I'll tell you what the monitors show."

A child ingests a caustic toilet bowl cleaner during a visit to a friend's house. The child's caregiver tells the nurse about feelings of guilt. What would be an appropriate response by the nurse? "Tell me more about your feelings." "Don't worry. The child is going to be fine." "You shouldn't feel guilty. You didn't know their cleaners weren't locked up." "Why didn't you watch your child more closely?"

"Tell me more about your feelings."

A nurse is talking to grieving parents whose child died from sudden infant death syndrome (SIDS). What should the nurse emphasize to the parents? "You must allow an autopsy to confirm the diagnosis." "You are still young and can have more children." "The death couldn't have been prevented and isn't your fault." "You should place other infants on their backs to sleep."

"The death couldn't have been prevented and isn't your fault."

A registered nurse (RN) is supervising the work of a licensed practical nurse (LPN) who is caring for a client diagnosed with a terminal illness. Which statement by the LPN would be corrected by the RN? "You could designate someone to make end-of-life decisions when you can't make them yourself." "Some clients write living wills indicating their end-of-life preferences." "Some people tell their healthcare providers they don't want to have cardiopulmonary resuscitation." "The law says you must write a new living will each time you're admitted to the hospital."

"The law says you must write a new living will each time you're admitted to the hospital."

A Black client is admitted for newly diagnosed leukemia under isolation precautions where only immediate family members may visit. A White visitor arrives to visit the client. What is the nurse's best response to the visitor? "No visitors are allowed while the client is on isolation precautions." "There are some visiting limitations. Are you a family member?" "You cannot visit. You will have to check in with the family." "Only immediate family members are allowed to visit today."

"There are some visiting limitations. Are you a family member?"

A 16-year-old client who is 16 weeks' pregnant informs the nurse that she is afraid to tell her parents about the pregnancy. Which response by the nurse is most appropriate? "You still have options for the pregnancy." "Would you like to discuss this further?" "I'm sure your parents will be thrilled to be grandparents." "Who else could you talk to about the pregnancy?"

"Would you like to discuss this further?"

A client on an inpatient psychiatric unit is pacing up and down the hallway. The client has a history of aggression. Which comment made by the nurse would be the most appropriate? "You are pacing. Let's walk together and talk about it." "You are pacing. Would you like some quiet time in your room?" "You are pacing. Would you like to have one of the techs walk with you?" "You are pacing. Does that help with your anxiety?"

"You are pacing. Let's walk together and talk about it."

When a nurse enters a client's room, the client frowns and states, "I've had my damn light on for 20 minutes. It's about time you got here. I'm sick of this place and the staff." The nurse's best response would be "You seem upset this morning." "I'm sorry. I was busy with another client." "My name is Mary and I'm your nurse for today." "You've had your light on for 20 minutes?"

"You seem upset this morning."

A prenatal client says she can't believe she has such mixed feelings about being pregnant. She tried for 10 years to become pregnant and now feels guilty for her conflicting reactions. Which response by the nurse is best? "You're experiencing the normal ambivalence pregnant mothers feel." "These feelings are expected only in women who have had difficulty becoming pregnant." "Let's make an appointment with a counselor." "You need to talk to your midwife about these feelings."

"You're experiencing the normal ambivalence pregnant mothers feel."

Which nursing action would be most beneficial to a client and her spouse who state they wish to go through labor without the use of analgesics or anesthetic agents? Provide privacy for the couple and respect their wishes for being left alone during labor. Provide information about the nature and availability of drugs for the client. Act as an advocate for the couple and verbalize their wishes to nurses and physicians. Encourage the use of drugs if the client has difficulty maintaining control during labor.

Act as an advocate for the couple and verbalize their wishes to nurses and physicians.

The nurse is caring for a Native American/indigenous client with type 2 diabetes who requests participating in a sweat lodge healing ceremony. The client has found these ceremonies to be helpful in the past. Which action(s) should the nurse take? Select all that apply. Ask the client about the processes and purpose of a sweat lodge healing ceremony. Ask what the client knows about the possible health risks associated with sweat lodges. Investigate empirical evidence available on the use of sweat lodges in medical literature. Discuss the client's request for a sweat lodge ceremony with spiritual support personnel. Encourage the client to defer the use of a sweat lodge until after the client is discharged.

Ask the client about the processes and purpose of a sweat lodge healing ceremony. Ask what the client knows about the possible health risks associated with sweat lodges. Investigate empirical evidence available on the use of sweat lodges in medical literature.

A client in college who has recently been diagnosed with human papillomavirus (HPV) infection comes to the health clinic and is anxious and tearful. Which nursing intervention would be most appropriate? Discuss the dangers of multiple sex partners. Ask the client to discuss concerns. Refer the client to a gynecologist. Provide the client with reliable information about this condition.

Ask the client to discuss concerns.

The nurse is caring for a terminally ill client with cancer who is receiving hospice services with an advance directive. Which nursing action is a priority? Maintain hydration status with IV fluids. Assist with the administration of chemotherapeutic agents. Care for elimination needs. Monitor airway status and prepare to assist with intubation.

Care for elimination needs.

Which statement is a correct reason for nurses to become culturally sensitive and develop their cultural competency skills? The code of ethics challenges nurses to practice in an ethical and caring way. It is important to facilitate the process of acculturation for people of different cultures. Cultural sensitivity and consideration of client diversity are necessary to provide ethical nursing care. There are many subcultures in our country, and it is important to know about these cultures and their practices.

Cultural sensitivity and consideration of client diversity are necessary to provide ethical nursing care.

A client must be placed on airborne precautions for several days. To help meet the client's emotional needs, what should the nurse do? Gently explain that the client's movements must be limited while in the isolation room. Describe the reasons for isolation and how it's carried out, and provide reassurance. Tell the client to bring whatever personal items are desired into the isolation unit. Tell the client that family members and significant others can't visit but may telephone at any time.

Describe the reasons for isolation and how it's carried out, and provide reassurance.

An 18-year-old client has suffered a C5 spinal cord contusion that resulted in quadriplegia. The parent is crying in the waiting room two days after the injury. When the nurse sits down to talk, the parent asks if the child will ever play sports again. Which response from the nurse would be best? Tell the parent that the primary health care provider will be available to talk right away. Encourage the parent to express any feelings and fears about the child's injury. Reassure the parent that, given time and motivation, the child will return to normal function. Advise the parent that it is not in the child's best interest to be so upset.

Encourage the parent to express any feelings and fears about the child's injury.

A client who has discovered a breast lump is tearful and expresses concern regarding the situation. What is the best response by the nurse? Encourage verbalization of fears. Give the client any reassurance needed. Ask the client to talk to a chaplain. Recommend a support group.

Encourage verbalization of fears.

A male nurse is assigned to care for a female client with a new colostomy. Upon entering the room, the spouse tells the nurse that it is considered immodest for a woman's body to be seen by any male that is not her husband in their Muslim culture. Which actions demonstrate culturally competent nursing care in this situation? Select all that apply. Explain that it is discriminatory to not accept male nursing care. Notify the facility patient-advocate to make them aware of the situation. Explore the possibility of a female nurse being willing to swap clients. Report to the charge nurse to make them aware of the situation. Explain that the unit is made up of mostly male nurses so it may not be possible.

Explore the possibility of a female nurse being willing to swap clients. Report to the charge nurse to make them aware of the situation. Notify the facility patient-advocate to make them aware of the situation.

A client learns that she is pregnant, and asks the nurse for the names of abortion clinics. The nurse does not believe abortion is moral alternative. What is the most appropriate response by the nurse? Tell the client that she will have to ask the health care provider. Give the client the available preprinted list of clinics. Remind the client that abortion stops a beating heart. Encourage the client to wait and think about it.

Give the client the available preprinted list of clinics.

A Jehovah's Witness client is admitted after a serious car accident and continues to experience severe anemia after significant blood loss. The family remains adamantly opposed to blood product support. What is the nurse's best intervention? Request a consultation with the hospital chaplaincy department. Offer the client alternative treatment options to consider. Continue to reinforce the need for and benefit of transfusion. Provide a range of literature to address their religious conflict.

Offer the client alternative treatment options to consider.

For a client with a sleep pattern disturbance, the nurse could use which measure to promote sleep? Encourage less activity during the day. Play soft or soothing music. Provide a cup of coffee and a snack in the evening. Increase the client's activity two hours before bedtime.

Play soft or soothing music.

A nurse is caring for a client who has lost the ability to express words. What should the nurse plan to do when caring for this client? Limit communication to speech therapy sessions so the client does not become tired. Provide opportunities for the client to repeat words and point to objects. Use complex sentences to acknowledge the client's intelligence. Communicate with the client's family, who can answer the nurse's questions.

Provide opportunities for the client to repeat words and point to objects.

A nurse working with the family of a client with Alzheimer's disease notes that the client's spouse is too exhausted to continue as the sole caregiver. The adult children live too far away to provide relief on a regular basis. Which nursing interventions would be most helpful? Select all that apply. Ask whether friends can help with errands or provide short periods of relief. Recommend that the client be placed in a long-term care facility. Call a family meeting to tell the absent children that they must participate in the client's care. Recommend community resources for adult day care and respite care. Suggest that the spouse seek psychological counseling to help cope with exhaustion. Encourage the spouse to talk about the difficulties of care giving.

Recommend community resources for adult day care and respite care. Encourage the spouse to talk about the difficulties of care giving. Ask whether friends can help with errands or provide short periods of relief.

A client is being seen in the emergency department and starts speaking in language not spoken by nursing staff. What is the nurse's first intervention? Call a local multicultural clinic for support. Communicate using hand gestures. Seek out a facility-approved translator. Find another staff member who speaks the client's language.

Seek out a facility-approved translator.

After contributing to a health education class on heart attack prevention, a nurse encounters a student from the previous year, who happily reports applying much from the class to everyday life. During the 5-minute meeting, the nurse notes that the former student is approximately 50 lb (22.7 kg) overweight, smokes, and is eating a bag of potato chips. Based on this information, what can the nurse conclude? The application of behavioral changes needs to be reevaluated. A demonstration of accurate knowledge of heart attack prevention is evident. The student did not attend the entire class. The student may have a hearing impairment.

The application of behavioral changes needs to be reevaluated.

The nurse is caring for a client diagnosed with diabetes mellitus. When collecting data from this client, what finding best indicates the client is not coping with the disease? The client cries whenever diabetes is mentioned. The client demonstrates a recent weight gain of 2 lb (0.9 kg) over 1 month. The client is monitoring blood glucose levels. The client omits the insulin dose if a meal is missed.

The client cries whenever diabetes is mentioned.

A primigravida client had an emergency cesarean birth because of fetal distress. Three days after the birth, the client seems preoccupied and troubled, and a nurse observes her crying in her room after visitors leave. She tells the nurse that her incision is ugly and that she "feels like a failure." In responding to the client, the nurse should consider which factor? The client is in the dependent taking-in phase described by Rubin. The client is experiencing abnormal feelings and needs psychiatric care. The client is grieving the loss of her anticipated birth experience. The client is tired and upset from having too many visitors.

The client is grieving the loss of her anticipated birth experience.

The nurse is talking with a client that is grieving over the death of a spouse. Which action exhibited by the client would cause the nurse to suggest counseling? The client refuses to acknowledge the spouse's family and blames them for the death. The client has already planned the spouse's funeral. The client takes out wedding pictures and memorabilia to show to the staff. The client is planning to give away the spouse's treasured items to family members.

The client refuses to acknowledge the spouse's family and blames them for the death.

Clients diagnosed with a chronic illness exhibit a general pattern of adaptation. What are the stages of the pattern of adaptation? Select all that apply. resistance retrospective thinking awareness alarm exhaustion

alarm exhaustion resistance

A nurse receiving morning report is told that the family members of a terminally ill client require a lot of attention. Which intervention should the nurse implement to meet the psychosocial needs of the family? short, frequent visitation, participation in care decisions, and extended rest breaks for the client unconstrained visitation, informing the family about imminent death, and responding to family needs flexible visitation, allowing participation in client care, and rest breaks for the family and client extended visitation, frequent client status updates, and limits to the number of family in the room

flexible visitation, allowing participation in client care, and rest breaks for the family and client

When preparing for a spiritual counselor to visit a hospitalized client, the nurse should ask the spiritual counselor to summarize the visit in the client's medical record. ensure that the hospital administration approves the counselor. ask to be present during the visit to explain any medical information or answer questions about the client's care. take measures to ensure privacy during the counselor's visit.

take measures to ensure privacy during the counselor's visit.

A mother and father of Iranian heritage bring their 14-month-old son to the health care facility, and he is subsequently admitted for leukemia. When the female pediatric oncologist introduces herself, the parents become uncooperative and refuse treatment. The nurse interprets which condition as being most likely responsible for the change in the parents' behavior? the gender of the health care provider who will be treating their child religious barriers preventing acceptance of care from someone who is not of their faith fear of being accused of child abuse and neglect by an authority figure aggressiveness that characterizes individuals from the Middle East

the gender of the health care provider who will be treating their child