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1. 10978474
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1.
After giving birth to her third child, a client tearfully says to the nurse, "How much more can I give of
myself?" What principle should the nurse consider in the care of any person with children?
1
It is easier to adjust to the first child than to later ones.
2
,Feeling anger and resentment toward a child is pathologic.
Correct3
Some parents experience feelings of being overwhelmed by multiple children.
4
Parents usually have inborn feelings of love and acceptance of their children.
A parent's feeling of being overwhelmed by multiple children is a normal response. It is vital to help parents realize
this as a means of easing feelings of guilt and shame. The first child causes the greatest amount of adjustment in
one's life. Anger and resentment toward one's child are expected feelings. Stating that parents usually have inborn
feelings of love and acceptance of their children is a false generalization.
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2. 11158003
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2.
An older client is transferred to a nursing home from a hospital with a diagnosis of dementia. One
morning, after being in the nursing home for several days, the client is going to join a group of residents
in recreational therapy. The nurse sees that the client has laid out several outfits on the bed but is still
wearing nightclothes. What should the nurse do?
1
Help the client dress and explain when residents are expected at the activity.
2
Prompt the client to dress more quickly to avoid delaying the other residents.
Correct3
Help the client select appropriate attire and offer to help the client get dressed.
4
Allow the client time to dress but explain that client has missed the opportunity to attend the activity.
Helping the client select appropriate attire and offering help in getting dressed aids the client in decision-making;
new situations may be stressful and may lead to ambivalent feelings. Helping the client dress and explaining when
residents are expected at the activity is not sharing decision-making; the client may not remember this explanation in
the future. Reminding the client to dress more quickly to avoid delaying the other residents may make the client feel
guilty and may increase anxiety. The client may perceive being told that the opportunity to attend the activity has
been missed as punishment.
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3. 11135602
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3.
A client in a group for people who abuse opiate drugs states, "I just got a prescription for an opioid for my
back pain." What is the mostappropriate response by the nurse leading the group?
1
"That was the wrong thing to do. Why did you do that?"
2
"You're going to get in trouble with your probation officer."
, Correct3
"Has anybody else had back pain? If you did, how did you handle it?"
4
"You may not attend the group anymore, because this is considered a relapse."
Using group members to explore other solutions that could change a client's behavior is an appropriate use of group
therapy. Telling the client that it was the wrong thing to do and asking why he did it are nontherapeutic and will not
elicit change from within the client. The question does not indicate that the client has a probation officer; that the
client will get in trouble may or may not be true. Saying the client may not attend the group anymore is a punitive
response. Opioid use may be medically indicated.
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4. 11172911
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4.
A mental health nurse is admitting a client with anorexia nervosa. When obtaining the history and
physical assessment, the nurse expects the client's condition to reveal what?
1
Edema
2
Diarrhea
Correct3
Amenorrhea
4
Hypertension
Amenorrhea results from endocrine imbalances that occur when fat stores are depleted. The client is dehydrated;
edema is not expected. Constipation, not diarrhea, may occur because of lack of fiber in the diet. Hypotension, not
hypertension, may occur because of dehydration.
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5. 10952715
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5.
A 28-year-old woman is recovering from her third consecutive spontaneous abortion in 2 years. What is
the most therapeutic nursing intervention for this client at her follow-up appointment?
1
Focusing on the client's physical needs
Correct2
Encouraging the client to verbalize her feelings about the loss
3
Reminding the client that she will be able to become pregnant again
4
Encouraging the client to think of herself, her husband, and their future
, Focusing on the client's physical needs demonstrates understanding of grief work; however, the nurse should first
help the client resolve the current problem. Although this is important, it focuses only on a part of the necessary
interventions; the client needs help to cope with her loss. Reminding the client that she will be able to become
pregnant again does not demonstrate understanding of the grieving process; the current loss must be dealt with
before the client can move on to planning for the future. Encouraging the client to think of herself, her husband, and
their future does not demonstrate understanding of the grieving process; the current loss must be dealt with before
the client can move on to planning for the future.
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6. 11132180
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6.
A nurse is developing a care plan for a client with obsessive-compulsive behavior disorder. Which
nursing intervention will most likely increase the client's anxiety?
1
Helping the client understand the nature of the anxiety
Correct2
Limiting the client's ritualistic acts to three times a day
3
Involving the client in establishing the therapeutic plan
4
Providing the client with a nonjudgmental environment
Limiting the client's ritualistic acts to three times a day sets an unrealistic limit that will increase anxiety by
removing a defense that the client needs. Helping the client understand the nature of the anxiety is done in therapy as
the client's condition improves. Insight is slowly developed to minimize anxiety. Involving the client in establishing
the therapeutic plan will increase self-esteem and self-control, not increase anxiety. Providing the client with a
nonjudgmental environment will reduce, not increase, anxiety, because the client will feel free to express feelings.
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7. 11112714
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7.
A nurse understands that when a client is a member of a different ethnic community it is important to:
1
Ensure that the nurse's biases are understood by the family.
2
Make plans to counteract the client's misconceptions about therapies.
Correct3
Offer a therapeutic regimen compatible with the lifestyle of the family .
4
Recognize that the client's responses will be similar to other clients' responses.
The client cannot be expected to accept or even respond to a plan that is incompatible with the family's lifestyle. The
family should not have to adjust to the nurse's biases; the nurse must self-identify biases and ensure that they do not
interfere with nursing care. There is no evidence that misconceptions will occur. All individuals respond differently
to situations.
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