exam 1 NR 326
1. Three years ago, Anna's dog, Lucky, her pet for 16 years, was killed by a car.
Since that time, Anna has lost weight, rarely leaves her home, and talks
excessively about Lucky. Anna's behavior would be considered maladaptive for
which of the following reasons?
a. It has been more than 3 years since Lucky died.
b. Her grief is too intense over the loss of a dog.
c. Her grief is interfering with her functioning.
d. Cultural norms typically do not comprehend grief over the loss of a pet. - -
correct answer c. Her grief is interfering with her functioning.
Anna states that Lucky was her closest friend, and since his death, no one can
ever replace the relationship they had. According to Maslow's hierarchy of needs,
which level of need is not being met?
a. Physiological needs
b. Self-esteem needs
c. Safety and security needs
d. Love and belonging needs - - correct answer d. Love and belonging needs
Anna's daughter notices that Anna appears to be listening to another voice when
just the two of them are in a room together. When questioned, Anna admits that
she hears someone telling her that she was a horrible caretaker for Lucky and did
not deserve to ever have a pet. Which of the following best describes what Anna
is experiencing?
a. Neurosis
b. Psychosis
c. Depression
d. Bereavement - - correct answer b. Psychosis
Anna, who is 72 years old, is at the age when she may have experienced several
losses in a short time. What is this called?
a. Bereavement overload
,exam 1 NR 326
b. Normal mourning
c. Isolation
d. Cultural relativity - - correct answer a. Bereavement overload
Anna has been grieving the death of Lucky for 3 years. She is unable to take care
of her normal activities because she insists on visiting Lucky's grave daily. What is
the most likely reason that Anna's daughter has put off seeking help for Anna?
Women are less likely than men to seek help for emotional problems.
b. Relatives often try to normalize behavior rather than label it mental illness.
c. She knows that all older people are expected to be a little depressed.
d. She is afraid that the neighbors will think her mother is "crazy." - - correct
answer b. Relatives often try to normalize behavior rather than label it mental
illness.
6. Lucky's accident occurred when he got away from Anna while they were taking
a walk. He ran into the street and was hit by a car. Anna cannot remember the
circumstances of his death. This is an example of what defense mechanism?
a. Rationalization
b. Suppression
c. Denial
d. Repression - - correct answer d. Repression
A client with a history of schizophrenia is brought to the emergency department
by police who report that she was knocking down food displays at a grocery store
and yelling that the food is all poisoned. The client reports to the nurse the she
has no idea why she was brought to the emergency department because "there is
nothing wrong with me." Which of these actions by the nurse demonstrates good
clinical judgment?
a. Instruct the police officer that this client should be incarcerated because there
is nothing that can be done in an emergency department.
b. Document that the client is manifesting suspicious ideation and anosognosia.
,exam 1 NR 326
c. Ask the doctor to order gastric lavage because the client reports having been
poisoned.
d. Instruct the client that the food is not poisoned and there is something very
wrong with her. - - correct answer b. Document that the client is manifesting
suspicious ideation and anosognosia.
8. During a primary care physician appointment, a client who has been a widow
for 7 years reports to the nurse that she does not want to wake up in the morning
and feels there is nothing left for her. Which of these actions by the nurse is a
priority?
a. Listen empathically and encourage the client to find some activities to increase
socialization.
b. Encourage the client to discuss this with her physician.
c. Assess the client for symptoms of depression and suicide risk.
d. Instruct the client that grief takes a long time to resolve but that she will be
feeling better soon. - - correct answer c. Assess the client for symptoms of
depression and suicide risk.
A client who has arrived at the health clinic for diabetic education is perspiring,
wringing his hands, and states, "I'm so anxious about giving myself shots I can
hardly breathe. I don't know what to do." Which of these actions by the nurse
demonstrates good clinical judgment?
a. Assist the client in relaxation exercises before commencing diabetes education.
b. Instruct the client that it is not hard to give oneself a shot and commence
teaching.
c. Assess the client further for symptoms of anxiety.
d. Cancel diabetic education and encourage the client to reschedule when he
feels less anxious. - - correct answer a. Assist the client in relaxation exercises
before commencing diabetes education.
10. A client who was admitted to the psychiatric unit for major depressive
disorder reports to the nurse, "Ever since my daughter died by suicide 10 years
, exam 1 NR 326
ago, I can't stand to be around my friends. They just don't get it!" Which of these
actions by the nurse demonstrates good clinical judgment?
a. Affirm that other people cannot possibly provide adequate support in
circumstances like these.
b. Assist the client to explore the connection between grief and anger.
c. Tell the client that her friends are doing the best they can and she should try to
accept their support.
d. Ask the client to describe how her daughter killed herself. - - correct answer b.
Assist the client to explore the connection between grief and anger.
The nurse decides to go against family wishes and tell the client of his terminal
status because that is what she would want if she were the client. Which of the
following ethical theories is considered in this decision?
a. Kantianism
b. Christian ethics
c. Natural law theories
d. Ethical egoism - - correct answer b. Christian ethics
The nurse decides to respect family wishes and not tell the client of his terminal
status because that would bring the most happiness to the most people. Which of
the following ethical theories is considered in this decision?
a. Utilitarianism
b. Kantianism
c. Christian ethics
d. Ethical egoism - - correct answer a. Utilitarianism
The nurse decides to tell the client of his terminal status because she believes it is
her duty to do so. Which of the following ethical theories is considered in this
decision?
a. Natural law theories
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