Molly Sue is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy. Her mother states to the nurse that it is hard to see Molly Sue with no hair. The best response for the nurse is: A. “Molly Sue looks very nice wearing a hat”. B. “You should not worry about her hair,… Read More »
A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take? A. Call security for assistance and prepare to sedate the client. B. Tell the client to calm down and ask him if he would like to… Read More »
The client with Alzheimer’s disease is being assisted with activities of daily living when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is aware that the client is exhibiting: A. Agnosia B. Apraxia C. Anomia D. Aphasia Correct Answer: A.… Read More »
The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as: A. Chronic fatigue syndrome B. Normal aging C. Sundowning D. Delusions Correct Answer: C. Sundowning Increased confusion at night is… Read More »
The client with confusion says to the nurse, “I haven’t had anything to eat all day long. When are they going to bring breakfast?” The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this conversation. Which response would be best for the nurse to make? A. “You know… Read More »
The client is admitted to the chemical dependence unit with an order for continuous observation. The nurse is aware that the doctor has ordered continuous observation because: A. Hallucinogenic drugs create both stimulant and depressant effects. B. Hallucinogenic drugs induce a state of altered perception. C. Hallucinogenic drugs produce severe respiratory depression.… Read More »
What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying? A. “Tell me about your feelings right now.” B. “When the doctor arrives, everything will be fine.” C. “This is a bad situation, but you’ll feel better soon.” D. “Please be assured we’re doing everything we… Read More »
A clinic nurse interviews a parent who is suspected of abusing her child. Which of the following characteristics is the nurse least likely to find in an abusing parent? A. Low self-esteem B. Unemployment C. Self-blame for the injury to the child D. Single status Correct Answer: C. Self-blame… Read More »
A priority goal of involuntary hospitalization of the severely mentally ill client is A. Re-orientation to reality B. Elimination of symptoms C. Protection from harm to self or others D. Return to independent functioning Correct Answer: C. Protection from self-harm and harm to others. Involuntary hospitalization may… Read More »
A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of “suppression”? A. “I don’t remember anything about what happened to me.” B. “I’d rather not talk about it right now.” C. “It’s the other… Read More »