The nurse is caring for a client with a personality disorder. The client feels as if she is
not accomplishing any of her goals. Which of the following is the most appropriate
response by the nurse?
1. “Would you like to increase your therapy visits?”
2. “Let’s look at the plan of care together.”
3. “Who told you that you weren”t accomplishing your goals?”
4. “I will discuss your feelings with the doctor.”
Answer:
A client requests vanilla pudding after a day of diagnostic tests and talking to doctors.
The client remembers the client’s mother always made vanilla pudding when the client
was sick. Which types of coping mechanism is the client describing?
Standard Text: Select all that apply.
1. Using symbolic substitutes
2. Privately thinking it through
3. Seeking comfort
4. Engaging in self-healing mind-body practices
5. Talking it out
Answer:
A priority nursing intervention for a client with bipolar mania who has difficulty
sleeping is to:
1. Have the night nurse talk with the client.
2. Encourage long naps during the day.
3. Administer PRN zolpidem tartrate (Ambien).
4. Provide strenuous exercise prior to bedtime.
Answer:
Which one of the following assessment questions would the nurse use when completing
a client’s sensation assessment during a sexual history?
1. “Does the use of fantasy increase or decrease your sexual desire?”
2. “Do you experience any physical discomfort during sexual activity?”
3. “What negative thoughts do you have about sex?”
4. “How rigidly were gender roles enforced in your family of origin?”
Answer:
A nurse acknowledges feeling anxious about meeting new people. By acknowledging
feelings to the client, the nurse is demonstrating:
1. Sympathy.
2. Genuineness.
3. Empathy.
4. Superficiality.
Answer:
Delirium poses a serious threat to a client’s:
1. Family relationships and roles.
2. Lifestyle and habits.
3. Dignity and safety.
4. Spirituality and religious beliefs.
Answer:
The primary nursing goal for treatment with clients who are transsexual is to help them:
1. Experience guilt for enjoying sex.
2. Live and function in society in the cross-gender role.
3. Internalize the negative expectations and beliefs of others about sex.
4. Make a list of anxiety-producing sexual interactions.
Answer:
When a client gives written notice of intention to leave the hospital after a voluntary
admission, what determines the number of hours or days between the notice and the
discharge?
1. Hospital policy
2. State law
3. Insurer
4. Federal law
Answer:
The nurse is explaining the purpose of negotiating a behavioral contract to an
adolescent’s parents. A primary reason for the contract is:
1. The contract is just between the client and nurse.
2. It is a legal document.
3. The terms cannot be changed once the contract is formed.
4. There is less room for misinterpretation.
Answer:
The nurse educator is teaching a group of students about the phases of the nurse”client
relationship. Which of the following objectives does the educator include as indicative
of the working phase of the nurse”client relationship?
1. Client accomplishments are honestly evaluated.
2. Plans for follow-up are clearly arranged.
3. Client behaviors and response patterns are openly analyzed.
4. Roles and responsibilities of the client are explicitly defined.
Answer:
A client is newly diagnosed with dissociative identity disorder. To support this client,
who is struggling to accept the diagnosis, the nurse would:
1. Flood the client with stressful stimuli.
2. Actively listen to each identity state and provide support.
3. Assess for secondary gain to confront the client.
4. Discourage the use of psychometric tests.
Answer:
The nurse educator is discussing manipulation that can occur when working with
adolescent clients. Which nurse is most at risk for being manipulated by an adolescent
client? The nurse who:
1. Avoids power struggles.
2. Rewards appropriate behavior.
3. Consistently enforces the rules.
4. Maintains an all-accepting attitude.
Answer:
Which of the following statements by a client would reflect a turning point?
1. “This was difficult for me, but I have learned how to manage myself in my new job.”
2. “If only they would give me another chance, I know I could do better.”
3. “I will get them for this.”
4. “I guess I deserved this. I was not a great employee.”
Answer:
During an education session, a community member asks what causes domestic
violence. The best response is:
1. The statistics indicate that it is caused by poverty.
2. It is caused by the demanding workload of either parent.
3. The police commissioner can provide complete and accurate data on the causes.
4. There is no single cause of this type of violence.
Answer:
The nurse is assessing the social and financial status of an older adult. Which of the
following questions would be appropriate to ask?
1. “Do you have transportation to get to doctor’s appointments?”
2. “Do you have problems with your family taking advantage of you?”
3. “How often do you forget to pay your bills?”
4. “How much money do you get from social security?”
Answer:
A psychiatric home care nurse knocks on the client’s door for the first time and is told
by the client, “Go away and leave me alone. I don”t want to buy any Girl Scout
cookies.” What should the nurse do in this instance?
1. Leave, and try to gain admittance to the client’s home tomorrow
2. Show the client identification and explain the purpose of the visit
3. Offer to give the client money to buy Girl Scout cookies
4. Call the home health agency and request a new assignment
Answer:
Following a particularly violent incident which resulted in a client being placed in
four-point restraints, the nurse recognizes feeling fearful of having to work with the
client again. How should the nurse handle this emotion?
1. Recognize that feeling fear and getting into physical confrontations is “part of the
job.”
2. Accept the fear, process the event with other staff, and continue working with the
client.
3. Ignore feelings of fear as it would impede the nurse’s ability to manage the client
effectively.
4. Engage in debriefing with the client to clear up hard feelings.
Answer:
The client has been taking fluvoxamine (Luvox) for years, has been symptom-free for
one year, and is now considering taking a drug holiday. What nursing teaching is
necessary?
1. The client should be symptom-free for at least two years before trying to go off the
medication
2. The client should let the prescriber make these decisions and should not suggest this
3. A drug holiday should be avoided due to discontinuation symptoms
4. This is worth trying since the client has been symptom-free for a year
Answer: