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Get faster at matching terms Terms in this set (30)A nurse in a long-term care setting is caring for a client who has Alzheimer's disease. The client states, "I just came back from a hard day's work in my office." The nurse should identify this statement is an example of which of the following coping
mechanisms? 2 Confabulation A nurse is collecting data from a client who has major depression disorder ( MDD). Which of the following finding should the nurse expect?
1. Significant change in weight A nurse is planning care for a new client. Which of the following actions should the nurse plan to take in order to use the technique of presence to establish the nurse-client relationship? 1. Telephone the client at his home prior to admission to make introduction. 4. Use active listening when with the client. A client who has a femur fracture states, "I can't stay in this bed any longer. I need to get home so I can take care of my family." The nurse responds by saying, "You have talked about your family. Can you tell me more about your specific concerns?" Which of the following therapeutic communication techniques is the nurse using? 1. Summmarizing 3. Focusing. A nurse is collecting data from a client following a recent suicide attempt. Which of the following findings in the client's history places him at the greatest risk for another suicide attempt? 1. Access to health care 2. Impulsively A nurse is caring for a group of older adult clients. Which of the following client findings indicates delirium? A client asks when family members will be arriving after visiting 1 hr earlier. A nurse is reinforcing teaching with a client about a new prescription for lithium. Which of the following statements should the nurse include in the teaching? "We will need to check your lithium levels in the next 3 to 5 days." Lithium is prescribed to treat bipolar disorder. The medication has a narrow therapeutic rang and establishing a therapeutic lithium level is an essential component of care. it is recommend to check lithium level with the first 5 days. of beginning of treatment and possibly twice weekly until a maintenace dosage has been reached. Lithium levels are checked about every 3 months during maintenance therapy when lithium levels have stabilized. A nurse is reinforcing teaching with a female client who is prescribed chlorpromazine. Which of the following statements by the client indicates an understanding of the teaching? "I will contact my provider if I have difficulty urinating." Chlorpromazine is a first generation , or typical , antipsychotic medication prescribed for schizophrenia. The client should monitor for anticholinergic adverse effects, such as dry mouth and urinary retention. Difficult urinating could be a sign of urinary retention and should be reported to the provider for further evaluation. A nurse is caring for an older adult client who is scheduled for surgery. The client becomes upset when the nurse asks her to remove her dentures prior to the surgery. Which of the following is a therapeutic response by the nurse? "You seem worried. Are you concerned someone may see you without your teeth?" A nurse is reinforcing discharge teaching with a client who is 2 days postpartum and has a history of postpartum depression. Which of the following instructions should the nurse include? Sleep as much as possible. A nurse is collecting data from a client who is receiving treatment for alcohol detoxification. Which of the following findings is the nurse's priority? Hallucinations A nurse is assisting with the plan of care for a client who is newly diagnosed with borderline personality disorder. Which of the following interventions is the nurse's priority? Protecting the client from self-harm behavior A nurse is assisting with a family therapy session for parents and 2 school-age children. Which of the following statements should the nurse recognize as an example of effective communication among family members? "Can you tell me the reason you get upset each time I go to the mall?" A nurse is collecting data from a client who has bipolar disorder with mania. Which of the following findings is the nurse's priority? The client paces in the hallway during the day and most of the night. A nurse is collecting data from a school age child who has an intellectual development disorder. Which of the following findings should the nurse expect? Has difficulty performing age-appropriate self-care activities A nurse is assessing a client in the emergency department who drank alcohol while taking disulfiram. The client states, "The nurse told me not to drink when taking the medication. I am just a social drinker. I didn't realize that having just one drink with my friends would cause such a problem." Which of the following defense mechanisms is the client demonstrating? Rationalization
A nurse is collecting data from a client who is taking bupropion. Which of the following findings indicates the medication is effective? Decrease in urge to smoke note: A nurse is caring for a client who reports acute anxiety. Which of the following actions should the nurse take first? Remain with the client. A nurse is caring for a client who escapes anxiety-causing thoughts by ignoring their existence. The nurse should recognize this behavior as which of the following defense mechanisms? Undoing A nurse is caring for a client whose wife died 6 months ago. For which of the following findings should the nurse monitor to identify a maladaptive grieving response? Disturbed self-esteem A nurse is evaluating the outcomes for a client who has depression following the death of his wife 3 months ago. Which of the following client statements indicates a need for further intervention? "I just don't feel like eating because I never liked to eat alone." A nurse is talking with a client who has schizophrenia. Suddenly the client states, "I'm frightened. Do you hear that? The voices are telling me to do terrible things." Which of the following responses by the nurse is appropriate? "What are the voices telling you to do?" A nurse is preparing to assist with the care of a client who is to undergo electroconvulsive therapy (ECT). What pieces of equipment should the nurse set up in the room prior to the treatment? -Electroencephalogram (EEG) monitor A nurse is collecting data from a client newly admitted for anorexia nervosa. Which of the following findings should the nurse expect? Amenorrhea A nurse is discussing comorbidities associated with eating disorders with a newly
licensed nurse. Which of the following comorbidities should the nurse include in the discussion? - Anxiety A nurse is discussing restraints with a newly licensed nurse. Which of the following situations should the nurse identify as an acceptable indication for using restraints for a client? Continued self-destructive behavior A nurse is caring for a client who has been diagnosed with end-stage liver cancer. Which of the following statements by the client indicates that the client is in the denial phase of the grief process? "The doctor says I only have a few months to live, but I know he is exaggerating to get me to take my medication." A nurse in an acute care facility is assisting with the admission of an older adult client who has late stage Alzheimer's disease. The nurse notes that the client's partner appears exhausted. He states that he is finding it more and more difficult to care for his partner. Which of the following actions should the nurse take first? Ask the partner to talk about his difficulties in caring for the client. A nurse is reinforcing discharge teaching with a client who has several new prescriptions for psychotropic medications. The client tells the nurse that she has always had trouble following a medication regimen. Which of the following responses should the nurse make? "Let's work together to devise a schedule that is convenient for you on a daily basis." A nurse is caring for a client who witnessed her brother's homicide and has posttraumatic stress disorder (PTSD). Which of the following findings should the nurse expect? The client is easily startled by loud voices. Sets found in the same folderCapstone Pharm Pre-Assessment Quiz30 terms beckyrs ATI Capstone Med Surg129 terms goandstudy Mental Health140 terms xtiffanytran ATI Capstone Mental Health Pre Assessment Quiz30 terms petersm78 Other sets by this creatorati review, my ati75 terms Orathai_Kerdchonphet VATI comprehensive study quiz.11 terms Orathai_Kerdchonphet PN comprehensive predictor practice B [2020]150 terms Orathai_Kerdchonphet Med surge study quiz 20223 terms Orathai_Kerdchonphet Other Quizlet setsThree Skeleton Key10 terms kristinreneetanner Psy 3430 Exam 140 terms Hamiltontaylor19 B2 revision 314 terms quizlette21079597 Bible17 terms Tradke29 Related questionsQUESTION What is the goal of moderate sedation? 15 answers QUESTION What is the parietal lobe do 15 answers QUESTION What are Peplau's Four Stages of Personality Development? 7 answers QUESTION The nurse is completing the physical assessment of a client suspected of a neurological disorder. The client reports having recently suffered a head trauma. In such a case, the nurse should: 4 answers |
A nurse is collecting data from a client who is receiving treatment for alcohol detoxification
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