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During an annual physical at the corporate clinic, a male employee expresses to the RN that his high-stress job is causing trouble in his personal life. He mentions getting so angry while driving to and from work that he has considered 'getting even' with other drivers. How should the RN respond?
- A. "Anger is contagious and could lead to major confrontations."
- B. "Try not to let your anger cause you to act impulsively."
- C. "Expressing your anger to a stranger could lead to an unsafe situation."
- D. "It seems like there are many situations that make you feel angry."
Correct Answer: B
Rationale: The correct response for the RN is to advise the employee not to act impulsively when feeling angry. This approach helps the individual learn to manage anger in a constructive manner, reducing the likelihood of potential conflicts. Choice A is incorrect because while acknowledging that anger can escalate into confrontations is valid, it does not provide immediate guidance on managing the anger. Choice C focuses on the dangers of expressing anger to strangers but does not address the core issue of managing anger. Choice D simply acknowledges the employee's feelings without providing guidance on how to address the situation effectively.
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An antidepressant medication is prescribed for a client who reports sleeping only 4 hours in the past 2 days and weight loss of 9 lbs within the last month. Which client goal is most important to achieve within the first three days of treatment?
- A. Meet scheduled appointment with a dietitian.
- B. Sleep at least 6 hours a night.
- C. Understand the purpose of the medication regimen.
- D. Describe the reasons for hospitalization.
Correct Answer: B
Rationale: The most important goal to achieve within the first three days of treatment is to ensure the client can sleep at least 6 hours a night. Adequate sleep is essential for stabilizing mood and improving overall functioning. Choice A is not as urgent as improving sleep patterns. Choice C is important but not as immediate as addressing the sleep deficit. Choice D is unrelated to the immediate treatment goal of improving sleep and managing symptoms of depression.
Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply.
- A. Limited language skills
- B. Level of cognitive development
- C. Level of emotional development
- D. Parental denial that a problem exists
Correct Answer: B
Rationale: The level of cognitive development is a crucial factor that can complicate the diagnosis of mental illness in young children. Young children may not have fully developed cognitive abilities to express their symptoms or understand diagnostic procedures, making it challenging for healthcare providers to assess their mental health accurately. Limited language skills (choice A) can hinder communication but are not as significant as cognitive development in diagnosing mental illness. Emotional development (choice C) is important but may not be as directly linked to the diagnostic challenges as cognitive development. Parental denial (choice D), although a potential barrier, is not a factor inherent to the child's characteristics affecting the diagnostic process.
A female client with obsessive-compulsive personality disorder is admitted to the hospital for a cardiac catheterization. The afternoon before the procedure, the client begins to keep detailed notes of the nursing care she is receiving and reports her findings to the RN at bedtime. What action should the nurse implement?
- A. Explain to the client that her behavior invades the rights of the nursing staff.
- B. Ask the client to explain why she is keeping a detailed record of her nursing care.
- C. Teach the client strategies to control her obsessive-compulsive behavior.
- D. Encourage the client to express her feelings regarding the upcoming procedure.
Correct Answer: B
Rationale: Asking the client to explain why she is keeping a detailed record of her nursing care is the most appropriate action for the nurse to take in this situation. Understanding the client's motivations for keeping detailed records can provide insight into her obsessive-compulsive behaviors and help manage them effectively. Choice A is incorrect because it may come across as confrontational and not address the underlying reasons for the behavior. Choice C is incorrect as teaching strategies to control behavior should be done after understanding the client's motives. Choice D is incorrect as it does not directly address the behavior of keeping detailed records.
A female client reports feeling hopeless and is unable to stop crying. She explains that she is worried about losing her job. Since the client's husband recently lost his job, she feels her employment is essential to the family's survival. To evaluate the effectiveness of cognitive-behavioral techniques, which client outcomes should the nurse include in the plan of care?
- A. Relates insights into problematic relationships
- B. Demonstrates a healthy relationship with her husband
- C. Describes how the family can resolve problems
- D. Changes thought patterns related to problem-solving
Correct Answer: D
Rationale: The correct answer is D. Cognitive-behavioral therapy focuses on changing thought patterns by guiding the client to engage in problem-solving strategies to address the current situation. This approach helps individuals modify negative thinking patterns and develop more adaptive ways to cope with challenges. Choices A, B, and C are incorrect because while they may be important aspects to consider in therapy, the primary focus in cognitive-behavioral therapy is on identifying and changing negative thought patterns rather than exploring relationships or family problem-solving skills.
A client with schizophrenia is being discharged home after an extended stay in a psychiatric hospital. Which statement by the client indicates that further teaching about medication management is needed?
- A. "I will take my medication only when I feel like it."
- B. "I need to follow up with my psychiatrist regularly."
- C. "I will notify my healthcare provider if I experience side effects."
- D. "I should avoid alcohol while on my medication."
Correct Answer: A
Rationale: The correct answer is A. This statement indicates a lack of understanding about medication management for schizophrenia. Medications for schizophrenia should be taken consistently as prescribed for optimal effectiveness, regardless of how the client feels. Choice B is a correct statement as regular follow-up with a psychiatrist is important for monitoring progress and adjusting treatment. Choice C demonstrates good awareness of potential side effects and the need for communication with healthcare providers. Choice D reflects appropriate knowledge as alcohol can interact with medications and may reduce their effectiveness.