Nokea
A client has made the decision to leave her alcoholic husband and reports feeling very depressed. Which of the following is a non-therapeutic statement by the nurse that demonstrates sympathy?
- A. You are feeling very depressed. I felt the same way when I decided to leave my husband.
- B. I can understand you are feeling depressed. It was a difficult decision. I'll sit with you.
- C. You seem depressed. It was a difficult decision to make. Would you like to talk about it?
- D. I know this is a difficult time for you. Would you like medication for anxiety?
Correct Answer: A
Rationale: The correct answer is A because the nurse is sharing her personal experience, which is not therapeutic as it shifts the focus from the client to the nurse's own experience. This can make the client feel unheard and invalidated. Choice B demonstrates empathy and offers support by acknowledging the client's feelings and offering to sit with them. Choice C also shows empathy and provides an opportunity for the client to talk. Choice D is non-therapeutic as it jumps to suggesting medication without exploring the client's emotions or needs.
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A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?
- A. Monitor the client closely to prevent self-mutilation.
- B. Set limits to prevent exploitation of other clients.
- C. Give positive feedback when the client is assertive with staff or clients.
- D. Discourage flamboyant or seductive behaviors.
Correct Answer: C
Rationale: The correct answer is C: Give positive feedback when the client is assertive with staff or clients. This is because individuals with dependent personality disorder often struggle with low self-esteem and lack of confidence in their own abilities. By providing positive feedback when the client demonstrates assertiveness, the nurse can reinforce and encourage this behavior, ultimately promoting the client's independence and self-confidence.
Choice A is incorrect because monitoring for self-mutilation is more relevant for clients with other mental health disorders such as borderline personality disorder. Choice B is incorrect as setting limits to prevent exploitation is more appropriate for clients with antisocial personality disorder. Choice D is incorrect as discouraging flamboyant or seductive behaviors is more relevant for clients with histrionic personality disorder.
A nurse is reviewing the history and physical of an adolescent client diagnosed with conduct disorder. The nurse recognizes that which of the following is an expected assessment finding of conduct disorder?
- A. Death of client's father two months ago
- B. Experiences frequent facial tics
- C. Adheres strictly to routines
- D. Suspended from school several times in the past year
Correct Answer: D
Rationale: The correct answer is D: Suspended from school several times in the past year. Conduct disorder is characterized by persistent patterns of behavior that violate the rights of others and societal norms. Being suspended from school multiple times indicates a disregard for rules and authority, which is a common feature of conduct disorder. Choices A, B, and C do not directly align with the typical behaviors associated with conduct disorder. A recent death in the family (A) may lead to emotional distress but is not a defining characteristic of conduct disorder. Frequent facial tics (B) are more indicative of a neurological or psychological condition, not conduct disorder. Adhering strictly to routines (C) is more characteristic of obsessive-compulsive disorder, not conduct disorder.
A nurse is caring for a client who has been diagnosed with end-stage liver cancer. The nurse recognizes that which of the following responses is an indication that the client is in the denial phase of the grief process?
- A. I can't believe the doctor graduated from medical school. He doesn't know a thing about treating cancer!
- B. Even though I am not hurting right now, I don't feel like I have the energy to get out of bed.
- C. The doctor says I only have a few months to live, but I know he is exaggerating to get me to take my medication.
- D. The doctor has been so good to me. I know he has tried everything he can. It's just my time.
Correct Answer: C
Rationale: The correct answer is C. In this response, the client is demonstrating denial by refusing to accept the doctor's prognosis of having only a few months to live. This indicates an inability to acknowledge the severity of the situation, a common characteristic of the denial phase in the grief process. The client's belief that the doctor is exaggerating shows a defense mechanism to cope with the overwhelming truth. Options A, B, and D do not exemplify denial. Option A shows anger, Option B indicates depression, and Option D reflects acceptance and resignation, which are not characteristics of denial in the grief process.
A nurse is assessing a school-age child who recently loaded a virus onto their teacher's computer after receiving a poor grade on a science project. The child's guardian tells the nurse their child often bullies the other kids at school. Which of the following diagnoses should the nurse expect?
- A. Oppositional defiant disorder (ODD)
- B. Attention deficit hyperactivity disorder (ADHD)
- C. Intermittent explosive disorder (IED)
- D. Conduct disorder (CD)
Correct Answer: D
Rationale: Correct Answer: D - Conduct disorder (CD)
Rationale:
1. Conduct disorder involves a pattern of behavior that violates the basic rights of others or societal norms.
2. The child's actions of loading a virus onto the teacher's computer and bullying classmates indicate a disregard for rules and the well-being of others.
3. Conduct disorder commonly presents with aggression, deceitfulness, and violation of rules.
4. These behaviors are more severe than those seen in Oppositional Defiant Disorder (A) and Attention Deficit Hyperactivity Disorder (B).
5. Intermittent Explosive Disorder (C) typically involves impulsive aggression, not premeditated actions like intentionally loading a virus.
6. Conduct disorder is the most appropriate diagnosis considering the child's behavior towards others.
Summary:
- A: Oppositional Defiant Disorder - less severe, lacks the pattern of aggression seen in the child's behavior.
- B: Attention Deficit Hyperactivity Disorder - does not fully capture the intentional harmful behavior
A nurse is providing teaching to a client who has hypothyroidism and has been prescribed levothyroxine. Which of the following medication instructions would the nurse include in the teaching?
- A. Take this medication before a meal or several hours after a meal.
- B. Take this medication during your morning meal.
- C. Take this medication with a full glass of water or fruit juice.
- D. Take this medication with high-protein foods.
Correct Answer: A
Rationale: The correct answer is A. Levothyroxine is best absorbed on an empty stomach, so taking it before a meal or several hours after a meal ensures optimal absorption. Taking it with food or certain beverages can interfere with absorption. Choice B is incorrect as taking it during a meal may reduce absorption. Choice C is incorrect as water or fruit juice is recommended, not required in full glass quantity. Choice D is incorrect as high-protein foods can also interfere with absorption.