Nokea
A client is having psychological counseling for problems communicating with his mother. Which model of stress is the most useful in reference to this stressor?
- A. Adaptation Model
- B. Stimulus-Based Model
- C. Transaction-Based Model
- D. Selye's Model of Stress
Correct Answer: C
Rationale: The Transaction-Based Model is, according to R.S. Lazarus, a state that Stimulus theory and Response theory do not consider individual differences. He takes into account cognitive processes that intervene between the encounter and the reaction and the factors that affect the nature of this process. He includes mental and psychological components or responses as part of his concept of stress (Person-Environment Transactions).
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A violation of a patient's confidentiality occurs if two nurses are discussing client information in which of the following scenarios?
- A. With a physical therapist treating the patient
- B. With a social worker planning for discharge
- C. With another nurse on duty to plan for break time
- D. In the hallway outside the patient's room.
Correct Answer: D
Rationale: Hallway discussions should not occur, because you do not know who is listening, even though it may be a professional discussion.
A nurse is caring for a client with an elevated cortisol level. The nurse can expect the client to exhibit symptoms of:
- A. urinary excess.
- B. hyperpituitarism.
- C. urinary deficit.
- D. hyperthyroidism.
Correct Answer: C
Rationale: High levels of cortisol can produce sodium and fluid retention and potassium deficit, thus creating urinary deficit.
Using clichés in therapeutic communication leads the client toward:
- A. viewing the nurse as human
- B. accepting himself as human
- C. self-disclosing
- D. feeling discounted
Correct Answer: D
Rationale: Clichés in communication can make clients feel dismissed or misunderstood, reducing trust and engagement in therapeutic interactions.
A nurse is returning phone calls in a pediatric clinic. Which of the following reports most requires the nurse's immediate attention and phone call?
- A. A 8 year-old boy has been vomiting and appears to have slower movements and has a history of an atrioventricular shunt placement.
- B. A 10 year-old girl feels a dull pain in her abdomen after doing sit-ups in gym class.
- C. A 7 year-old boy has been having a low fever and headache for the past 3 days that has history of an anterior knee wound.
- D. A 7 year-old girl that had a cast on her right ankle is complaining of itching.
Correct Answer: A
Rationale: The shunt may be blocked and require immediate medical attention.
When planning intervention for a client during a crisis, which of the following outcomes is most appropriate?
- A. The client should explore deep psychological problems.
- B. The client should express positive feelings about event.
- C. The client should identify needs that are threatened by the event.
- D. The client should use constructive coping mechanisms.
Correct Answer: D
Rationale: The primary goal of crisis intervention is to relieve the symptoms of anxiety and foster constructive coping. Previous psychological issues might recur during crisis, but the focus is on short-term resolution of the current problem. At the end, the nurse credits a client for positive changes and helps him or her understand what was learned. This allows the client to use the learned coping mechanisms when new problems arise.