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A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?
- A. Prior physical health followed by the need for two surgeries within the last three months.
- B. Obsession over a fictitious defect in physical appearance.
- C. Sudden unexplained loss of peripheral sensation.
- D. Constant worry about the undiagnosed presence of an illness.
Correct Answer: D
Rationale: The correct answer is D because individuals with illness anxiety disorder experience persistent and excessive worry about having a serious medical condition despite reassurance from healthcare providers. This constant preoccupation with the possibility of being sick is a key characteristic of the disorder. Option A is incorrect as surgeries do not directly relate to illness anxiety disorder. Option B describes body dysmorphic disorder, not illness anxiety disorder. Option C does not align with the typical presentation of illness anxiety disorder.
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A nurse is caring for a client who has rheumatoid arthritis and tells the nurse that she wears a copper bracelet to help her feel better. Which of the following responses should the nurse make?
- A. "Yes, I understand that you feel better wearing your bracelet."
- B. "Why do you think the copper helps with your arthritis?"
- C. "Believing objects have powers to make you feel better has no scientific basis."
- D. "I think you should rely more on your medication therapy than on your bracelet."
Correct Answer: A
Rationale: Correct Answer: A
Rationale: The nurse should acknowledge and validate the client's feelings and beliefs regarding the copper bracelet without dismissing them. By responding with empathy and understanding, the nurse can establish a trusting relationship with the client. This approach can lead to open communication and collaboration in the client's care. It is important to respect the client's perspective and provide support rather than judgment.
Incorrect Choices:
B: Asking the client why she thinks the copper helps may come off as dismissive or confrontational, potentially alienating the client.
C: Dismissing the client's beliefs outright can damage the nurse-client relationship and hinder effective communication.
D: Suggesting the client rely more on medication than the bracelet may be perceived as disregarding the client's preferences and autonomy in managing her condition.
A nurse is teaching about electroconvulsive therapy (ECT) with a newly licensed nurse. The nurse should identify that the newly licensed nurse understands the teaching when she states that ECT treats which of the following disorders?
- A. Narcotic addiction
- B. Major depressive disorder
- C. Personality disorder
- D. Eating disorder
Correct Answer: B
Rationale: ECT is most commonly used for treatment-resistant major depressive disorder.
A client commits suicide in an acute mental health facility. Which of the following is the priority intervention for staff following this incident?
- A. Provide professional counseling for staff members.
- B. Change policies for staff observation of clients who are suicidal.
- C. Identify cues in the client's behavior that might have warned them that he was contemplating suicide.
- D. Give the family an opportunity to talk about their feelings.
Correct Answer: C
Rationale: The correct answer is C: Identify cues in the client's behavior that might have warned them that he was contemplating suicide. This is the priority intervention because understanding the warning signs can help prevent future suicides by recognizing and addressing high-risk behaviors. Providing counseling (A) is important but not the immediate priority. Changing policies (B) may be necessary in the long term but does not address the current situation. Giving the family an opportunity to talk (D) is important for support but does not directly address staff intervention.
A client at 36 weeks gestation has just delivered a stillborn baby. Which of the following statements should the nurse make?
- A. "I understand your grief. I lost a baby also."
- B. "You may hold your baby as long as you want."
- C. "I have called for the chaplain to come and stay with you."
- D. "This is for the best. Your baby was very ill."
Correct Answer: B
Rationale: Correct Answer: B
Rationale: Offering the client the option to hold the stillborn baby allows for the initiation of the grieving process and provides closure. It shows empathy and respect for the client's loss, allowing them to spend time with their baby and say goodbye. This statement acknowledges the client's emotions and offers them control over their grieving process.
Summary of Incorrect Choices:
A: Sharing personal experiences may unintentionally minimize the client's grief and shift the focus away from them.
C: While spiritual support may be beneficial, it may not align with the client's beliefs or preferences.
D: Telling the client that the stillbirth is for the best may come off as insensitive and dismissive of their feelings, causing further distress.
A nurse is caring for a client who reports bilateral knee pain after hiking this past weekend in the mountains on rough ground. He says he is concerned because his cousin died from bone cancer recently. Which of the following actions should the nurse take?
- A. Tell the client that it is unlikely that he has bone cancer.
- B. Ask the client why he thinks the pain isn't a result of hiking.
- C. Suggest genetic testing so the client can understand his risks.
- D. Explain that the provider will see him and determine a course of action.
Correct Answer: D
Rationale: The nurse should provide reassurance while ensuring proper medical evaluation.