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A nurse is caring for a client who has a phobia of elevators. Which of the following behavioral strategies should the nurse plan to use to decrease anxiety?
- A. Response prevention.
- B. Systematic desensitization.
- C. Thought stopping.
- D. Flooding.
Correct Answer: B
Rationale: Systematic desensitization is an effective behavioral strategy for decreasing anxiety related to specific phobias. This method involves gradually exposing the client to the feared object or situation—in this case, elevators—in a controlled and progressive manner while teaching relaxation techniques. By slowly and systematically confronting the phobia, the client can learn to reduce their anxiety response over time.
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A nurse is reinforcing teaching with a client who is to receive electroconvulsive therapy. Which of the following statements should the nurse include in the teaching?
- A. You will be given an opioid analgesic before the procedure.
- B. Expect to be confused several hours after the procedure.
- C. You cannot eat or drink for 24 hours before the procedure.
- D. A consent form is not required to have this procedure.
Correct Answer: B
Rationale: Confusion and temporary memory loss are common side effects immediately following ECT. Clients should be informed to expect these cognitive effects, which can last for a few hours to days. Educating the client about these side effects helps prepare them for what to expect post-procedure and ensures they have appropriate support during their recovery period.
A nurse is reinforcing teaching about home care with the family of a client who has Alzheimer's disease and wanders at night. Which of the following instructions should the nurse include?
- A. Keep the client's bedroom area dark at night.
- B. Have the client exercise 30 minutes before bedtime.
- C. Place the client's mattress on the bedroom floor.
- D. Encourage the client to nap often during the day.
Correct Answer: C
Rationale: Placing the client's mattress on the bedroom floor is a practical safety measure for clients with Alzheimer's disease who wander at night. This approach minimizes the risk of injury from falls, as the client will be closer to the ground. By reducing the height of the bed, families can create a safer sleeping environment and help prevent potential injuries due to wandering and confusion.
A nurse is caring for a client who has depressive disorder following the recent death of their partner. Which of the following responses should the nurse make?
- A. I remember how depressed I was after my friend died.
- B. You should start participating in your usual activities.
- C. Everyone feels depressed during the grieving process.
- D. Tell me what your relationship with your partner was like.
Correct Answer: D
Rationale: This response opens a conversation about the client’s feelings and experiences, showing empathy and a willingness to understand their perspective. It helps build trust and rapport, allowing the nurse to provide appropriate support.
A nurse is discussing the care of a client who has alcohol use disorder with another nurse. Which of the following statements should the nurse identify as an indication of countertransference?
- A. The client is just like my parent, who never could quit drinking.
- B. The client needs to accept responsibility for their drinking.
- C. The client asked me to go on a date.
- D. The client shares their feelings openly during group therapy.
Correct Answer: A
Rationale: This statement is an indication of countertransference because the nurse is projecting personal feelings and experiences onto the client. By comparing the client to their parent who struggled with drinking, the nurse may unconsciously treat the client differently based on unresolved emotions or past experiences. Countertransference can interfere with the nurse's ability to provide objective and compassionate care.
A nurse is caring for a client who has agreed to a verbal safety contract following a self-mutilation attempt. Which of the following behaviors indicates that the contract has been effective?
- A. The client goes to their room alone when they feel overwhelmed.
- B. The client displaces their feelings of self-harm until they talk to the provider.
- C. The client suppresses their feelings when they are angry.
- D. The client notifies the nurse when they want to harm themselves.
Correct Answer: D
Rationale: Notifying the nurse when they want to harm themselves is a clear indication that the safety contract has been effective. The client is following the agreed-upon plan to seek help and communicate their feelings of self-harm, which is the primary goal of the safety contract. This behavior demonstrates that the client is taking steps to ensure their safety and seeking support from healthcare providers.