Nokea
A nurse on the mental health unit is preparing a presentation on suicide for a group of student nurses. Which information would be included in this presentation? Select all that apply.
- A. Chronic pain or serious, disabling illness has little to no effect on suicide risk.
- B. Hispanic Americans attempt suicide at a greater rate than whites or African Americans.
- C. Suicide risk declines sharply once antidepressant medication has been taken for a few weeks.
- D. White males over the age of 80 are at the greatest risk among all age, race, and gender groups.
- E. Threatened suicide and/or gestures should be taken seriously and handled by trained professionals.
Correct Answer: D,E
Rationale: Chronic pain and serious illness increase suicide risk, making A incorrect. Data shows Hispanic Americans have lower suicide rates than whites, making B incorrect. Antidepressants may initially increase risk, making C incorrect. White males over 80 have the highest suicide rates, and all threats should be taken seriously, making D and E correct.
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A client with arterial leg ulcers tells the nurse, 'I'm so discouraged. I have had this pain for more than a year now. The pain never seems to go away. I can't do anything, and I feel as though I'll never get better.' The nurse determines that which is the priority client concern?
- A. Fatigue
- B. Uneasiness
- C. Chronic pain
- D. An acute illness
Correct Answer: C
Rationale: The major focus of the client's complaint is the experience of pain. Pain that has a duration of more than 3 months is defined as chronic pain and does not indicate an acute illness. There are no data in the question that indicate fatigue or uneasiness.
The nurse provides care for a client diagnosed with paranoia. Two days after admission, the client refuses to give any information other than name and age. Which action is most important for the nurse to take?
- A. Tell the client that the hospital is a safe place.
- B. Urge the client to reveal more information.
- C. Focus on developing a trusting relationship with the client.
- D. Introduce the client to other clients on the unit.
Correct Answer: C
Rationale: Building trust is critical for clients with paranoia, who may be suspicious and guarded. A trusting relationship encourages engagement and cooperation, making it the priority over reassurance, urging disclosure, or socialization.
The nurse is assessing a client who was admitted to the hospital with a diagnosis of urinary calculi. The client received 4 mg of morphine sulfate approximately 2 hours previously. The client states to the nurse, 'I'm scared to death that it'll come back.' Based on these statements, which concern should the nurse identify for this client at this time?
- A. Fear of dying
- B. Lack of understanding about the disease process
- C. Anxiety about the anticipation of recurrent severe pain
- D. Retention of urine from the obstruction of the urinary tract by calculi
Correct Answer: C
Rationale: The client stated, 'I'm scared to death that it'll come back.' The anticipation of the recurring pain produces anxiety and threatens the client's psychological integrity. There is no evidence that the client has a calculus in the right ureter. There is also no evidence that the client has lack of knowledge or urinary retention.
The nurse is reviewing the preoperative teaching plan for a client scheduled for a radical neck dissection for laryngeal cancer. Which part of the nursing care plan should the nurse initially focus on?
- A. The financial status of the client
- B. Postoperative communication techniques
- C. Information given to the client by the surgeon
- D. The client's support systems and coping behaviors
Correct Answer: C
Rationale: The first step in client teaching is establishing what the client already knows. This allows the nurse not only to correct any misinformation, but also to determine the starting point for teaching and to implement the education at the client's level. Although the remaining options may be components of the plan, they are not the initial focus.
The nurse is caring for a teenage client diagnosed with anorexia nervosa. The client's mother asks the nurse about eating disorders in general. Which information would the nurse provide? Select all that apply.
- A. Anorexia nervosa is more common than bulimia.
- B. Clients with bulimia may have erosion of the tooth enamel.
- C. Binging and purging can occur in both anorexia nervosa and bulimia.
- D. Extreme exercising and calorie restriction is common with anorexia nervosa.
- E. Clients with eating disorders may develop the disorders because of issues of power and control.
- F. Clients with anorexia have a distorted body image and think that they are fat even if they are very thin.
Correct Answer: B,C,D,E,F
Rationale: Bulimia is more common than anorexia, making A incorrect. Tooth enamel erosion, binging/purging, extreme exercising, power/control issues, and distorted body image are all accurate.