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A parent of a young child says, 'I'm so upset! The doctor prescribed an antidepressant!' Which response is best?
- A. Tell me more about what's bothering you.'
- B. Weren't you told about the need for the medication?'
- C. I'll notify the healthcare provider about your concerns.'
- D. Maybe the medication is for attention deficit disorder.'
Correct Answer: A
Rationale: The best response in this situation is to express empathy and encourage the parent to share more about their concerns. Option A ('Tell me more about what's bothering you.') allows the nurse to show understanding and gather more information to address the parent's distress effectively. Option B ('Weren't you told about the need for the medication?') is confrontational and may make the parent defensive, hindering effective communication. Option C ('I'll notify the healthcare provider about your concerns.') is premature; the nurse should first assess the parent's feelings before deciding on further actions. Option D ('Maybe the medication is for attention deficit disorder.') assumes without clarification, which is not appropriate; the nurse should validate the prescription before suggesting alternative reasons.
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Which priority action would the nurse manager use to help the nurse who may be experiencing burnout?
- A. Transfer the nurse to another unit in the facility.
- B. Help the nurse choose a position on a low-stress unit.
- C. Encourage the nurse to attend educational programs.
- D. Help the nurse identify personal responses to job stress.
Correct Answer: D
Rationale: The correct priority action for the nurse manager to help a nurse experiencing burnout is to assist the nurse in identifying personal responses to job stress. This involves recognizing work stressors in the environment and evaluating coping strategies to determine their effectiveness. While transferring the nurse to another unit could be a solution, the initial focus should be on self-awareness and coping strategies. Choosing a position on a low-stress unit and attending educational programs can be beneficial in reducing burnout, but they are not the primary steps to address burnout when it occurs.
When assessing the mental status of a young school-aged child, which action would be important for the nurse to take?
- A. Listen to the parents' description of the child's behavior.
- B. Compare the child's function from one occasion to another.
- C. Engage the parents in a discussion about the child's feelings.
- D. Determine the child's mental status through direct questioning.
Correct Answer: B
Rationale: To accurately assess the mental status of a young school-aged child, it is crucial for the nurse to compare the child's function over time. This approach allows for a more objective evaluation of the child's mental status. While listening to the parents' description of the child's behavior can provide valuable insights, it may be biased and subjective. Engaging parents in discussions about the child's feelings is important for overall understanding but may not directly assess the child's mental status. Directly questioning the child about their mental status can be threatening and may lead to anxiety, making it a less optimal approach compared to observing and comparing the child's function over time.
A client who is in labor has human immunodeficiency virus (HIV) and states to the nurse, 'I know I will have a sick-looking baby.' Which appropriate therapeutic response should the nurse make?
- A. You are very sick, but your baby may not be.'
- B. All babies are beautiful. I am sure your baby will be too.'
- C. You have concerns about how HIV will affect your baby?'
- D. There is no reason to worry. Our neonatal unit offers the latest treatments available.'
Correct Answer: C
Rationale: Option 3 is the most therapeutic response, and it will elicit the best information. It addresses the therapeutic communication technique of paraphrasing. Option 3 also is an open-ended response that will provide an opportunity for the client to verbalize her concerns. Parents need to know that their baby will not look sick from HIV at birth and that there may be a period of uncertainty before it is known whether the baby has acquired the infection. Options 1 and 2 provide false reassurances. The client should not be told that there is no reason to worry.
A teenager begins to cry while talking with the nurse about the problem of not being able to make friends. Which is the correct therapeutic nursing intervention?
- A. Sitting quietly with the client
- B. Telling the client that crying is not helpful
- C. Suggesting that the client play a board game
- D. Recommending how the client can change this situation
Correct Answer: A
Rationale: The correct therapeutic nursing intervention in this situation is sitting quietly with the client. This approach conveys empathy, acceptance, and a willingness to listen, which can help the teenager feel supported and understood. It is important for the nurse to create a safe space for the client to express their emotions without judgment. Telling the client that crying is not helpful dismisses their feelings and can hinder the therapeutic relationship. Suggesting a board game as a distraction may prevent the client from fully exploring and addressing their emotions about the issue. Recommending how the client can change the situation may be premature at this stage, as the priority is to provide emotional support and establish trust before delving into problem-solving.
For a client with obsessive-compulsive disorder, which reaction is most likely to occur when the performance of a ritual is interrupted?
- A. Anxiety
- B. Hostility
- C. Aggression
- D. Withdrawal
Correct Answer: A
Rationale: When a client with obsessive-compulsive disorder is interrupted while performing a ritual, the most likely reaction is anxiety. The compulsive ritual serves as a coping mechanism to control anxiety, so any disruption to this ritual can heighten the individual's anxiety levels. Hostility is typically part of the disorder itself and not a direct reaction to the interruption of the ritual. Aggression may occur only if anxiety escalates to a panic level, leading to overt anger expression. Withdrawal is not a common behavioral pattern associated with obsessive-compulsive disorder and is not a typical reaction to ritual interruption.