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A young female client hospitalized on the inpatient psychiatric unit receives treatment for anorexia nervosa. Which statement made by the client to the nurse best indicates improvement?
- A. The client states, 'I realize I am too thin and that it is not good for me, but I do not know how to eat more without getting fat.'
- B. The client requests a sanitary pad, saying, 'I did not think to bring anything with me. I have not had a period for months.'
- C. The client states, 'Either the food here is getting better or my appetite is coming back, but lately I find myself looking forward to meals.'
- D. The client asks for her discharge date to be delayed and says, 'I do not feel ready yet to deal with the tension in my family and their demands for perfection.'
Correct Answer: C
Rationale: Looking forward to meals indicates improved appetite and a positive shift in attitude toward eating, a key sign of progress in anorexia treatment. Other statements reflect awareness, physical changes, or anxiety, but do not directly indicate improved eating behavior.
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The nurse is working in a mental health facility that uses group therapy with the clients. The nurse understands which to be correct regarding group therapy?
- A. The termination stage begins with the initial group meeting.
- B. Members' feelings about their accomplishments are explored in the working stage.
- C. During the working stage, members may be unclear about the purpose of the group.
- D. Group roles and responsibilities are established in the working stage of group therapy.
Correct Answer: D
Rationale: Group roles and responsibilities are established in the working stage, when members actively engage in therapeutic goals.
Which comment made by the parents of a male infant who will have a surgical repair of a hernia indicates a need for further teaching by the nurse?
- A. I understand that surgery will repair the hernia.'
- B. I don't know if he will be able to father a child when he grows up.'
- C. The day nurse told me to give him sponge baths for a few days after surgery.'
- D. I'll need to buy extra diapers because we need to change them frequently now.'
Correct Answer: B
Rationale: The anatomical location of a hernia frequently causes more psychological concern to the parents than does the actual condition or treatment. The remaining options all indicate accurate understanding associated with the surgery. The correct option is an incorrect comment requiring follow-up.
The nurse is assessing a client who was just admitted to the psychiatric unit. The client says, 'You won't have to worry about me much longer.' Which meaning should the nurse interpret from this statement?
- A. An intention of suicide
- B. An expression of depression
- C. An intention of self-mutilation
- D. An expression of hopelessness
Correct Answer: A
Rationale: A client who is at risk for suicide who says, 'You won't have to worry about me much longer,' is making an expression of a suicidal intent. Although depression, self-mutilation, and hopelessness may relate to violence to oneself, the statement that he or she will not be around is a direct comment about the act of suicide.
A client diagnosed with empyema is to undergo decortication to remove inflamed tissue, pus, and debris. On the basis of which understanding about this procedure should the nurse offer emotional support to the client?
- A. This problem may decrease the client's life expectancy.
- B. The client is likely to be in excruciating pain after surgery.
- C. The client will probably have chronic dyspnea after the surgery.
- D. Chest tubes will be in place after surgery, and the healing process is slow.
Correct Answer: D
Rationale: The client undergoing decortication to treat empyema needs ongoing support from the nurse. This is especially true because the client will have chest tubes in place after surgery, and these must remain until the former pus-filled space is completely obliterated. This may take some time, and it may be discouraging to the client. Progress is monitored by chest x-ray. This information supports that the remaining options are not accurate.
The nurse is assisting with providing a form of psychotherapy in which the client acts out situations that are of emotional significance. Based on this assessment data, which form of therapy should the nurse expect the primary health care provider has prescribed?
- A. Psychodrama
- B. Reality therapy
- C. Psychoanalytic therapy
- D. Short-term dynamic psychotherapy
Correct Answer: A
Rationale: Psychodrama involves the enactment of emotionally charged situations. Reality therapy is used for individuals with cognitive impairment. Both short-term dynamic psychotherapy and psychoanalytic therapy depend on techniques that are drawn from psychoanalysis.