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The best rationale for having the client reflect on the statements is that during the middle years of life, adults tend to do what?
- A. Assess their accomplishments
- B. Set unreasonable goals
- C. Envy others' achievements
- D. Doubt their judgment
Correct Answer: A
Rationale: Middle adulthood involves evaluating life achievements, per Erikson's generativity vs. stagnation stage, often prompting reflection on regrets.
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If a schizophrenic client says, 'Wing ding, the world is a ring,' which response by the nurse is most therapeutic?
- A. How clever. You've made up a poem.
- B. I don't understand what you mean.
- C. Let's talk about what's happening today.
- D. Tell me more about what you're thinking.
Correct Answer: B
Rationale: Acknowledging the nurse's lack of understanding gently prompts clarification, fostering communication without reinforcing delusional content.
Which question best assesses the client's long-term memory?
- A. What is your current age?
- B. What is today's date?
- C. What is your date of birth?
- D. What occurred last January?
Correct Answer: C
Rationale: Recalling date of birth tests long-term memory, as it requires retrieving well-established, distant personal information.
The nurse educator is orienting new nursing staff to the behavioral care unit when one nurse asks “How will I know which clients are potentially violent?” Which response by the nurse educator is best?
- A. “Just be alert and aware of your client’s behavioral clues.”
- B. “The client prone to violence will usually tell you they are angry about something.”
- C. “As you plan care review the clients’ charts to determine who has a history of violence.”
- D. “Your orientation will include an in-service on violent clients and how to identify them.”
Correct Answer: C
Rationale: Reviewing charts for violence history (C) identifies risk as history and impulsivity predict violence. Vague alertness (A) verbal cues (B) or delayed training (D) are less effective.
The nurse is caring for the toddler who has been hospitalized for observation because of apnea spells that have led to cardiac arrest at home three times in the past 6 months. The nurse suspects Munchausen Syndrome by Proxy (MSP) and contacts the HCP who does not believe that this is a correct assessment of the condition of the child or of the family dynamics. What should the nurse do?
- A. Contact the head of the department of pediatrics to report the incident.
- B. Consult with the clinical charge nurse as to what action should be taken.
- C. Call a case conference involving physicians nurses and social workers.
- D. File a variance report indicating the HCP was notified but took no action.
Correct Answer: B
Rationale: Consulting the charge nurse (B) follows the chain of command for suspected MSP a hard-to-confirm abuse. Bypassing to the department head (A) calling a conference (C) or filing a variance (D) skips protocol.
The nurse is unavoidably late in changing the dressing on the client’s leg. The client reacts by becoming verbally aggressive and telling the nurse “None of you can be trusted. You all just make promises you never intend to keep.” Which should be the nurse’s initial action?
- A. Alert other staff to the client’s apparent escalation.
- B. Ask why the client is overreacting to the situation.
- C. Leave the room until the client has regained control.
- D. Apologize to the client for being late with the treatment.
Correct Answer: D
Rationale: Apologizing (D) validates the client’s distress and acknowledges the nurse’s role de-escalating the situation. Alerting staff (A) is secondary asking why (B) may escalate defensiveness and leaving (C) avoids communication.