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The best way for a healthcare provider and a healthcare facility to control the effects of poor and disruptive patient behavior is to _________________.
- A. prevent it
- B. restrain the patient
- C. medicate the patient
- D. isolate the patient
Correct Answer: A
Rationale: The most effective approach to managing poor and disruptive patient behavior is by preventing it proactively. This involves implementing strategies, communication techniques, and environmental modifications that address the underlying causes of the behavior. Restraint, medication, and isolation should only be used as a last resort when the patient or others are at risk of harm. Restraint and isolation are primarily used to ensure safety, while medication, especially when used solely to control behavior, can have adverse effects and is considered a measure of last resort. Therefore, prevention is crucial in promoting a therapeutic environment and fostering positive patient outcomes.
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According to psychodynamic theory, what purpose do delusions serve?
- A. Delusions are a defense against anxiety caused by real or imagined threats.
- B. Magical thinking is a delusion that ensures desirable outcomes.
- C. Delusions are a method of dealing with and interpreting external stimuli.
- D. Subconsciously, delusions are a way to safely express anger and hostility.
Correct Answer: A
Rationale: According to psychodynamic theory, delusions serve as a defense mechanism against anxiety triggered by real or perceived threats. Delusions are the individual's unconscious way of protecting themselves from overwhelming feelings of anxiety. Magical thinking, on the other hand, involves believing that one's thoughts can influence external events. This is not the same as delusions. Delusions are not a way of interpreting external stimuli but rather a defense mechanism. Expressing anger and hostility is typically associated with defense mechanisms like displacement or projection, not delusions.
Before inserting a peripheral intravenous (IV) catheter into a preoperative client, the nurse notes that the client's muscles are tense and the client is fidgeting with the bed sheet, stating that she does not understand why she has to have the IV. Which statement should the nurse first verbalize to the client?
- A. This will be finished before you know it.'
- B. Inserting the IV does not hurt very much.'
- C. The IV adds needed fluid into your bloodstream.'
- D. The IV catheter is an 18-gauge angiocatheter, which is small.'
Correct Answer: C
Rationale: In option 3 the nurse uses simple terms to clearly inform the client about the IV's purpose. Option 1 is an unethical statement for the nurse to make because the information is incorrect. Avoiding the client's feelings in option 2 blocks client communication regarding justifiable fears and feelings related to the IV insertion. Option 4 is an unsuitable statement because the client potentially would not understand the word 'angiocatheter.'
The nurse admits a client diagnosed with Alzheimer disease. The client is mildly anxious and very confused. Which action does the nurse take?
- A. Remain with the client and begin explaining the environment.
- B. Give the client a copy of the unit rules and procedures.
- C. Ask the client to sign a consent form for medications.
- D. Orient the client to self, day, time, place, and situation.
Correct Answer: D
Rationale: Orienting the client to self, day, time, place, and situation addresses confusion and anxiety, providing a calming and grounding effect. Explaining the environment is helpful but less structured, and rules or consent forms are inappropriate given the client’s confusion.
Which instruction should the nurse provide to a preschool-age client to prevent altered growth and development?
- A. Trust
- B. Empathy
- C. Impulse control
- D. Problem-solving
Correct Answer: C
Rationale: Teaching a preschool-age child and their parents about the importance of impulse control is essential to prevent the risk of altered growth and development. Preschool-age children are at a stage where they are developing self-regulation skills, so teaching them to manage their impulses can help in their overall growth and development. Trust is a critical concept taught during infancy to foster secure attachments. Empathy is crucial for parents of toddlers to understand their child's emotions. Problem-solving skills are typically emphasized for school-age children to enhance cognitive development.
The nurse leads group therapy for clients diagnosed with substance abuse. A client diagnosed with alcoholism, and who occasionally uses marijuana and cocaine, attends the meeting. During the meeting the client states, 'I am having trouble sitting still. Am I bothering anybody? Maybe I should not come to these meetings.' Which action by the nurse is most appropriate?
- A. Encourage the client to share problems with the group.
- B. Remove the client from the group and further assess needs.
- C. Recognize this as manipulative behavior and encourage the client to remain in the group.
- D. Tell the other group members to ignore the client and continue with the group meeting.
Correct Answer: A
Rationale: Encouraging the client to share promotes engagement and allows the group to support them, addressing their restlessness therapeutically. Removing them isolates, labeling as manipulative is judgmental, and ignoring dismisses their needs.