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The nurse counsels the spouse of a client diagnosed with generalized anxiety disorder about how to cope with the client's anxiety. Which statement, made by the spouse, indicates that teaching is successful?
- A. Anxiety is a conscious means of resolving conflict.
- B. Anxiety represents an unconscious conflict of needs.
- C. I should confront my spouse when I notice signs of anxiety.
- D. Defense mechanisms increase anxiety.
Correct Answer: B
Rationale: Recognizing anxiety as an unconscious conflict of needs demonstrates understanding of its psychological basis, indicating successful teaching. Other statements are incorrect or promote unhelpful actions like confrontation.
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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.
The nurse is assessing a client who is a polysubstance abuser, with fentanyl being one of the drugs most frequently used. Which physiological symptoms are suggestive of fentanyl intoxication? Select all that apply.
- A. diarrhea
- B. nausea
- C. urge to urinate
- D. anxiety
Correct Answer: B
Rationale: Nausea is a common symptom of fentanyl intoxication. Diarrhea, urge to urinate, and anxiety are not typical physiological signs.
A client diagnosed with chronic respiratory failure is dyspneic. The client becomes anxious, which worsens the feelings of dyspnea. The nurse teaches the client which method to best interrupt the dyspnea-anxiety-dyspnea cycle?
- A. Guided imagery and limiting fluids
- B. Relaxation and breathing techniques
- C. Biofeedback and coughing techniques
- D. Distraction and increased dietary carbohydrates
Correct Answer: B
Rationale: Relaxation and breathing techniques are effective in interrupting the dyspnea-anxiety-dyspnea cycle by calming the client and improving respiratory efficiency. These techniques help reduce anxiety, which can exacerbate dyspnea, and promote controlled breathing to enhance oxygenation. Guided imagery may be helpful but limiting fluids is unrelated to managing dyspnea or anxiety. Biofeedback and coughing techniques are not primarily indicated for this cycle. Distraction and increased dietary carbohydrates do not directly address the cycle and may not provide immediate relief.
The nurse is caring for a child who is a victim of abuse and has determined that the child uses repression to cope with past life experiences. Which activity should the nurse implement as part of the nursing care plan?
- A. Encourage the child to use therapeutic play to act out past experiences.
- B. Tell the child to let the past go and concentrate on the present and future.
- C. Place the child on medications that will help the child forget the incidents.
- D. Have the child talk about the abuse in detail during the first therapy session.
Correct Answer: A
Rationale: Therapeutic play is used to reduce the trauma of illness and hospitalizations. It is a nonthreatening avenue through which the child can use artwork, dolls, or puppets to act out frightening life experiences. Option 3 would be extremely threatening to the child and nontherapeutic. Options 2 and 4 devalue the child and force the child to further repress harmful past experiences rather than facing them and moving on.
The spouse of a client who is scheduled for the insertion of an implantable cardioverter-defibrillator (ICD) expresses anxiety about what would happen if the device discharges during physical contact. Which information is most appropriate for the nurse to provide to the spouse?
- A. Physical contact should be avoided whenever possible.
- B. The spouse would not feel or be harmed by the countershock.
- C. The shock would be felt, but it would not cause the spouse any harm.
- D. A warning device sounds before countershock, so there is time to move away.
Correct Answer: C
Rationale: Clients and families are often fearful about the activation of the ICD. Their fears are about the device itself and also about the occurrence of life-threatening dysrhythmias that trigger its function. Family members need reassurance that, even if the device activates while they are touching the client, the level of the charge is not high enough to harm the family member, although it will be felt. The ICD emits a warning beep when the client is near magnetic fields, which could possibly deactivate it, but it does not beep before countershock.