Nokea
The nurse evaluates the client response to a 2-week trial of electroconvulsive therapy (ECT). Which data indicates to the nurse that treatment is successful?
- A. The client no longer experiences phobias and anxiety.
- B. The client no longer counts objects out loud.
- C. The client is no longer mute and withdrawn.
- D. The client no longer displays overreaction to events.
Correct Answer: C
Rationale: ECT is primarily used for severe depression or catatonia. A client no longer being mute and withdrawn indicates improved engagement and mood, suggesting successful treatment. Other options are less directly associated with ECT outcomes.
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A client who is quadriplegic frequently makes lewd sexual suggestions and uses profanity. The nurse concludes that the client is inappropriately using displacement. Which concern should the nurse identify as being appropriate for this client?
- A. Disuse syndrome
- B. Lack of coping skills
- C. Negative body image
- D. Lack of awareness of surroundings
Correct Answer: B
Rationale: Lack of coping skills is evident when the client demonstrates an impaired ability to adapt to meeting life's demands and roles. This client is displacing feelings onto the environment instead of using them in a constructive fashion. Option 3 may be appropriate, but it has nothing to do with the displacement that the client is currently using. Options 1 and 4 have no relation to this situation.
The family of a client diagnosed with a myocardial infarction complicated by cardiogenic shock is visibly anxious and upset about the client's condition. Which should the nurse plan to implement to provide support to the family?
- A. Offer them coffee and other beverages on a regular basis.
- B. Insist that they go home to sleep at night to keep up their own strength.
- C. Ask the hospital chaplain to sit with them until the client's condition stabilizes.
- D. Provide flexible visiting times according to the client's condition and family needs.
Correct Answer: D
Rationale: The use of flexible visiting hours meets the needs of both the client and family for reducing the anxiety levels of both. Offering the family beverages does not provide support. Insisting that the family go home is nontherapeutic. Although the chaplain may provide support, it is unrealistic for the chaplain to stay until the client stabilizes.
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.
A new mother is trying to decide whether to have her baby boy circumcised. The nurse should make which statement to assist the mother with making the decision?
- A. Discuss the procedure with the male members of your family.'
- B. Circumcision is a difficult decision, but your primary health care provider is the best, and it's better to get it done now than later.'
- C. You know they say it prevents cancer and sexually transmitted infections, so I would definitely have my son circumcised.'
- D. Circumcision is a difficult decision. Here, read this pamphlet that discusses the pros and cons, and we will talk about any questions that you have after you read it.'
Correct Answer: D
Rationale: Informed decision making is the strategic point when answering this question. The nurse should provide educational materials and answer questions pertaining to the education of the mother. Providing written information to the mother will give her the information she needs to make an educated and informed decision. The nurse's personal thoughts and feelings should not be part of the educational process. The remaining options are not well focused on answering the mother's concerns.
While providing care to a 12-year-old client, the nurse observes small round burn scars on the client's arms and legs, bruising on the buttocks, and tenderness of the right jaw. The client is anxious, has poor eye contact, and denies being injured at home when the nurse asks questions. Based on these observations, the nurse suspects victimization. Which is the next priority question the nurse should therapeutically ask the client in providing a safe environment for the client?
- A. Are you sure your parents didn't do this?
- B. You need to tell me now, or I'll call security, who did this to you?
- C. Is someone bullying you at school, or at home, or in your neighborhood?
- D. I can see this is difficult for you to talk about, you are safe here, but I need to ask you, who hurt you like this?
Correct Answer: D
Rationale: Based on the nurse's assessment data, the suspect of victimization needs to be analyzed to determine how the client received the old and new injuries. Option 4 offers the therapeutic approach for obtaining information using an open-ended question. It is important to determine if the injuries resulted from a family member or someone else outside the home. There are many forms of abuse besides physical abuse to consider such as sexual, emotional, and psychological abuse. Identifying the victimizer is important to stop the abuse and avoid further injuries. Safety is a priority concern for the client while in the care of the nurse and then after discharge from care. Option 1 implies that the nurse is challenging if the client is telling the truth. Option 2 could be perceived as demanding and a threat to the client to answer the question. Option 3 focuses on outside the family but there is not enough information given in the question to determine whether a family member is not suspected.