Nokea
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.
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The nurse is caring for an elderly female client who presents as being alert and oriented. In the late afternoon, the client becomes extremely agitated and confused. Which of the following responses by the nurse is most appropriate?
- A. call a family member to come and stay with the client
- B. call the health care provider and ask for an order for Xanax
- C. reorient the client and offer distraction and reassurance in a soft voice
- D. tell the client that if she does not cooperate, she will be placed in restraints
Correct Answer: C
Rationale: This behavior suggests sundowning, common in elderly clients. Reorientation and reassurance are appropriate non-pharmacological interventions.
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.
An English-speaking Hispanic client has a newly applied long leg cast to stabilize a right proximal fractured tibia. During rounds at night, the nurse finds the client restless, withdrawn, and unusually quiet. Which nursing statement would be most appropriate?
- A. Are you uncomfortable?
- B. Tell me what you are feeling.
- C. You'll feel better in the morning.
- D. I'll get your pain medication right away.
Correct Answer: B
Rationale: Option 2 is open-ended and makes no assumptions about the client's psychological or emotional state. Option 1 is incorrect because males in traditional standard Hispanic cultures practice 'machismo' in which stoicism is valued, so this client may deny any pain when asked. False reassurance is never therapeutic, which makes option 3 incorrect. Option 4 is incorrect because an assessment is necessary before administering medication for pain.
A client who recently had a gastrostomy feeding tube inserted refuses to participate in the plan of care, will not make eye contact, and does not speak to family or visitors. Which type of coping mechanism should the nurse assess the client is using?
- A. Denial
- B. Distancing
- C. Regression
- D. Suppression
Correct Answer: B
Rationale: Distancing is an unwillingness or inability to discuss events. The behaviors described are not associated with any of the other options.
A primigravida client who came to the clinic has been diagnosed with a urinary tract infection. She repeatedly verbalizes concern regarding the safety of the fetus. Which should the nurse address first?
- A. Maternal and infant safety
- B. Obtaining a sedative prescription
- C. Instructions regarding improved hygiene
- D. Instructions regarding medication compliance
Correct Answer: A
Rationale: The primary concern of this client is the safety of her fetus rather than herself. The priority for the nurse to address at this time is the issues regarding safety. The remaining options lack this priority.