Nokea
When planning intervention for a client during a crisis, which of the following outcomes is most appropriate?
- A. The client should explore deep psychological problems.
- B. The client should express positive feelings about event.
- C. The client should identify needs that are threatened by the event.
- D. The client should use constructive coping mechanisms.
Correct Answer: D
Rationale: The primary goal of crisis intervention is to relieve the symptoms of anxiety and foster constructive coping. Previous psychological issues might recur during crisis, but the focus is on short-term resolution of the current problem. At the end, the nurse credits a client for positive changes and helps him or her understand what was learned. This allows the client to use the learned coping mechanisms when new problems arise.
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A 64 year-old Alzheimer's patient has exhibited excessive cognitive decline resulting in harmful behaviors. The physician orders restraints to be placed on the patient. Which of the following is the appropriate procedure?
- A. Secure the restraints to the bed rails on all extremities.
- B. Notify the physician that restraints have been placed properly.
- C. Communicate with the patient and family the need for restraints.
- D. Position the head of the bed at a 45 degree angle.
Correct Answer: C
Rationale: Both the family and the patient should have the need for restraints explained to them.
A nurse observes a client sitting alone and talking. When asked, the client reports that he is 'talking to the voices.' The nurse's next action should be:
- A. touching the client to help him return to reality.
- B. leaving the client alone until reality returns.
- C. asking the client to describe what is happening.
- D. telling the client there are no voices.
Correct Answer: C
Rationale: Nurses might observe behavioral cues that can indicate the presence of hallucinations. Talking about the hallucinations is reassuring and validating to the client who has them. Focusing on the symptoms and asking about the hallucinations helps the client gain control.
The highest incident of child abuse occurs in children in which age group?
- A. birth-3 years old
- B. 4-6 years old
- C. 6-10 years old
- D. more than 10 years old
Correct Answer: A
Rationale: Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000 children). Girls are slightly more likely to be victims than boys.
In the United States, several definitions of death are currently being used. The definition that uses apnea testing and pupillary responses to light is termed:
- A. whole brain death.
- B. heart-lung death.
- C. circulatory death.
- D. higher brain death.
Correct Answer: A
Rationale: Most protocols require two separate clinical examinations, including induction of painful stimuli, papillary responses to light, oculovestibular testing, and apnea testing. Heart-lung and higher brain death have no specific test required. Circulatory death is not a current definition of death in the United States.
A man reports his wife is constantly cleaning. The activity has interfered with the family life. Friends have stopped visiting because she makes them uncomfortable. He states he has awakened in the middle of the night and found her cleaning. The nurse should consult with the couple and recommend the husband help with therapy by:
- A. telling his wife to stop cleaning whenever he notices her actions
- B. making a baseline record of the time the wife spends cleaning
- C. decreasing the stimuli in the home
- D. helping his wife with the cleaning
Correct Answer: C
Rationale: Reducing environmental stimuli can decrease anxiety driving obsessive-compulsive cleaning, supporting therapy without confronting or enabling the behavior.