1.
Situation: A widow age 28. whose husband died one (1) year ago due to AIDS. has just been told that she has AIDS. Panky says to the nurse. “Why me? How could God do this to me?” This reaction is one of:
Correct Answer
C. Anger
Explanation
Anger is experienced as reality sets in. This may either be directed to God. the deceased or displaced on others.Option A: Depression is a painful stage where the individual mourns for what was lost.Option B: Denial is the first stage of the grieving process evidenced by the statement “No. it can’t be true.” The individual does not acknowledge that the loss has occurred to protect self from the psychological pain of the loss.Option D: In bargaining the individual holds out hope for additional alternatives to forestall the loss. evidenced by the statement “If only…”
2.
The nurse’s therapeutic response is:
Correct Answer
D. ”It must really be frustrating for you. How can I best help you?”
Explanation
This response reflects the pain due to loss. A helping relationship can be forged by showing empathy and concern.Option A: This is not therapeutic since it passes the buck or responsibility to the clergy.Option B: This response is not therapeutic because it gives the client the impression that she is right which prevents the client from reconsidering her thoughts.Option C: This statement passes judgment on the client.
3.
One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you thinking about?” This communication technique is:
Correct Answer
D. Giving broad opening
Explanation
Broad opening technique allows the client to take the initiative in introducing the topic.Options A. B. and C are all therapeutic techniques but these are not exemplified by the nurse’s statement.
4.
The client says to the nurse “Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:
Correct Answer
B. Suicidal ideation
Explanation
The client’s statement is a verbal cue of suicidal ideation. not anxiety. While suicide is common among clients with major depression. this occurs when their depression starts to lift. Hopelessness indicates no alternatives available and may lead to suicide. the statement and nonverbal cue of the client indicate suicide.
5.
Which of the following interventions should be prioritized in the care of the suicidal client?
Correct Answer
A. Remove all potentially harmful items from the client’s room.
Explanation
Accessibility of the means of suicide increases the lethality. Allowing patient to express feelings and setting a no-suicide contract are interventions for a suicidal client but blocking the means of suicide is a priority.Option C: Increasing self-esteem is an intervention for depressed clients bur not specifically for suicide.
6.
Situation: A 14-year-old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as a nurse. The client has which of the following developmental focus:
Correct Answer
A. Establishing a relationship with the opposite sex and career planning.
Explanation
The client belongs to the adolescent stage. The adolescent establishes his sense of identity by making decisions regarding familial. occupational and social roles. The adolescent emancipates himself from the family and decides what career to pursue. what set of friends to have and what value system to uphold.Option B: This refers to the middle adulthood stage concerned with transmitting his values to the next generation to ensure his immortality through the perpetuation of his culture.Option C: This reflects school age which is concerned with the pursuit of knowledge and skills to deal with the environment both in the present and in the future.Option D: The stage of young adulthood is concerned with the development of an intimate relationship with the opposite sex. the establishment of a safe and congenial family environment and building of one’s lifework.
7.
The personality type of Ryan is:
Correct Answer
B. Dependent
Explanation
A client with dependent personality is predisposed to develop asthma.Option A: The conforming non-assertive client is predisposed to develop hypertension because of the tendency to repress rage.Option C: The perfectionist and compulsive tend to develop a migraine.Option D: The masochistic. self-sacrificing type are prone to develop rheumatoid arthritis.
8.
The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu?
Correct Answer
C. A living. learning or working environment.
Explanation
A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. The six environmental elements include structure. safety. norms. limit setting. balance and unit modification.Option A: Behavioral approach in psychiatric care is based on the premise that behavior can be learned or unlearned through the use of reward and punishment.Option B: Cognitive approach to change behavior is done by correcting distorted perceptions and irrational beliefs to correct maladaptive behaviors.Option D: This is not congruent with the therapeutic milieu.
9.
Included as a priority of care for the client will be:
Correct Answer
C. Place in semi-fowlers position and render O2 inhalation as ordered
Explanation
Since psychophysiological disorder has an organic basis. priority intervention is directed towards disease-specific management. Failure to address the medical condition of the client may be a life threat.Options A and B. The client has a physical symptom that is adversely affected by psychological factors. Verbalization of feelings in a non-threatening environment and involvement in relaxing activities are an adaptive way of dealing with stressors. However. these are not the priority.Option D: Helping the client connect the physical symptoms with the emotional problems can be done when the client is ready.
10.
The client is concerned about his coming discharge. manifested by being unusually sad. Which is the most therapeutic approach by the nurse?
Correct Answer
C. “You seem to have concerns about going home.”
Explanation
This statement reflects how the client feels. Showing empathy can encourage the client to talk which is important as an alternative more adaptive way of coping with stressors.Option A: Giving false reassurance is not therapeutic.Option B: While this technique explores plans after discharge. it does not focus on the expression of feelings.Option D: This close-ended question does not encourage verbalization of feelings.