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Hesi, fundandamental and mother chailed
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Hesi, fundandamental and mother chailedA nurse on the psychiatric unit of the hospital has been assigned four
clients for the shift. The assignment includes an 84-year-old client who
is severely depressed, a 73-year-old client who is being discharged, a
53-year-old client who was admitted for lithium toxicity, and a 48-
year- old client who has panic attacks. Which client should the nurse
evaluate first after receiving report?
1
84-year-old client
2
73-year-old client
Correct3
53-year-old client
4
48-year-old client
The 53-year-old client should be evaluated first because of the severity of
adaptations associated with lithium toxicity. A severely depressed client has
a low energy level and is not at the greatest risk at this time. A client who is
stable enough to be discharged does not need immediate attention. Clients
with panic attacks usually seek immediate attention when it is needed.
A young female client admitted to the trauma center after being
sexually assaulted continues to talk about the rape. Toward what goal
should the primary nursing intervention be directed?
1
Getting her involved with a rape therapy group
2
Remaining available and supportive to limit destructive anger
3
Exploring her feelings about men to promote future relationships
Correct4
Providing a safe environment that permits the ventilation of feelings
The client needs to be able to express her current feelings. Providing an
environment in which she feels safe will encourage this expression of
feelings. It is too soon after the assault to discuss this topic in a group.
Although the nurse should be available and supportive, feelings of anger
are
,Hesi, fundandamental and mother chailed
usually not the initial response. It is too soon after the assault to discuss her
feelings about men and future relationships.
A client is dying. Hesitatingly, his wife says to the nurse, "I'd like to tell
him how much I love him, but I don't want to upset him." Which is the
best response by the nurse?
1
"You must keep up a strong appearance for him."
2
"I think he'd have difficulty dealing with that now."
3
"Don't you think he knows that without your telling him?"
Correct4
"Why don't you share your feelings with him while you can?"
It is difficult to work through a loss; however, encouraging the sharing of
feelings helps both parties to feel better about having to let go. The response
"You must keep up a strong appearance for him" impedes the work of
acceptance of one's finality and the use of the remaining time to the best
advantage. There is no evidence to suggest that the client cannot cope with
these emotions; the response "I think he'd have difficulty dealing with that
now" denies that this is a time for closeness and honesty. The response
"Don't you think he knows that without your telling him?" is demeaning,
closes off communication, and does not foster the expression of feelings.
A nonviolent client on the psychiatric unit suddenly refuses to take the
prescribed antipsychotic medication. What should the nurse do?
Correct1
Honor the client's decision and document the behavior and all interventions
2
Use an authoritarian approach to induce the client to take the prescribed
medication
3
Call the health care provider and request that the client be discharged
against medical advice
4
,Hesi, fundandamental and mother chailed
Start proceedings to have the client declared incompetent and seek a court order permitting m
A client has the right to refuse treatment and should not be forcibly
medicated unless the client is deemed dangerous to him- or herself or
others. An authoritarian approach is not therapeutic and may compromise
the nurse-client relationship. Calling the health care provider is premature;
first the nurse should attempt therapeutic interventions to meet the client's
needs. Starting proceedings to have the client declared incompetent is
appropriate for a client who is considered to be dangerous to him- or herself
or others, or incompetent to evaluate necessary treatment.
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Which psychotherapeutic theory uses hypnosis, dream interpretation,
and free association as methods to release repressed feelings?
1
Behaviorist model
Correct2
Psychoanalytical model
3
Psychobiological model
4
Social-interpersonal model
The psychoanalytical model studies the unconscious and uses the strategies
of hypnosis, dream interpretation, and free association to encourage the
release of repressed feelings. The behaviorist model holds that the self and
mental symptoms are learned behaviors that persist because they are
consciously rewarding to the individual; this model deals with behaviors on a
conscious level of awareness. The psychobiological model views emotional
and behavioral disturbances as stemming from a physical disease; abnormal
behavior is directly attributed to a disease process. This model deals with
behaviors on a conscious level of awareness. The social-interpersonal model
affirms that crucial social processes are involved in the development and
, Hesi, fundandamental and mother chailed
resolution of disturbed behavior; this model deals with behavior on a
conscious level of awareness.
A depressed client has been taking Paroxetine (Paxil) 20
mg by mouth once a day for 4 weeks. The practitioner
concludes that there is no clinical improvement in the
client's condition and increases the daily dose to 30 mg.
The medication is supplied in an oral suspension of 10
mg/5 mL. How many milliliters of Paxil solution should
the nurse instruct the client to take? Record your
answer using a whole number. mL
Solve the problem with the use of ratio and proportion: Desired 30 mg :: x mL
Have 10 mg 5 mL
10 x = 30 x 5
x = 150 ÷ 10
x = 15 mL
Test-Taking Tip: Do not fret over any one question for too long. If you are having trouble, skip th
A parent of a 13-year-old adolescent with recently diagnosed Hodgkin
disease tells a nurse, "I don't want her to know about the diagnosis."
How should the nurse respond?
1
"It's best for your child to know the diagnosis."
2
"Did you know that the cure rate for Hodgkin disease is high?"
3
"Would you like someone with Hodgkin disease to talk with you?"
Correct4
"Let's talk about how you're feeling about your child's diagnosis."
Initiating a conversation about the client's feelings does not prejudge the
parent; it encourages communication. Stating that it is best for the child to
know the diagnosis disregards the parent's feelings and cuts off further
communication. Asking the client about the cure rate may stop
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