Exam 1 NR 326/192 Questions and
Answers
1. Three years ago, Anna's dog, Lucky, her pet for 16 years, was killed by a
car. Since that time, Anna has lost weight, rarely leaves her home, and talks
excessively about Lucky. Anna's behavior would be considered maladaptive
for which of the following reasons?
a. It has been more than 3 years since Lucky died.
b. Her grief is too intense over the loss of a dog.
c. Her grief is interfering with her functioning.
d. Cultural norms typically do not comprehend grief over the loss of a pet. - -
c. Her grief is interfering with her functioning.
-Anna states that Lucky was her closest friend, and since his death, no one
can ever replace the relationship they had. According to Maslow's hierarchy
of needs, which level of need is not being met?
a. Physiological needs
b. Self-esteem needs
c. Safety and security needs
d. Love and belonging needs - -d. Love and belonging needs
-Anna's daughter notices that Anna appears to be listening to another voice
when just the two of them are in a room together. When questioned, Anna
admits that she hears someone telling her that she was a horrible caretaker
for Lucky and did not deserve to ever have a pet. Which of the following best
describes what Anna is experiencing?
a. Neurosis
b. Psychosis
c. Depression
d. Bereavement - -b. Psychosis
-Anna, who is 72 years old, is at the age when she may have experienced
several losses in a short time. What is this called?
a. Bereavement overload
b. Normal mourning
c. Isolation
d. Cultural relativity - -a. Bereavement overload
-Anna has been grieving the death of Lucky for 3 years. She is unable to
take care of her normal activities because she insists on visiting Lucky's
grave daily. What is the most likely reason that Anna's daughter has put off
seeking help for Anna?
Women are less likely than men to seek help for emotional problems.
,b. Relatives often try to normalize behavior rather than label it mental
illness.
c. She knows that all older people are expected to be a little depressed.
d. She is afraid that the neighbors will think her mother is "crazy." - -b.
Relatives often try to normalize behavior rather than label it mental illness.
-6. Lucky's accident occurred when he got away from Anna while they were
taking a walk. He ran into the street and was hit by a car. Anna cannot
remember the circumstances of his death. This is an example of what
defense mechanism?
a. Rationalization
b. Suppression
c. Denial
d. Repression - -d. Repression
-A client with a history of schizophrenia is brought to the emergency
department by police who report that she was knocking down food displays
at a grocery store and yelling that the food is all poisoned. The client reports
to the nurse the she has no idea why she was brought to the emergency
department because "there is nothing wrong with me." Which of these
actions by the nurse demonstrates good clinical judgment?
a. Instruct the police officer that this client should be incarcerated because
there is nothing that can be done in an emergency department.
b. Document that the client is manifesting suspicious ideation and
anosognosia.
c. Ask the doctor to order gastric lavage because the client reports having
been poisoned.
d. Instruct the client that the food is not poisoned and there is something
very wrong with her. - -b. Document that the client is manifesting suspicious
ideation and anosognosia.
-8. During a primary care physician appointment, a client who has been a
widow for 7 years reports to the nurse that she does not want to wake up in
the morning and feels there is nothing left for her. Which of these actions by
the nurse is a priority?
a. Listen empathically and encourage the client to find some activities to
increase socialization.
b. Encourage the client to discuss this with her physician.
c. Assess the client for symptoms of depression and suicide risk.
d. Instruct the client that grief takes a long time to resolve but that she will
be feeling better soon. - -c. Assess the client for symptoms of depression
and suicide risk.
-A client who has arrived at the health clinic for diabetic education is
perspiring, wringing his hands, and states, "I'm so anxious about giving
,myself shots I can hardly breathe. I don't know what to do." Which of these
actions by the nurse demonstrates good clinical judgment?
a. Assist the client in relaxation exercises before commencing diabetes
education.
b. Instruct the client that it is not hard to give oneself a shot and commence
teaching.
c. Assess the client further for symptoms of anxiety.
d. Cancel diabetic education and encourage the client to reschedule when he
feels less anxious. - -a. Assist the client in relaxation exercises before
commencing diabetes education.
-10. A client who was admitted to the psychiatric unit for major depressive
disorder reports to the nurse, "Ever since my daughter died by suicide 10
years ago, I can't stand to be around my friends. They just don't get it!"
Which of these actions by the nurse demonstrates good clinical judgment?
a. Affirm that other people cannot possibly provide adequate support in
circumstances like these.
b. Assist the client to explore the connection between grief and anger.
c. Tell the client that her friends are doing the best they can and she should
try to accept their support.
d. Ask the client to describe how her daughter killed herself. - -b. Assist the
client to explore the connection between grief and anger.
-The nurse decides to go against family wishes and tell the client of his
terminal status because that is what she would want if she were the client.
Which of the following ethical theories is considered in this decision?
a. Kantianism
b. Christian ethics
c. Natural law theories
d. Ethical egoism - -b. Christian ethics
-The nurse decides to respect family wishes and not tell the client of his
terminal status because that would bring the most happiness to the most
people. Which of the following ethical theories is considered in this decision?
a. Utilitarianism
b. Kantianism
c. Christian ethics
d. Ethical egoism - -a. Utilitarianism
-The nurse decides to tell the client of his terminal status because she
believes it is her duty to do so. Which of the following ethical theories is
considered in this decision?
a. Natural law theories
b. Ethical egoism
c. Kantianism
d. Utilitarianism - -c. Kantianism
, -The nurse assists the physician with electroconvulsive therapy on a client
who has refused to give consent. With which of the following legal actions
might the nurse be charged because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality - -b. Battery
-A competent, voluntary client has stated he wants to leave the hospital.
The nurse hides his clothes to keep him from leaving. With which of the
following legal actions might the nurse be charged because of this nursing
action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality - -c. False imprisonment
-Joe is very restless and is pacing the room. The nurse says to Joe, "If you
don't sit down in the chair and be still, I'm going to put you in restraints!"
With which of the following legal actions might the nurse be charged
because of this nursing action?
a. Defamation of character
b. Battery
c. Breach of confidentiality
d. Assault - -d. Assault
-A nurse reports to the supervisor that a depressed client is refusing
medication to treat his heart condition and states he "would rather just die."
The nurse is not sure how to intervene because, although clients have a right
to refuse medication, this client may be so depressed that his behavior
represents risk for suicide. Which of these actions by the supervisor is a
priority?
a. Tell the nurse that medication will have to be given forcibly if the client
continues to refuse medication.
b. Instruct the nurse that, because the client is elderly, he is unable to make
this decision and medication will need to be secretly mixed in his food.
c. Educate the nurse that the physician has the final say so the nurse should
ask the physician what to do.
d. Activate appropriate hospital resources, such as an ethics committee, so
this issue can be explored further. - -d. Activate appropriate hospital
resources, such as an ethics committee, so this issue can be explored
further.
-A client on the psychiatric unit begins yelling out loud that no one is
listening to him and that he is going to "blow up" soon. The orderly asks the
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