NUR 213 - Exam 3 2023/ 63 Questions
and Answers / 100% Correct.
A moderately depressed client who was hospitalized 2 days ago
suddenly begins smiling and reporting that the crisis is over. The
client says to the nurse, "I'm finally cured." How should the nurse
interpret this behavior as a cue to modify the treatment plan?
1.
Suggesting a reduction of medication
2.
Allowing increased "in-room" activities
3.
Increasing the level of suicide precautions
4.
Allowing the client off-unit privileges as needed - -3
(pt who is moderately depressed and has only been in the
hospital 2 days is unlikely to have such a dramatic cure. When a
depression suddenly lifts, it is likely that the client may have
made the decision to harm himself or herself. Suicide precautions
are necessary to keep the client safe)
-The emergency department nurse is caring for an adult client
who is a victim of family violence. Which priority instruction
should be included in the discharge instructions?
1.
Information regarding shelters
2.
Instructions regarding calling the police
3.
Instructions regarding self-defense classes
, 4.
Explaining the importance of leaving the violent situation - -1
-A female victim of a sexual assault is being seen in the crisis
center. The client states that she still feels "as though the rape
just happened yesterday," even though it has been a few months
since the incident. Which is the most appropriate nursing
response?
1.
"You need to try to be realistic. The rape did not just occur."
2.
"It will take some time to get over these feelings about your
rape."
3.
"Tell me more about the incident that causes you to feel like the
rape just occurred."
4.
"What do you think that you can do to alleviate some of your
fears about being raped again?" - -3
(trash response irl though)
-A client is admitted to the mental health unit after an attempted
suicide by hanging. The nurse can best ensure client safety by
which action?
1.
Requesting that a peer remain with the client at all times
2.
Removing the client's clothing and placing the client in a hospital
gown
3.
,Assigning to the client a staff member who will remain with the
client at all times
4.
Admitting the client to a seclusion room where all potentially
dangerous articles are removed - -3
-Which behavior observed by the nurse indicates a suspicion that
a depressed adolescent client may be suicidal?
1.
The adolescent gives away a DVD and a cherished autographed
picture of a performer.
2.
The adolescent runs out of the therapy group, swearing at the
group leader, and to her room.
3.
The adolescent becomes angry while speaking on the telephone
and slams down the receiver.
4.
The adolescent gets angry with her roommate when the
roommate borrows the client's clothes without asking. - -1
-A depressed client on an inpatient unit says to the nurse, "My
family would be better off without me." Which is the nurse's best
response?
1.
"Have you talked to your family about this?"
2.
"Everyone feels this way when they are depressed."
3.
"You will feel better once your medication begins to work."
, 4.
"You sound very upset. Are you thinking of hurting yourself?" - -4
-A client is admitted with a recent history of severe anxiety
following a home invasion and robbery. During the initial
assessment interview, which statement by the client should
indicate to the nurse the possible diagnosis of posttraumatic
stress disorder? Select all that apply.
1.
"I'm afraid of spiders."
2.
"I keep reliving the robbery."
3.
"I see his face everywhere I go."
4.
"I don't want anything to eat now."
5.
"I might have died over a few dollars in my pocket."
6.
"I have to wash my hands over and over again many times." - -2
35
(Reliving an event, experiencing emotional numbness (facing
possible death), and having flashbacks of the event (seeing the
same face everywhere) are all common occurrences with
posttraumatic stress disorder. The statement "I'm afraid of
spiders" relates more to having a phobia. The statement "I have
to wash my hands over and over again many times" describes
ritual compulsive behaviors to decrease anxiety for someone with
obsessive-compulsive disorder. Stating "I don't want anything to
eat now" is vague and could relate to numerous conditions)
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