Exam One Flashcards
(88 cards)
A single, pregnant teenager in a parenting class discloses her ambivalence towards the pregnancy and the subsequent guilt that these thoughts generate. A mother of three shares that she has felt that way herself. Which of Yalom’s therapeutic factors does this illustrate?
Universality
A client has a nursing diagnosis of Insomnia related to paranoid thinking as evidenced by middle of the night awakening, delays in falling asleep, and daytime napping. Which is a correctly written and appropriate outcome for this client?
The client will sleep 7 uninterrupted hours by day 4 of hospitalization
A nurse would identify which of the following as most characteristic of accurately developed client outcomes?
Client outcomes are realistically based on client capability
Which of the following conditions promote a therapeutic community? (Select all that apply)
Unit responsibilities are assigned according to client capabilities
A democratic form of gov exists
A client diagnosed with schizophrenia functions well and is bright, spontaneous, and interactive during hospitalization but then decompensates after discharge. Which does the milieu provide that may be missing in the home environment?
Structured programming
During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating?
Democratic
The nurse has just met a new client and is beginning to get to know the client. Which would be the priority nursing action during this phase of the nurse-client relationship?
Establish rapport and develop tx goals
A nursing instructor is teaching about case management. What student statement indicates that learning has occurred?
“Case management provides coordination of services required to meet client needs.”
A client exhibiting dependent behaviors says, “Do you think I should move out of my parents’ house and get a job?” Which nursing response is most appropriate?
“Let’s discuss and explore all of your options.”
Which therapeutic communication technique is being used in the following nurse-client interaction?
Client: “My father spanked me often.”
Nurse: “Your father was a harsh disciplinarian.”
Restating
The nurse discovers a client’s suicide note that details the time, place and means to commit suicide. Which would be the priority nursing intervention and the rationale for this action?
Place the client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide
A wife brings her husband to the emergency department (ED) after he attempted suicide by hanging himself. He is a full-time student and works the night shift to support his family. During the admission assessment, he states, “I can’t function any longer under all of this stress!!” The nurse correctly identifies that the client is experiencing which type of crisis?
Psychiatric emergency crisis
A nurse deciding whether or not to place an agitated patient in seclusion or restraints would need to keep in mind that:
The goal in using either seclusion or restraints is always to maintain the safety of the patient and others
An inpatient client with a known history of violence suddenly begins to pace. Which additional client behavior would alert a nurse to escalating anger and aggression?
The client has a tense facial expression
Which nursing intervention demonstrates false imprisonment?
A patient has been irritating and attention seeking much of the day. Now a nurse escorts the patient down the hall saying, “Stay in your room or I’ll put you in the seclusion room.”
Which is an example of an intentional tort?
A nurse physically places an irritating client in four-point restraints
Which describes the rationale for holding a debriefing session with clients and staff after a take-down intervention has taken place in an inpatient unit?
Discuss the situation that led to the inappropriate expression of anger
Which of the following is most critical to assess when determining risk for suicide for a client newly admitted to an inpatient psychiatric unit?
The client’s history of suicide attempts
After disturbing the peace, an aggressive, disoriented, unkempt, homeless individual is escorted to an emergency department. The client threatens suicide. Which of the following criteria would enable this client to be considered for involuntary commitment? (Select all that apply.)
Being gravely disabled and unable to meet basic needs
Being dangerous to others
Being suicidal
After years of dialysis, an 84 y/o client states “I’m exhausted, depressed and done with these attempts to keep me alive.” Which question would the nurse ask the client’s spouse when preparing a discharge plan of care?
“how often is your spouse left alone?”
Which information should the nurse include in a staff education program about the history of psychopharmacology?
Psychotropic medications are used as adjunctive therapy.
The nurse is preparing to assess a client before the physician prescribes a regimen of psychopharmacological therapy. Which components are important for the nurse to assess when considering medications for the client? (Select all that apply)
Medical hx
Current medications
Ethnocultural characteristics
Physical examination findings
The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which laboratory result would reveal a potentially fatal side effect of this medication?
Low absolute neutrophil count (ANC)
Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse would recognize that this situation validates which study perspective?
Psychoneuroimmunology
