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A client is receiving acupuncture as a complementary treatment for alcoholism. An expected outcome would be that the client will:

  • Verbalize knowledge of how to cope with relapse
  • Practice skills that promote well-being
  • State he has decreased desire for alcohol (correct)
  • Experience fewer symptoms of anxiety

What is Guided Imagery?

  • A technique where patients visualize their body fighting off an illness to enhance their immune response. (correct)
  • Focuses on cure rather than prevention
  • A method that uses structured breathing exercises to reduce stress and anxiety
  • A form of therapy that involves listening to music to improve mental well-being.

What is Walking Meditation?

  • A practice that combines slow, mindful walking with deep breathing to promote relaxation and mindfulness (correct)
  • A method where individuals walk at a fast pace to increase heart rate and cardiovascular fitness
  • A technique where participants listen to calming music while walking briskly to reduce stress
  • A practice using foot pressure point and rapid breathing to reduce stress

Trust may develop in the nurse/client relationship when the nurse:

<p>uses consistency in approaching the client (B)</p> Signup and view all the answers

A patient has been in hospice and in the terminal phase of dying for approximately 10 days. His wife has remained by his side, leaving only for brief periods, and now appears pale and exhausted. The nurse, noticing that the wife has not eaten much, suggests she take a break to eat and rest. The wife declines, expressing. "I don't want to leave him. I won't have him much longer, and I don't want him to go when I'm gone." What is the most appropriate nursing intervention in this scenario?

<p>Arrange for a cot for her at the bedside and arrange to have food brought to her. (D)</p> Signup and view all the answers

A nurse enters the client's room and introduces himself. The nurse states "I will be your registered nurse today. I will be providing your nursing care and I will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on." What phase of Peplau's Interpersonal relationship has occurred?

<p>Orientation phase (B)</p> Signup and view all the answers

In the provision of care and the establishment of the therapeutic relationship, the nurse must first:

<p>be aware of one's own personality/self-talk (D)</p> Signup and view all the answers

When the preoperative client tells the nurse that he cannot sleep because he keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is:

<p>&quot;The thought of having surgery is keeping you awake?&quot; (C)</p> Signup and view all the answers

Medication Calculation: A client with a diagnosis of panic disorder is prescribed Sertraline (Zoloft) 75 milligrams by mouth daily. Sertraline (Zoloft) 50 milligram tablets are received from the pharmacy. How many tablets will the registered nurse administer in 24 hours?

<p>1.5</p> Signup and view all the answers

You are the nurse caring for a 72-year-old female who is recovering from abdominal surgery on the Medical Surgical unit. The surgery was very stressful and prolonged, and you note on the chart that her blood sugars are elevated yet she is not diagnosed with diabetes. To what do you attribute this elevation in blood sugars?

<p>The blood sugars are probably a result of the &quot;fight-or-flight&quot; reaction (D)</p> Signup and view all the answers

A young woman who has just started college is 6 weeks into the semester and has several tests and assignments due in approximately 3 days. She has developed a sore throat and fever. The development of illness is related to:

<p>immunosuppression with stress (C)</p> Signup and view all the answers

Which of the following statements, made by a senior citizen who has taken a class on stress reduction, would indicate to the nurse the need for further instruction?

<p>“As one grows older, their stress decreases.&quot; (C)</p> Signup and view all the answers

The nurse is suffering from job burnout and has taken the first step of learning to recognize stress and personal reactions. Which of the following should the nurse do next?

<p>Identity which situations produce the most pronounced stress reactions (B)</p> Signup and view all the answers

When working with clients regarding stress and stressors, which of the following statements should you keep in mind?

<p>All people experience stress (C)</p> Signup and view all the answers

Which defense mechanism describes a return to bed-wetting behavior in an older sibling when another child is born?

<p>Regression (B)</p> Signup and view all the answers

A client comes to the emergency department after a car accident in a severe state of anxiety. What is the most appropriate nursing intervention at this time?

<p>Remain with the client (C)</p> Signup and view all the answers

The nurse is assigned to be the primary nurse of a client who has a history of bisexuality and whose sexual values are quite different from their own. The nurse's most appropriate initial action during the pre-interaction phase of the relationship should be to:

<p>examine her own feelings and anxieties in regard to her client (B)</p> Signup and view all the answers

When working with clients of a particular culture, which action should a nurse avoid?

<p>Assuming that all individuals who share a culture or ethnic group are similar (D)</p> Signup and view all the answers

Which of the following is true about a therapeutic relationship?

<p>it's directed towards helping an individual both physically and emotionally (D)</p> Signup and view all the answers

Clients reactions of intense hostility or dependence toward the nurse are common forms of:

<p>Transference (D)</p> Signup and view all the answers

The nurse should introduce information about the end of the nurse-patient relationship:

<p>when the patient is able to tolerate it (C)</p> Signup and view all the answers

A depressed client is unable to maintain eye contact with the nurse. The client's chin drops, and the client looks at the floor. Which aspect of communication has the nurse assessed?

<p>Nonverbal communication (B)</p> Signup and view all the answers

A Native American client is admitted to an emergency department (ED) with an ulcerated toe secondary to uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a shaman is present. Which nursing intervention is most appropriate?

<p>Try to locate a shaman that will agree to come to the ED. (B)</p> Signup and view all the answers

A 34 year old single male client has very few close friends and relatives. He was very dependent on his mother before her death, although he often complained about her intrusiveness. What statement best describes his risk for problems in resolving his grief?

<p>He is at high risk because he was dependent on his mother, demonstrated ambivalence toward her and has a limited support system (D)</p> Signup and view all the answers

Which of the following is a physiological response experienced during the exhaustion stage of general adaptation syndrome?

<p>Decreased immune response (D)</p> Signup and view all the answers

A supervisor observes inconsistency in a psychiatric and mental health nurse's behavior toward a client as unreasonably concerned, overly kind, or irrationally hostile. The best explanation is that the nurse is displaying:

<p>Countertransference (A)</p> Signup and view all the answers

A client has had a total knee replacement and will need assistance for several weeks after discharge. She tells the nurse caring for her"I do not intend to assume the 'sick role." The nurse knows the client is objecting to:

<p>Giving up independent functioning to assume a dependent role. (C)</p> Signup and view all the answers

A client hospitalized after a myocardial infarction is restlessly moving about in bed. The client's pulse, blood pressure, and respiratory rate are elevated. In a shaky voice, the client tells the nurse "I think I am going to die. The pain is gone, but it could come back anytime. Where is the doctor? Why isn't the doctor here with me?" The nurse should analyze this behavior as suggesting the nursing diagnosis of

<p>Anxiety (D)</p> Signup and view all the answers

When attempting to take the blood pressure of a client newly admitted to a nospite program, the client pushes the stethoscope away, loudly stating that nothing the nurse can do will help anyway, and asks the nurse to leave. The nurses response should be based on the knowledge that

<p>Anger at impending loss may be directed at health care providers (B)</p> Signup and view all the answers

A client has been receiving hemodialysis for 3 months. During the history assessment the client reports that they find themselves feeling angry whenever it is time for the dialysis treatment. The nurse can probably attribute this to:

<p>A normal response to grief and loss (B)</p> Signup and view all the answers

A client who has been diagnosed with polymyalgia rheumatica has muscle pain and weakness and has curtailed physical and social activities to accommodate her condition. She tells the nurse. I cannot do anything. I have to depend on other people to help me. I do not enjoy much of anything anymore; even food does not taste good, I cannot see that my situation will change, so I feel pretty hopeless." The priority action the nurse should take is to:

<p>Assess for depression and suicide risk (C)</p> Signup and view all the answers

Which client would the nurse assess as having ineffective coping skills?

<p>Mr. C. who is HIV positive and expresses guilt about his sexual behavior and thinks often about the hopelessness of his situation (B)</p> Signup and view all the answers

A client tells the nurse. "My doctor thinks my problems with stress relates to the negative way I think about things, and he wants me to learn a new way of thinking." Which response would be in keeping with the doctor's recommendations?

<p>Teaching the client to recognize, reconsider, and reframe irrational thoughts (C)</p> Signup and view all the answers

The nurse planning to teach a client how to use Benson's relaxation techniques to treat hypertension is essentially teaching the client to:

<p>switch from the sympathetic mode of the autonomic nervous system to the parasympathetic mode to alter neurotransmission receptor sites. (C)</p> Signup and view all the answers

As a Hispanic client nears death, the spouse begins to weep and call out loudly at the bedside, the nurse responds by:

<p>quietly sitting with the spouse (C)</p> Signup and view all the answers

A nurse assigned to a client with a terminal illness appears increasingly reluctant to spend time with the client, rushing through routine assessments and speaking to the client in short, quick sentences. The nursing & supervisor suspects that the nurse is experiencing

<p>unresolved issues preventing a therapeutic relationship (D)</p> Signup and view all the answers

Poplars most universal contribution to the practice of mental health nursing is the Mentification of

<p>levels of anxiety (A)</p> Signup and view all the answers

The nurse practitioner prescribers: Trazodone 150 milligrams by mouth at bedtime for insomnia. Trazodone 25 milligrams is available. How many tablets would you administer at bedtime?

<p>6 tablets (D)</p> Signup and view all the answers

The nurse Practitioner orders: Sertraline (zoloft) 150 milligram by mouth once a day. Sertraline (zoloft) 100 milligram tablets are available. How many tablets would you administer today?

<p>1.5 tablets (D)</p> Signup and view all the answers

A client is prescribed Remeron (Mirtazapine) 7.5 milligrams by mouth at bedtime. Remeron (Mirtazapine) 15 milligram tablets are available. How many tablets do you administer to the client by mouth at bedtime.

<p>0.5</p> Signup and view all the answers

Flashcards

Acupuncture for Alcoholism: Expected Outcomes

Reduced anxiety symptoms, decreased alcohol cravings, and improved coping skills.

Guided Imagery

A mind-body technique where patients visualize positive images to promote relaxation and healing.

Walking Meditation

A mindfulness practice combining slow, deliberate steps with focused breathing.

Building Trust in Nurse-Client Relationship

Consistency allows the client predict the nurse's responses to a specific event, fostering a safe relationship.

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Supporting a Grieving Spouse

Provide a cot and meals at the bedside while acknowledging the wife's feelings.

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Peplau's Orientation Phase

The initial stage where the nurse introduces themselves and clarifies the purpose and parameters of the relationship.

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Self-Awareness in Therapeutic Relationship

Nurses must reflect on their own personalities and self-talk to provide unbiased care.

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Reflecting Patient's Concerns

Reflecting the patient's feelings back to them demonstrates attentiveness and encourages open dialogue.

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Stress-Induced Hyperglycemia

Elevated blood sugar can be a physiological response to a stressful event, even without a diagnosis of diabetes.

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Stress and Immune Suppression

Stress weakens the immune system, making individuals more susceptible to illness.

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Misconceptions About Stress and Aging

The statement suggesting that stress decreases with age indicates a need for further instruction.

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Next Step after Recognizing Job Burnout

First identify stressors and reactions, then seek solutions.

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Universality of Stress

Stress is a universal human experience.

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Regression

The return to earlier patterns of behavior when faced with stress.

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Immediate Intervention for Severe Anxiety

The client's immediate safety is prioritized by staying with them, until they are calmer and safer.

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Pre-Interaction Phase: Addressing Personal Values

Examine the nurse's own feelings and biases about sexuality before interacting with the client.

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Avoiding Assumptions in Cross-Cultural Care

Assuming uniformity within a cultural group disregards individual differences. The nurse must allow the client to be an individual and not make broad assumptions.

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Therapeutic Relationship Focus

Focuses on promoting the client's well-being, not the nurse's. It has clear goals.

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Transference

These intense reactions are often unconscious redirections of feelings from past experiences.

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Discussing Termination Phase

The end of the therapeutic relationship should be discussed early, during the orientation phase.

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Depressed client, with little eye contact

The nurse has assessed nonverbal communication

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Native American client requesting a shaman

Try to locate a shaman to assist with treatment.

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Single male dependent on his mother and few friends

He is at high risk because he was dependent on his mother, demonstrated ambivalence toward her and has a limited support system

Signup and view all the flashcards

Physiological Response experienced during Exhaustion Stage of General Adaptation Syndrome

Decreased immune response

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Inconsistency in a psychiatric and mental health nurses behavior toward a client

Best explanation is that the nurse is displaying countertransference

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Client's objection to sick role

Giving up independent functioning to assume a dependent role.

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Total Knee Replacement - Fearful Client.

Suggesting the nursing diagnosis of anxiety.

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Client getting angry upon getting hospice

Anger at impending loss may be directed at health care providers

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A client gets angry before having dialysis done. What can the nurse attribute this to?

A normal response to grief and loss

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Hopeless Client

Assess for depression and suicide risk

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Study Notes

  • Acupuncture is a complementary alcoholism treatment.
  • An expected outcome is the client stating a decreased desire for alcohol.

Guided Imagery

  • A technique where patients visualize their body fighting off an illness to enhance their immune response.

Walking Meditation

  • Walking meditation is a practice that combines slow, mindful walking with deep breathing to promote relaxation and mindfulness.

Trust in Nurse-Client Relationship

  • Trust develops when the nurse uses consistency in approaching the client.

Hospice Care

  • The most appropriate nursing intervention is arranging for a cot at the bedside and food for the wife.

Nurse Introduction Example

  • A nurse introduces themself, stating, "I will be your registered nurse today. I will be providing your nursing care and I will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on."
  • This is the Orientation phase of Peplau's Interpersonal relationship.

Therapeutic Relationship

  • In a therapeutic relationship, the nurse must first be aware of their own personality/self-talk.

Addressing Patient Concerns

  • The statement "The thought of having surgery is keeping you awake?" is an appropriate reflection when the preoperative client says they cannot sleep because they keep thinking about the surgery.

Sertraline Dosage Calculation

  • For a prescription of Sertraline (Zoloft) 75 mg daily with 50 mg tablets available, administer 1.5 tablets.

Elevated Blood Sugars Post-Surgery

  • Elevated blood sugars post-surgery in a non-diabetic patient can likely be attributed to the "fight-or-flight" reaction.

Illness and Stress

  • The development of illness in a young woman 6 weeks into college with several tests and assignments due in 3 days is related to immunosuppression with stress.

Stress Reduction Class

  • The statement "As one grows older, their stress decreases" indicates the need for further instruction.

Job Burnout Recovery

  • Identify the situations which produce the most pronounced stress reactions

Stress and Stressors

  • All people experience stress.

Defense Mechanisms

  • Regression is a return to bed-wetting behavior in an older sibling when another child is born.

Emergency Department Arrival

  • A client in a severe state of anxiety after a car accident requires the nurse to remain with the client.

Nurse-Client Interactions

  • A nurse assigned to a client with a history of bisexuality should examine her own feelings and anxieties in regard to her client during the pre-interaction phase.

Cultural Sensitivity

  • Avoid assuming that all individuals who share a culture or ethnic group are similar.

Therapeutic Relationships

  • Therapeutic relationships are directed towards helping an individual both physically and emotionally.

Intense Reactions Toward Nurse

  • Client reactions of intense hostility or dependence toward the nurse are common forms of transference.

Ending Nurse-Patient Relationship

  • The nurse should introduce information about the end of the nurse-patient relationship during the orientation phase.

Communication Assessment Clues

  • A depressed client unable to maintain eye contact is an example of nonverbal communication being assessed.

Cultural Considerations

  • The most appropriate nursing intervention is to try to locate a shaman that will agree to come to the ED.

Grief Risk Factors

  • The death of a client's mother is considered high risk because he was dependent on his mother, demonstrated ambivalence toward her, and has a limited support system.

Exhaustion Stage

  • A physiological response experienced during the exhaustion stage of general adaptation syndrome is decreased immune response.

Mental Health Assessment

  • The best explanation is that the nurse is displaying countertransference

Sick Role Assessment

  • Giving up independent functioning to assume a dependent role.

Anxiety Symptoms

  • Anxiety, symptoms include a client hospitalized after a myocardial infarction restlessly moving about in bed, with elevated pulse, blood pressure, and respiratory rate, and in a shaky voice states "I think I am going to die. The pain is gone, but it could come back anytime. Where is the doctor? Why isn't the doctor here with me?"

Dying Client Assessment

  • Anger at impending loss may be directed at health care providers

Hemodialysis

  • Receiving hemodialysis for 3 months and feeling angry is a normal response to grief and loss

Polmyalgia Rheumatica

  • Assess for depression and suicide risk

Ineffective Coping

  • A HIV positive client expresses guilt about sexual behavior and thinks about the hopelessness of his situation

Changing Thinking Styles

  • Teaching the client to recognize, reconsider, and reframe irrational thoughts

Benson's Relaxation Techniques

  • Switching from the sympathetic mode of the autonomic nervous system to the parasympathetic mode to alter neurotransmission receptor sites.

Hispanic Client Death

  • Quietly sitting with the spouse.

Terminal Illness

  • Unresolved issues preventing a therapeutic relationship

Mental Health Nursing

  • Identification of levels of anxiety

Trazodone Dosage Calculation

  • The order is Trazodone 150 milligrams and the supply is Trazodone 25 milligrams. Six tablets would be administered at bedtime.

Sertraline (Zoloft) Tablet Calculation

  • If Sertraline (zoloft) 150 milligram and with Sertraline (zoloft) 100 milligram tablets available, administer 1.5 tablets

Remeron (Mirtazapine Tablet Calculation

  • A client is prescribed Remeron (Mirtazapine) 7.5 milligrams and Remeron (Mirtazapine) 15 milligram tablets are available. Administer 0.5 tablets.

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