NUR 2890 Exam 1 PDF

1.​ A client is receiving acupuncture as a complementary treatment for alcoholism. An expected outcome would be that the client will a.​ Experience fewer symptoms of anxiety b.​ Practice skills that promote well-being c.​ Verbalize knowledge of how to cope with relapse....

1.​ A client is receiving acupuncture as a complementary treatment for alcoholism. An expected outcome would be that the client will a.​ Experience fewer symptoms of anxiety b.​ Practice skills that promote well-being c.​ Verbalize knowledge of how to cope with relapse. d.​ State he has decreased desire for alcohol 2.​ What is Guided Imagery? a.​ Focuses on cure rather than prevention b.​ A form of therapy that involves listening to music to improve mental well-being. c.​ A technique where patients visualize their body fighting off an illness to enhance their immune response. d.​ A method that uses structured breathing exercises to reduce stress and anxiety 3.​ What is Walking Meditation? a.​ A practice using foot pressure point and rapid breathing to reduce stress b.​ A method where individuals walk at a fast pace to increase heart rate and cardiovascular fitness c.​ A technique where participants listen to calming music while walking briskly to reduce stress d.​ A practice that combines slow, mindful walking with deep breathing to promote relaxation and mindfulness 4.​ Trust may develop in the nurse/client relationship when the nurse: a.​ uses consistency in approaching the client b.​ encourages the client to use "testing" behaviors c.​ tells the client how he should behave d.​ avoids limit setting 5.​ 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? a.​ Arrange for a cot for her at the bedside and arrange to have food brought to her. b.​ Call the primary care provider to come and try to persuade her to take physical care of hersett. c.​ Explain that she will be of more help to her husband if she is rested and well d.​ Tell the wife that it is safe to leave her husband for an hour or two because he won't die that soon. 6.​ 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? a.​ Termination phase b.​ Orientation phase c.​ Intimate look phase d.​ Determination phase 7.​ In the provision of care and the establishment of the therapeutic relationship, the nurse must first: a.​ avoid labeling clients b.​ perform a comprehensive review of systems c.​ be aware of one's own personality/self-talk d.​ understand the client's response 8.​ 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: a.​ "You have a great surgeon. You have nothing to worry about." b.​ “Sounds as if your surgery is a pretty scary procedure." c.​ "You shouldn't be nervous. We perform this procedure every day." d.​ "The thought of having surgery is keeping you awake?” 9.​ 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? Ans: 1.5 10.​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? a.​ She must have had diabetes prior to surgery b.​ The blood sugars are probably a result of the "fight-or-flight" reaction c.​ She has become a diabetic from the abdominal surgery d.​ It is a result of antidiuretic hormone 11.​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: a.​ Decreased energy b.​ sleep deprivation  c.​ immunosuppression with stress d.​ exposure to streptococcus 12.​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? a.​ “Adults draw on coping skills learned throughout life.” b.​ “Family members can be supportive during stress." c.​ “Stress may be positive or negative." d.​ “As one grows older, their stress decreases." 13.​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? a.​ Identity which situations produce the most pronounced stress reactions b.​ Let other people know you are burned out so they can help you c.​ Stop working at stress-related tasks for 6 weeks d.​ Change jobs or tasks within the job 14.​When working with clients regarding stress and stressors, which of the following statements should you keep in mind? a.​ All people experience stress b.​ All stress is harmful c.​ Stress is not present in some cultures d.​ Stress is never an asset 15.​Which defense mechanism describes a return to bed-wetting behavior in an older sibling when another child is born? a.​ Identification b.​ Rationalization c.​ Regression d.​ Repression 16.​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? a.​ Remain with the client b.​ Place the client in a secluded, quiet room c.​ Assist the client with deep breathing and rapid walking d.​ Encourage the client to talk about the accident 17.​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: a.​ assist the client in chamong ts sexual valves b.​ examine her own feelings and anxieties in regard to her client  c.​ review the literature pertaining to the human response d.​ attempt to identify underlying reasons for the client's values 18.​When working with clients of a particular culture, which action should a nurse avoid? a.​ Supporting the client in participating in cultural and spiritual rituals b.​ Assuming that all individuals who share a culture or ethnic group are similar c.​ Using an interpreter to clarify communication d.​ Maintaining eye contact based on cultural norms 19.​Which of the following is true about a therapeutic relationship? a.​ it's directed towards helping an individual both physically and emotionally b.​ It is maintained even after the client doesn't need any more of the nurse's help c.​ It is based on friendship and mutual trust d.​ Goals are set solely by the nurse 20.​Clients reactions of intense hostility or dependence toward the nurse are common forms of: a.​ emotional catharsis b.​ Counter-resistance c.​ Counter-transference d.​ Transference 21. The nurse should introduce information about the end of the nurse-patient relationship: O as the goals of the relationship are reached O during the orientation phase O when the patient is able to tolerate it O at least one or two sessions before the last meeting 22. 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? O Social skills O Nonverbal communication O A cultural barrier O A message filter 23. 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? Inform the client that refusing treatment is a client's right. O Inform the client that refusing treatment is a client’s right O Try to locate a shaman that will agree to come to the ED. O Ask the client to explain what the shaman can do that the physician cannot. O Explain to the client that "voodoo" medicine will not heal the ulcerated toe. 24. 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? O He is at no particular risk because the death of parents is an expected event in one's life O He is at low risk because the task of young adulthood is to develop independence from the family of origin O He is at moderate risk O He is at high risk because he was dependent on his mother, demonstrated ambivalence toward her and has a limited support system 25. Which of the following is a physiological response experienced during the exhaustion stage of general adaptation syndrome? O Increased mental alertness O The initiation of neuroendocrine activity O Meditative Alpha state O Decreased immune response 26. 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: O Countertransference O Seductive behavior O Empathic resonance O Transference 27. 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: O Giving up financial responsibility for hospital and medical care. O Using a variety of defense mechanisms to reduce anxiety associated with hospitalization O Giving up independent functioning to assume a dependent role. O Coordinating various aspects of medical and nursing care. 28. 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 O Noncompliance. O Ineffective breathing pattern. O Spiritual distress. O Anxiety. 29. 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 O Dying clients anger must be reduced to promote a peaceful environment O Anger at impending loss may be directed at health care providers O Vital signs should be deferred as they are not necessary for hospice clients O Changing to a different nurse may diffuse the situation 30. 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: O Organic changes in Ms. Peter's brain O A normal response to grief and loss O A flaw in Ms. Peter's personality O Denial of the reality of a poor prognosis 31. 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. Ste tets 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: O Point out the positive aspects of the client's situation O Discuss the importance of physical exercise O Assess for depression and suicide risk O Inquire about her social support system 32. Which client would the nurse assess as having ineffective coping skills? O Mr. D., who has an adult-onset diabetes mellitus and actively seeks information about management of his illness O Mr. C., who is HIV positive and expresses guilt about his sexual behavior and thinks often about the hopelessness of his situation O Ms. B. who has multiple sclerosis and keeps herself busy and maintains positive emotional ties with family and friends O Ms. A. who has breast cancer and joins a breast cancer support group **33. 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? O Teaching the client to use instruments that give feedback about bodily functions O Provide the client with a blank journal and guidance about journaling O Teaching the client to recognize, reconsider, and reframe irrational thoughts O Encouraging the client to imagine being in calming circumstances 34. The nurse planning to teach a client how to use Benson's relaxation techniques to treat hypertension is essentially teaching the client to: O replace stress-producing thoughts and activities with daily stress-reducing thoughts and activities O alter the internal state by modifying electronic signals related to physiological processes O switch from the sympathetic mode of the autonomic nervous system to the parasympathetic mode to alter neurotransmission receptor sites. O reduce catecholamine production and promote the production of additional adrenaline for improved focus and attention 35. As a Hipanic client nears death, the spouse begins to weep and call out loudly at the bedside, the nurse responds by: O explaining the importance of a peaceful death to the spouse O ask another relative to help control the spouse’s reaction. O quietly sitting with the spouse O leading the spouse away to grieve in another room. 36. 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 O urinary retention O a client load too heavy to provide thorough care O the acceptance phase of grieving for the client O unresolved issues preventing a therapeutic relationship 37. Poplars most universal contribution to the practice of mental health nursing is the Mentification of O levels of anxiety O the analysis of behavior using a developmental framework O the identified human responses molded by environment O the development of ego defense mechanisms 38. Medication Calculation: 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? O 2 tablets O 1 tablet O 1.5 tablets O 6 tablets 39. 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? O 0.5 (half) tablet O 2 tablets O 4 tablets O 1.5 tablets 40. 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. Ans: 0.5