Question 42
NUR 140 Behavioral Health. What characteristic is needed by the nurse to begin a therapeutic nurse-patient relationship?
- Sound knowledge of psychiatric nursing
- Self-awareness and understanding
- Acceptance of others
- Sincere desire to help others
Question 43
The nursing student is experiencing a severe personal crisis. What potential negative effect can this situation have on a student’s performance in a psychiatric rotation.
- The student might fear patients and avoid them.
- The student might doubt his/her value to assist patients because of lack of knowledge.
- The student might overidentify with patients and meet his/her own needs.
- The student might feel inadequate and fear emotionally harming patients.
Question 44
A patient remarks to the nurse, “The family therapist mentioned that our family is enmeshed. Can you tell me what that means?” What is the nurse’s best reply?
- “Enmeshment refers to the tendency of your family to try to maintain balance. When the balance tips, you take measures to restore the balance.”
- “It means that your communication patterns often give double messages. Your body language doesn’t match the meaning of what you say.”
- “Enmeshment refers to blaming the weakest family member for all of the troubles of the family.”
- “It means that your family members don’t have a strong sense of their own individual selves.”
Question 45
An adult client is scheduled for a hysterectomy and states to the nurse, “I don’t know why I’m so upset about it, it’s not like I am going to have more children.” Which is the most therapeutic response by the nurse?
- “Your feelings are valid. Let’s talk about your feelings about having the surgery and what bothers you most.”
- “You’ll do fine during your surgery because you have one of the best surgeons performing the procedure.”
- “If you think about it logically, it really is just like getting your appendix taken out.”
- “I had a hysterectomy when I was about your age and felt so much better after it.”
Question 46
A nurse is teaching a couple how to use positive reinforcement techniques with their child. What should be included in this teaching?
- Restrict privileges to encourage desired behaviors
- Reward desired behaviors to promote their recurrence
- Role model desired behaviors for their child
- Remove adverse consequences to produce desired results
Question 47
Hans Seyle has termed the body’s general reaction to stress as the general adaptation syndrome or GAS response. Which systems play a major role during this GAS response?
- Excretory system
- Parasympathetic nervous system
- Integumentary system
- Sympathetic nervous system
Question 48
A nurse manager overhears a nurse telling a patient, “I know how you feel. My husband can be really insensitive, too. I’m thinking of divorce.” What is the manager’s analysis of the nurse’s comments?
- Probably having a counter-transference reaction
- Encouraging the patient to express negative feelings
- Inappropriately using self-disclosure
- Using empathy to establish trust with the patient
Question 49
A man is admitted into the psychiatric emergency department after walking around the neighborhood without wearing shoes in the snow. He appears confused and disoriented. Which intervention is the most immediate nursing action? NUR 140 Behavioral Health.
- Arrange a transfer to a skilled nursing facility
- Assess and stabilize the patient’s psychological needs
- Arrange a transfer to the nearest medical facility
- Assess and stabilize the patient’s medical needs
Question 50
The nurse has identified that a patient and the patient’s spouse have an inability to relate to each other and share feelings, ideas, and experiences. There is an underlying mistrust of each other. Which theory of personality development would be most beneficial in addressing these issues?
- Behavioral theory
- Moral development theory
- Interpersonal theory
- Cognitive theory
Question 94
The nurse is planning care for a client admitted with Myasthenia Gravis. Which intervention should the nurse include in the plan of care?
- Keep the head of bed elevated during and after meals.
- Provide the client with thin liquids frequently and with meals.
- Provide the client with high-calorie meals three times a day.
- Encourage client to chew food 40 times before swallowing.
Question 95
The nurse is caring for a client with HIV and the client states, “I’m feeling nervous today.” Which response by the nurse is appropriate?
- “You have no reason to feel nervous today.”
- “Please explain what you mean by nervous.”
- “Why are you saying that you feel nervous?”
- “Would a back rub make you feel better?”
Question 96
The nurse is educating a client with acquired immunodeficiency syndrome (AIDS) on nutritional methods of maintaining weight. Which client statement indicates a need for further instruction?
- “I will consume more nutrient-dense foods and beverages.”
- “I will keep easy-to-prepare foods available in the home.”
- “I will eat small and frequent meals throughout the day.”
- “I will be sure to eat low-calorie snacks between meals.”
Question 97
The nurse is caring for a client and suspects the client is experiencing an anaphylactic reaction. What is the nurse’s priority action?
- Place the client on a cardiac monitor and observe for arrhythmia.
- Ask the client about previous reaction to various types of allergens.
- Apply oxygen using a high-flow non rebreather mask at 90-100%.
- Insert a large bore IV and begin infusion of normal saline.
Question 99
The nurse is admitting a client for possible systemic lupus erythematosus (SLE). What assessment findings does the nurse correlate with this diagnosis?
- High red blood cell count
- Petechiae on the abdomen
- Joint deformities of hands
- Abnormal hair loss on scalp
Question 100
A client with systemic lupus erythematosus (SLE) is admitted to the nursing unit. Which assessment findings indicate the client may be experiencing lupus nephritis?
- Peripheral edema, hematuria and low urine output
- Erythema, rash and inflammation of skin
- Fever, fatigue and swollen lymph nodes
- Anorexia, weight loss and generalized weakness NUR 140 Behavioral Health.
