Deck 2: Pyschosocial Care

Question 1

When communicating with a paranoid client, to the most important action is to:

A)Use logic and be persistent.
B)Provide an anxiety-free environment.
C)Express doubt and not argue.
D)Encourage ventilation of anger.

Answer 1

Provide an anxiety-free environment.

Question 2

Mr. Li, a 63-year-old Chinese immigrant, is extremely agitated today. Which activity do you expect the licensed nurse will recommend?

A)Competitive sports
B)Bingo
C)Trivial Pursuit
D)Daily walks

Answer 2

Daily walks

Question 3

Mr. Arnold Robbins is placed on suicide precautions. During the care planning conference, the nursing staff discussed a care plan for Mr. Robbins. Which of the following tasks do you anticipate the licensed nurse will delegate to you?

A)Do not allow him to leave his room.
B)Remove all sharp and cutting objects.
C)Give him the opportunity to ventilate feelings.
D)Stay with him at all times.

Answer 3

Stay with him at all times.

Question 4

A client who has Alzheimer's disease is told by the nurse assistant to brush his teeth. He shouts angrily, "Tomato soup!" Which of the following actions by the nurse assistant would be correct?

A)Focusing on the emotional reaction.
B)Clarifying the meaning of the client's statement.
C)Giving him step-by-step directions.
D)Doing the procedure for him.

Question 5

The stages of grieving identified by Elizabeth Kubler-Ross are:

A)Numbness, anger, resolution, and reorganization.
B)Denial, anger, identification, depression, and acceptance.
C)Anger, loneliness, depression, and resolution.
D)Denial, anger, bargaining, depression, and acceptance.

Question 6

Situation: Judy Montgomery, an 85-year-old client with Alzheimer's disease, developed a serious complication of pneumonia with a very poor prognosis.
One night while doing your rounds, Judy asks for you to stay and talk in the middle of the night. What should you do?

A)Tell Judy that she needs to sleep.
B)Call Judy's family to stay with her.
C)Call a pastor to talk with Judy.
D)Sit on the chair next to Judy's bed and converse with her.

Question 7

Situation: Judy Montgomery, an 85-year-old client with Alzheimer's disease, developed a serious complication of pneumonia and is now attached to a respirator.
Knowing that for a comatose client, hearing is the last sense to be lost. As Judy's nurse assistant all through her stay in the hospice, what should you do?

A)Tell her family that probably she can't hear them.
B)Talk loudly so that Judy can hear you.
C)Tell her family who are in the room not to talk.
D)Speak softly then hold her hands gently.

Question 8

Ms. Julia Jacobs is diagnosed with breast cancer and is undergoing chemotherapy. She appears depressed and has verbalized concerns about impending hair loss. How should the nurse assistant deal with this?

A)Discuss hair loss as it occurs.
B)Provide reading material about chemotherapy.
C)Acknowledge that hair loss may be a difficult side effect, and explore the client's feelings about this.
D)Give the client information about head scarves, hats, or wigs.

Question 9

When the nursing assistant identifies a client who has attempted to commit suicide, the nursing assistant should:

A)Call a priest.
B)Counsel the client.
C)Report immediately to the nurse.
D)Refer the matter to the police.

Question 10

Mr. Clyde, a divorced 33-year-old former drug addict, is paralyzed from the waist down. During hospitalization, no family ties are evident; however, he reportedly has two teenage sons. How might you assist him in meeting his needs as they related to roles and relationships?

A)Have get-well cards sent anonymously.
B)Provide paper and pen for letter writing to his sons.
C)Spend time with him after work hours.
D)Leave him alone to allow for meditation.

Question 11

Stereotyping in providing care may result in:

A)Wrong assessments and inappropriate interventions.
B)More frustration on the part of the nursing assistant than the client.
C)Less frustration on the part of the nursing assistant and the client.
D)Fuller cooperation by the clients and family members.

Question 12

Clients and families have the right to receive care that is:

A)Determined necessary by the health team.
B)Culturally acceptable to them.
C)Dictated as appropriate by medical research.
D)Technologically advanced and inexpensive.

Question 13

When caring for a dying client, the nurse aide should perform which of the following activities?

A)Encourage the client to reach optimal death.
B)Assist the client to perform activities of daily living.
C)Assist client towards a peaceful death.
D)Motivate client to gain independence.

Question 14

When a terminally-ill client assumes artificial cheerfulness and refuses to believe that loss is happening, what stage of grieving is he in?

A)Bargaining
B)Acceptance
C)Denial
D)Depression

Question 15

Which of the following is an appropriate intervention for a client who is grieving over the death of her husband?

A)Advise her not to cry because it won't do her any good.
B)Encourage her to accept a new love object to replace lost person.
C)Provide the person an opportunity to "tell their story."
D)Discourage expression of difficult feelings such as anger and sadness.

Question 16

As you assist a Hispanic client during her meal time, which food selections do you expect to be incorporated into a diet that would represent culturally sensitive care?

A)Beans and tortillas.
B)Cheese and olive oils.
C)Vegetables and rice.
D)Red meat and potatoes.

Question 17

Which of the following actions would least likely be effective when dealing with a client with aggressive behavior?

A)Approach in calm, direct manner.
B)Provide opportunities to express feelings.
C)Maintain eye contact with the client.
D)Isolate the client from other clients.

Question 18

Lanie, a nursing assistant student, is studying for an examination on caring for clients with mental health disorders. She should know that defense mechanisms are used to:

A)Blame others.
B)Make excuses for behavior.
C)Return to an earlier time.
D)Block unpleasant feelings.

Question 19

A client in the day room is having a panic attack. The nursing assistant should:

A)Tell the client to take deep breaths.
B)Have the client talk about the panic attack.
C)Encourage the client to verbalize feelings.
D)Ask the client about the cause of the panic attack.

Question 20

As a nurse attendant enters the client's room, the client says, "Bugs are crawling on my sheets! Get them off my bed!" Which of the following responses is the most appropriate?

A)"Don't worry, I'll stay here and brush away the bugs for you."
B)"Try to relax. The crawling sensation will go away sooner if you can relax."
C)"There are no bugs on your sheets. It's just your imagination playing tricks on you."
D)"I know you're frightened. I don't see bugs crawling on your sheets, but I'll stay with you."

Question 21

Which of the following may indicate that a client is experiencing an illusion?

A)The client tries to hit the nurse aide when vital signs must be taken.
B)The client says, "I keep hearing a voice telling me to run away."
C)The client becomes anxious whenever the nurse aide leaves the bedside.
D)The client looks at the shadows on a wall and tells the nurse aide she sees frightening faces on the wall.

Question 22

Which of the following actions will be most effective in improving transcultural communications with cancer clients and their families?

A)Use touch to show concern and caring for the client.
B)Focus attention on verbal communication skills only.
C)Establish a rapport and listen to their concerns.
D)Maintain eye contact at all times.

Question 23

The nurse aide takes a confused client to the bathroom every night at 9:00 PM prior to helping him to bed for the night. This is an example of:

A)Bladder and bowel training.
B)Encouraging client participation.
C)Establishing a consistent routine.
D)Providing orientation cues.

Question 24

Barbara Stanford, an 82-year-old writer, has Alzheimer's disease. Which of the following actions is an important part of providing care to Mrs. Stanford?

A)Avoid physical contact.
B)Apply wrist and ankle restraints.
C)Provide a high level of sensory stimulation.
D)Monitor the client carefully.

Question 25

Which of the following actions would help a client diagnosed with Alzheimer's disease perform activities of daily living?

A)Have the client perform all basic care without help.
B)Tell the client morning care must be done by 9 AM.
C)Give the client a written list of activities he's expected to do.
D)Encourage the client, and give ample time to complete basic tasks.

Question 26

The nurse assistant observes that a client with amnesia looksfine but responds to questions in a vague, distant manner. What should the nurse assistant do?

A)Give the client lots of space to test his/her independence.
B)Keep the client busy, and make sure he/she doesn't take naps during the day.
C)Use short, simple sentences whenever the client needs direction.
D)Spend as much time with the client as possible and ask questions about his/her recent life.

Question 27

During the end-of-shift report, the nurse informed the nurse assistant that a client of Jewish faith requested for a strict kosher diet, and arrangements have been made in the dietary department. At lunchtime, which of the following meal trays would be appropriate for the nurse assistant to serve said client?

A)Pork roast, rice, vegetables, mixed fruit, milk
B)Crab salad on a croissant, vegetables with dip, potato salad, milk
C)Sweet and sour chicken with rice and vegetables, mixed fruit, juice
D)Fettuccini Alfredo with shrimp and vegetables, salad, mixed fruit, iced tea

Question 28

A client with cancer tells the nurse assistant, "I am taking advantage of every treatment available for my disease, even herbal remedies, so I can be around until a cure is discovered." This statement indicates which stage of Kubler-Ross's Stages of Dying?

A)Acceptance
B)Anger
C)Bargaining
D)Denial

Question 29

The nurse assistant is caring for a client with delirium when the client says, "Look at the spiders on the wall."What should the nurse assistant say to the client?

A)"You're having hallucinations. There are no spiders in this room at all."
B)"I can see the spiders on the wall, but they are not going to hurt you."
C)"Would you like me to kill the spiders?"
D)"I know you are frightened, but I do not see spiders on the wall."

Question 30

A terminally ill client's husband tells the nurse assistant, "I wish we had taken that vacation to Europe last year. We just kept puttingoff, and now I'm furious that we didn't go." The nurse assistant interprets the husband's statement as indicating which of the following stages of adaptation to dying?

A)Anger
B)Denial
C)Bargaining
D)Depression

Question 31

Postmortem care is carried out by the licensed nurse, and the nurse aide may be asked to assist. What is the main purpose of postmortem care?

A)To maintain good appearance of the body.
B)To identify any other reasons for the cause of death.
C)To prepare the body for autopsy.
D)To promote drainage of any remaining body secretions.

Question 32

Ms. Rush is a nursing center resident. She needs assistance with walking. She tells you that she needs to go to the chapel for her confession and to hear mass. You should:

A)Assist her in going to the chapel.
B)Tell her family about her request.
C)Tell her she can go if she can find a way to go there.
D)Ask the nurse what to do.

Question 33

The nurse assistant's most importanttool in working with the emotionally ill client is his/her:

A)Theoretical knowledge.
B)Personality make up.
C)Emotional reactions.
D)Communication skills.

Question 34

Silence has various meanings in different cultures. The nurse assistant should be aware that among Asians, silence is:

A)A sign of agreement between parties.
B)A sign of respect.
C)Used for privacy.
D)Telling somebody that he/she is not welcome.