Deck 2: Partnership

Question 1

You have medicated your patient for complaints of pain. You tell your patient you will return in 15 minutes to check on them. When you do return in the 15 minutes, what aspect of a therapeutic relationship are you reinforcing?

A)Empathy
B)Trust
C)Closure
D)Sympathy

Answer 1

Trust

Question 2

Natalia, an 18-year-old college student, is in her first trimester. She calls a nurse working at a clinic and reports increased vaginal discharge that is thin and colorless in appearance. The most appropriate INITIAL response of the nurse is:

A)"You need immediate medical care. Go to the nearest emergency department."
B)"It can be distressing. Wear panty-liners and change them frequently."
C)"That type of vaginal discharge is expected during the first trimester."
D)"That is a normal occurrence. If profuse, use tampons and change them frequently."

Answer 2

"That type of vaginal discharge is expected during the first trimester."

Question 3

Lauren, a G1P0 at 37 weeks' gestation, calls the clinic and tells the nurse that her baby has been moving a lot less for the past two days. Which of the following responses made by the nurse is the most appropriate in this situation?

A)"Increase your intake of foods that are high in sugar content."
B)"Lie down on your side, and record how long it takes you to feel 10 distinct fetal movements."
C)"See your physician as soon as you can. An ultrasound is necessary."
D)"You may take a very hot bath to stimulate fetal movement."

Answer 3

"Lie down on your side, and record how long it takes you to feel 10 distinct fetal movements."

Question 4

A client is rushed to the emergency department due to left-sided substernal chest pain, which was unresolved by sublingual nitroglycerin. Acute myocardial infarction is suspected. The client tells the nurse, "I am scared. Am I dying?" Which of the following responses made by the nurse is the most therapeutic?

A)"Be calm. You will be fine once the physician comes in."
B)"I'm assuring you that we are doing everything we can to make it all better."
C)"Acute myocardial infarction is a life-threatening condition, but we have saved many clients with the same condition."
D)"Tell me how you feel right now."

Question 5

A nurse meets with the family members of a client with Alzheimer's disease. The nurse and the family agree that effective communication is essential when caring for the client. The nurse encourages the family members to adhere to which of the following strategies when communicating with the client?

A)Ask one question at a time
B)Speak in a loud voice
C)If the client has difficulty understanding, repeat words that were used the first time
D)None of the above

Question 6

A nurse is assigned to care for Meizhen, an immigrant from China. The client is a traditional Chinese woman. When communicating with the client, the nurse keeps in mind that the client is more likely to demonstrate the following EXCEPT:

A)The client may not verbally express criticism.
B)The client may nod her head, but it does not necessarily mean agreement.
C)The client may consider eye contact inappropriate.
D)The client values silence.

Question 7

A nurse is caring for a 21-year-old female who has a phobic disorder. Which of the following is the most effective nursing intervention when caring for the client?

A)Encourage the client to identify the source of anxiety.
B)Help the client develop problem-solving strategies.
C)Encourage use of effective relaxation techniques.
D)Encourage the client to keep a journal.

Question 8

Marsha, a registered nurse, is caring for Mrs. Mitchell, who is diagnosed with post-traumatic stress disorder. Mr. Mitchell approaches the nurse in private and tells her that he does not believe that his wife has the disorder. Which of the following is the best action of Marsha?

A)Assess for signs of domestic abuse.
B)Provide the husband with information about post-traumatic stress disorder.
C)Teach the couple about problem solving.
D)Discuss the husband's thoughts about the diagnosis.

Question 9

A nurse is assigned to care for a female client who practices Hinduism. The nurse is aware that the religion prohibits its members to consume certain types of foods. The nurse informs the dietician that the clientshould not be served which of the following food items?

A)Pork
B)Alcohol
C)Veal
D)Coffee

Question 10

A nurse is caring for Maxine, a 21-year-old female with mania. Which of the following communication techniques is the most effective when talking to a manic client?

A)Allow the client to introduce and talk about different topics.
B)Use humor.
C)Ask the client with open-ended questions.
D)Focus and redirect conversation if necessary.

Question 11

A male Orthodox Jew is admitted to the unit for a scheduled surgery. The nurse notes that the client adheres to kosher dietary laws. Which of the following food items is not appropriately offered to the client?

A)Fish that have scales
B)Milk and a piece of apple
C)Kosher goat meat, kosher with vegetable side dish.
D)Milkshake and kosher goat meat

Question 12

Bessie, a practicing Jehovah's Witness, has been told that a surgery is needed. The nurse caring for the client is aware of the client's religious preferences. Based on Bessie's religion, the nurse appropriately documents which of the following?

A)The client is prohibited from having any type of surgery.
B)The client cannot receive blood and blood products.
C)The client is prohibited from taking synthetic drugs.
D)The client can donate her organs.

Question 13

Betty, a 52-year-old female who divorced her husband a year ago, is brought to the hospital. The client's adult daughter reports that her mother has refused to get out of bed, eat, or bathe for three days. Betty is diagnosed with major depression on admission. Which of the following questions asked by the admitting nurse is the most appropriate?

A)"Why weren't you eating and bathing? You can trust me."
B)"What can I do to help you out?"
C)"How do you feel about your life after the divorce?"
D)"What has been bothering you? Tell me."

Question 14

Thomas, a 35-year-old stay-at-home dad, is diagnosed with major depression. On assessment, the nurse notes new cutting marks and old scars on his arms and wrists. The nurse suspects that Thomas is suicidal. Which of the following strategies is most appropriate to use with Thomas?

A)Talk to the client's spouse to verify whether or not the client is suicidal.
B)Ask the client if he ever thought about killing himself.
C)Initiate suicidal precautions.
D)Inform the client that the cuts and wounds suggest that he is suicidal.

Question 15

White, a 55-year-old sales agent, has been drinking 7 to 10 cans of beer per day for the past five years. The client says alcohol helps him function at work. Mr. White says, "I'm sure I can cut down on my drinking. Drinking socially won't be a problem." Which of the following responses made by the nurse is the most appropriate?

A)"How many cans of beer does a social drinker consume per day?"
B)"Has alcohol caused any major problems in your life?"
C)"What can you do to become a social drinker?"
D)"Why do you abuse alcohol just to function at work?"

Question 16

A father brings his seven-month-old baby boy to a well-baby clinic for a routine examination. During the assessment, which of the following questions should the nurse ask the father to obtain the most important information about the child's growth and development?

A)"Can he transfer an object from one hand to another?"
B)"Can he sit up unsupported?"
C)"Has he started cruising along the furniture?"
D)"Does he make babbling or cooing sounds?"

Question 17

Emily is a 75-year-old female who is diagnosed with a terminal disease. One afternoon, the client says, "If I can only live to see my granddaughter born, I would be OK." The nurse recognizes that the client demonstrates:

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

Question 18

A 25-year-old female was admitted to a facility for the treatment of substance abuse. The admission was ordered by the court after the client attempted to harm her daughter and planned a (second) suicide attempt. A central part of the treatment program is to complete a series of group meetings. On the fifth day of the treatment, the client tells the nurse, "You cannot make me go to this group thing today. I am not going. I am getting out of here." Which of the following is the most appropriate response made by the nurse?

A)"I understand, but I would like to inform you that you may choose not to attend 10% of treatment activities without any consequences."
B)"You are required to stay in the facility; however, you have the right to informed consent in regard to group treatment participation."
C)"You have the right to leave the facility any time you want; however, you need to sign a form stating that you are leaving the facility against medical advice."
D)"You are required by law to attend the meetings. You need to attend the meeting as scheduled."

Question 19

Brad, a male client, was admitted to the nursing unit. During the admission, he was diagnosed with human immunodeficiency virus or HIV. A physician has just ordered the client for discharge. The nurse emphasizes which of the following home instructions to the client as the topmost priority at this stage of the disease?

A)Compliance with prescribed medications
B)Compliance with nutritional recommendations
C)Compliance with safe sex
D)Compliance with follow-up visits

Question 20

Mary Lou is an 85-year-old female client who is brought to the emergency department due to a fractured clavicle. On physical assessment, the nurse notes bruises in varying coloration on the upper arms, thorax, and upper legs. The client informs the nurse that her daughter hits her every time she fails to quiet down her granddaughter. Which of the following is the most appropriate response of the nurse?

A)"This is not right. As your advocate, I need to talk to your daughter about this."
B)"Let me discuss with you how you can quiet down your granddaughter."
C)"Violence at home is a legal issue. I have to report this, but I am assuring you that the information will be kept confidential."
D)"Why is your daughter doing this to you? Tell me. You are safe here."

Question 21

Carla is a 13-year-old girl who has just been diagnosed with diabetes mellitus type 1. Before discharge, the nurse conducts a teaching session that mainly focuses on blood sugarcontrol. As a nurse educator, the nurse makes use of which of the following methods of instruction when teaching Carla about diabetes care?

A)Interactive computer software that discusses diabetes mellitus type 1 management
B)A book that discusses diabetes care; the book is written by a celebrity with diabetes type 1
C)Group discussion that focuses on diabetes management; the group consists of teen-agers with diabetes type 1
D)A pamphlet that contains steps and tips on how to manage diabetes mellitus type 2

Question 22

A nurse is working with Marieta, a Hispanic immigrant who speaks little English. Marieta is referred to thenurse to discuss reproductive health. Which of the following interventions by the nurse is the least therapeutic when working with the client?

A)Provide education materials written in Spanish.
B)Provide a language interpreter.
C)Include a Hispanic member of the health care team in the teaching session.
D)Use conversational pacing during the teaching session.

Question 23

Which specific communication technique should a nurse utilize when caring for a client with mild cognitive decline due to Alzheimer's disease?

A)Keep communication simple and concrete.
B)Offerthe client alternative ideas.
C)Implement comic enjoyment of the imperfect.
D)Use open-ended questions.

Question 24

Andie is a registered nurse who works in a medical-surgical unit. Andie understands the importance of avoiding barriers to achieve therapeutic nurse-client communication during the course of care. Which of the following techniques is NOT a barrier to therapeutic communication?

A)Giving advice
B)Using probing questions
C)Using open-ended questions
D)Using leading questions

Question 25

A therapeutic nurse-client interaction has three phases: introduction, working, and termination. Which of the following interventions is appropriately employed during the working phase?

A)Reviewing the client's progress
B)Establishing each person's role in the relationship
C)Making a contract with the client regarding goals of the interaction
D)Implementation of a care plan through therapeutic alliance

Question 26

A nurse understands that trust builders are essential when establishing a therapeutic nurse-client relationship. When communicating with an anxious elderly client who is visually impaired, which of the following trust builders is the most appropriate?

A)Communicate in an organized and professional manner.
B)Use touch in a gentle matter when speaking to the client.
C)Offeropen and frank communication without prejudice.
D)Offer all available resources to the client.

Question 27

A nurse is assisting Brenda, a female client who has difficulty controlling self-destructive behaviors. The nurse utilizes a contractmade with the client as an intervention. Which of the following is the most important purpose for the use of contracts as a behavioral management technique?

A)It is used to give a client greater control over negative thinking.
B)It promotes self-expression and exchange of ideas.
C)It is used hold the client accountable for her actions.
D)It is used to give the client a sense of security.

Question 28

A nurse is tasked with making the room assignments in a psychiatric unit. The nurse makes the room assignments based on all of the following factors EXCEPT:

A)The client's length of stay
B)The client's race
C)The client's level of personal distress
D)The client's overall behavior

Question 29

Eunice is a 15-year-old female who sustained lacerated wounds on the lower extremities. Which evaluation would be most indicative of readiness to begin selfwound care?

A)The client watches as the nurse performs care.
B)The client begins to ask questions about how the wound is managed.
C)The client turns away every time the nurse cares for the wound.
D)The client is reading a pamphlet on wound management.

Question 30

A nurse prepares to teach a newly diagnosed diabetic client about diabetes and how it is managed. Which of the following is the initial step when preparing the client for a teaching session?

A)Gather written and visual materials for the client's use.
B)Evaluate the client's willingness to learn.
C)Identify the client's level of education.
D)Determine what the client knows about the disease.

Question 31

A nurse is caring for a 7-year-old boy who has an IQ score of 70. The child's mother asks the nurse about the optimal learning environment for child. Which of the following is the best response of the nurse?

A)"Your son is educable. He may be mainstreamed for some classes as he receives additional help for other subjects."
B)"Your son is educationally trainable, but he will require supervision throughout life."
C)"Your sound will most likely require lifelong support and supervision."
D)"Your son will need custodial care. Educational skills will aim for basic skills of eating and use of extremities."

Question 32

Circe is a 58-year-old housewife who had a surgery for permanent colostomy seven days ago. She is extremely concerned about caring for her colostomy. The client refuses to do the draining and cleaning herself. As the nurse changes the bag, Mrs. Circe said, "Does it really look that red and swollen?" Before discharge, the nurse must include this activity to promote self-care of colostomy:

A)Provide step-by-step written instruction with illustrations on colostomy care.
B)Teach Mrs. Circe's daughter how to perform proper colostomy care.
C)Discuss what the client should expect during colostomy care.
D)Allow the client to perform some portion of colostomy care.

Question 33

Dane is a 34-year-old lawyer who will have a total hip replacement surgery in two weeks. He is concerned about allowable sexual activity after hip replacement. Mr. Dane asks the nurse what is a safe sexual activity after surgery. The nurse makes which of the following appropriate statements?

A)"You must have a talk about sexual activity after hip replacement with your surgeon."
B)"Usually, sexual activity is allowed 10 weeks after surgery."
C)"There are basically no restrictions on sexual positions so long as you don't experience pain."
D)"Are you concerned about your surgery affecting your sex life?"

Question 34

Dee, a female client who has a history of major depression, is rushed to the emergency department after attempting to jump off from a building. The client says she has been planning to kill herself since her husband left her for another woman. Which action by the admitting nurse is the priority?

A)Search the client for weapons.
B)Pad the side rails of the bed.
C)Place the client in a room with CCTV camera.
D)Remove the client's clothing and search her belongings.

Question 35

Wilkins is an 85-year-old female diagnosed with an advanced case of Alzheimer's disease. The client's memory has severely declined through the years. As the nurse assists the client in performing morning care, the client tells the nurse that she worked as a neuroscientist in the 1950s. The client's husband immediately corrects the client by informing the nurse that his wife worked as science teacher. After the morning care, the nurse talks to the husband in private and encourages him to do which of the following?

A)Leave the area as soon as his wife starts telling her stories.
B)Continue correcting her wife's stories.
C)Allow his wife to tell her storiesas she recalls them.
D)Discourage his wife from telling inconsistent stories.

Question 36

Belle, a mother of two children, informs the nurse that her three-year-old potty trained son has started urinating in his pants. The regression started about two months after she gave birth to her daughter. Which response by the nurse is the most therapeutic?

A)"Initiate a time out before it becomes a pattern."
B)"Talk to your son about the change. Spend an hour with him, without your daughter, every other day to let him feel that he is still important."
C)"It is an expected occurrence. Children usually regress when a new baby is introduced to the family. Encourage the child to go the rest room every time he feels the need to urinate."
D)"It is an expected outcome. Do not worry. It is normal."

Question 37

A competent adult client, a member of the Jehovah's Witnesses, refuses blood transfusion. The nurse caring for the client follows his decision based on which ethical principle?

A)Advance directive
B)The right to refuse treatment
C)The right to refuse third-party interference
D)Substituted judgment

Question 38

A client who is in for coronary artery bypass gastric surgery expresses his fears to the nurse about the surgery. Which of the following statements by the nurse is appropriate?

A)"Don't be afraid. The surgeon is one of the best in this facility."
B)"It's normal to feel nervous. Every patient feels that way before surgery."
C)"Would you like to tell me what you were told about the surgery?"
D)"I'll explain every important detail about the procedure."

Question 39

A nurse observes an agitated client pacing up and down the hallway. Which of the following statements by the nurse is the most appropriate?

A)"If you don't stop now, you're leaving us with no other choice but to restrain you until you calm down."
B)"You will be placed in seclusion until you calm down."
C)"What is causing your agitation?"
D)"You can join the group activity in the dayroom."

Question 40

A female client with depression tells the nurse that her family is better off without her. The nurse's most appropriate response is:

A)"You will feel better once the therapeutic effects of your medications set in."
B)"Everyone feels this way sometimes."
C)"Have you talked to your family about this?"
D)"Are you planning to hurt yourself?"

Question 41

A nurse is assessing a client who is admitted due to depression. The most appropriate question to ask the client is which of the following?

A)"Do you experience a sense of impending doom when you're out of the house?"
B)"Do you find it hard to enjoy things that you used to?"
C)"Are you easily angered?"
D)"Are you hearing voices?"

Question 42

A newly-admitted male client with depression refuses to interact with anyone and prefers to sit alone during meals. A nurse observes that the client barely touched his meals. Which of the following nursing actions is the most correct for this case?

A)Insist that the client eat meals with the rest of the group.
B)Allow the client to eat in the bedroom until he gets used to the environment, staff, and other clients.
C)Sit with the client during meals and offer smaller meals.
D)Allow the client to choose the best time and place where he can have hismeals.