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1. A nurse is counseling the spouse of a client who has a history of alcohol abuse. What does the nurse ex
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plain is the main reason for drinking alcohol in people with a long history of alcohol abuse?
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They are dependent on it. dt dt dt dt




They lack the motivation to stop. Th
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ey use it for coping.
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They enjoy the associated socialization.
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✓ Ans- 1 dt




Alcohol causes both physical and psychological dependence; the individual needs the alcohol to function.
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Alcoholism is a disorder that entails physical and psychological dependence. Because alcohol is so
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physiologically addictive, the client's body craves the alcohol, so most clients lack the motivation to stop because
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they will go into withdrawal. Clients who abuse alcohol have numbed their ability to utilize other
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coping mechanisms, so alcohol is used as an excuse for coping. People with alcoholism usually drink alone or fee
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l alone in a crowd; socialization is not the prime reason for their drinking.
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2. How do adolescents establish family identity during psychosocial development? Select all that apply. B
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y acting independently to make his or her own decisions
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By evaluating his or her own health with a feeling of well-being
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By fostering his or her own development within a balanced family structure B
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y building close peer relationships to achieve acceptance in the society By a
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chieving marked physical changes dt dt dt




✓ Ans- 1,3 dt




An adolescent establishes family identity by acting independently for taking important decisions about self.
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They also need to foster their development along with maintaining a balanced family structure. Health identity is
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associated with the evaluation of one's own dt dt dt dt dt dt

,health with a feeling of well-being. By building close peer relationships, an adolescent develops a sense of
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belonging, approval, and the opportunity to learn acceptable behavior. These actions establish an adolescent's group
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identity. The sound and healthy growth of the adolescent, with marked physical changes, helps to build an adolescent's
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sexual identity. dt




3. A clinic nurse observes a 2-year-
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old client sitting alone, rocking and staring at a small, shiny top that she is spinning. Later the father relates
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his concerns, stating, "She pushes me away. She doesn't speak, and she only shows feelings when I take he
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r top away. Is it something I've done?" What is the most therapeutic initial response by the nurse?
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Asking the father about his relationship with his wife
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Asking the father how he held the child when she was an infant
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Telling the father that it is nothing he has done and sharing the nurse's observations of the child
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Telling the father not to be concerned and stressing that the child will outgrow this developmental phase
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✓ Ans- 3 dt




The nurse provides support in a nonjudgmental way by sharing information and observations about the child. Thi
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s child exhibits symptoms of autism, which is not attributable to the actions of the parents. Asking the father about
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his relationship with his wife or how he held the child when she was an infant indirectly indicates that the parent ma
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y be at fault; it negates the father's need for support and increases his sense of guilt.
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Telling the father not to be concerned and stressing that the child will outgrow this developmental phase is false reassur
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ance that does not provide support; the father recognizes that something is wrong.
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4. What is most appropriate for a nurse to say when interviewing a newly admitted depressed client whose th
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oughts are focused on feelings of worthlessness and failure? dt dt dt dt dt dt dt dt




"Tell me how you feel about yourself." "Te
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ll me what has been bothering you." "Why
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do you feel so bad about yourself?"
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"What can we do to help you while you're here?"
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✓ Ans- 1 dt

,Because major depression is a result of the client's feelings of self-
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rejection, it is important for the nurse to have the client initially identify these feelings before developing a plan of c
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are. Later discussion should be focused on other topics to prevent reinforcement of negative thoughts and feelings.
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"Tell me what has been bothering you" is asking the client to draw a conclusion; the client may be unable to do so
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at this time. Also, depression may be related not to external events but instead to a client's psychobiology. Asking
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why does not let a client explore
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feelings; it usually elicits an "I don't know" response. "What can we do to help you while you're here?" is beyond th
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e scope of the client's abilities at this time.
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5. A client is admitted to the mental health unit with the diagnosis of major depressive disorder. Which sta
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tement alerts the nurse to the possibility of a suicide attempt? dt dt dt dt dt dt dt dt dt dt




"I don't feel too good today."
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"I feel much better; today is a lovely day."
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"I feel a little better, but it probably won't last."
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"I'm really tired today, so I'll take things a little slower."
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✓ Ans- 2 dt




A rapid mood upswing and psychomotor change may signal that the client has made a decision and has
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developed a plan for suicide. "I don't feel too good today"; "I feel a little better, but it probably won't last"; and "I'
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m really tired today, so I'll take things a little slower" are all typical of the depressed client; none of these
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statements signals a change in mood. dt dt dt dt dt




6. During a group discussion it is learned that a group member hid suicidal urges and committed suicide se
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veral days ago. What should the nurse leading the group be prepared to manage?
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Guilt of the co- dt dt dt




leaders for failing to anticipate and prevent the suicide Guilt of group mem
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bers because they could not prevent another's suicide
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Lack of concern over the suicide expressed by several of the members in the group
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Fear by some members that their own suicidal urges may go unnoticed and that they may go unprotected
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✓ Ans- 4 dt




Ambivalence about life and death, plus the introspection commonly found in clients with emotional problems, can
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lead to increased anxiety and fear among the group members. These feelings must be handled within the support
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and supervisory systems for the staff;
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, the group members are the primary concern. Guilt that the group's leaders or members might feel because they co
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uld not prevent another's suicide will probably be a secondary concern of the group leader. Lack of concern over
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the suicide expressed by several of the members in the group is not a primary concern, but this should be explore
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d later to determine the reason for such apparent indifference, which may be a mask to cover true
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feelings.


7. Which screening report will help the nurse determine skeletal growth in a child? E
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lectroencephalogram reports dt




Radiographs of the hand and wrist Magneti dt dt dt dt dt dt




c resonance imaging (MRI) Denver Develo
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pmental Screening Test dt dt




✓ Ans- 2 dt




Skeletal growth in a child can be determined from the ossification centers. At 5 to 6 months of age, the capitate an
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d hamate bones in the wrist are the earliest centers. Therefore radiographs of the hand and wrist will help
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determine skeletal growth in the child. dt dt dt dt dt




Electroencephalogram reports will help assess a child's brain activity. MRI is used to scan the internal dt dt dt dt dt dt dt dt dt dt dt dt dt dt dt




structures of a client. The Denver Developmental Screening Test is used to understand developmental issues of a c
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hild.


8. A client describes his delusions in minute detail to the nurse. How should the nurse respond? C
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hanging the topic to reality-based events
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Continuing to discuss the delusion with the client Gettin dt dt dt dt dt dt dt dt




g the client involved in a social project with peers
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Disputing the perceptions with the use of logical thinking
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✓ Ans- 1 dt




Decreasing time spent on delusions prevents reinforcement of psychotic thinking. Discussing reality-
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based events improves contact with reality. Encouraging discussion will give validity to the delusion. The client wi
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ll
have difficulty getting involved in a social activity; the activity will not stop the delusion. Challenging the client ma
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y increase anxiety.
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9. A nurse working on a mental health unit is caring for several clients who are at risk for suicide. Which cli
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ent is at the greatest risk for successful suicide?
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