NSG 503/ NSG503 Final exam_ Questions and answers | Latest 2026 - Rush University.

NSG 503/ NSG503 Final exam_ Questions and answers | Latest 2026 - Rush University. Chapter 13: Neurocognitive Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. 1. The geriatric nurse is teaching the client’s family about the possible cause of delirium. Which information should the nurse include in the teaching session? :f) “Taking multiple medications may lead to adverse interactions or toxicity.” 2. “Age-related cognitive changes may lead to alterations in mental status.” 3. “Lack of rigorous exercise may lead to decreased cerebral blood flow.” 4, “Decreased social interaction may lead to profound isolation and psychosis.” 2. A male client diagnosed with a vascular neurocognitive disorder (NCD) is discharged to home under the care of his wife. Which information should cause the nurse to question the client’s safety? 1. His wife works from home in telecommunication. 2. The client has worked the night shift his entire career. 3. His wife has minimal family support. The client smokes one pack of cigarettes per day. 3. A client diagnosed with Alzheimer’s disease (AD) can no longer ambulate, does not recognize family members, and communicates with agitated behaviors and incoherent moaning. The nurse recognizes these symptoms as indicative of which stage of the illness? 1. Stage 4: Moderate Cognitive Decline 2. Stage 5: Moderately Severe Cognitive Decline 3. Stage 6: Severe Cognitive Decline (& Stage 7: Very Severe Cognitive Decline 4. A client is diagnosed in stage 7 of Alzheimer’s disease (AD). To address the client’s symptoms, which nursing intervention should take priority? 1. Improve cognitive status by encouraging involvement in social activities. 2. Decrease social isolation by providing group therapies. Promote dignity by providing comfort, safety, and self-care measures. Facilitate communication by providing assistive devices.5. The nurse is asked why there seems to be more people diagnosed with neurocognitive disorders (NCDs). Which rationale would the nurse offer? 1. Increased numbers of neurotransmitters have been implicated in the proliferation of NCDs. 2. Similar symptoms of NCD and depression lead to misdiagnoses, increasing numbers of NCDs. Societal stress contributes to the increase in this diagnosis. More people now survive into the high-risk period for NCDs. 6. A client diagnosed recently with Alzheimer’s disease (AD) is prescribed donepezil (Aricept). The client’s spouse inquires, “How does this work? Will this cure him?” Which response by the nurse is appropriate? “This medication delays the destruction of acetylcholine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the disease.” 2. “This medication encourages production of acetylcholine, a chemical in the brain necessary for memory processes. It delays the progression of the disease.” 3. “This medication delays the destruction of dopamine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the disease.” 4, “This medication encourages production of dopamine, a chemical in the brain necessary for memory processes. It delays the progression of the disease.” 7. A client diagnosed with Alzheimer’s disease (AD) exhibits diminished cognitive functioning, has verbal aggression upon experiencing frustration, and has a nursing diagnosis of inability to provide self-care. Which nursing intervention is most appropriate? 1. Organize a group activity to present reality. 2. Minimize environmental lighting. (B Schedule structured daily routines. 4. Explain the consequences for aggressive behaviors. 8. After 1 week of continuous mental confusion, an older African American client is admitted with a preliminary diagnosis of Alzheimer’s disease (AD). What should cause the nurse to question this diagnosis? 1. AD does not typically occur in African American clients. 2. The symptoms presented are more indicative of parkinsonism. AD does not develop suddenly. 4. There have been no liver function studies ordered.9. A client diagnosed with Alzheimer’s disease (AD) has impairments of memory and judgment and is incapable of performing activities of daily living. Which nursing intervention should take priority? 1. Present evidence of objective reality to improve cognition. 2. Design a bulletin board to represent the current season. 3. Label the client’s room with name and number. &) Assist with bathing and toileting. 10. A client diagnosed with major neurocognitive disorder (NCD) is exhibiting behavioral problems on a daily basis. At change of shift, the client’s behavior escalates from pacing to screaming and flailing. Which action should be a nursing priority? 1. Consult the psychologist regarding behavior-modification techniques. Medicate the client with prn antianxiety medications. 3. Assess environmental triggers and potential unmet needs. 4. Anticipate the behavior and restrain when pacing begins. 11. A client with a history of cerebrovascular accident is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client’s assessment data, on which medical diagnosis would the nurse focus the plan of care? 1. Delirium due to adverse effects of cardiac medications (*2 Vascular neurocognitive disorder 3. Neurocognitive disorder due to Huntington’s disease 4. Alzheimer’s disease 12. An older client has recently moved to a nursing home. The client has a sad affect, trouble concentrating, and socially isolates. A physician believes the client would benefit from medication therapy. Which medication would the nurse most likely administer to the client? 1. Haloperidol (Haldol) 2. Donepezil (Aricept) 3. Diazepam (Valium) Sertraline (Zoloft) 13. The client diagnosed with neurocognitive disorder (NCD) is disoriented and ataxic and wanders. Which is the priority nursing diagnosis? 1. Disturbed thought processes 2. Self-care deficitRisk for trauma 4. Altered health-care maintenance 14. Which information would the nurse include in a staff teaching session about the differences between mild neurocognitive disorder (NCD) and major NCD? 1. Major NCD involves disorientation that develops suddenly, whereas mild NCD develops more slowly. 2. Major NCD involves impairment of abstract thinking and judgment, whereas mild NCD does not. Major NCD criteria require substantial cognitive decline from a previous level of performance, and mild NCD requires modest decline. 4. Major NCD criteria require decline from a previous level of performance in three of the listed domains, and mild NCD requires only one. 15. The nurse attended a seminar about neurocognitive disorders (NCDs). Which information from the nurse indicates a correct understanding of the differences between NCD and pseudodementia (depression)? 1. NCD has arapid onset, whereas pseudodementia does not. (2D NCD symptoms include disorientation to time and place, and pseudodementia does not. 3. NCD symptoms improve as the day progresses, but symptoms of pseudodementia worsen. 4. NCD causes decreased appetite, whereas pseudodementia does not. Multiple Response Identify one or more choices that best complete the statement or answer the question. 16. Which conditions have been known to precipitate delirium in some individuals? (Select all that apply.) g Febrile illness Seizures D Mi graine headaches 4. Gallstones 5. Temporomandibular joint syndrome 17. Which medications have been known to precipitate delirium in clients? (Select all that apply.) 9. Mo %M(Mc[)]c " i %BSMH/_.’YgChapter 23: Children and Adolescents Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A client is diagnosed with moderate intellectual developmental disorder. Which developmental characteristic would the nurse identify as typical of a client diagnosed with moderate intellectual developmental disorder? 1. The client can perform activities without supervision. 2. The client can easily adhere to social convention. The client’s motor development may be limited to gross motor activities. 4. The client communicates wants and needs by “acting out” behaviors. 2. The mother of a child diagnosed with moderate intellectual developmental disorder asks, “What educational level will my child be able to attain?” The nurse knows that a child with moderate intellectual developmental disorder would be capable of which of the following? 1. Graduating from vocational school 2. A ssixth-grade level of cognitive proficiency 3. Graduating from elementary school A second-grade level of cognitive proficiency 3. A child has been diagnosed with autism spectrum disorder. The distraught mother cries out, “I’m such a terrible mother. What did I do to cause this?” Which nursing response is most appropriate? 1. “Researchers really don’t know what causes autism spectrum disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored.” “Poor parenting doesn’t cause autism spectrum disorder. Research has shown that abnormalities in brain structure or function are to blame. This is beyond your control.” 3. “Research has shown that the mother appears to play a greater role in the development of autism spectrum disorder than the father.” 4. “Lack of early infant bonding with the mother has shown to be a cause of autism spectrum disorder. Did you breastfeed or bottle-feed?” 4. In planning care for a child diagnosed with autism spectrum disorder, which would be a realistic client outcome?1. The client will communicate all needs verbally by discharge. 2. The client will participate with peers in a team sport by day 4. The client will establish trust with at least one caregiver by day 5. 4. The client will perform most self-care tasks independently. 5. After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. Which is the best explanation for this weight loss? (15 The pharmacological action of Ritalin causes a decrease in appetite. 2. Hyperactivity seen in ADHD causes increased caloric expenditure. 3. Side effects of Ritalin can include nausea; therefore, caloric intake is decreased. 4. Increased ability to concentrate allows the client to focus on activities rather than food. 6. A nurse assesses an adolescent client diagnosed with conduct disorder who, at the age of 8 years, was sentenced to juvenile detention. How would the nurse interpret this assessment data? Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood. 2. Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood. 3. Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5 years, and, therefore, improvement is likely. 4. Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder. 7. Which finding would a nurse expect when assessing a child diagnosed with separation anxiety disorder? 1. The child has a history of antisocial behaviors. The child’s mother was stressed during the pregnancy. 3. The child previously had an extroverted temperament. 4. The child’s mother and father have an inconsistent parenting style. 8. An angry parent brings their 10-year-old child into an outpatient clinic for evaluation. She states, “My son has been angry and defiant. He seeks to undermine my control.” The nurse recognizes that which of the following is true regarding the development and diagnosis of Oppositional Defiant Disorder (ODD)? 1. The parents probably had a diagnosis of ODD in childhood as there is a strong genetic component.The parents likely struggle with exercising parental control and hence a power struggle ensues between parent and child. 3. The child is likely to view their own behavior as defiant. 4. The child is too young to be diagnosed with ODD. 9. A client diagnosed with attention deficit-hyperactivity disorder (ADHD) is seen sitting calmly and does not run around with the other children. The child’s mother is questioning the ADHD diagnosis. The nurse recognizes that: 1. This client likely does not need treatment for ADHD. 2. This client likely has hyperactive type of ADHD. 3™ The client likely has inattentive type of ADHD. 4. The client likely is intellectually inferior to the other children. 10. A preschool child is admitted to a psychiatric unit with a diagnosis of autism spectrum disorder. To help the child feel more secure on the unit, which intervention would a nurse include in this client’s plan of care? 1. Encourage and reward peer contact. Provide consistent caregivers. 3. Provide a variety of safe daily activities. 4. Maintain close physical contact throughout the day. 11. A preschool child diagnosed with autism spectrum disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate? 1. Place client in restraints until the aggression subsides. 2. Sedate the client with antipsychotic medications. Hold the client’s head steady and apply a helmet. 4. Distract the client with a variety of games and puzzles. 12. When planning care for a client, which medication classification would a nurse recognize as effective in the treatment of Tourette’s syndrome? Antipsychotic medications 2. Antimanic medications 3. Tricyclic antidepressant medications 4. Monoamine oxidase inhibitor medications13. Which behavioral approach would a nurse use when caring for children diagnosed with disruptive behavior disorders? 1. Involving parents in designing and implementing the treatment process Reinforcing positive actions to encourage repetition of desirable behaviors 3. Providing opportunities to learn appropriate peer interactions 4. Administering psychotropic medications to improve quality of life 14. A child diagnosed with severe autism spectrum disorder has the nursing diagnosis Disturbed Personal Identity. Which outcome would best address this client diagnosis? The client will name own body parts as separate from others by day 5. 2. The client will establish a means of communicating personal needs by discharge. 3. The client will initiate social interactions with caregivers by day 4. 4. The client will not harm self or others by discharge. 15. A nursing instructor presents a case study in which a 3-year-old child is in constant motion and is unable to sit still during story time. She asks a student to evaluate this child’s behavior. Which student response indicates an appropriate evaluation of the situation? “This child’s behavior must be evaluated according to developmental norms.” 2. “This child has symptoms of attention deficit-hyperactivity disorder.” 3. “This child has symptoms of the early stages of autism spectrum disorder.” 4. “This child’s behavior indicates possible symptoms of oppositional defiant disorder.” 16. The mother of a child diagnosed with intellectual developmental disorder asks, “How could this have happened?” The nurse recognizes that which of the following risk factors may contribute to the development of intellectual developmental disorder? 1. A maternal history of peri-partum depression 2. A family history of low educational attainment 3. Overstimulation in early infancy, including an excess of social contact A family history of Tay-Sachs disease 17. Which would the nurse identify as risk factors related to family dynamics for predisposition to a conduct disorder? 1. Stable residence 2. Consistency in discipline 3. Excessive supervision Economic stressors18. Which would be the priority nursing intervention when caring for a child diagnosed with conduct disorder? 1. Modify environment to decrease stimulation and provide opportunities for quiet reflection. 2. Convey unconditional acceptance and positive regard. 3 Recognize escalating aggressive behavior and intervene before violence occurs. 4. Provide immediate positive feedback for appropriate behaviors. 19. A mother questions the decreased effectiveness of methylphenidate (Ritalin) prescribed for her child’s attention deficit-hyperactivity disorder. Which nursing response best addresses the mother’s concern? 1. “The health-care provider will probably switch from Ritalin to a central nervous system stimulant.” 2. “The health-care provider may prescribe an antihistamine with the Ritalin to improve effectiveness.” “Your child has probably developed a tolerance to Ritalin and may need a higher dosage.” 4. “Your child has developed sensitivity to Ritalin and may be exhibiting an allergy.” 20. After studying the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for oppositional defiant disorder (ODD), which listed symptom would a student nurse recognize? 1. Arguing and annoying older sibling over the past year 2. Angry and resentful behavior over a 3-month period 3. Initiating physical fights for more than 18 months Arguing with authority figures for more than 6 months Multiple Response Identify one or more choices that best complete the statement or answer the question. 21. The mother of a child diagnosed with intellectual developmental disorder asks, “How did the doctors arrive at this diagnosis?” The nurse knows that the following factors are considered in the diagnosis of intellectual developmental disorder: (Select all that apply.) 1. A family history of poor educational attainment General intellectual functioning Adaptive functioning & T ScoreChapter 24: The Aging Individual Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A client has recently been placed in a long-term care facility because of marked confusion and inability to perform most activities of daily living. Which nursing intervention is most appropriate to maintain the client’s self-esteem? 1. Leave the client alone in the bathroom to test ability to perform self-care. 2. Assign a variety of caregivers to increase potential for socialization. Allow client to choose between two different outfits when dressing for the day. 4. Modify the daily schedule often to maintain variety and decrease boredom. 2. A son who recently brought his extremely confused parent to a nursing home for admission reports feelings of guilt. Which is the appropriate nursing response? “Support groups are held here on Mondays for children of residents in similar situations.” 2. “Youdid what you had to do. I wouldn’t feel guilty if I were you.” “Support groups are available to low-income families.” 4. “Your parent is doing just fine. We’ll take very good care of him.” W 3. A family asks why their father is attending activity groups at the long-term care facility. The son states, “My father worked hard all of his life. He just needs some rest at this point.” Which is the appropriate nursing response? 1. “I’m glad we discussed this. We’ll excuse him from the activity groups.” “The groups benefit your father by providing social interaction, sensory stimulation, and reality orientation.” 3. “The groups are optional. Only clients at high functioning levels would benefit.” 4. “If your father doesn’t go to these activity groups, he will be at high risk for developing cognitive problems.” 4. Which student statement indicates that learning has occurred regarding reminiscence therapy? 1. “Reminiscence therapy is a group in which participants create collages representing significant aspects of their lives.” “Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution.”3. “Reminiscence therapy is a social group where members chat about past events and future plans.” - - " oy . 4. “Reminiscence therapy encourages members to share positive memories of significant life transitions.” 5. A couple resides in a long-term care facility. The husband is admitted to the psychiatric unit after physically abusing his wife. He states, “My wife is having an affair with a young man, and I want it investigated.” Which is the appropriate nursing response? 1. “Your wife is not having an affair. What makes you think that?” 2. “Why do you think that your wife is having an affair?” 3. “Your wife has told us that these thoughts have no basis in fact.” “T understand that you are upset. We will talk about it.” 6. A student nurse asks the instructor, “Which psychiatric disorder is most likely initially diagnosed in the elderly?” Which instructor response gives the student accurate information? 1. “Schizophrenia is most likely diagnosed later in life.” “Major depressive disorder is most likely diagnosed later in life.” 3. “Phobic disorder is most likely diagnosed later in life.” 4. “Dependent personality disorder is most likely diagnosed later in life.” 7. A nurse is precepting a student who is caring for a 75-year-old woman who was recently widowed. Which statement by the student indicates that further teaching is needed? 1. “Itis not unusual that my client became widowed at this age.” 2. “The client may already be thinking deeply about death and loss.” “I can’t image that the client was sexually active with her husband near the end of his life.” 4. “It would not be unusual for the client to continue to live independently after her husband’s death.” 8. An older client who lives with a caregiver is admitted to an emergency department with a fractured arm. The client is soaked in urine and has dried fecal matter on lower extremities. The client is 6 feet tall and weighs 120 pounds. Which condition would the nurse suspect? 1. Inability of the client to meet self-care needs 2. Alzheimer’s disease (3 Abuse and/or neglect 4, Caregiver role strain9. The nurse overhears a 66-year-old client treated for depression say to her friend, “I feel that I accept myself regardless of my age.” The nurse recognizes that: 1. Mental illnesses decrease over the course of the life cycle. A person who demonstrates self-acceptance will have an easier time adapting to older adulthood. 3. Regardless of the client’s confidence, she should consider moving into a long-term care facility. 4. The client’s perspective on aging is congruent with the larger cultural perspective on aging in the United States. 10. An aging client has difficulty communicating because of decreased sensory capabilities. Which nursing intervention is appropriate to improve communication during assessment? 1. Discourage attempts at verbal communication owing to increased client frustration. 2. Increase the volume of the communication. (3 Look directly at client when communicating. 4. Encourage the client to communicate by writing. 11. A nurse reads in a client chart that the client is 92 years old. According to the U.S. Census Bureau, the nurse knows that the client is classified as what stage of older adulthood? 1. Aged 2. Elderly (3D Veryold 4. Older 12. Which therapeutic intervention would a nurse anticipate will be ordered for an older client with major depressive disorder not responding to antidepressant medications? (T Electroconvulsive therapy (ECT) 2. Neuroleptic therapy 3. Anantiparkinsonian agent 4. Ananxiolytic agent 13. An elderly client expresses concern about the possibilities of memory loss and cognitive decline in older adulthood. Which of the following statements by the nurse is correct? 1. “Long-term memory worsens in older adulthood.” “The ability to learn continues throughout life.” 3. “Short-term memory improves in older adulthood.” 4. “The ability to solve novel problems remains stable during older adulthood.”14. Which individual is most at risk for suicide in the United States based on statistics? A 70-year-old Hispanic woman living alone 2. A 72-year-old African American man living with family 3. A 68-year-old Asian American woman living with family 4. A 75-year-old White American man living alone Multiple Response Identify one or more choices that best complete the statement or answer the question. 15. Which statement(s) by the nurse indicates that teaching has been effective regarding the environmental theory? (Select all that apply.) 1. “Personality characteristics in old age are correlated with early life characteristics.” “Carcinogens can affect aging.” % “Trauma can affect the aging process.” “The effects of sunlight can have an effect on the aging process.” 5. “Decline in the immune system can affect the aging process.” Completion Complete each statement. 16. The discipline of C."m is the branch of clinical medicine specializing in psychopathology of the elderlg) population.Chapter 25: Survivors of Abuse or Neglect Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the child’s face and arms. Which other symptom would indicate to the nurse that the child may have been physically abused? (T The child shrinks at the approach of adults. 2. 3. 4. The child begs or steals food or money. The child is frequently absent from school. The child is delayed in physical and emotional development. 2. A client who is a victim of intimate partner violence describes a situation in which her ex-spouse contacts her when she has asked him not to. She also has seen him lurking outside of her workplace, which increasingly makes the client feel unsafe. The violence described here is termed: 2. 3. 4. Stalking Physical violence Sexual violence Incest 3. Which information would be included in a lesson about domestic violence? 2. 3. 4. Power and control are central to the dynamic of domestic violence. Poor communication and social isolation are central to the dynamic of domestic violence. Erratic relationships and vulnerability are central to the dynamic of domestic violence. Emotional injury and learned helplessness are central to the dynamic of domestic violence. 4. Which nursing action is appropriate for a client brought to the emergency department after being raped? 1. Discourage the client from discussing the rape because this may lead to further emotional trauma. Remain nonjudgmental while actively listening to the client’s description of the rape event.3. Meet the client’s self-care needs by assisting with showering and perineal care. 4. Probe for further, detailed description of the rape event. 5. A client who has been raped answers a nurse’s questions in a monotone voice with single words, appears calm, and exhibits a blunt affect. How would the nurse interpret this client’s responses? 1. The client may be fabricating details of the incident. 2. The client may be experiencing a silent rape reaction. (3 The client may be demonstrating a controlled response pattern. 4. The client may be having a compounded rape reaction. 6. A client who is in an abusive relationship is admitted to a psychiatric inpatient unit. The client fears for her life. A staff nurse asks, “Why doesn’t she just leave him?” Which is the nursing supervisor’s most appropriate response? 1. “These clients don’t know life any other way, and change is not an option until they have improved insight.” “These clients have limited cognitive skills and few vocational abilities to be able to make it on their own.” “These clients often have a lack of financial independence to support themselves and their children, and most have religious beliefs prohibiting divorce and separation.” . “These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness.” 2. 7. A woman comes to an emergency department with a broken nose and multiple bruises after being physically assaulted by her husband. She states, “The beatings have been getting worse, and I'm afraid next time he will kill me.” Which is the appropriate nursing response? 1. “People in general do not change their behaviors. He will likely never change.” 2. “There are things you can do to prevent him from losing control.” QD “Let’s talk about your options so that you don’t have to go home.” 4. “Why don’t we call the police so that they can confront your husband with his behavior? 8. A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement would indicate to a nurse that the student is handling this situation in a healthy manner? (1) “Iknow that it was not my fault.” 2. “My boyfriend has trouble controlling his sexual urges.” 3. “IfIdon’t put myself in a dating situation, I won’t be at risk.”4. “Next time I will think twice about wearing a revealing dress.” 9. A nurse is investigating wound characteristics of a young mother who is the victim of intimate partner violence. The nurse recognizes that: 1. Documenting wound injuries should be postponed indefinitely because doing so may retraumatize the client. 2. Wound characteristics of nonfatal strangulations are very obvious. 3. Itis impossible to make assessments about the type of weapon involved based on wound characteristics. Nonfatal strangulation can result in major internal injuries or death days or weeks after the strangulation. 10. When questioned about bruises, a woman states, “It was an accident. My husband just had a bad day at work. He’s being so gentle now and even brought me flowers. He’s going to get a new job, so it won’t happen again.” This client is in which phase of the cycle of battering? 1. Phase I: The tension-building phase 2. Phase II: The acute battering incident phase Phase II1: The honeymoon phase . Phase IV: The resolution and reorganization phase 11. A nurse is giving a lesson about trauma-informed care. Which of the following statements by the nursing student indicates that further instruction is necessary? 1. “Trauma-informed care is foundational to all treatment modalities when responding to survivors.” 2. “Trauma influences an individual’s ability to establish a trusting relationship with the nurse during the assessment process.” “If a client cannot recall traumatic events, it is important that we press them to tell the exact details in sequence.” 4. “The client’s sensory experience can become fragmented following a traumatic event.” 12. A survivor of rape presents in an emergency department crying, pacing, and cursing her attacker. A nurse would recognize these client actions as which behavioral defense? 1. Controlled response pattern 2. Compounded rape reaction Expressed response pattern 4. Silent rape reaction13. Which assessment data would a school nurse recognize as a sign of physical neglect in a child? The child is often absent from school and seems apathetic and tired. 2. The child is very insecure and has poor self-esteem. 3. The child has multiple bruises on various body parts. 4. The child has sophisticated knowledge of sexual behaviors. 14. A client diagnosed with an eating disorder experiences insomnia, nightmares, and panic attacks that occur before bedtime. She has never married or dated, and she lives alone. She states to a nurse, “My father has recently moved back to town.” Which would the nurse suspect? 1. Possible major depressive disorder Possible history of childhood incest 3. Possible histrionic personality disorder 4. Possible history of childhood physical abuse Multiple Response Identify one or more choices that best complete the statement or answer the question. 15. In planning care for a woman who presents as a survivor of domestic abuse, a nurse would be aware of which of the following data? (Select all that apply.) g It often takes several attempts before a woman leaves an abusive situation. Substance abuse is a common factor in abusive relationships. 3. Until children reach school age, they are usually not affected by abuse between their parents. Women in abusive relationships usually feel isolated and unsupported. 5. Economic factors rarely play a role in the decision to stay. 16. Which of the following nursing diagnoses are typically appropriate for an adult survivor of incest? (Select all that apply.) (D Low self-esteem Powerlessness 3. Disturbed personal identity 4. Knowledge deficit 5. Nonadherence17. Which of the following student statements indicate that learning has occurred regarding intimate partner violence? (Select all that apply.) “Intimate partner violence is a pattern of abusive behavior that is used by an intimate partner.” “Intimate partner violence is used to gain power and control over the other intimate partner.” . “Fifty-one percent of victims of intimate violence are women.” é “Women ages 25 to 34 years experience the highest per capita rates of intimate violence.” 5. “Victims are typically young married women who are dependent housewives.” Other 18. Order the description of the progressive phases of Walker’s model of the “cycle of battering.” (Enter the number of each step in the proper sequence, using comma and space format, such as I, 2,3, 4.) z 1. This phase is the most violent and the shortest, usually lasting up to 24 hours. l ~— 2. In this phase, the man’s tolerance for frustration is declining. 3 PR 3. In this phase, the batterer becomes extremely loving, kind, and contrite. Completion Complete each statement. 19. | []’, o | 2.1 ci e refers to abuse or aggression that occurs in a romantic relationship and can apply to both current and former spouses and dating partners. ‘F;f&f,g:c_ 20. sl dfi is a specialized nursing role in which nurses apply their skills to the care, evaluation, advocacy for victims of crime in a variety of settings.Chapter 27: The Bereaved Individual Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A client is diagnosed with terminal cancer. Which situation represents Kiibler-Ross’s grief stage of “anger”? 1. The client registers for an [ronman marathon to be held in 9 months. The client is a devout Catholic but refuses to attend church and states that his faith has failed him. 3. The client promises God to give up smoking if allowed to live long enough to witness a grandchild’s birth. 4. The client gathers family in order to plan a funeral and make last wishes known. 2. Which of the following is the sixth stage of grief, an innovation of the original Kiibler-Ross model of grief? 1. Forgetting 2. Revision 3D Making meaning 4. Acceptance 3. A client whose wife was recently diagnosed with breast cancer begins to experience anticipatory grief while his wife is still alive. The nurse recognizes that which of the following is incorrect regarding anticipatory grief? 1. The client is at risk of distancing himself and detaching from his wife prematurely. 2. The client’s wife may experience feelings of loneliness and isolation. 3. Anticipatory grief tends to become more intense with time, as the loss is imminent. Anticipatory grief is a maladaptive grief process. 4. A teenager’s parent has recently died. Which grieving behavior should a school nurse expect when assessing this client? 1. Denial of personal mortality 2. Preoccupation with the loss 3. Clinging behaviors and personal insecurity Acting-out behaviors, exhibited in aggression and defiance5. Which statement made by a family member of a hospice client requires correction by the nurse? 1. “My mom will receive pain management and be kept as comfortable as possible.” “My mom will receive aggressive treatment as a final attempt to cure the disease to give her more time to spend with us.” “The dietician can work with us to help plan some high-calorie meals incorporating foods my mom will eat.” “There is a nurse or staff member available 24/7 in case my mom needs assistance.” 6. A nurse assigns a client the nursing diagnosis of Complicated Grieving. According to Bowlby, which long-term outcome would be most appropriate for this nursing diagnosis? 1. The client will accomplish the recovery stage of grief by year 1. 2. The client will accomplish the acceptance stage of grief by year 1. The client will accomplish the reorganization stage of grief by year 1. 4. The client will accomplish the emotional relocation stage of grief by year 1. 7. A nurse assesses a female client whose partner died 13 months ago. The client isolates herself, screams at her deceased partner, and is increasingly restless. According to Bowlby, this client is in which stage of the grieving process? 1. Stage I: Numbness or protest 2. Stage II: Disequilibrium (®» Stage III: Disorganization and despair 4. Stage IV: Reorganization 8. A nurse is caring for a client who recently lost his spouse. The nurse recognizes that bereavement practices are greatly influenced by cultural and religious backgrounds. Which statement by the nurse will help identify the client’s cultural expectations around grief? 1. “Itis important to cremate the client within the first 48 hours of death.” 2. “Itis best not to describe your mourning practices at this time because it could be triggering for you.” 3. “Everyone experiences loss similarly.” “When you are ready, describe to me the death rituals and expectations that are common in your family.” Multiple Response Identify one or more choices that best complete the statement or answer the question.9. Which of following members of a bereavement group would the nurse identify as being at high risk for complicated grieving? (Select all that apply.) IO A widower who has recently experienced the death of two good friends CZ A man whose wife died suddenly after a cerebrovascular accident 3. A widow who removed life support after her husband was in a vegetative state for a year (& A woman who had a competitive relationship with her recently deceased brother (33 A young couple whose child recently died of a genetic disorder 10. According to Worden, which of the following client behaviors would delay or prolong the grieving rocess? (Select all that apply.) Ci Refusing to allow oneself to think painful thoughts 2. Indulging in the pain of loss Using alcohol and drugs ¢4) Idealizing the object of loss 5. Recognizing that time will heal 11. A nurse is assessing a client for maladaptive grieving. Which of the following “red flags” might indicate maladaptive grief? (Select all that apply.) 1. Grieving for 8 weeks g Avoidance of any reminders of the loss Increased use of alcohol in the weeks following the death 4. Avowed statements of self-worth in the weeks following the loss Inability to focus on anything but the loss 12. Which statement is true regarding a 7-year-old client’s perception of death? (Select all that apply.) 1. They believe their behavior caused another person to die. They are old enough to understand the actual cause of death. They may believe the “bogeyman” took the person. They may associate death with old age. 5. They understand death to be inevitable. Ordered Response13. Order the stages of normal grief, according to John Bowlby. (Enter the number of each step in the p proper sequence, using comma and space format, such as 1, 2, 3, 4.) 1. Reorganization 2———) Disequilibrium 3 —3. Disorganization and despair | ~——4. Numbness/protest 14. Order the stages of normal grief, according to J. William Worden. (Enter the number of each step in the proper sequence, using comma and space format, such as 1, 2, 3, 4.) /—,l- —1.. Finding an enduring connection with the lost entity in the midst of embarking on a new life | —=—2. Accepting the reality of the loss _‘3 —— 3. Adjusting to a world without the lost entity 5 — 4., Processing the pain of grief Completion Complete each statement. 15. éfl""‘ll/rf_, is deep mental and emotional anguish that is a response to the subjective experiencé’ of loss of something significant. 16. Denial, anger, bargaining, depression, and acceptance are well-known stages of the grief process identified by I} _PosA