Kilgore College NURSING 1429041 MODULE 3 EXAM QUESTIONS AND ANSWERS

Week 3 Prep-U: Cognition and Interpersonal Relationships 1. A nurse tells a client, "I'll come back in 10 minutes to reassess your pain." When the nurse returns in 10 minutes, which aspect of the therapeutic relationship is the nurse developing? o empathy o closure o sympathy o Trust 2. A client with Alzheimer's disease tells the nurse, "I'm so afraid. Where am I? Where is my family?" What is the best response by the nurse? o "You know where you are. You were admitted here two weeks ago. Don't worry, your family will be back soon." o "Are you hungry or thirsty? Would you like me to take you for a walk to the kitchen for a snack?" o "Can you tell me what year it is? Do you know your name? How many fingers am I holding up right now?" o "You're in the hospital, and you're safe here. Your family will return at 10 o'clock, which is one hour from now." 3. A nurse on a rehabilitation unit is caring for a client with a head injury resulting from a motor vehicle collision. The nurse notes the client is restless and agitated during therapy. Previous documentation describes the client as cooperative during therapy sessions. What is the priority action by the nurse? o Assess the client and notify the healthcare provider of the change in status. o Call the healthcare provider to request additional pain medication for the client. o Encourage the client to participate cooperatively during therapy. o Notify the client’s family and ask them to sit with the client during therapy. 4. The client with dementia states to the nurse, “I know you. You’re Margaret, the girl who lives down the street from me.” Which response by the nurse is most therapeutic? o “Mrs. Jones, I’m Rachel, a nurse here at the hospital.” o "Now Mrs. Jones, you know who I am." o “I think you forgot that I’m Rachel, Mrs. Jones.” o “Mrs. Jones, I told you already, I’m Rachel, and I don’t live down the street.” 5. The client is to undergo a series of diagnostic tests to determine if the client’s cognitive impairment is treatable. Which state can lead to nonreversible cognitive impairment? o electrolyte imbalance o Alzheimer's disease o delirium o cerebral abscess 6. The terms "judgment" and "insight" are sometimes used incorrectly. Insight is the ability to: o understand the nature of one's problem or situation. o control inappropriate impulses. o make appropriate choices. o explain one's psychiatric diagnosis. 7. Clozapine therapy has been initiated for a client with schizophrenia who has been unresponsive to other antipsychotics. The client states, "Why do I have to have a blood test every week?" Which response by the nurse would be most appropriate? o "Weekly blood tests are done so that you can receive another week's supply of the medication." o "Everyone taking clozapine has to go through the same procedure because it's required by the drug company." o “Your health care provider (HCP) will want to know how well you’re progressing with the medication therapy.” o "Weekly blood tests are necessary to determine safe dosage and to monitor the effect of the medication on the blood." 8. The nurse is administering medications to a client with advanced Alzheimer’s dementia who is confused to person, place, and time. Prior to administering the medication, what action should the nurse perform to verify the client’s identity? o Check the name listed on the unit board for the room. o Ask another staff member the name of the client in the room. o Ask the client to state name and birthdate, then compare it to the medication administration record. o Compare the name and ID number on the client’s wristband to the medication administration record. 9. A nurse walks into the room of a client who has had surgery for testicular cancer. The client says that he'll be undesirable to his wife. Becoming tearful, he says he's been spoiled by a happy, satisfying sex life with his wife. Which nursing diagnosis is appropriate? o social isolation o risk for situational low self-esteem o risk for loneliness o unilateral neglect 10. The client in the early stage of Alzheimer’s disease and his adult son attend an appointment at the community mental health center. While conversing with the nurse, the son states, “I’m tired of hearing about how things were 30 years ago. Why does Dad always talk about the past?” What should the nurse tell the son? o "You need to be more accepting of your dad's behavior." o "I want you to understand your dad's level of anxiety." o "Reminding your dad that you have heard that story will help him stop." o "Your dad lost his short-term memory, but he still has his long-term memory." 11. A client with bipolar disorder, manic phase, just sat down to watch television in the lounge. As the nurse approaches the lounge area, the client states, “The sun is shining. Where is my son? I love Lucy. Let’s play ball.” The client is displaying which condition? o use of neologisms o concreteness o flight of ideas o Depersonalization 12. A 22-year-old client exhibits memory loss, confusion, and wandering behavior. Which comment by the nurse would provide the best reality orientation for the client when she first awakens in the morning? o Good morning. This is your 2nd day in Memorial Hospital, and I’m your nurse for today. My name is Rachel.” o "Do you remember who I am or what day it is today?" o “ There will be pancakes for breakfast this morning. After breakfast your partner will come for a visit” o "Hello, did you sleep well? Which dress would you like to wear today, the yellow or the green one?" 13. Which behavior indicates to the n