Med Surg Practice Questions with
correct answers
A 25-year-old male presents to the trauma center after a motor vehicle collision. The
nurse is assessing the client and notes the abdomen to be distended with bruising around
the umbilicus. Which of the following diagnostics would the nurse anticipate the
physician ordering for the client? Select all that apply.
1. CBC (complete blood count)
2. Blood type and crossmatch
3. Urine drug screen
4. Thyroid profile
5. RA factor - CORRECT ANSWER-Answer: 1; 2; 3
Rationale: The diagnostic tests ordered once the client reaches the hospital depend on the
type of injury the client has sustained. Tests that might be ordered will include blood type
and crossmatching for the client's serum and donor red blood cells. Blood alcohol level
and urine drug screen might be ordered to assess alcohol or drugs. Thyroid studies should
always be considered, but based on the client's presenting symptoms, it is not a critical
diagnostic at this time.
A 34-year-old client, who is at her annual gynecologic examination, is being taught
about early screening for breast cancer. The client has a sister and mother with a history
of breast cancer. Which action by the client demonstrates good screening techniques for
someone with her family history?
Answer Choices:
1. Routine breast exams to begin after age 35
2. Reporting of any changes in breast tissue to the health provider at the next routine
visit
3. Annual screening mammography staring at age 40
4. Clinical breast examination every three years - CORRECT ANSWER-Answer: 4
Rationale: American Cancer Society guidelines for cancer screening include routine
breast self-examination starting at age 20; prompt reporting of any change in breast tissue
to healthcare provider; clinical breast examination every three years from ages 20 to 39,
and yearly thereafter; annual screening mammography starting at age 40, except in
women at increased risk, who may have more frequent mammography or other tests such
as breast ultrasound exams.
A 45-year-old client voices concerns about gaining 12 pounds over the past two years.
The client reports no change in dietary habits. Which response by the nurse is most
appropriate?
a. "Age-related changes in metabolism can result in weight gain despite consistent dietary
intake."
b. "Are you exercising?"
c. "You might be eating more than you think."
d. "You are getting older." - CORRECT ANSWER-Answer: a
Rationale: A reduction in metabolic rate often accompanies aging. This will cause weight
gain despite not eating more calories. Asking the client about exercise fails to provide the
needed information to the client. It also assumes the client is sedentary. Implying the
client is overeating is judgmental, and will do little to establish a therapeutic rapport. The
client is aware of aging. Pointing this out does little to meet the client's obvious interest
in more information.
,A 45-year-old woman presents to the ambulatory clinic for a gynecological
examination. The health history reveals no significant personal or family medical history.
What information concerning health-promotion behaviors should be presented to the
client?
a. It is time to begin having mammograms every other year.
b. If the client is in a monogamous relationship, Pap smears will not be needed.
c. Bone density examinations are indicated every year.
d. Recommended calcium intake is at least 1,200 mg per day. - CORRECT ANSWER-Answer: d
Rationale: The recommended calcium intake is at least 1,200 mg per day. This will be
beneficial in the prevention of osteoporosis. Women should begin having annual
mammograms by age 40. Pap smears are continued for women in monogamous
relationships. For women with no significant risk for the development of osteoporosis,
bone density examinations should be done every other year.
A 75-year-old client seeks care at an ambulatory clinic. The client reports having
experienced extreme drowsiness after recently taking dosages of an over-the-counter cold
medication. When collecting data, the nurse notes the client reports taking only the
prescribed amount of the preparation. What inferences can be made by the nurse
concerning the events?
a. The client likely has taken more of the preparation than stated.
b. The client likely has experienced a reaction between the cold medication and other
routine medications.
c. The client's age has influenced his response to the medication.
d. The client is allergic to the cold medication. - CORRECT ANSWER-Answer: c
Rationale: Older clients often experience altered responses to medications. These changes
are in response to age-related developments in the kidneys and liver. There is no evidence
the client has taken too much medication. There is no information provided to indicate
the client is taking other medications. Allergic reactions typically manifest with
integumentary- or respiratory-related symptoms.
A client at risk for the development of skin cancer is discussing sun exposure
prevention with the nurse. What information should be included in the discussion?
1. Sunscreen is not needed on cloudy days.
2. The higher the sunscreen rating, the less the protection provided.
3. When swimming, sunscreen should be reapplied every four hours.
4. A higher-rated sunscreen is needed between 10 a.m. and 3 p.m. - CORRECT ANSWER-Answer: 4
Rationale: Sun exposure is greatest between 10 a.m. and 3 p.m. Sun exposure is possible
on both cloudy and sunny days. The higher the level of the sunscreen's rating, the greater
the protection. When swimming, sunscreen should be reapplied hourly.
A client develops hyperthermia related to a diagnosis of Pneumonia. Which of the
following nursing interventions would be effective in the treatment of hyperthermia?
Select all that apply.
1. Increase the temperature of the room environment to prevent shivering.
2. Use ice packs and a tepid bath as needed.
3. Administer antipyretic medications per physician's orders.
4. Promote frequent rest periods to increase energy reserve.
5. Restrict fluids during periods of hyperthermia because of the risk of
electrolyte imbalance. - CORRECT ANSWER-Answer: 2; 3; 4
Rationale: Hyperthemia is an expected consequence of the infectious disease process.
Fever can produce mild, short-term effects or, when prolonged, can cause life-
threatening effects. The nurse should administer antipyretic medications as
indicated for elevated temperatures. The nurse should use ice packs, cool/tepid
baths, or hypothermia blanket with caution. The nurse should enforce frequent
rest periods because rest increases energy reserve, which is depleted by an
increased metabolic, heart, and respiratory rate. The nurse should encourage fluids
rather than restrict fluids because of the risk of electrolyte imbalance.
A client develops hyperthermia related to a diagnosis of pneumonia. Which of the
following nursing interventions would be effective in the treatment of hyperthermia?
Select all that apply.
,1. Increase the temperature of the room environment to prevent shivering.
2. Use ice packs and a tepid bath as needed.
3. Administer antipyretic medications per physician's orders.
4. Promote frequent rest periods to increase energy reserve.
5. Restrict fluids during periods of hyperthermia because of the risk of electrolyte
imbalance. - CORRECT ANSWER-Answer: 2; 3; 4
Rationale: Hyperthermia is an expected consequence of the infectious disease process. Fever can produce mild, short-
term effects, and when prolonged can cause life-
threatening effects. The nurse should administer antipyretic medications as
indicated for elevated temperatures. The nurse should use ice packs, cool/tepid
baths, or a hypothermia blanket with caution. The nurse should enforce frequent
rest periods because rest increases energy reserve that is depleted by increased
metabolic, heart, and respiratory rates. The nurse should encourage fluids rather
than restrict fluids because of the risk of electrolyte imbalance.
A client diagnosed with scabies asks the nurse how he "caught" the disorder. What
information should be provided to the client?
1. The disorder is transmitted by the feces of infected animals.
2. The disorder is transmitted by contact with infected persons or their possessions.
3. Scabies is a bacterial infection transmitted by direct contact with infected persons.
4. Scabies is a fungal infection transmitted by contact with infected respiratory
secretions. - CORRECT ANSWER-Answer: 2
Rationale: Scabies is the result of infestation of the itch mite. It is transmitted via contact
with infected people or their contaminated articles. Scabies is a parasitic disorder. It is not
bacterial, viral, or fungal.
A client has a diagnosis of AIDS. The nurse is teaching the client regarding a diet with
increased kilocalories. Which of the following diets would indicate that the client has an
understanding of the appropriate diet?
1. Spaghetti and meat sauce, raisin salad, whole grain roll with butter, vanilla
milkshake (with Ensure), and a piece of pecan pie
2. Baked chicken (thigh), cabbage, small green salad, slice of white bread, dried
prunes, and a soda
3. Red beans and rice, slaw, tomato, crackers, chocolate pudding, and iced tea
4. Vegetable soup, small piece of cornbread, banana pudding, and water - CORRECT ANSWER-Answer: 1
Rationale: Provide a diet high in protein and kilocalories. A high-protein, high-kilocalorie
diet provides the necessary nutrients to meet metabolic and tissue healing needs. The
diet with the most kilocalories is the spaghetti and meat sauce with the vanilla
milkshake made with Ensure and pecan pie.
A client has a history of malignant hyperthermia. A bowel resection with colostomy
placement surgery is scheduled. The nurse anticipates which type of anesthesia will be
used with this client?
a. Regional anesthesia
b. Inhaled anesthesia
c. Conscious sedation
d. Total intravenous anesthesia - CORRECT ANSWER-Correct answer: d
Rationale: The client is having a major surgery. General anesthesia would be indicated.
Inhaled and total intravenous anesthesia are general anesthesia options. The use of
inhaled anesthesia in a client with a history of malignant hyperthermia would be avoided,
as it can trigger malignant hyperthermia. Total intravenous anesthesia would be used in
this situation.
A client has an area of rough, thickened, hardened epidermis. Which disorder could be
the reason for this skin lesion?
Answer Choices:
1. Chronic dermatitis
2. Athlete's foot
3. Earring piercing
4. Psoriasis - CORRECT ANSWER-Answer: 1
Rationale: Lichenification is a rough, thickened, hardened area of epidermis resulting
, from chronic irritation such as scratching or rubbing. An example of lichenification is
chronic dermatitis. A fissure is a linear crack with sharp edges, extending into the dermis.
Examples of a fissure include cracks at the corners of the mouth or in the hands, or those
seen with athlete's foot. A keloid is an elevated, irregular, darkened area of excess scar
tissue caused by excessive collagen formation during healing. It extends beyond the site
of the original injury. An example of a keloid is scar tissue from ear piercing. Scales are
shedding flakes of greasy, keratinized skin tissue. Examples of scales include dry skin,
dandruff, psoriasis, and eczema.
A client has presented with a burn injury. The injury site is pale and waxy with large
flat blisters. The client asks questions about the severity of the injury and how long it will
take for this injury to heal. Based upon your knowledge, what information should be
provided to the client?
a. The wound is a partial-thickness burn, and could take up to two weeks to heal.
b. The wound is a superficial burn, and will take up to three weeks to heal.
c. The wound is a deep partial-thickness burn, and will take more than three weeks to
heal.
d. Wound healing is individualized. - CORRECT ANSWER-Answer: c
Rationale: The wound describes is a deep partial-thickness burn. Deep partial thickness
wounds will take more than three weeks to heal. A superficial burn is bright red and
moist, and might appear glistening with blister formation. The healing time for this type
of wound is within 21 days.
A client has reported to the physician's office with complaints of an inability to sleep at
night. During the data collection, the client reports her estranged husband died a little
over a year ago. She states "I am not sure why this is so difficult, I really couldn't stand
him near the end." Which response by the nurse is most appropriate?
1. "You seem angry."
2. "You should contact a therapist."
3. "Sometimes a rocky relationship with someone at the time of their death can impact
your ability to grieve."
4. "You are just entering the grief process, things will get better." - CORRECT ANSWER-Answer: 3
Rationale: Unresolved conflict at the time of death can impact the ability of survivors to
successfully grieve the deceased. The client's demeanor does not seem angry. It is
inappropriate for the nurse to refer the client to a therapist. Referrals must be initiated by
the physician. The death occurred more than a year ago. The client's continued inability
to sleep indicates impaired grieving.
A client has returned to the unit following surgery. The nurse knows that which
intervention will provide the most pain relief for the client?
a. Offer pain relief before the client complains of pain.
b. Wait until the client can describe the pain specifically.
c. Assess the pain level every four hours around the clock.
d. Allow the client to "sleep off" the anesthesia, and then offer pain medication. - CORRECT ANSWER-Correct answer:
a
Rationale: Anticipating a client's pain will ensure a more manageable pain experience
than will waiting until the client complains of pain. Pain management need to be
implemented prior to the client describing specific postoperative pain, or "sleeping off"
anesthesia. If the client is asleep, she should not be awakened simply to assess the pain
every four hours unless there are other significant nonverbal signs during sleep that
indicate the client is in pain. These can include grimacing, moaning, thrashing, or
guarding of a surgical site.
A client hospitalized for diagnostic testing reports an intense fear of being found to
have a terminal condition. What response by the nurse will be most therapeutic?
1. "There is no indication you are going to die."
2. "I am not sure why you feel that way."
3. "What has your doctor told you about your condition?"
4. "What types of symptoms lead you to feel this way?" - CORRECT ANSWER-Answer: 3
Rationale: The client is demonstrating signs of death anxiety. This involves a fear of
dying. The nurse's responsibility will be to determine what has caused this belief. Telling
the client that the feelings are unfounded will do little to ease the client's anxiety. Further,
this might not be entirely true. Expressing to the client a lack of understanding about his
correct answers
A 25-year-old male presents to the trauma center after a motor vehicle collision. The
nurse is assessing the client and notes the abdomen to be distended with bruising around
the umbilicus. Which of the following diagnostics would the nurse anticipate the
physician ordering for the client? Select all that apply.
1. CBC (complete blood count)
2. Blood type and crossmatch
3. Urine drug screen
4. Thyroid profile
5. RA factor - CORRECT ANSWER-Answer: 1; 2; 3
Rationale: The diagnostic tests ordered once the client reaches the hospital depend on the
type of injury the client has sustained. Tests that might be ordered will include blood type
and crossmatching for the client's serum and donor red blood cells. Blood alcohol level
and urine drug screen might be ordered to assess alcohol or drugs. Thyroid studies should
always be considered, but based on the client's presenting symptoms, it is not a critical
diagnostic at this time.
A 34-year-old client, who is at her annual gynecologic examination, is being taught
about early screening for breast cancer. The client has a sister and mother with a history
of breast cancer. Which action by the client demonstrates good screening techniques for
someone with her family history?
Answer Choices:
1. Routine breast exams to begin after age 35
2. Reporting of any changes in breast tissue to the health provider at the next routine
visit
3. Annual screening mammography staring at age 40
4. Clinical breast examination every three years - CORRECT ANSWER-Answer: 4
Rationale: American Cancer Society guidelines for cancer screening include routine
breast self-examination starting at age 20; prompt reporting of any change in breast tissue
to healthcare provider; clinical breast examination every three years from ages 20 to 39,
and yearly thereafter; annual screening mammography starting at age 40, except in
women at increased risk, who may have more frequent mammography or other tests such
as breast ultrasound exams.
A 45-year-old client voices concerns about gaining 12 pounds over the past two years.
The client reports no change in dietary habits. Which response by the nurse is most
appropriate?
a. "Age-related changes in metabolism can result in weight gain despite consistent dietary
intake."
b. "Are you exercising?"
c. "You might be eating more than you think."
d. "You are getting older." - CORRECT ANSWER-Answer: a
Rationale: A reduction in metabolic rate often accompanies aging. This will cause weight
gain despite not eating more calories. Asking the client about exercise fails to provide the
needed information to the client. It also assumes the client is sedentary. Implying the
client is overeating is judgmental, and will do little to establish a therapeutic rapport. The
client is aware of aging. Pointing this out does little to meet the client's obvious interest
in more information.
,A 45-year-old woman presents to the ambulatory clinic for a gynecological
examination. The health history reveals no significant personal or family medical history.
What information concerning health-promotion behaviors should be presented to the
client?
a. It is time to begin having mammograms every other year.
b. If the client is in a monogamous relationship, Pap smears will not be needed.
c. Bone density examinations are indicated every year.
d. Recommended calcium intake is at least 1,200 mg per day. - CORRECT ANSWER-Answer: d
Rationale: The recommended calcium intake is at least 1,200 mg per day. This will be
beneficial in the prevention of osteoporosis. Women should begin having annual
mammograms by age 40. Pap smears are continued for women in monogamous
relationships. For women with no significant risk for the development of osteoporosis,
bone density examinations should be done every other year.
A 75-year-old client seeks care at an ambulatory clinic. The client reports having
experienced extreme drowsiness after recently taking dosages of an over-the-counter cold
medication. When collecting data, the nurse notes the client reports taking only the
prescribed amount of the preparation. What inferences can be made by the nurse
concerning the events?
a. The client likely has taken more of the preparation than stated.
b. The client likely has experienced a reaction between the cold medication and other
routine medications.
c. The client's age has influenced his response to the medication.
d. The client is allergic to the cold medication. - CORRECT ANSWER-Answer: c
Rationale: Older clients often experience altered responses to medications. These changes
are in response to age-related developments in the kidneys and liver. There is no evidence
the client has taken too much medication. There is no information provided to indicate
the client is taking other medications. Allergic reactions typically manifest with
integumentary- or respiratory-related symptoms.
A client at risk for the development of skin cancer is discussing sun exposure
prevention with the nurse. What information should be included in the discussion?
1. Sunscreen is not needed on cloudy days.
2. The higher the sunscreen rating, the less the protection provided.
3. When swimming, sunscreen should be reapplied every four hours.
4. A higher-rated sunscreen is needed between 10 a.m. and 3 p.m. - CORRECT ANSWER-Answer: 4
Rationale: Sun exposure is greatest between 10 a.m. and 3 p.m. Sun exposure is possible
on both cloudy and sunny days. The higher the level of the sunscreen's rating, the greater
the protection. When swimming, sunscreen should be reapplied hourly.
A client develops hyperthermia related to a diagnosis of Pneumonia. Which of the
following nursing interventions would be effective in the treatment of hyperthermia?
Select all that apply.
1. Increase the temperature of the room environment to prevent shivering.
2. Use ice packs and a tepid bath as needed.
3. Administer antipyretic medications per physician's orders.
4. Promote frequent rest periods to increase energy reserve.
5. Restrict fluids during periods of hyperthermia because of the risk of
electrolyte imbalance. - CORRECT ANSWER-Answer: 2; 3; 4
Rationale: Hyperthemia is an expected consequence of the infectious disease process.
Fever can produce mild, short-term effects or, when prolonged, can cause life-
threatening effects. The nurse should administer antipyretic medications as
indicated for elevated temperatures. The nurse should use ice packs, cool/tepid
baths, or hypothermia blanket with caution. The nurse should enforce frequent
rest periods because rest increases energy reserve, which is depleted by an
increased metabolic, heart, and respiratory rate. The nurse should encourage fluids
rather than restrict fluids because of the risk of electrolyte imbalance.
A client develops hyperthermia related to a diagnosis of pneumonia. Which of the
following nursing interventions would be effective in the treatment of hyperthermia?
Select all that apply.
,1. Increase the temperature of the room environment to prevent shivering.
2. Use ice packs and a tepid bath as needed.
3. Administer antipyretic medications per physician's orders.
4. Promote frequent rest periods to increase energy reserve.
5. Restrict fluids during periods of hyperthermia because of the risk of electrolyte
imbalance. - CORRECT ANSWER-Answer: 2; 3; 4
Rationale: Hyperthermia is an expected consequence of the infectious disease process. Fever can produce mild, short-
term effects, and when prolonged can cause life-
threatening effects. The nurse should administer antipyretic medications as
indicated for elevated temperatures. The nurse should use ice packs, cool/tepid
baths, or a hypothermia blanket with caution. The nurse should enforce frequent
rest periods because rest increases energy reserve that is depleted by increased
metabolic, heart, and respiratory rates. The nurse should encourage fluids rather
than restrict fluids because of the risk of electrolyte imbalance.
A client diagnosed with scabies asks the nurse how he "caught" the disorder. What
information should be provided to the client?
1. The disorder is transmitted by the feces of infected animals.
2. The disorder is transmitted by contact with infected persons or their possessions.
3. Scabies is a bacterial infection transmitted by direct contact with infected persons.
4. Scabies is a fungal infection transmitted by contact with infected respiratory
secretions. - CORRECT ANSWER-Answer: 2
Rationale: Scabies is the result of infestation of the itch mite. It is transmitted via contact
with infected people or their contaminated articles. Scabies is a parasitic disorder. It is not
bacterial, viral, or fungal.
A client has a diagnosis of AIDS. The nurse is teaching the client regarding a diet with
increased kilocalories. Which of the following diets would indicate that the client has an
understanding of the appropriate diet?
1. Spaghetti and meat sauce, raisin salad, whole grain roll with butter, vanilla
milkshake (with Ensure), and a piece of pecan pie
2. Baked chicken (thigh), cabbage, small green salad, slice of white bread, dried
prunes, and a soda
3. Red beans and rice, slaw, tomato, crackers, chocolate pudding, and iced tea
4. Vegetable soup, small piece of cornbread, banana pudding, and water - CORRECT ANSWER-Answer: 1
Rationale: Provide a diet high in protein and kilocalories. A high-protein, high-kilocalorie
diet provides the necessary nutrients to meet metabolic and tissue healing needs. The
diet with the most kilocalories is the spaghetti and meat sauce with the vanilla
milkshake made with Ensure and pecan pie.
A client has a history of malignant hyperthermia. A bowel resection with colostomy
placement surgery is scheduled. The nurse anticipates which type of anesthesia will be
used with this client?
a. Regional anesthesia
b. Inhaled anesthesia
c. Conscious sedation
d. Total intravenous anesthesia - CORRECT ANSWER-Correct answer: d
Rationale: The client is having a major surgery. General anesthesia would be indicated.
Inhaled and total intravenous anesthesia are general anesthesia options. The use of
inhaled anesthesia in a client with a history of malignant hyperthermia would be avoided,
as it can trigger malignant hyperthermia. Total intravenous anesthesia would be used in
this situation.
A client has an area of rough, thickened, hardened epidermis. Which disorder could be
the reason for this skin lesion?
Answer Choices:
1. Chronic dermatitis
2. Athlete's foot
3. Earring piercing
4. Psoriasis - CORRECT ANSWER-Answer: 1
Rationale: Lichenification is a rough, thickened, hardened area of epidermis resulting
, from chronic irritation such as scratching or rubbing. An example of lichenification is
chronic dermatitis. A fissure is a linear crack with sharp edges, extending into the dermis.
Examples of a fissure include cracks at the corners of the mouth or in the hands, or those
seen with athlete's foot. A keloid is an elevated, irregular, darkened area of excess scar
tissue caused by excessive collagen formation during healing. It extends beyond the site
of the original injury. An example of a keloid is scar tissue from ear piercing. Scales are
shedding flakes of greasy, keratinized skin tissue. Examples of scales include dry skin,
dandruff, psoriasis, and eczema.
A client has presented with a burn injury. The injury site is pale and waxy with large
flat blisters. The client asks questions about the severity of the injury and how long it will
take for this injury to heal. Based upon your knowledge, what information should be
provided to the client?
a. The wound is a partial-thickness burn, and could take up to two weeks to heal.
b. The wound is a superficial burn, and will take up to three weeks to heal.
c. The wound is a deep partial-thickness burn, and will take more than three weeks to
heal.
d. Wound healing is individualized. - CORRECT ANSWER-Answer: c
Rationale: The wound describes is a deep partial-thickness burn. Deep partial thickness
wounds will take more than three weeks to heal. A superficial burn is bright red and
moist, and might appear glistening with blister formation. The healing time for this type
of wound is within 21 days.
A client has reported to the physician's office with complaints of an inability to sleep at
night. During the data collection, the client reports her estranged husband died a little
over a year ago. She states "I am not sure why this is so difficult, I really couldn't stand
him near the end." Which response by the nurse is most appropriate?
1. "You seem angry."
2. "You should contact a therapist."
3. "Sometimes a rocky relationship with someone at the time of their death can impact
your ability to grieve."
4. "You are just entering the grief process, things will get better." - CORRECT ANSWER-Answer: 3
Rationale: Unresolved conflict at the time of death can impact the ability of survivors to
successfully grieve the deceased. The client's demeanor does not seem angry. It is
inappropriate for the nurse to refer the client to a therapist. Referrals must be initiated by
the physician. The death occurred more than a year ago. The client's continued inability
to sleep indicates impaired grieving.
A client has returned to the unit following surgery. The nurse knows that which
intervention will provide the most pain relief for the client?
a. Offer pain relief before the client complains of pain.
b. Wait until the client can describe the pain specifically.
c. Assess the pain level every four hours around the clock.
d. Allow the client to "sleep off" the anesthesia, and then offer pain medication. - CORRECT ANSWER-Correct answer:
a
Rationale: Anticipating a client's pain will ensure a more manageable pain experience
than will waiting until the client complains of pain. Pain management need to be
implemented prior to the client describing specific postoperative pain, or "sleeping off"
anesthesia. If the client is asleep, she should not be awakened simply to assess the pain
every four hours unless there are other significant nonverbal signs during sleep that
indicate the client is in pain. These can include grimacing, moaning, thrashing, or
guarding of a surgical site.
A client hospitalized for diagnostic testing reports an intense fear of being found to
have a terminal condition. What response by the nurse will be most therapeutic?
1. "There is no indication you are going to die."
2. "I am not sure why you feel that way."
3. "What has your doctor told you about your condition?"
4. "What types of symptoms lead you to feel this way?" - CORRECT ANSWER-Answer: 3
Rationale: The client is demonstrating signs of death anxiety. This involves a fear of
dying. The nurse's responsibility will be to determine what has caused this belief. Telling
the client that the feelings are unfounded will do little to ease the client's anxiety. Further,
this might not be entirely true. Expressing to the client a lack of understanding about his
