NR 326 EXAM 1 QUESTIONS WITH ALL
CORRECT & VERIFIED ANSWERS
1. Three years ago, Anna's dog, Lucky, her pet for 16 years, was killed by a car. Since that time, Anna
has lost weight, rarely leaves her home, and talks excessively about Lucky. Anna's behavior would be
considered maladaptive for which of the following reasons?
a. It has been more than 3 years since Lucky died.
b. Her grief is too intense over the loss of a dog.
c. Her grief is interfering with her functioning.
d. Cultural norms typically do not comprehend grief over the loss of a pet. Correct answer-c. Her
grief is interfering with her functioning.
Anna states that Lucky was her closest friend, and since his death, no one can ever replace the
relationship they had. According to Maslow's hierarchy of needs, which level of need is not being
met?
a. Physiological needs
b. Self-esteem needs
c. Safety and security needs
d. Love and belonging needs Correct answer-d. Love and belonging needs
Anna's daughter notices that Anna appears to be listening to another voice when just the two of
them are in a room together. When questioned, Anna admits that she hears someone telling her that
she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following
best describes what Anna is experiencing?
a. Neurosis
b. Psychosis
c. Depression
d. Bereavement Correct answer-b. Psychosis
Anna, who is 72 years old, is at the age when she may have experienced several losses in a short
time. What is this called?
a. Bereavement overload
b. Normal mourning
c. Isolation
d. Cultural relativity Correct answer-a. Bereavement overload
Anna has been grieving the death of Lucky for 3 years. She is unable to take care of her normal
activities because she insists on visiting Lucky's grave daily. What is the most likely reason that Anna's
daughter has put off seeking help for Anna?
Women are less likely than men to seek help for emotional problems.
b. Relatives often try to normalize behavior rather than label it mental illness.
c. She knows that all older people are expected to be a little depressed.
d. She is afraid that the neighbors will think her mother is "crazy." Correct answer-b. Relatives
often try to normalize behavior rather than label it mental illness.
6. Lucky's accident occurred when he got away from Anna while they were taking a walk. He ran into
the street and was hit by a car. Anna cannot remember the circumstances of his death. This is an
example of what defense mechanism?
a. Rationalization
b. Suppression
c. Denial
,d. Repression Correct answer-d. Repression
A client with a history of schizophrenia is brought to the emergency department by police who
report that she was knocking down food displays at a grocery store and yelling that the food is all
poisoned. The client reports to the nurse the she has no idea why she was brought to the emergency
department because "there is nothing wrong with me." Which of these actions by the nurse
demonstrates good clinical judgment?
a. Instruct the police officer that this client should be incarcerated because there is nothing that can
be done in an emergency department.
b. Document that the client is manifesting suspicious ideation and anosognosia.
c. Ask the doctor to order gastric lavage because the client reports having been poisoned.
d. Instruct the client that the food is not poisoned and there is something very wrong with her.
Correct answer-b. Document that the client is manifesting suspicious ideation and anosognosia.
8. During a primary care physician appointment, a client who has been a widow for 7 years reports to
the nurse that she does not want to wake up in the morning and feels there is nothing left for her.
Which of these actions by the nurse is a priority?
a. Listen empathically and encourage the client to find some activities to increase socialization.
b. Encourage the client to discuss this with her physician.
c. Assess the client for symptoms of depression and suicide risk.
d. Instruct the client that grief takes a long time to resolve but that she will be feeling better soon.
Correct answer-c. Assess the client for symptoms of depression and suicide risk.
A client who has arrived at the health clinic for diabetic education is perspiring, wringing his hands,
and states, "I'm so anxious about giving myself shots I can hardly breathe. I don't know what to do."
Which of these actions by the nurse demonstrates good clinical judgment?
a. Assist the client in relaxation exercises before commencing diabetes education.
b. Instruct the client that it is not hard to give oneself a shot and commence teaching.
c. Assess the client further for symptoms of anxiety.
d. Cancel diabetic education and encourage the client to reschedule when he feels less anxious.
Correct answer-a. Assist the client in relaxation exercises before commencing diabetes education.
10. A client who was admitted to the psychiatric unit for major depressive disorder reports to the
nurse, "Ever since my daughter died by suicide 10 years ago, I can't stand to be around my friends.
They just don't get it!" Which of these actions by the nurse demonstrates good clinical judgment?
a. Affirm that other people cannot possibly provide adequate support in circumstances like these.
b. Assist the client to explore the connection between grief and anger.
c. Tell the client that her friends are doing the best they can and she should try to accept their
support.
d. Ask the client to describe how her daughter killed herself. Correct answer-b. Assist the client to
explore the connection between grief and anger.
The nurse decides to go against family wishes and tell the client of his terminal status because that is
what she would want if she were the client. Which of the following ethical theories is considered in
this decision?
a. Kantianism
b. Christian ethics
c. Natural law theories
d. Ethical egoism Correct answer-b. Christian ethics
,The nurse decides to respect family wishes and not tell the client of his terminal status because that
would bring the most happiness to the most people. Which of the following ethical theories is
considered in this decision?
a. Utilitarianism
b. Kantianism
c. Christian ethics
d. Ethical egoism Correct answer-a. Utilitarianism
The nurse decides to tell the client of his terminal status because she believes it is her duty to do so.
Which of the following ethical theories is considered in this decision?
a. Natural law theories
b. Ethical egoism
c. Kantianism
d. Utilitarianism Correct answer-c. Kantianism
The nurse assists the physician with electroconvulsive therapy on a client who has refused to give
consent. With which of the following legal actions might the nurse be charged because of this
nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality Correct answer-b. Battery
A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes
to keep him from leaving. With which of the following legal actions might the nurse be charged
because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality Correct answer-c. False imprisonment
Joe is very restless and is pacing the room. The nurse says to Joe, "If you don't sit down in the chair
and be still, I'm going to put you in restraints!" With which of the following legal actions might the
nurse be charged because of this nursing action?
a. Defamation of character
b. Battery
c. Breach of confidentiality
d. Assault Correct answer-d. Assault
A nurse reports to the supervisor that a depressed client is refusing medication to treat his heart
condition and states he "would rather just die." The nurse is not sure how to intervene because,
although clients have a right to refuse medication, this client may be so depressed that his behavior
represents risk for suicide. Which of these actions by the supervisor is a priority?
a. Tell the nurse that medication will have to be given forcibly if the client continues to refuse
medication.
b. Instruct the nurse that, because the client is elderly, he is unable to make this decision and
medication will need to be secretly mixed in his food.
c. Educate the nurse that the physician has the final say so the nurse should ask the physician what
to do.
, d. Activate appropriate hospital resources, such as an ethics committee, so this issue can be explored
further. Correct answer-d. Activate appropriate hospital resources, such as an ethics committee, so
this issue can be explored further.
A client on the psychiatric unit begins yelling out loud that no one is listening to him and that he is
going to "blow up" soon. The orderly asks the nurse if he should go ahead and put the client in
restraints for the safety of others. Which of these responses by the nurse is most appropriate?
a. Educate the orderly that restraints may never be initiated without a physician's order.
b. Instruct the orderly that it would be best to see if the client can be assisted to calm down by
listening to his concerns.
c. Instruct the orderly to put the client in restraints but make sure to assess the client every 15
minutes for issues regarding circulation, nutrition, respiration, hydration, and elimination.
d. Instruct the orderly to get others to assist him in restraining the client but be aware restraints
should be discontinued at the earliest possible time regardless of when a physician's order is
scheduled to expire. Correct answer-b. Instruct the orderly that it would be best to see if the client
can be assisted to calm down by listening to his concerns.
The nurse collects the following information during the admission assessment. For which of these
pieces of data should the nurse take additional action to ensure that "duty to warn" laws are
followed?
a. The client threatens violence toward another individual.
b. The client states he wants to kill everyone that has demons.
c. The client is having command hallucinations.
d. The client reveals paranoid delusions about another individual. Correct answer-a. The client
threatens violence toward another individual.
Which of these actions by the nurse demonstrates an application of the QSEN competency related to
informatics?
a. Learns how to effectively communicate information using electronic health records
b. Provides a verbal report of client behavioral issues at shift change
c. Asks the supervisor for guidelines on how to prevent lawsuits
d. Reads journals to learn information about new treatments and approaches to nursing care
Correct answer-a. Learns how to effectively communicate information using electronic health records
Which of the following behaviors suggest a possible breach of professional boundaries? (Select all
that apply.)
a. The nurse repeatedly requests to be assigned to a specific patient.
b. The nurse shares the details of her divorce with the patient.
c. The nurse makes arrangements to meet the patient outside of the therapeutic environment.
d. The nurse shares how she dealt with a similar difficult situation. Correct answer-a. The nurse
repeatedly requests to be assigned to a specific patient.
b. The nurse shares the details of her divorce with the patient.
c. The nurse makes arrangements to meet the patient outside of the therapeutic environment.
. Which of the following tasks are associated with the orientation phase of relationship
development? (Select all that apply.)
a. Promoting the patient's insight and perception of reality
b. Creating an environment for the establishment of trust and rapport
c. Using the problem-solving model toward goal fulfillment
d. Obtaining available information about the patient from various sources
CORRECT & VERIFIED ANSWERS
1. Three years ago, Anna's dog, Lucky, her pet for 16 years, was killed by a car. Since that time, Anna
has lost weight, rarely leaves her home, and talks excessively about Lucky. Anna's behavior would be
considered maladaptive for which of the following reasons?
a. It has been more than 3 years since Lucky died.
b. Her grief is too intense over the loss of a dog.
c. Her grief is interfering with her functioning.
d. Cultural norms typically do not comprehend grief over the loss of a pet. Correct answer-c. Her
grief is interfering with her functioning.
Anna states that Lucky was her closest friend, and since his death, no one can ever replace the
relationship they had. According to Maslow's hierarchy of needs, which level of need is not being
met?
a. Physiological needs
b. Self-esteem needs
c. Safety and security needs
d. Love and belonging needs Correct answer-d. Love and belonging needs
Anna's daughter notices that Anna appears to be listening to another voice when just the two of
them are in a room together. When questioned, Anna admits that she hears someone telling her that
she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following
best describes what Anna is experiencing?
a. Neurosis
b. Psychosis
c. Depression
d. Bereavement Correct answer-b. Psychosis
Anna, who is 72 years old, is at the age when she may have experienced several losses in a short
time. What is this called?
a. Bereavement overload
b. Normal mourning
c. Isolation
d. Cultural relativity Correct answer-a. Bereavement overload
Anna has been grieving the death of Lucky for 3 years. She is unable to take care of her normal
activities because she insists on visiting Lucky's grave daily. What is the most likely reason that Anna's
daughter has put off seeking help for Anna?
Women are less likely than men to seek help for emotional problems.
b. Relatives often try to normalize behavior rather than label it mental illness.
c. She knows that all older people are expected to be a little depressed.
d. She is afraid that the neighbors will think her mother is "crazy." Correct answer-b. Relatives
often try to normalize behavior rather than label it mental illness.
6. Lucky's accident occurred when he got away from Anna while they were taking a walk. He ran into
the street and was hit by a car. Anna cannot remember the circumstances of his death. This is an
example of what defense mechanism?
a. Rationalization
b. Suppression
c. Denial
,d. Repression Correct answer-d. Repression
A client with a history of schizophrenia is brought to the emergency department by police who
report that she was knocking down food displays at a grocery store and yelling that the food is all
poisoned. The client reports to the nurse the she has no idea why she was brought to the emergency
department because "there is nothing wrong with me." Which of these actions by the nurse
demonstrates good clinical judgment?
a. Instruct the police officer that this client should be incarcerated because there is nothing that can
be done in an emergency department.
b. Document that the client is manifesting suspicious ideation and anosognosia.
c. Ask the doctor to order gastric lavage because the client reports having been poisoned.
d. Instruct the client that the food is not poisoned and there is something very wrong with her.
Correct answer-b. Document that the client is manifesting suspicious ideation and anosognosia.
8. During a primary care physician appointment, a client who has been a widow for 7 years reports to
the nurse that she does not want to wake up in the morning and feels there is nothing left for her.
Which of these actions by the nurse is a priority?
a. Listen empathically and encourage the client to find some activities to increase socialization.
b. Encourage the client to discuss this with her physician.
c. Assess the client for symptoms of depression and suicide risk.
d. Instruct the client that grief takes a long time to resolve but that she will be feeling better soon.
Correct answer-c. Assess the client for symptoms of depression and suicide risk.
A client who has arrived at the health clinic for diabetic education is perspiring, wringing his hands,
and states, "I'm so anxious about giving myself shots I can hardly breathe. I don't know what to do."
Which of these actions by the nurse demonstrates good clinical judgment?
a. Assist the client in relaxation exercises before commencing diabetes education.
b. Instruct the client that it is not hard to give oneself a shot and commence teaching.
c. Assess the client further for symptoms of anxiety.
d. Cancel diabetic education and encourage the client to reschedule when he feels less anxious.
Correct answer-a. Assist the client in relaxation exercises before commencing diabetes education.
10. A client who was admitted to the psychiatric unit for major depressive disorder reports to the
nurse, "Ever since my daughter died by suicide 10 years ago, I can't stand to be around my friends.
They just don't get it!" Which of these actions by the nurse demonstrates good clinical judgment?
a. Affirm that other people cannot possibly provide adequate support in circumstances like these.
b. Assist the client to explore the connection between grief and anger.
c. Tell the client that her friends are doing the best they can and she should try to accept their
support.
d. Ask the client to describe how her daughter killed herself. Correct answer-b. Assist the client to
explore the connection between grief and anger.
The nurse decides to go against family wishes and tell the client of his terminal status because that is
what she would want if she were the client. Which of the following ethical theories is considered in
this decision?
a. Kantianism
b. Christian ethics
c. Natural law theories
d. Ethical egoism Correct answer-b. Christian ethics
,The nurse decides to respect family wishes and not tell the client of his terminal status because that
would bring the most happiness to the most people. Which of the following ethical theories is
considered in this decision?
a. Utilitarianism
b. Kantianism
c. Christian ethics
d. Ethical egoism Correct answer-a. Utilitarianism
The nurse decides to tell the client of his terminal status because she believes it is her duty to do so.
Which of the following ethical theories is considered in this decision?
a. Natural law theories
b. Ethical egoism
c. Kantianism
d. Utilitarianism Correct answer-c. Kantianism
The nurse assists the physician with electroconvulsive therapy on a client who has refused to give
consent. With which of the following legal actions might the nurse be charged because of this
nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality Correct answer-b. Battery
A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes
to keep him from leaving. With which of the following legal actions might the nurse be charged
because of this nursing action?
a. Assault
b. Battery
c. False imprisonment
d. Breach of confidentiality Correct answer-c. False imprisonment
Joe is very restless and is pacing the room. The nurse says to Joe, "If you don't sit down in the chair
and be still, I'm going to put you in restraints!" With which of the following legal actions might the
nurse be charged because of this nursing action?
a. Defamation of character
b. Battery
c. Breach of confidentiality
d. Assault Correct answer-d. Assault
A nurse reports to the supervisor that a depressed client is refusing medication to treat his heart
condition and states he "would rather just die." The nurse is not sure how to intervene because,
although clients have a right to refuse medication, this client may be so depressed that his behavior
represents risk for suicide. Which of these actions by the supervisor is a priority?
a. Tell the nurse that medication will have to be given forcibly if the client continues to refuse
medication.
b. Instruct the nurse that, because the client is elderly, he is unable to make this decision and
medication will need to be secretly mixed in his food.
c. Educate the nurse that the physician has the final say so the nurse should ask the physician what
to do.
, d. Activate appropriate hospital resources, such as an ethics committee, so this issue can be explored
further. Correct answer-d. Activate appropriate hospital resources, such as an ethics committee, so
this issue can be explored further.
A client on the psychiatric unit begins yelling out loud that no one is listening to him and that he is
going to "blow up" soon. The orderly asks the nurse if he should go ahead and put the client in
restraints for the safety of others. Which of these responses by the nurse is most appropriate?
a. Educate the orderly that restraints may never be initiated without a physician's order.
b. Instruct the orderly that it would be best to see if the client can be assisted to calm down by
listening to his concerns.
c. Instruct the orderly to put the client in restraints but make sure to assess the client every 15
minutes for issues regarding circulation, nutrition, respiration, hydration, and elimination.
d. Instruct the orderly to get others to assist him in restraining the client but be aware restraints
should be discontinued at the earliest possible time regardless of when a physician's order is
scheduled to expire. Correct answer-b. Instruct the orderly that it would be best to see if the client
can be assisted to calm down by listening to his concerns.
The nurse collects the following information during the admission assessment. For which of these
pieces of data should the nurse take additional action to ensure that "duty to warn" laws are
followed?
a. The client threatens violence toward another individual.
b. The client states he wants to kill everyone that has demons.
c. The client is having command hallucinations.
d. The client reveals paranoid delusions about another individual. Correct answer-a. The client
threatens violence toward another individual.
Which of these actions by the nurse demonstrates an application of the QSEN competency related to
informatics?
a. Learns how to effectively communicate information using electronic health records
b. Provides a verbal report of client behavioral issues at shift change
c. Asks the supervisor for guidelines on how to prevent lawsuits
d. Reads journals to learn information about new treatments and approaches to nursing care
Correct answer-a. Learns how to effectively communicate information using electronic health records
Which of the following behaviors suggest a possible breach of professional boundaries? (Select all
that apply.)
a. The nurse repeatedly requests to be assigned to a specific patient.
b. The nurse shares the details of her divorce with the patient.
c. The nurse makes arrangements to meet the patient outside of the therapeutic environment.
d. The nurse shares how she dealt with a similar difficult situation. Correct answer-a. The nurse
repeatedly requests to be assigned to a specific patient.
b. The nurse shares the details of her divorce with the patient.
c. The nurse makes arrangements to meet the patient outside of the therapeutic environment.
. Which of the following tasks are associated with the orientation phase of relationship
development? (Select all that apply.)
a. Promoting the patient's insight and perception of reality
b. Creating an environment for the establishment of trust and rapport
c. Using the problem-solving model toward goal fulfillment
d. Obtaining available information about the patient from various sources
