A nurse is planning care for a client following a suicide attempt. Which of the following
interventions should the nurse include in the plan? - ANSWER Provide the client with
plastic eating utensils.
A nurse is performing an admission assessment for a client who appears withdrawn and
fearful. Which of the following actions should the nurse take first? - ANSWER Inform
the client that this admission is confidential.
A nurse is caring for an adolescent client who has anorexia nervosa. The client states, "Have I
done any permanent damage to my body?" Which of the following responses should the
nurse make? - ANSWER You're afraid you have caused physical injury to yourself?
A nurse is caring for a client following a fire that destroyed her home and killed one of her
children. The client is crying and does not make eye contact with the nurse. Which of the
following questions should the nurse ask first? - ANSWER Have you thought of
harming yourself?
A nurse is checking laboratory values for a hospitalized young adult client who has bipolar
disorder and is taking lithium. Which of the following values is the priority for the nurse to
report to the provider? - ANSWER Serum creatinine 2.1 mg/dL
A nurse is providing information to a client who is seeking voluntary admission to a mental
health facility. Which of the following information should the nurse include? -
ANSWER You will still need to give informed consent for treatment after admission.
1
, A nurse is developing a plan of care for an adolescent client who has conduct disorder.
Which of the following interventions should the nurse include in the plan? -
ANSWER Initiate a behavioral contract with the client.
A hospice nurse is talking with the family of a client who recently died from cancer following
a series of chemotherapy treatment. One of the adult children is angry w/ provider and
blames the provider for their father's death. Which of the following defense mechanisms is
the family using? - ANSWER Displacement
A nurse in an acute care facility is providing teaching for the adult child of an older adult
client who is admitted with a UTI and delirium. The client has been living independently at
home. Which of the following statements by the adult child demonstrates the teaching has
been effective? - ANSWER I expect that my father will no longer be confused when he
is discharged.
A nurse is caring for a client who is experiencing a manic episode. Which of the following
actions should the nurse take first? - ANSWER Encourage the client to rest each hour
A nurse is leading a medication education group for several clients. A client who is
sometimes violent becomes angry and begins yelling at others in the group. Which of the
following actions should the nurse take? SATA - ANSWER Move others away from the
client.
Offer the client a PRN dose of lorazepam.
Ask the client open ended questions about the behavior.
A charge nurse is planning an in-service for a group of newly licensed nurses about the use
of restraints. Which of the following information should the nurse include? -
ANSWER Record the client's behavior every 15mins while in restraints.
A nurse is assessing a client who has bulimia nervosa. Which of the following findings should
the nurse expect? - ANSWER Dental caries
2
interventions should the nurse include in the plan? - ANSWER Provide the client with
plastic eating utensils.
A nurse is performing an admission assessment for a client who appears withdrawn and
fearful. Which of the following actions should the nurse take first? - ANSWER Inform
the client that this admission is confidential.
A nurse is caring for an adolescent client who has anorexia nervosa. The client states, "Have I
done any permanent damage to my body?" Which of the following responses should the
nurse make? - ANSWER You're afraid you have caused physical injury to yourself?
A nurse is caring for a client following a fire that destroyed her home and killed one of her
children. The client is crying and does not make eye contact with the nurse. Which of the
following questions should the nurse ask first? - ANSWER Have you thought of
harming yourself?
A nurse is checking laboratory values for a hospitalized young adult client who has bipolar
disorder and is taking lithium. Which of the following values is the priority for the nurse to
report to the provider? - ANSWER Serum creatinine 2.1 mg/dL
A nurse is providing information to a client who is seeking voluntary admission to a mental
health facility. Which of the following information should the nurse include? -
ANSWER You will still need to give informed consent for treatment after admission.
1
, A nurse is developing a plan of care for an adolescent client who has conduct disorder.
Which of the following interventions should the nurse include in the plan? -
ANSWER Initiate a behavioral contract with the client.
A hospice nurse is talking with the family of a client who recently died from cancer following
a series of chemotherapy treatment. One of the adult children is angry w/ provider and
blames the provider for their father's death. Which of the following defense mechanisms is
the family using? - ANSWER Displacement
A nurse in an acute care facility is providing teaching for the adult child of an older adult
client who is admitted with a UTI and delirium. The client has been living independently at
home. Which of the following statements by the adult child demonstrates the teaching has
been effective? - ANSWER I expect that my father will no longer be confused when he
is discharged.
A nurse is caring for a client who is experiencing a manic episode. Which of the following
actions should the nurse take first? - ANSWER Encourage the client to rest each hour
A nurse is leading a medication education group for several clients. A client who is
sometimes violent becomes angry and begins yelling at others in the group. Which of the
following actions should the nurse take? SATA - ANSWER Move others away from the
client.
Offer the client a PRN dose of lorazepam.
Ask the client open ended questions about the behavior.
A charge nurse is planning an in-service for a group of newly licensed nurses about the use
of restraints. Which of the following information should the nurse include? -
ANSWER Record the client's behavior every 15mins while in restraints.
A nurse is assessing a client who has bulimia nervosa. Which of the following findings should
the nurse expect? - ANSWER Dental caries
2
