NURS 1011 Basic Psychosocial Needs 1 Questions & Answers

NURS 1011 Basic Psychosocial Needs 1 Questions & Answers Basic Psychosocial Needs 1 46 0f 50 Answer Key Question 1 See full question A nurse is preparing a client for chemotherapy to treat colon cancer. The client says, "I don't know about this treatment. After everything is said and done, it may not do a bit of good. This thing may get me anyway." Which response by the nurse is most therapeutic? You Selected: • "You're wondering whether you've made the right decision about your treatment." Correct response: • "You're wondering whether you've made the right decision about your treatment." Explanation: By rephrasing the client's statement and focusing on his concerns, the nurse encourages further discussion of his feelings. Telling the client to keep a positive attitude incorrectly implies that the nurse knows the best way to deal with the situation. Saying that cancer of the colon may be cured ignores the client's feelings. Mentioning that everyone who has cancer worries disregards the uniqueness of the client's feelings and implies that his concerns aren't acceptable. Question 2 See full question For a client with a nursing diagnosis of Insomnia, the nurse should use which measure to promote sleep? You Selected: • Playing soft or soothing music Correct response: • Playing soft or soothing music Explanation: Playing soft or soothing music promotes relaxation, which fosters rest and sleep. To promote sleep, the nurse should also encourage the client to increase his activity during the day, avoid providing stimulating beverages (such as caffeinated coffee) in the evening, and offer an evening snack with warm milk. The nurse should also encourage the client to decrease his activity 2 hours before bedtime to promote sleep. Remediation: Question 3 See full question When a nurse enters a client's room, the client frowns and states, "I've had my damn light on for 20 minutes. It's about time you got here. I'm sick of this place and the staff." The nurse's best response would be: You Selected: • "You seem upset this morning." Correct response: • "You seem upset this morning." Explanation: To be therapeutic, the nurse should always comment on the client's statements. The client's words are strong, and it's obvious that he's angry. By introducing herself or apologizing, the nurse ignores the client's problem. Repeating the client's statement would only add to his anger. Remediation: Question 4 See full question A client says he's stressed by his job but enjoys the challenge. What should the nurse suggest? You Selected: • Take stress-management classes. Correct response: • Take stress-management classes. Explanation: The nurse should suggest stress-management classes, which would identify factors that contribute to stress in the client's life and teach him how to manage stress more effectively. The client may not have to leave a job he enjoys. The information provided by the client doesn't indicate that spending too little time with his family and taking his job home with him contribute to the client's stress. Remediation: Question 5 See full question During the termination phase of a nurse-client relationship, which intervention may lead to client confusion? You Selected: • Introducing new issues to the client Correct response: • Introducing new issues to the client Explanation: The nurse shouldn't introduce new issues during the termination phase because doing so may confuse the client. This phase is a time for wrapping up the relationship. It's appropriate for the nurse to refer the client to support groups. Reviewing what's been accomplished during the relationship is a goal of the termination phase. The client may express sadness during the termination phase, but this is a normal response. Remediation: Question 6 See full question The client with recurrent depression and suicidal ideation tells the nurse, "I cannot afford this medicine anymore. I know I will be okay without it." The nurse should: You Selected: • ask the social worker to find financial assistance for the client. Correct response: • ask the social worker to find financial assistance for the client. Explanation: Because the client is in danger of noncompliance with the medication due to financial concerns, the nurse should contact the social worker to assist with locating available resources for the client to ensure continuation of the medication needed for the recurrent illness. The client needs to continue the medications with no interruptions to minimize the chance of decompensation. Although the HCP is the person responsible for prescribing the client’s medication, routinely the HCP is not involved in finding financial assistance for the client’s medication needs. The client needs the medication at the present time. Scheduling a follow-up appointment in two weeks does not address the immediate concern. The client could stop the medication before being seen and could become severely depressed. A family member’s assistance may not be a sufficient or a permanent means of financial help for the client in terms of medication needs. Question 7 See full question The nurse cares for a middle-aged client with a below-the-knee amputation. What statement indicates the need for further assessment of the client's body image? You Selected: • "I hope I can handle having a prosthesis, but I am really wondering what my wife will think." Correct response: • "I hope I can handle having a prosthesis, but I am really wondering what my wife will think." Explanation: The client expressing doubts about his wife’s response to his amputation as well as possible doubt on his part is still struggling with body image issues. Looking forward to participating in walkathons and helping others indicates plans for the future that imply an acceptance of his amputee status. Remembering that his friend died in the accident that caused his amputation indicates that the client is aware that there was a worse end result to the accident than his amputation. Remediation: Question 8 See full question Which client statement indicates that the client has coped effectively with a relationship problem? You Selected: • "My wife and I are talking about our likes and dislikes in activities." Correct response: • "We are really listening to each other about our different view on issues." Explanation: The client's statement that he and his wife listen to each other reflects improved efforts at communicating about issues. The other statements provide some insight into the need for better communication. However, they are but steps along the way to coping effectively with the problem. Question 9 See full question The nurse refers the parents of a child with cystic fibrosis to an organization that helps families with children who have this disease. Such organizations are especially beneficial for parents by helping them: You Selected: • meet with other parents of children with cystic fibrosis for mutual support. Correct response: • meet with other parents of children with cystic fibrosis for mutual support. Explanation: An important function of support organizations for any health problem is to put parents of children with the condition in touch with each other. Other parents can commonly offer support and help. In some instances, organizations can offer assistance, such as providing equipment required for home care of their child with cystic fibrosis. These organizations do not obtain tutors for children, nor do they provide medications, financial assistance, or genetic counseling for parents. Remediation: Question 10 See full question A client who has been recently diagnosed with acquired immunodeficiency syndrome (AIDS) inquires about hospice services. The nurse explains that hospice care is appropriate: You Selected: • for clients with an inevitable death within weeks to months. Correct response: • for clients with an inevitable death within weeks to months. Explanation: Hospice programs are appropriate programs for clients with any type of terminal illness when death is imminent within weeks up to 6 months. Clients may discuss their prognosis of a terminal illness before it progresses to the terminal stage when a referral to hospice care is indicated. Clients are not required to have advance directives to be admitted to hospice services, but will be asked to complete them upon admission. Remediation: Question 11 See full question A client with rheumatoid arthritis tells the nurse that she feels “quite alone” in adjusting to changes in her lifestyle. The nurse should respond by: You Selected: • telling the client about her community's arthritis support group. Correct response: • telling the client about her community's arthritis support group. Explanation: The client should be encouraged to join the community arthritis support group so that she can share her feelings with others who are facing similar experiences with this chronic illness and can identify with her concerns. A hobby will not help her resolve her feelings of being alone. Seeking counseling or discussing her feelings with a minister may be helpful, but these activities will not necessarily help the client to understand that there are many individuals who must adjust their lifestyles because of arthritis and that she is not alone. Remediation: Question 12 See full question A father of a child with a urinary tract infection calls the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We do not want to use discipline because of the illness, but we are worried about the behavior." Which response by the nurse is best? You Selected: • "I understand it is hard to discipline a child who is ill, but things need to be kept as normal as possible." Correct response: • "I understand it is hard to discipline a child who is ill, but things need to be kept as normal as possible." Explanation: To ensure appropriate psychosocial development, a child needs to have normal patterns maintained as much as possible during illness. It is tempting to give ill children special treatment and to relax discipline. However, family routines and discipline should be kept as normal as possible. The child needs to know the limits to ensure feelings of security. When they are ill, children commonly attempt to stretch the rules and limits. If this occurs, returning to the previous well-behavior patterns will take time. Question 13 See full question A client tells the nurse on admission that she is uneasy about having to leave her children with a relative while being in the hospital for surgery. What should the nurse do? You Selected: • Gather more information about the client's feelings about the childcare arrangements. Correct response: • Gather more information about the client's feelings about the childcare arrangements. Explanation: The health history is conducted to ascertain a client’s state of wellness or illness. A personal dialogue between a client and a nurse is conducted to obtain information. To achieve a relationship of mutual trust and respect, the nurse must have the ability to communicate a sincere interest in the client. The therapeutic communication must be adapted to the responses, problems, and needs of the client. Reassurance and the remaining options do not demonstrate that the nurse is genuinely interested in the client’s needs. Remediation: Question 14 See full question The most common issue associated with sleep disturbances in the hospitalized client with cancer is: You Selected: • psychological. Correct response: • psychological. Explanation: Most hospitalized persons are at risk for sleep disturbances. Psychological issues (such as anxiety and depression) and pain are related to sleep deprivation. Social, nutritional, and cultural issues are not necessarily associated with sleep disturbances. Remediation: Question 15 See full question When caring for a client who is experiencing spiritual distress, what should the nurse do first? You Selected: • Help the client explore his or her own values and beliefs. Correct response: • Help the client explore his or her own values and beliefs. Explanation: The nurse must first allow the client to explore his or her own beliefs and values before making referrals, explaining various religious beliefs, or suggesting appropriate reading material. Remediation: Question 16 See full question A client has entered a smoking cessation program to quit a two-pack-a-day cigarette habit. The client has not smoked a cigarette for 3 weeks and tells the nurse about fears of starting smoking again because of current job pressures. What would be the most appropriate reply for the nurse to make in response to the client's comments? You Selected: • "It is good that you can talk about your concerns. Try calling a friend when you want to smoke." Correct response: • "It is good that you can talk about your concerns. Try calling a friend when you want to smoke." Explanation: It is important for individuals who are engaged in smoking cessation efforts to feel comfortable with sharing their fears of failure with others and seeking support. Although fewer than 5% of smokers successfully quit on their first attempt, it is not helpful to tell a client to anticipate failure. Telling the client to exercise more self-control does not provide support. Taking a vacation to avoid job pressures does not address the issue of how to manage the desire to smoke when in a stressful situation. Question 17 See full question A client with chronic renal failure was recently told by the healthcare provider of being a poor candidate for a transplant because of chronic uncontrolled hypertension and diabetes mellitus. Now the client tells the nurse, “I want to go off dialysis. I’d rather not live than be