A client reports to the nurse that her elderly mother has become increasingly angry and responds inappropriately to conversations within the past few months.

She notes that her mother does not respond when the mother’s back is turned. What is the best intervention for the nurse?

Teach the client techniques for coping with the mother’s anger.

Ask if the mother could come in for a hearing evaluation.

Tell the client it appears the mother has a hearing loss.

Inform the client to ignore the behavior and treat the mother with love.

Answer and Explanation

The Correct Answer is B

Choice A rationale
While teaching the client techniques for coping with the mother’s anger might be helpful, it does not address the root cause of the problem. The mother’s anger and inappropriate responses could be due to frustration from not being able to hear properly.
Choice B rationale
The mother’s behavior of not responding when her back is turned and becoming increasingly angry could be signs of hearing loss. A hearing evaluation would help determine if this is the case and appropriate interventions can be put in place.
Choice C rationale
Telling the client that it appears the mother has a hearing loss is not the best intervention because it is based on assumption without any professional evaluation. It is important to have a professional evaluation before making such conclusions.
Choice D rationale
Informing the client to ignore the behavior and treat the mother with love does not address the potential issue of hearing loss. Ignoring the problem does not solve it and could lead to further frustration and misunderstanding.

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Correct Answer is A

Explanation

The correct answer is Choice A.

A patient who returned from a procedure after receiving general anesthesia and is aggressive and confused is experiencing delirium.

A. Increasing feelings of anger. B. Sleeping 12 hours or more each day. C. Increasing sense of attachment to others. D. Constant need to talk about the event.

Correct Answer is A

Explanation

Choice A rationale:
Anger is a common and expected response to trauma, including sexual assault. It can stem from various sources, including:
Feelings of violation and powerlessness: Survivors may feel intense anger towards the perpetrator for taking control of their bodies and lives.
Betrayal: If the assault was committed by someone they knew or trusted, survivors may feel intense anger towards that person for breaking their trust.
Frustration and injustice: Survivors may feel angry at the injustice of the situation, the lack of control they had, and the ongoing impact of the trauma.
Difficulty processing other emotions: Anger can sometimes mask other emotions that are difficult to deal with, such as fear, sadness, or guilt.
Anger can manifest in various ways, including:
Irritability and outbursts: Survivors may have a short temper, snap at others easily, or have difficulty controlling their anger. Aggression: In some cases, anger can lead to physical or verbal aggression towards others or self-harming behaviors.
Withdrawal and isolation: Some survivors may withdraw from social interactions and relationships to avoid potential triggers for their anger.
Substance abuse: Some survivors may turn to alcohol or drugs to numb their feelings or cope with their anger.
Choice B rationale:
Sleeping 12 hours or more each day can be a symptom of PTSD, but it is not a specific indicator of anger. It can also be a sign of depression, anxiety, or hypersomnia, a sleep disorder characterized by excessive daytime sleepiness.
Choice C rationale:
PTSD can sometimes lead to an increased sense of detachment from others, rather than attachment. Survivors may feel emotionally numb, have difficulty trusting others, or withdraw from relationships.
Choice D rationale:
While some survivors of sexual assault may feel a need to talk about the event, it is not a universal symptom of PTSD. Some survivors may avoid talking about the event altogether due to the distress it causes.

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A client reports to the nurse that her elderly mother has become increasingly angry and responds inappropriately to conversations within the past few months. She notes that her mother does not respond when the mother’s back is turned. What is the best intervention for the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient returned from a procedure after receiving general anesthesia and is aggressive and confused. The nurse knows that the patient is experiencing:

Correct Answer is A

Explanation

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

Correct Answer is A

Explanation

A patient with a history of suicidal ideation is under observation. When is the patient at the highest risk for self-harm?

A client who recently went through an upsetting divorce is threatening to commit suicide with a handgun. The client is voluntarily admitted to the psychiatric unit. Which of the following nursing diagnoses has the highest priority?

During the mental status examination, the nurse observes that the client rapidly shifts from one idea to another related thought. Which disordered thinking process is the client displaying?

A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is voluntarily admitted to the psychiatric unit. Which of the following nursing diagnoses has the highest priority?

A patient is pacing the hall near the nurse’s station, swearing loudly. What would be an appropriate initial intervention for the nurse?

During the assessment phase of the nursing process, data collection takes place. What methods does the nurse employ to gather data? (Select all that apply.)

A recently widowed client is experiencing memory loss, insomnia, loss of appetite, and irritability over the last few months. Which data should the nurse obtain when assessing this client?

Upon entrance into a mental health care system, clients are thoroughly assessed, and this is followed by the development of a mental health treatment plan assessment. Which of the following are purposes of the treatment plan? (Select all that apply)

A client reports to the nurse that her elderly mother has become increasingly angry and responds inappropriately to conversations within the past few months.

She notes that her mother does not respond when the mother’s back is turned. What is the best intervention for the nurse?