A client who has just been raped arrives at the Emergency Room. The client is crying, pacing and cursing their attacker. Which is the priority therapeutic statement for the nurse to make?

"The police will want to interview you."

"I will call your spouse."

"We'll have to take photographs of those wounds."

"You are safe now."

Answer and Explanation

The Correct Answer is D

D. This statement prioritizes the client's immediate emotional needs by providing reassurance, validation, and a sense of safety in a traumatic situation. It acknowledges the client's distress and communicates empathy and support, which are essential for building trust and rapport and facilitating the client's emotional healing process.
A. The client may feel overwhelmed by the prospect of speaking to the police at that moment, and it may not be the most therapeutic statement to prioritize.
B. Contacting the client's spouse may provide emotional support and assistance, but it may not be the priority therapeutic statement in this situation.
C. The client may already be feeling vulnerable and exposed, and discussing the need for photographs may exacerbate feelings of distress or discomfort.

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Correct Answer is C

Explanation

C. Bringing birth certificates and Social Security cards is essential for establishing identity and accessing necessary services, such as shelters, legal assistance, or government benefits. These documents may be needed for applying for assistance, obtaining housing, or enrolling children in school.
A. Ensuring the well-being and comfort of any children involved is important but bringing toys to amuse them for a few days may not be the highest priority when creating an escape plan from spousal abuse.
B. A cell phone can be used to call for help, contact emergency services, or reach out to trusted individuals for assistance. However, it is not the most important item.
D. Having reading materials may provide distraction and comfort during stressful times but they are not typically considered essential items for an escape plan from spousal abuse.

A. Encourage dividing tasks into smaller, attainable steps and reward successful completion. B. Remove privileges if homework is not completed within a 2-hour period. C. Seek a physician's order to discontinue the stimulant methylphenidate. D. Mandate that the client remains in his room until all homework is complete.

Correct Answer is A

Explanation

A. Dividing tasks into smaller, attainable steps and reward successful completion aligns with the principles of behavioral therapy and is likely to be effective for improving the task performance of an adolescent with ADHD. Breaking tasks into smaller, manageable steps can help reduce overwhelm and improve focus.
B. Removing privileges if homework is not completed within a 2-hour period is punitive and may not be effective for improving the task performance of an adolescent with ADHD. Negative consequences, such as removing privileges, can lead to feelings of frustration, demotivation, and resistance to task completion.
C. Methylphenidate is a commonly prescribed stimulant medication for ADHD, and discontinuing it abruptly without medical supervision can lead to withdrawal symptoms and worsening of ADHD symptoms.
D. Mandating isolation in the room is overly restrictive and can lead to feelings of frustration, isolation, and resentment, which can further impact task performance and exacerbate ADHD symptoms.

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A client who has just been raped arrives at the Emergency Room. The client is crying, pacing and cursing their attacker. Which is the priority therapeutic statement for the nurse to make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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