A female high school teacher, who was a child of alcoholic parents, seeks counseling at the community health clinic because of depression over a student who was killed by a drunk driver. After several weeks of counseling, which client behavior is the best indicator that the client is coping well with the anxiety related to the student's death?

Becomes the faculty sponsor for Students Against Drunk Driving (SADD).

Describes alternatives to becoming depressed over the student's death.

Confronts her parents about the hurt she felt as a child of alcoholic parents.

Signs a safety contract with the nurse agreeing not to hurt herself or others.

Answer and Explanation

The Correct Answer is A

A) Becoming the faculty sponsor for Students Against Drunk Driving (SADD) is a proactive and constructive behavior that indicates the client is coping well with her anxiety related to the student’s death. This action demonstrates her ability to channel her grief into positive advocacy, suggesting that she is processing her emotions and seeking to create meaningful change, which is a strong indicator of healthy coping.

B) Describing alternatives to becoming depressed over the student’s death is a positive step, as it shows the client is engaging in cognitive strategies to manage her emotions. However, while this indicates some progress, it is less impactful than taking active steps to address the issue, like becoming involved in advocacy or community efforts.

C) Confronting her parents about the hurt she felt as a child of alcoholic parents can be a significant therapeutic step, but it may not directly relate to her current coping with the loss of her student. While this confrontation may contribute to her overall healing, it does not necessarily indicate coping specifically related to the anxiety from the recent event.

D) Signing a safety contract with the nurse indicates that there may still be significant concerns regarding self-harm or emotional distress. While this is an important safety measure, it suggests that the client is not yet fully coping well with her anxiety, as it implies she is still in a vulnerable state rather than demonstrating effective coping mechanisms.

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Correct Answer is C

Explanation

A) Moving to a quiet area and providing peanut butter with crackers may help address the client’s nutritional needs, but it may not adequately address the client’s agitation and pacing. The immediate priority is to stabilize the client’s behavior before focusing on nutrition.

B) Encouraging the spouse to eat lunch with the client may create an opportunity for social interaction, but it might not be effective in calming the client’s agitation. If the client is already highly agitated, the spouse's presence alone may not help diffuse the situation.

C) Walking with the client to the cafeteria and staying while the client eats is the best intervention at this time. This approach allows the nurse to provide a calming presence and guidance while encouraging the client to eat. It also helps redirect the client's energy and agitation into a structured activity, promoting both physical movement and nutrition, which is crucial after several days without food.

D) Requesting a full lunch tray from the dietary department could provide a more substantial meal; however, it might not address the immediate need for calming the client. If the client remains agitated and loud, it may be challenging to ensure that they can eat peacefully, making this intervention less effective than accompanying the client directly to eat.

A. Schedule the client for group therapy with other bulimic clients. B. Assign the client's care to a nurse of approximately the same age. C. Assess and report the client's electrolyte status to the healthcare provider. D. Monitor the client carefully for binging activities.

Correct Answer is C

Explanation

A) Scheduling the client for group therapy with other bulimic clients can be beneficial for support and shared experiences. However, it is not the highest priority intervention at the time of admission, especially if there are immediate health concerns that need to be addressed.

B) Assigning the client's care to a nurse of approximately the same age may help with rapport and understanding, but it does not directly address the critical health risks associated with bulimia nervosa. The age of the nurse is less relevant compared to the immediate medical needs of the client.

C) Assessing and reporting the client's electrolyte status to the healthcare provider is the highest priority. Clients with bulimia nervosa often experience significant electrolyte imbalances due to behaviors such as vomiting, laxative use, or excessive exercise, which can lead to serious complications such as cardiac arrhythmias. Monitoring electrolyte levels is essential for ensuring the client’s safety and guiding further treatment.

D) Monitoring the client carefully for binging activities is an important part of care, but it is secondary to addressing any immediate medical concerns. While observation is necessary to prevent harm, it should occur alongside medical assessments, particularly for electrolyte status, to ensure comprehensive care.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with bipolar disorder has not slept or eaten in four days. The client is pacing and becomes increasingly agitated and loud while the nurse talks to the client's spouse. Which intervention is best for the nurse to implement at this time?

Correct Answer is C

Explanation

A young adult client is admitted to a psychiatric facility with a diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?

Correct Answer is C

Explanation

The occupational health nurse is working with a female employee who was just notified that her child was involved in a motor vehicle collision and taken to the hospital. The employee states, 1 can't believe this. What should I do? Which response is best for the nurse to provide in this crisis?

The nurse is admitting a client who has not slept in three days to the inpatient care facility. The client has pressured speech and describes an increase in sexual promiscuity. Which problem should the nurse include in the client's plan of care?

The mental health team working with a homeless client with chronic schizophrenia establishes the treatment goal of, "Improvement in avolition prior to discharge." Which behavior demonstrates achievement of this goal to the nurse?

A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and amotivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?