A home health nurse visits a client who lost their partner 2 years ago. Which of the following behaviors by the client indicates a maladaptive grief response?

The client gives away some of the partner's belongings.

The client expresses feelings of guilt.

The client relocates from a house to an apartment.

The client is unable to perform basic hygiene tasks.

Answer and Explanation

The Correct Answer is D

A maladaptive grief response is one that interferes with normal functioning or causes significant distress for the bereaved person. The client who is unable to perform basic hygiene tasks is showing signs of depression and impaired self-care, which indicate a maladaptive grief response. The other behaviors are not necessarily maladaptive, but may reflect normal coping strategies or adjustments after losing a partner.

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Correct Answer is D

Explanation

A blood pH of 7.60 indicates alkalosis, which is a life-threatening condition that can result from vomiting, laxative abuse, or diuretic use in clients who have anorexia nervosa. Alkalosis can cause cardiac arrhythmias, seizures, coma, and death if not corrected promptly. The nurse should notify the provider and prepare to administer IV fluids and electrolytes as ordered. The other findings are also concerning, but they are not as urgent as alkalosis.

A. Report suspected abuse to Child Protective Services. B. Determine the immediate safety needs of the child. C. Ask the child how the injury occurred. D. Request that the parent leave the room while interviewing the child.

Correct Answer is B

Explanation

The nurse's priority is to ensure that the child is safe and protected from further harm. A spiral fracture is a type of fracture that occurs when a bone is twisted, and it is often associated with child abuse. The nurse should assess if there are any other signs of abuse, such as bruises, burns, or cuts, and if there are any threats to the child's well-being at home or elsewhere. The nurse should also provide emotional support and comfort to thechild. The other options are important steps to take, but they are not as urgent as ensuring safety.

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A home health nurse visits a client who lost their partner 2 years ago. Which of the following behaviors by the client indicates a maladaptive grief response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse?

Correct Answer is D

Explanation

A nurse in a provider's office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts of the cause of the injury. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse is caring for a client who is undergoing electroconvulsive therapy. Which of the following tasks should the nurse delegate to an assistive personnel?

A nurse is planning to conduct a support group for adolescents who have cancer. Which of the following actions should the nurse include during the orientation phase?

A nurse is caring for a client who has borderline personality disorder and has been engaging in self-mutilation. The nurse should encourage the client to participate in which of the following groups?

A nurse is conducting an admission interview with a new client who tells the nurse, "My life is so stressful. I can't take it anymore." Which of the following responses should the nurse make first?

A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client's personal coping skills?

A home health nurse visits a client who lost their partner 2 years ago. Which of the following behaviors by the client indicates a maladaptive grief response?

A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has major depressive disorder. Which of the following findings obtained during the initial assessment is the priority to report to other disciplines?

A nurse is caring for a client who has Alzheimer's disease. Which of the following findings should the nurse expect?