A nurse is caring for a client who is dying. The client says, “My mother died in the hospital, but I did not get there before she died.” Which of the following statements should the nurse make?

I will tell your family of your concern so that they can be here.

We will call your family in time for them to get here.

I will make sure a staff member is in your room at all times.

I wonder if you are fearful of dying alone.

Answer and Explanation

The Correct Answer is D

Choice A reason: Informing the family without addressing the client’s emotional concern misses the opportunity to explore their feelings. This response does not directly respond to the client’s expressed fear about their mother’s death.

Choice B reason: Promising to call the family in time assumes the client’s primary concern is family presence, which may not address the underlying fear of dying alone. It also risks making a promise that may not be feasible.

Choice C reason: Ensuring a staff member’s constant presence is supportive but does not directly address the client’s stated concern about their mother’s death or explore their emotional needs, making it less therapeutic.

Choice D reason: Acknowledging the client’s potential fear of dying alone directly addresses the emotional content of their statement. This therapeutic response encourages the client to express their fears, fostering emotional support and understanding.

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Correct Answer is A

Explanation

Choice A reason:Sublimation is a defense mechanism where negative emotions, like anger, are channeled into positive or socially acceptable activities, such as exercise. Working out in the gym when feeling mad transforms the emotion into a constructive outlet, reflecting adaptive use of sublimation.

Choice B reason:Forgetting the event suggests repression or dissociation, not sublimation. This response does not involve channeling emotions into productive activities and is not adaptive for addressing anxiety.

Choice C reason:Denying anxiety indicates denial, not sublimation. This statement avoids acknowledging the emotion rather than redirecting it into a positive action, making it non-adaptive.

Choice D reason:Expressing inability to move past the tragedy reflects rumination or despair, not sublimation. It does not involve transforming negative emotions into constructive behaviors, so it is not an adaptive response.

A. This medication will help prevent seizures. B. This medication will be administered by intramuscular injection every 2 weeks. C. I will rise slowly from a lying position to prevent fainting while taking this medication. D. I should expect to develop ringing in my ears while taking this medication.

Correct Answer is C

Explanation

Choice A reason:Clozapine is an antipsychotic used primarily for schizophrenia, not for preventing seizures. While it may lower the seizure threshold as a side effect, it is not prescribed for seizure control, making this statement incorrect.

Choice B reason:Clozapine is typically administered orally, not by intramuscular injection every 2 weeks. Long-acting injectable antipsychotics exist, but clozapine is not one of them, so this statement does not reflect correct understanding.

Choice C reason:Clozapine can cause orthostatic hypotension, leading to dizziness or fainting upon standing. Rising slowly from a lying position helps prevent this, indicating the client understands an important precaution for safe use of the medication.

Choice D reason:Ringing in the ears (tinnitus) is not a common side effect of clozapine. More common side effects include sedation, weight gain, and agranulocytosis, so this statement does not show correct understanding.

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A nurse is caring for a client who is dying. The client says, “My mother died in the hospital, but I did not get there before she died.” Which of the following statements should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who seems anxious following a recent tragedy. Which of the following statements by the client reflects an adaptive use of sublimation?

Correct Answer is A

Explanation

A nurse is providing teaching for a client who has a new prescription for clozapine. Which of the following statements indicates the client understands the teaching?

Correct Answer is C

Explanation

A nurse is teaching a newly-admitted client about the possible physical effects of alcohol withdrawal. Which of the following manifestations should the nurse include in the teaching? (Select all that apply.)

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A nurse is caring for a group of clients on a mental health unit. Which of the following should the nurse recognize as a maladaptive defense mechanism?

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