A nurse is caring for several clients who are attending community-based mental health programs. Which Of the following clients should the nurse plan to visit first?
Select one:

A client who recently burned her arm by accident while using a hot iron at home.

A client who tells the nurse he experienced manifestations of severe anxiety before and during a job interview.

A client who requests that her antipsychotic medication be changed due to some new adverse eﬀects.

A client that says he is hearing a voice that tells him he is not worthy of living anymore.

Answer and Explanation

The Correct Answer is D

This client is experiencing auditory hallucinations and may be at risk for self-harm or suicide. The nurse should prioritize visiting this client first to assess their safety and provide appropriate interventions.

Option a. A client who recently burned her arm by accident while using a hot iron at home may require wound care and education on safety, but this situation is not as urgent as the client experiencing auditory hallucinations.

Option b. A client who tells the nurse he experienced manifestations of severe anxiety before and during a job interview may benefit from interventions to manage anxiety, but this situation is not as urgent as the client experiencing auditory hallucinations.

Option c. A client who requests that her antipsychotic medication be changed due to some new adverse eﬀects may require medication adjustment and monitoring for side eﬀects, but this situation is not as urgent as the client experiencing auditory hallucinations.

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Correct Answer is C

Explanation

The child is striving for independence.” The behaviors described by the parent are typical for a child who is 26 months old. At this age, children are beginning to develop a sense of autonomy and independence, and they may resist direction and assert their own will. Toilet training can also be a challenging process for both children and parents, and it is not uncommon for children to resist or refuse toilet training at first.

Option a. “The child needs more control. You have been weak” is not a helpful response because it places blame on the parent and does not provide any useful information or guidance.

Option b. “Some undesirable attitudes are developing currently. A child psychologist can help you develop a remedial plan” may be an appropriate response if the child’s behaviors were significantly outside the norm for their age or if they were causing significant distress or disruption. However, based on the information provided by the parent, this does not appear to be the case.

Option d. “There may be developmental problems. Most children are toilet trained by age 2 years and a half” is not a helpful response because it may cause unnecessary worry or concern for the parent. While many children are toilet trained by age 2 and a half, there is a wide range of normal variation in when children achieve this milestone.

A. Compensation B. Suppression C. Rationalization D. Reaction-formation

Correct Answer is C

Explanation

Rationalization is a defence mechanism in which a person attempts to justify or explain their behavior or actions in a way that makes them seem more acceptable or reasonable. In this case, the client is using rationalization by attributing their alcohol abuse to their job and the need to drink with clients at parties.

Option a. Compensation is a defense mechanism in which a person attempts to make up for a perceived weakness or deficiency by excelling in another area.

Option b. Suppression is a defense mechanism in which a person consciously chooses to avoid thinking about or dealing with unpleasant thoughts or feelings.

Option d. Reaction-formation is a defense mechanism in which a person behaves in a way that is opposite to their true feelings or desires.

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A nurse is caring for several clients who are attending community-based mental health programs. Which Of the following clients should the nurse plan to visit first? Select one:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 26-month-old child displays many negative behaviors. The parent says, "My child refuses toilet training and shouts, 'No, no, no!' when given directions. What do you think is wrong?" Select the registered nurse's best reply: Select one:

Correct Answer is C

Explanation

A registered nurse is admitting a client to an alcohol abuse program. The client states, here because of my boss. It was part of my job to go to parties and drink with clients. The client's statement is an example of which of the following defense mechanisms? Select one:

Correct Answer is C

Explanation

A client is agitated and pacing in the hall near the nurses' station and swearing loudly. What response is the best for the registered nurse to provide? Select one:

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A registered nurse is providing a community health education class about suicide prevention. Which of the following should the nurse identify as risk factors for suicide? (Select all that apply).

Group therapy is encouraged but not mandatory. on an inpatient psychiatric unit, the unit manager's policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit manager preserve?

A nurse is caring for a client who has been diagnosed with end-stage liver cancer. Which of the following responses is an indication the client is in the denial phase of the grief process?

A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive higher priority? The patient who: Select one:

A nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram. The client reports discontinued the medication after experiencing severe nausea and vomiting. Which of the following reasons should the nurse suspect to be a likely cause of the Client’s distress?

A nurse is caring for several clients who are attending community-based mental health programs. Which Of the following clients should the nurse plan to visit first?
Select one: