A nurse is counseling an older adult client whose partner died suddenly the previous month. The client cries periodically and rarely makes eye contact. Which of the following questions is the priority for the nurse to ask?

"What are you looking forward to each day?"

"Can you tell me about your sleep patterns?"

"Have you ever felt like you don't want to live anymore?"

"Are you taking any medications at this time?"

Answer and Explanation

The Correct Answer is C

A) "What are you looking forward to each day?": While asking about daily expectations can provide insight into the client's coping mechanisms and hopefulness, it does not immediately address potential safety concerns. It is a helpful question for assessing the client's adjustment but not the priority if there is a concern about suicidal ideation.

B) "Can you tell me about your sleep patterns?": Sleep patterns are important for understanding overall well-being, especially during grief. However, this question is secondary to addressing the immediate risk of self-harm. Assessing sleep can come after determining if the client is having suicidal thoughts.

C) "Have you ever felt like you don't want to live anymore?": This question is crucial because it directly assesses the client's risk of suicidal ideation or self-harm. Given the client's recent loss and current symptoms, it is important to evaluate if there is a risk to their safety, making this the priority question.

D) "Are you taking any medications at this time?": While it is important to know about the client's medication use, this question does not address the immediate risk of self-harm or assess the psychological impact of the recent loss. Medication information is less urgent compared to evaluating suicidal thoughts.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

A) Hyperreflexia:
Hyperreflexia is typically associated with low calcium levels (hypocalcemia), not elevated levels. An elevated calcium level often results in reduced neuromuscular excitability, leading to diminished reflexes rather than heightened ones.

B) Diarrhea:
Elevated calcium levels are more likely to cause constipation rather than diarrhea. Hypercalcemia often slows gastrointestinal motility, which can lead to decreased bowel movements and constipation.

C) Muscle twitching:
Muscle twitching is generally a symptom of hypocalcemia rather than hypercalcemia. Elevated calcium levels tend to depress neuromuscular activity, making muscle twitching less likely.

D) Lethargy:
Lethargy is a common symptom of hypercalcemia. High calcium levels can depress the central nervous system, leading to symptoms such as fatigue, weakness, confusion, and lethargy. This makes lethargy a likely finding in a client with an elevated total calcium level.

A. "After chewing an antacid, wait 1 hour before drinking water." B. "Plan to have a bedtime snack each evening." C. "Elevate the head of your bed 12 inches." D. "Eat a sugar-free peppermint when symptoms occur."

Correct Answer is C

Explanation

A) "After chewing an antacid, wait 1 hour before drinking water.": This is incorrect advice as drinking water after taking an antacid can help wash the medication down and ensure it reaches the stomach effectively. Waiting an hour to drink water is unnecessary and does not benefit GERD management.

B) "Plan to have a bedtime snack each evening.": Having a bedtime snack can exacerbate GERD symptoms by increasing stomach acid production just before lying down. Clients with GERD should avoid eating close to bedtime to minimize symptoms.

C) "Elevate the head of your bed 12 inches.": Elevating the head of the bed helps prevent stomach acid from flowing back into the esophagus during sleep, which can reduce nighttime GERD symptoms. This is a recommended non-pharmacological intervention for managing GERD.

D) "Eat a sugar-free peppermint when symptoms occur.": Peppermint can relax the lower esophageal sphincter, potentially worsening GERD symptoms by allowing stomach acid to reflux into the esophagus. Therefore, peppermint is not recommended for managing GERD symptoms.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is counseling an older adult client whose partner died suddenly the previous month. The client cries periodically and rarely makes eye contact. Which of the following questions is the priority for the nurse to ask?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has an electrolyte imbalance with an elevated total calcium level of 12.8 mg/dL. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is providing teaching to a client who has gastroesophageal reflux disease. Which of the following statements should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse in an emergency department is caring for a client who has a compound fracture of the right tibia. Which of the following actions should the nurse take?

A nurse is reviewing laboratory results of a client who has a family history of hyperlipidemia and cardiac disease. Which of the following results should the nurse report to the provider?

A nurse is teaching a client who has hearing impairment due to Meniere’s disease about meclizine. Which of the following statements should the nurse include in the teaching?

A charge nurse in a long-term care facility is developing an educational program for staff members about common physiological changes in older adults. Which of the following information should the nurse include?

A nurse in a provider's office is reviewing the laboratory report of a young adult female client who has had the communicable disease mononucleosis for the past 3 weeks. Which of the following laboratory results indicate the client is recovering from the virus?

A nurse is reviewing the medical record for a client who has generalized anxiety disorder. Which of the following manifestations should the nurse expect to see included in the client's medical record?

A nurse is planning care for a client who has the communicable disease pertussis. Which of the following isolation guidelines should the nurse include in the plan?

A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?