A nurse is observing & newly licensed nurse as she interacts with a client regarding his concerns about his relationship with his partner. Which of the following statements by the newly licensed nurse requires intervention by the nurse?

Tell me about the concerns that you have regarding your relationship."

"Relationship difficulties are stressful and require effort to resolve."

"We could develop a plan for how to talk about this with your partner."

"You should try to see your partner's point of view before your own."

Answer and Explanation

The Correct Answer is D

A. "Tell me about the concerns that you have regarding your relationship."

This choice is an appropriate and open-ended question that encourages the client to express their feelings and concerns. It helps in building rapport and understanding the client's perspective.

B. "Relationship difficulties are stressful and require effort to resolve."

This choice acknowledges the challenges of relationship difficulties and conveys a supportive and empathetic attitude. It is a reasonable and non-biased statement.

C. "We could develop a plan for how to talk about this with your partner."

This choice suggests a proactive approach to address the client's concerns and promote effective communication. It is a helpful and appropriate statement.

D. "You should try to see your partner's point of view before your own."

This statement implies a biased approach, suggesting that the client should prioritize their partner's perspective over their own. While empathy and understanding are important in relationships, it's not appropriate for a healthcare professional to imply that one perspective is more important than the other. The nurse should encourage open communication and understanding from both sides rather than favoring one viewpoint.

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Correct Answer is A

Explanation

A. "I need to make sure that the potential victim is warned."

Explanation: Correct Answer. When a client threatens to harm a specific individual, it's important to take steps to ensure the safety of both the client and the potential victim. Warning the potential victim or taking appropriate measures to protect them is an important action to take.

B. "I need to keep the information confidential due to the client's right to privacy."

Explanation: While respecting a client's right to privacy is important, when there's a threat of harm to an individual, it becomes a matter of safety that takes precedence over confidentiality.

C. "I can only discuss the client's threats with a court order."

Explanation: This statement is incorrect. When there's a credible threat to harm an individual, waiting for a court order is not an appropriate or timely response. Immediate actions should be taken to ensure safety.

D. "I should verbally report this information to the psychiatrist."

Explanation: While involving the psychiatrist is important for the client's overall care, it's essential to take more immediate steps to ensure the safety of the potential victim, such as notifying the appropriate authorities or taking appropriate precautions.

A. Focus attention on meaningful tasks. B. Decrease anxiety to a tolerable level. C. Manipulate and control others' behaviors. D. Limit the amount of time available to interact with others.

Correct Answer is B

Explanation

While the behavior may occupy the client's time and attention, the primary motivation behind OCD-related compulsions is not to engage in meaningful tasks but rather to alleviate anxiety caused by obsessive thoughts.

B. Decrease anxiety to a tolerable level.

Explanation: Individuals with obsessive-compulsive disorder (OCD) often engage in compulsive behaviors, such as cleaning, organizing, or checking, as a way to reduce the anxiety caused by their obsessive thoughts. In this scenario, the client's constant picking up after others is likely a compulsive behavior that serves the purpose of decreasing their anxiety to a tolerable level. The act of tidying up may temporarily alleviate the distress caused by obsessive thoughts related to cleanliness, order, or potential harm.

C. Manipulate and control others' behaviors.

The behavior described does not inherently indicate a desire to manipulate or control others. The behavior is driven by the client's internal anxiety rather than an intention to control external factors.

D. Limit the amount of time available to interact with others.

The behavior is more closely related to managing anxiety than limiting social interactions. OCD-related behaviors are driven by the need to reduce distress, not necessarily to avoid interacting with others.

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A nurse is observing & newly licensed nurse as she interacts with a client regarding his concerns about his relationship with his partner. Which of the following statements by the newly licensed nurse requires intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly licensed nurse about appropriate actions to take when a client threatens to harm a specific individual. Which of the following statements by the newly licensed nurse indicates understanding?

Correct Answer is A

Explanation

A nurse is caring for a client who has been diagnosed with obsessive compulsive disorder (OCD) and is constantly picking up after others in the day room. The nurse should recognize that the client uses this behavior to do which of the following?

Correct Answer is B

Explanation

A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responses by the nurse is appropriate?

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

A nurse is caring for a client who has severe manifestations of schizophrenia and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects?

A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?

A nurse in an emergency department is caring for an adolescent client who reports being sexually assaulted just prior to admission. Which of the following actions should the nurse take?

A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actions should the nurse plan to take?

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make?