The nurse is caring for a patient preparing for surgery. Which finding would concern the nurse?

Positive pregnancy test

Family history of hypertension

Signed advance directive

Medical history of diabetes

Answer and Explanation

The Correct Answer is A

Choice A reason: A positive pregnancy test is a significant concern for a patient preparing for surgery as it can affect the type of anesthesia used and the surgical approach, due to the potential impact on the fetus.

Choice B reason: While a family history of hypertension is important, it is not as immediately concerning as a positive pregnancy test in a patient preparing for surgery.

Choice C reason: A signed advance directive is a document that outlines a patient's wishes regarding medical treatment and is not a concern but rather a part of preoperative preparation.

Choice D reason: A medical history of diabetes is important to consider in surgical patients due to potential complications with wound healing and blood glucose control, but it is not as urgent as confirming pregnancy status before surgery.

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Correct Answer is D

Explanation

Choice A reason: Nurse self-awareness is crucial in providing care for individuals with personality disorders to avoid countertransference.

Choice B reason: Trust is a fundamental component of the nurse-client relationship and is necessary for effective care.

Choice C reason: Limit setting is essential for maintaining professional boundaries and providing structure in the therapeutic relationship.

Choice D reason: Vague communication is not therapeutic and can lead to misunderstandings and increased feelings of inferiority, which is not conducive to treatment.

A. Auditory hallucinations B. Free-floating anxiety C. Flashbacks D. Delusions of grandeur

Correct Answer is C

Explanation

Choice A reason: Auditory hallucinations involve hearing voices or sounds that are not present, which does not match Audrey's experience of visual perceptions.

Choice B reason: Free-floating anxiety is a general feeling of unease that is not tied to a specific situation, whereas Audrey's anxiety is triggered by a specific scenario reminiscent of past trauma.

Choice C reason: Flashbacks are vivid, often distressing, memories of past traumatic events that feel as though they are happening in the present. Audrey's experience is indicative of flashbacks related to her military service.

Choice D reason: Delusions of grandeur involve beliefs of inflated worth, power, or identity, which is not described in Audrey's situation.

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The nurse is caring for a patient preparing for surgery. Which finding would concern the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Nursing care for people with personality disorders includes all the following except:

Correct Answer is D

Explanation

Audrey is a veteran who served in Afghanistan. She finds it very difficult to drive through a parking ramp because she perceives that "There are people hiding behind the pillars! They have guns! Be careful." Audrey is most likely experiencing which of the following?

Correct Answer is C

Explanation

What is evisceration?

A nurse is assisting with the care of a malnourished patient being prepared for surgery. Which statement by the patient regarding nutrition would indicate adequate teaching?

A nurse is contributing to the plan of care for a client who has obsessive-compulsive disorder (OCD) regarding brushing his teeth. The client brushes his tongue several times a day and has developed several ulcerations. Which of the following interventions should the nurse identify as a priority?

The nurse is providing care for a patient after an above-the-knee amputation due to diabetes complications. Which nursing care is essential for promoting ambulation?

A nurse is reinforcing preoperative teaching to a client who is undergoing total hip replacement surgery. Which of the following statements should the nurse include in the teaching?

Which of the following are NOT nursing interventions for people with anxiety disorders? Select all that apply.

A schizophrenic client is being assessed by the nurse. The client is demonstrating negative symptoms. Which symptoms should be considered negative? (select all that apply)