The psychiatric nurse is talking to a newly admitted client when another male client, who is diagnosed with antisocial behavior, intrudes on the conversation and tells the nurse, "I have to talk to you right now! It is very important!" How should the nurse respond to this client?

Put his behavior on extinction and continue talking with the newly admitted client.

Inform him that the nurse is busy admitting a new client and will talk to him later.

Encourage him to go to the nurse's station and talk with another nurse.

Introduce him to the newly admitted client and ask him to join in the conversation.

Answer and Explanation

The Correct Answer is B

A. Ignoring the client's behavior (putting it on extinction) may escalate the situation, as clients with antisocial behavior often do not respond well to being ignored.

B. Informing him that the nurse is busy and will talk to him later sets clear boundaries while acknowledging his request. It helps manage his behavior without reinforcing negative actions.

C. Encouraging him to talk with another nurse may not address his immediate need for attention and could result in further disruptive behavior.

D. Introducing him to the newly admitted client may not be appropriate as it could disrupt the admission process and potentially intimidate the new client.

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Correct Answer is A

Explanation

A. Instituting droplet precautions, placing the client in a private room, and keeping the door closed are critical actions to prevent the spread of COVID-19 within the healthcare facility. These measures protect other clients and healthcare workers from potential exposure to the virus.

B. Notifying the charge nurse is important but should follow the immediate action of instituting droplet precautions to prevent transmission.

C. Updating the client and family about available COVID-19 vaccines is essential for future prevention but does not address the immediate need to prevent virus spread.

D. Teaching the client to wear a mask, hand wash, and social distance is important, but immediate isolation and droplet precautions take precedence to contain potential spread within the facility.

A. Pain scale rating of a 9 on a 0 to 10 scale. B. History of irritable bowel syndrome (IBS). C. Reports white, curdy vaginal discharge. D. Last menstrual period was 7 weeks ago. E. None F. None

Correct Answer is D

Explanation

A. Severe pain is important to document and manage, but the cause (possible ectopic pregnancy) takes priority.

B. A history of IBS is relevant but not as immediately critical in this acute situation.

C. White, curdy vaginal discharge may indicate a yeast infection or other serious gynecological issue, which could be important in the differential diagnosis of abdominal pain.

D. A missed menstrual period of 7 weeks in a young adult female with acute lower abdominal pain is concerning for possible pregnancy complications, including ectopic pregnancy, which is a medical emergency. Prompt reporting allows the healthcare provider to initiate appropriate diagnostic testing and treatment to prevent serious complications, such as rupture and hemorrhage.

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The psychiatric nurse is talking to a newly admitted client when another male client, who is diagnosed with antisocial behavior, intrudes on the conversation and tells the nurse, "I have to talk to you right now! It is very important!" How should the nurse respond to this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Two weeks after returning home from traveling, a client presents to the clinic with conjunctivitis and describes a recent loss in the ability to taste and smell. The nurse obtains a nasal swab to test for COVID 19. Which action is most important for the nurse to take?

Correct Answer is A

Explanation

A young adult female presents at the emergency center with acute lower abdominal pain. Which assessment finding is most important for the nurse to report to the healthcare provider?

Correct Answer is D

Explanation

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