What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviors that indicate

rapport and trust with the nurse.

self-responsibility and autonomy.

a greater sense of independence.

resolved transference.

Answer and Explanation

The Correct Answer is A

A. The orientation stage focuses on establishing trust, building rapport, clarifying roles, and setting boundaries. Developing trust and rapport is essential before deeper therapeutic work can occur.
B. Self-responsibility and autonomy are outcomes seen later in the working/termination phases as the patient gains insight and coping skills.
C. A greater sense of independence is expected as the therapeutic relationship progresses, not in the orientation stage.
D. Transference (patient projecting feelings onto the nurse) may occur at any phase and is addressed in the working phase, not resolved in orientation.

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Correct Answer is B

Explanation

A. Distinguishing between reality and fantasy shows intact cognition, not mental illness.
B. A persistent sad, hopeless mood suggests depression, a hallmark of mental illness when symptoms are severe and ongoing.
C. Occasional anxiety and insomnia can be normal stress responses, not necessarily mental illness.
D. Difficulty making a decision about work is a common life stressor, not a clear sign of mental illness.

A. Obtain a blood specimen. B. Implement seizure precautions. C. Perform a neurological exam D. Insert an intravenous (IV) access site.

Correct Answer is B

Explanation

A. While laboratory tests are important for assessing electrolyte imbalances and liver function, they are not the immediate priority in acute alcohol withdrawal.

B. Acute alcohol withdrawal can rapidly lead to seizures and delirium tremens, which are life-threatening. Patient safety and prevention of injury are the priority.

C. Neurological assessment is important, but first ensuring the client’s safety from potential seizures takes precedence.

D. IV access is necessary for fluid or medication administration, but it follows implementing immediate safety measures.

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What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviors that indicate

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The patient

Correct Answer is B

Explanation

A nurse in an emergency department is caring for a client who is experiencing acute alcohol withdrawal. Which of the following actions should the nurse first take?

Correct Answer is B

Explanation

Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. This person wears layered loose clothing. Her current weight is 95 pounds and has a loss of 35 pounds. Which medical diagnosis is most likely?

An adult outpatient diagnosed with major depressive disorder has a history of several suicide attempts by overdose. Given this patient's history and diagnosis, which antidepressant medication would the nurse expect to be prescribed to this patient?

A patient insistently states, "I can decipher codes of DNA just by looking at someone." Which problem is evident?

Select an example of a tort.

A nurse cares for a patient experiencing an opioid overdose. Which focused assessment has the highest priority?

Which individual in the emergency department should be considered at highest risk for completing suicide?

A nurse has prepared teaching materials for the parents of a child newly diagnosed with ADHD. The information will focus on which medication likely to be prescribed?

An adult patient assaulted another patient and was then restrained. One hour later, which statement by the restrained patient requires the nurse's immediate attention?