When setting limits with patients with personality disorders, the consequences of violating those limits should be set at which time?

Just before the nurse anticipates the behavior

When the behavior is done

When the staff or family complains about the behavior

When the limit is set

Answer and Explanation

The Correct Answer is D

Choice A reason: Setting consequences just before the behavior occurs does not provide clear expectations and boundaries for the patient.

Choice B reason: Setting consequences after the behavior is done may not effectively prevent the behavior and can lead to inconsistent enforcement.

Choice C reason: Waiting for complaints before setting consequences can lead to a reactive rather than proactive approach to care.

Choice D reason: Consequences should be clearly communicated when the limit is set to establish clear boundaries and expectations, which is essential in managing patients with personality disorders.

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Correct Answer is ["B","C","D"]

Explanation

Choice A reason: Observing nonverbal communication is a valid nursing intervention for assessing a patient's anxiety level.

Choice B reason: Maximizing stimuli can overwhelm a patient with anxiety and is not a recommended intervention.

Choice C reason: Discouraging activities is not recommended as activities can be a form of therapy for anxiety disorders.

Choice D reason: Documenting only positive changes is not appropriate as all changes, positive or negative, should be documented for a comprehensive understanding of the patient's condition.

Choice E reason: Encouraging patients to verbalize thoughts and feelings is a therapeutic intervention that can help manage anxiety.

Choice F reason: Observing for signs of suicidal thoughts is crucial as anxiety disorders can increase the risk of suicide.

A. Deep breathing and coughing B. Incentive spirometry C. Leg exercises D. Early ambulation E. Hand squeezes

Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Deep breathing and coughing exercises help clear the lungs and prevent atelectasis, a common postoperative respiratory complication.

Choice B reason: Incentive spirometry encourages patients to take deep breaths, which can help keep the lungs clear of mucus and prevent pneumonia.

Choice C reason: Leg exercises improve circulation and can help prevent blood clots, which can lead to pulmonary embolism, another serious respiratory complication.

Choice D reason: Early ambulation, or getting the patient moving as soon as possible after surgery, is crucial for preventing respiratory complications by promoting circulation and lung expansion.

Choice E reason: Hand squeezes are not directly related to preventing respiratory complications; they are more associated with preventing circulatory complications.

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When setting limits with patients with personality disorders, the consequences of violating those limits should be set at which time?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is ["B","C","D"]

Explanation

Which of the following does the nurse implement to prevent postoperative respiratory complications for a patient? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

The nurse is reading a patient's chart and notes the patient has a tumor stage of IV. Which describes the meaning of stage IV cancer?

The nurse is preparing to teach about the long-term complications for patients diagnosed with diabetes. Which finding is accurate?

A nurse is preparing a young adult client who has a hearing impairment for surgery. Which of the following actions should the nurse take?

Patients who display very bizarre behavior but who are still functional in society are most likely to have which of the following types of personality disorder?

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The 3 main types of Phobias as identified by DSM-5 include: (select all that apply)

When setting limits with patients with personality disorders, the consequences of violating those limits should be set at which time?

Which of the following is a priority when caring for a highly anxious patient?