Review PNU Adult Health II Spring 2023 Exam 2

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PNU Adult Health II Spring 2023 Exam 2

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Total Questions : 50

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Question 1:

A nurse is caring for a client in an acute care mental health unit who was involuntarily admitted for 72 hr after attacking a neighbor. To keep the client in the hospital when the initial time to hold the client expires, which of the following must be determined?

A. Whether the client is financially incapable of paying for prescribed medications. B. Whether the client is a danger to herself or others. C. Whether the client is unable to make arrangements to stay with someone. D. Whether the client is unwilling to accept that treatment is needed.

Answer and Explanation

Choice A:

This does not address the primary concern of ongoing safety for the client and others. The client's financial status or ability to pay for prescribed medications is not relevant to their safety or need for hospitalization.

Choice B:

Whether the client is a danger to herself or others. When a client is involuntarily admitted to a mental health unit, they are held for an initial period of 72 hours for evaluation and treatment. Afterward, a determination must be made as to whether or not the client is still a danger to themselves or others to keep them in the hospital.

Choice C:

This does not address the primary concern of ongoing safety for the client and others. The client's ability to make arrangements to stay with someone is important for discharge planning but not for determining their need for ongoing hospitalization.

Choice D:

This does not address the primary concern of ongoing safety for the client and others. Whether the client is unwilling to accept treatment is important, but not the sole determining factor as to whether they are a danger to themselves or others.

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Question 2:

A nurse in a community clinic is speaking to other nurses about risk factors for domestic violence. Which of the following statements by one of the other nurses indicates the need for further teaching?

A. "I have heard that abusers try to keep their partner isolated from others." B. "I know that abusers lack social support and social skills." C. "I have heard that abusers think of themselves as important and have high self-esteem." D. "I know that men who are abusers gain power through intimidation."

Answer and Explanation

Choice A:

Abusers often isolate their partner to gain control over them

Choice B:

Abusers may lack social support and social skills, leading to violent behavior.

Choice C:

"I have heard that abusers think of themselves as important and have high self-esteem." This statement is incorrect and shows the nurse may need further education on the characteristics of an abuser. Abusers often lack self-esteem and feel powerless, using abuse as a way to gain control and confidence.

Choice D:

Abusers use intimidation tactics to maintain power in the relationship.

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Question 3:

A nurse in an urgent care facility is caring for a client who has traumatic injuries following an assault. The client sits quietly and calmly tells the nurse, "I'm fine." The nurse should recognize the client's behavior as which of the following reactions?

A. Projection B. Displacement C. Denial D. Undoing

Answer and Explanation

Choice A:

Projection would involve the client attributing their own feelings to others.

Choice B:

Displacement, would involve the client redirecting their emotions onto someone or something else.

Choice C:

The client's behavior of stating "I'm fine" despite having traumatic injuries is an example of denial, a coping mechanism that involves denying that a problem or issue exists. Projection involves attributing one's own feelings to another person, displacement involves redirecting one's emotions onto a less threatening target, and undoing involves seeking to undo or forget past actions.

Choice D:

Undoing, would involve the client attempting to forget or undo past actions.

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Question 4:

A nurse facilitating a group therapy session is listening to clients discuss their coping strategies when feeling stressed. Which of the following statements indicates adaptive coping? (Select all that apply.)

A. "I sleep in in the mornings." B. "I isolate myself in my room for a few hours when things get overwhelming." C. "I call a friend who makes me smile and laugh." D. "I think about being on my favorite beach vacation." E. "I tense and release my muscles, starting with my feet."

Answer and Explanation

Choice A:

"I sleep in in the mornings," is not an adaptive coping strategy because it doesn't address the source of stress and may actually lead to avoidance.

Choice B:

"I isolate myself in my room for a few hours when things get overwhelming," is not adaptive because it promotes social withdrawal and avoidance.

Choice C:

This is anadaptive coping strategy that helps to reduce stress and promote relaxation. Calling a friend who makes you smile and laugh, for example, can help to distract from negative thoughts and promote positive emotions.

Choice D:

"I think about being on my favorite beach vacation," is not adaptive because it promotes avoidance and doesn't address the source of stress.

Choice E:

This is an adaptive coping strategy that helps to reduce stress and promote relaxation. Tense and release exercises can help to reduce muscle tension and promote relaxation.

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Question 5:

A nurse is helping a client relieve stress through cognitive reframing. Which of the following actions by the client demonstrates effective use of cognitive reframing?

A. The client imagines being in a quiet, relaxing environment. B. The client trains his mind to relax by using deep inner resources. C. The client learns to change negative thoughts into positive statements. D. The client learns the source of his stress by writing down daily events.

Answer and Explanation

Choice A:

"The client imagines being in a quiet, relaxing environment," is not an example of cognitive reframing, but rather an example of visualization, which can also be useful in reducing stress.

Choice B:

"The client trains his mind to relax by using deep inner resources," is not an example of cognitive reframing, but rather an example of relaxation training.

Choice C:

"The client learns to change negative thoughts into positive statements." This demonstrates the effective use of cognitive reframing, which involves changing negative thoughts into positive self-talk. This strategy can help to reduce stress and improve coping skills.

Choice D:

"The client learns the source of his stress by writing down daily events," is not an example of cognitive reframing, but rather an example of stress management through self-reflection.

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Question 6:

A nurse on an inpatient unit is caring for a newly-admitted client who has anorexia nervosa. Which of the following actions should the nurse take? (Select all that apply.)

A. Stay with the client during meals and for 1 hr afterward. B. Give the client a weight gain goal of 4 to 5 lb per week. C. Monitor the client's weight daily after first voiding. D. Encourage the client to keep a diary of daily food intake. E. Offer specific privileges for sustained weight gain.

Answer and Explanation

Choice A:

"Stay with the client during meals and for 1 hr afterward," This is an important intervention for clients with anorexia nervosa, as they can help to prevent complications such as dehydration and electrolyte imbalances.

Choice B:

"Give the client a weight gain goal of 4 to 5 lb per week," is not an appropriate intervention, as it can be overwhelming and may promote unhealthy weight gain.

Choice C:

"Monitor the client's weight daily after first voiding." This is animportant intervention for clients with anorexia nervosa, as it can help to prevent complications such as dehydration and electrolyte imbalances.

Choice D:

"Encourage the client to keep a diary of daily food intake," may be helpful for some clients, but is not a priority intervention.

Choice E:

"Offer specific privileges for sustained weight gain," is not an appropriate intervention.

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Question 7:

A nurse is discussing comorbidities associated with eating disorders with a newly licensed nurse.

Which of the following comorbidities should the nurse include in the discussion? (Select all that apply.)

A. Depression B. Anxiety C. Breathing-related sleep disorder D. Obsessive-compulsive disorder E. Schizophrenia

Answer and Explanation

Choice A:

A nurse discussing comorbidities associated with eating disorders with a newly licensed nurse should include depression, anxiety, and obsessive-compulsive disorder (OCD) in the discussion. Clients who have eating disorders often have comorbid psychiatric conditions.

Depression and anxiety are two common conditions among clients with eating disorders. OCD is another condition that is often associated with eating disorders. Clients with OCD may have obsessive thoughts about food intake, weight, and body image. These clients may also engage in compulsive behaviors related to eating, such as calorie counting or food restriction.

Choice B:

Choice C:

This is incorrect because breathing-related sleep disorders and schizophrenia are not typically associated with eating disorders.

Choice D:

Choice E:

This is incorrect because breathing-related sleep disorders and schizophrenia are not typically associated with eating disorders.

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Question 8:

An assistive personnel (AP) says to the nurse, "This client is incontinent of stool three or four times a day. I get angry because I think that the client might be doing it just to get attention." Which of the following responses by the nurse is therapeutic?

A. "You are probably right. Soiling the bed is a way of getting attention from the nursing staff." B. "Tell me what makes you feel the client is doing this on purpose?" C. "Why don't you spend more time with the client if you think that she is trying to get attention?" D. "Next time this happens, tell me and I'll talk to the client about his behavior."

Answer and Explanation

Choice A:

Option A is confrontational

Choice B:

When an assistive personnel expresses concerns or vents about client behaviors, a therapeutic response is necessary. Asking the AP to explain or to further describe his or her thoughts, feelings, or concerns will allow the AP to reflect on these issues and help clarify any misconceptions or misunderstandings. The nurse's response should be nonjudgmental, noncritical, and focused on the AP's perceptions and feelings.

Choice C:

This is inappropriate because it suggests that the AP is not spending enough time with the client.

Choice D:

shifts responsibility for managing the client's behavior to the nurse instead of helping the AP reflect on his or her perception of the situation.

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Question 9:

A nurse is caring for a client who reports acute anxiety. Which of the following actions should the nurse take first?

A. Encourage verbalization of feelings. B. Provide an activity for diversion. C. Remain with the client. D. Have the client identify two coping skills.

Answer and Explanation

Choice A:

Option A is an appropriate action to take when caring for a client with anxiety, but they are not the first priority.

Choice B:

Option B may be an appropriate intervention when caring for a client with anxiety, but it is not the first priority.

Choice C:

If a client reports acute anxiety, the nurse's first priority should be to remain with the client. The nurse should provide a safe, supportive environment for the client and help the client feel less anxious. This can be accomplished by staying with the client, listening attentively to the client, and offering reassurance and support.

Choice D:

OptionD is the appropriate action to take when caring for a client with anxiety, but they are not the first priority.

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Question 10:

A nurse is collecting data from a female client who has anorexia nervosa. Which of the following findings should the nurse expect?

A. Decreased cholesterol levels B. Heavy monthly periods C. Elevated serum potassium level D. Low bone density

Answer and Explanation

Choice A:

Decreased cholesterol levels may be an indication of malnutrition.

Choice B:

Heavy monthly periods, or menstrual irregularities, may occur in clients with anorexia nervosa because of the hormonal changes that can result from severe weight loss.

Choice C:

Elevated serum potassium levels are not a common finding in a client with anorexia nervosa.

Choice D:

When collecting data from a female client who has anorexia nervosa, the nurse should expect a finding of low bone density.

Anorexia nervosa is an eating disorder characterized by self-starvation, distorted body image, and a fear of gaining weight. Clients with anorexia nervosa are at risk for severe malnutrition, which can lead to a variety of complications, including bone loss and osteoporosis.

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Total Questions : 50

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PNU Adult Health II Spring 2023 Exam 2

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