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NR 222 Final Exam – Question with Answers

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NR 222 Final Exam – Question with Answers 1.) The nurse is to instruct the client about the long- term consequences of non-. Which education strategy would be most appropriate for the nurse to use in order to develop the affective learning domain of the client? • A. Lecture followed by a simple written test. • B. Role playing and group discussion • C. Video presentation and handouts • D. Demonstration and practice 2.) A nurse manager is teaching a group of nurses about the levels of prevention. Which example of the tertiary level of prevention should be included in the instruction. • A. Surgery to repair a hip dislocation of an older adult client. • B. Teaching breastfeeding to expectant mothers in a prenatal clinic. • C. Chemotherapy treatment to a client newly diagnosed with cancer. • D. Physical therapy to a patient who has a right sided paralysis from a stroke. 3.) A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension and has a BMI of 26. Which of the following goals should the nurse include? • A. The client will list foods that are high in calcium, which should be avoided. • B. The client will walk for 30 mins a day 5 days a week. • C. The client will increase calorie intake by 200 cal per day. • D. The client will replace cigarettes with smokeless tobacco products. 4.) Which of the following emphasizes that an individuals belief in being personally capable of preforming the behavior is required to influence one’s own health? A. Social Cognitive Theory B. Self–Efficacy Theory C. Health Belief Model D. Theoretical Model 5.) The nurse is discussing the importance of routine preventive care with a Hispanic family who has recently immigrated to the United States. Which factor will the nurse consider as a barrier in the family’s interest to receive professional health care? Select All That Apply A. Lack of health insurance B. Concern about invasion of privacy C. Absence of transportation services D. Limited proficiency in the English Language E. Belief and accessibility to folk healers and remedies F. The availability of family members for support and help 6.) The following are true about Healthy People 2020 initiative (Select All That Apply) • A. Healthy People Initiative provides science-based, 10 year national objectives for improving the health of all Americans. • B. Healthy People initiative seeks to change the health practices of people who are most at risk to illness and injury thereby decreasing the cost of health care and maintenance. • C. For 3 decades, Healthy People initiative has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors. • D. Healthy People initiative was developed to established health improvement priorities and measure the impact of prevention activates. • E. Healthy People initiative gives protocols to each state on how conduct community health prevention education and giving nurses standards on educational programs. • F. Healthy People initiative empower individuals towards making informed health decisions . 7.) True statements about the ANA Code of Ethics (Select All That Apply): • A. The nurses primary commitment is to self first; then , if the situation is favorable, commitment to the patients whether the individual, family, group, community, or population. • B. The nurse has authority, accountability and responsibility for nursing practices; make decisions; and takes action consistent with the obligations to provide optimal patient care. • C. The profession of nursing articulates its values through individual nurses without recommendations from professional organizations; maintaining integrity and principles of social justice into nursing and healthy policy is optimal for nurses. • D. The nurse owes the same duties to self as to other, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional duties. • E. It is the nurses responsibility to protect human rights, promote health diplomacy, and reduce health disparities. • F. Nurse advocates for, and protects the rights, health, and safety of the patient. 8.) The following are health concerns and issues of migrant workers (Select All that Apply) • A. Pesticide exposure • B. Iron deficiency anemia • C. Constipation and Dehydration • D. Tuberculosis • E. Chronic Conditions • F. Dental Disease 9.) Which data represents objective findings? (Select All That Apply) • A. Lab values • B. Pain level state by the patients • C. Patients stated emotional status • D. Respiratory and pulse oximetry reading. • E. The nurse’s description of the patient’s gait. 10.) The steps included in the nursing process include: (Select All That Apply) • A. Use a nursing diagnosis to state the problem. • B. Plan care to help meet stated patient goals • C. Collect data and asses the patient • D. Establishes priorities, patient goals and outcomes. • E. Determine appropriate nursing interventions for patient care. • F. Order labs that are needed for the patient. 11.) What information is about nursing standards of care? • A. Nursing standards of care guidelines for nursing practice. • B. Nursing standards of care are defined in Nurse Practice Acts. • C. Nursing standards of care are used to measure nursing conduct in malpractice suit. • D. Nursing standards of care are specific guidelines only for unlicensed assistive personnel. • E. Nursing standards of care are upheld by law and indicate what standards nurse must follow. • F. Nursing standards of care are used to determine whether the nurse acted as any reasonably prudent nurse under the same or similar conditions. 12.) The nurse is discussing the importance of routine healthcare with a Hispanic family who has recently immigrated to the United States. Which factor will the nurse consider as a barrier to the family’s interest to receive professional health care? (Select All That Apply?) • A. Lack of health insurance. • B. Concern about invasion of privacy. • C. Absence of transportation services. • D. Limited proficiency in the English language • E. Belief and accessibility to folk healers and remedies • F. The availability of family member for support and help. 13.) Which statement by the nurse best describes values? • A. Values are not constant; they change over time. • B. Values learned in childhood remain the same for a lifetime. • C. It is impossible for people to understand their own values. • D. The clients values are not considered when care is provided. 14.) Which educational strategy would be most appropriate to use in order to provide affective learning domain of the client? • A. Lecture followed by simple written test • B. Video presentation and handouts • C. Role playing and group discussion • D. Demonstration and practice 15.) The American Nurses Association (ANA) has recommended the following competency for RNs? • A. The RN’s to recognize their own values, beliefs, and cultural heritage. • B. The RNs to function independently and occasionally engage in collaboration. • C. The RNs to be concerned about the existence of vulnerable cultural groups. • D. The RNs to provide health care opportunities to those with financial capabilities. 16.) An RN is teaching a group of patients about Diabetes Management material from a Diabetes Education Program. Which of the following should an RN prepare prior to each teaching session? • A. Plan handouts on general principles that patients can understand materials at the high school level. • B. Implement changes during class whenever a patient complains the material is too difficult to understand. • C. Assess materials to be relevant plan changes according to the needs of patients, implement teaching according to the patients ability to understand the information. • D. Assess, plan, implement, and evaluate teaching materials only according to the recommendations of the director of nursing. 17.) Which statement is true regarding secondary prevention? • A. The nurse creates a care plan for the patients outpatient therapy. • B. The nurse identifies individuals in an early detectable state of the disease process. • C. The nurse focuses on increasing the patient’s self-care by providing prevention instructions. • D. The nurse is driven by the objective to minimize the effect of the disability through rehabilitation. 18.) One Leading Health Indicator (LHI) of Healthy People 2020 is the availability of medical services to all people. Which topic does this cover • A. Injury and Violence • B. Environmental Quality • C. Access to Health Services • D. Clinical Preventative Services 19.) How would the nurse approach this ethical dilemma: Two patients are on the list for kidney transplants and they will both die without one. Which patient would get the one kidney that is immediately available for transplantation. • A. Choose the patients who has the ability to fiancé the hospitalization and treatment. • B. Advocate for the younger of the two clients since that client will live longer. • C. Use ethical principles to guide the decision making process. • D. Select a client who is most productive in society. 20.) The leading health indicators found in Healthy People 2020 are the following: (Select all that apply) • A. Access to health services • B. Holistic and CAM strategies • C. Oral Health • D. Issues related to legal and illegal immigration • E. Environmental health • F. Holistic Care 21.) Which statement best describes Erikson’s Theory of Development. • A. The premise of the theory is that individuals are interdependent beings. • B. Developmental stages result in an attempt to make sense of the world. • C. A healthy personality will achieve the pre-conventional stage by 15. • D. An individuals achievements of identity is through sequential psychosocial stages. 22.) A patient with chest pain is being admitted to the ER. When asked about the next of kin the patients states, “Don’t bother calling my daughter; she is always too busy.” Which is best response by the nurse? • A. “She might be upset if you don’t call her.” • B. “ What does your daughter do that makes her so busy?” • C. “Is there someone else that you would like me to call for you?” • D. “I cant imagine that your daughter wouldn’t want to know that you are sick.” 23.) A patient states, “Do you think I could have cancer?” The nurse responds, “What did the doctor tell you?” Which interviewing approach did the nurse use? • A. Paraphrasing • B. Confrontation • C. Reflective Technique • D. Open-ended question 24.) A patient is admitted to the hospital with cirrhosis of the liver causes by long-term alcohol abuse. Which is the best response by the nurse when the patient says “I really don’t believe that my drinking a couple of beers a day has anything to do with my liver problem?” • A. “You find it hard to believe that beer can hurt the liver” • B. “How long is it that you have been drinking several beers a day?” • C. “ Each beer is equivalent to one shot of liquor so its just as damaging to the liver as hard liquor.” • D. “ Do you believe that beer is not harmful even though research shows that it is just as bad for you as hard liquor?” 25.) A patient is extremely upset and mentions something about work-related issues that the nurse cannot understand. Which is the nurses best response? • A. “Its natural to worry about your job.” • B. “ Your job must be very important to you.” • C. “Calm down so I can understand what you are saying.” • D. “ I’m not quite sure I heard what you were saying about your work.” 26.) A nurse must conduct a focused interview to complete an admission history. Which interviewing technique should the nurse use? • A. Probing • B. Clarification • C. Direct questions • D. Paraphrasing statements 27.) The home care nurse is visiting an older client whose spouse died 6 months ago. Which behaviors by the client indicates effective coping? • A. Neglecting personal grooming • B. Looking as old snapshots of family. • C. Participating in a senior citizens program • D. Visiting spouses grave once a month • E. Decorating a wall with the spouses pictures and awards received. 28.) A nurse is planning to provide personal health care information to several patients. Which patients should the nurse anticipate will be more motivational to learn? • A. 55 y/o F who has a mastectomy and is very anxious about her body image. • B. 56 y/o M who has a heart attack last week and is requesting information about exercise • C. 18 y/o M who smokes two packs per day and is in denial about the dangers or smoking. • D. 47 y/o F who has a long leg cast after sustaining a broken leg and is still experience severe pain. 29.) The nurse asses a patient and collects a variety of data. Identify the human response that are subjective data. Select all that apply: • A. Nausea • B. Jaundice • C. Dizziness • D. Diaphoresis • E. Hypotension. 30.) A nurse is collecting information to prepare a teaching plan for a patient with type 1 diabetes. Which question asked by the nurse is associated with collecting information in the cognitive domain of leaning? • A. “ How do you inspect your feet each day?” • B. “Can you measure a serum glucose levels?” • C. “ What do you know about diabetes mellitus?” • D. “Are you able to preform a subcutaneous injection? 31.) Which of the following emphasizes an individuals belief and being personably capable of preforming the behavior is required to influence ones own health. • A. Social cognitive theory • B. Self efficiency theory • C. Health Belief Model • D. Transtheoretical Model 32.) A nurse sets up an education program to discuss health disparities for high school students, one of the first steps of the process is for: Which of the following • A. Describe health behaviors • B. Decrease morbitity

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MENTAL HEALTH NCLEX
QUESTIONS AND ANSWERS
Mental Health

1. The home care nurse is visiting an older client whose spouse died 6 months ago.
Which behavior by the client indicates ineffective coping?
1. Neglecting personal grooming
2. Looking at old snapshots of family
3. Participating in a senior citizens' program
4. Visiting their spouse's grave once a month


2. A client with a diagnosis of major depression who has attempted suicide says to the
nurse, "I should have died. I've always been a failure. Nothing ever goes right for me."
Which response demonstrates therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?"


3. When the mental health nurse visits a client at home, the client states, "I haven't slept at
all the last couple of nights." Which response by the nurse illustrates a therapeutic
communication response to this client?
1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too."


3. A client experiencing disturbed thought processes believes that his food is being
poisoned. Which communication technique should the nurse use to encourage the
client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition

,5. A client admitted to a mental health unit for treatment of psychotic behavior spends hours
at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't
belong here." What defense mechanism is the client implementing?
1. Denial
2. Projection
3. Regression
4. Rationalization


6. A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish
my family would stop hoping for a cure! I get so angry when they carry on like this.
After all, I'm the one who's dying." Which response by the nurse is therapeutic?
1. "Have you shared your feelings with your family?"
2. "I think we should talk more about your anger with your family."
3. "You're feeling angry that your family continues to hope for you to be cured?"
4. "You are probably very depressed, which is understandable with such a diagnosis."


7. On review of the client's record, the nurse notes that the mental health admission was
voluntary. Based on this information, the nurse anticipates which client behavior?
1. Fearfulness regarding treatment measures.
2. Anger and aggressiveness directed toward others.
3. An understanding of the pathology and symptoms of the diagnosis.
4. A willingness to participate in the planning of the care and treatment plan.


8. When reviewing the admission assessment, the nurse notes that a client was admitted to
the mental health unit involuntarily. Based on this type of admission, the nurse should
provide which intervention for this client?
1. Monitor closely for harm to self or others.
2. Assist in completing an application for admission.
3. Supply the client with written information about their mental illness.
4. Provide an opportunity for the family to discuss why they felt the admission was
needed.


9. The nurse is preparing a client for the termination phase of the nurse-client relationship.
The nurse prepares to implement which nursing task that is most appropriate for this
phase?
1. Planning short-term goals
2. Making appropriate referrals

, 3. Developing realistic solutions
4. Identifying expected outcomes


10. The nurse in the mental health unit recognizes which as being therapeutic communication
techniques? Select all that apply.
1. Restating
2. Listening
3. Asking the client, "Why?"
4. Maintaining neutral responses
5. Providing acknowledgment and feedback
6. Giving advice and approval or disapproval

o 1. Restating

o 2. Listening

o 4. Maintaining neutral responses

o 5. Providing acknowledgment and feedback

11. A client being seen in the emergency department immediately after being sexually
assaulted appears calm and controlled. The nurse analyzes this behavior as
indicating which defense mechanism?
1. Denial
2. Projection
3. Rationalization
4. Intellectualization

1. Denial

12. A client's unresolved feelings related to loss would be most likely observed during which
phase of the therapeutic nurse-client relationship?
1. Trusting
2. Working
3. Orientation
4. Termination

4. Termination

13. The nurse is working with a client who despite making a heroic effort was unable to
rescue a neighbor trapped in a house fire. Which client-focused action should the
nurse engage in during the working phase of the nurse-client relationship?
1. Exploring the client's ability to function
2. Exploring the client's potential for self-harm

, 3. Inquiring about the client's perception or appraisal of why the rescue was unsuccessful
4. Inquiring about and examining the client's feelings for any that may block adaptive
coping

4. Inquiring about and examining the client's feelings for any that may block adaptive
coping

14. The nurse employed in a mental health unit of a hospital is the leader of a group
psychotherapy session. What is the nurse's role during the termination stage of
group development?
1. Acknowledging that the group has identified goals
2. Encouraging the accomplishment of the group's work
3. Acknowledging the contributions of each group member
4. Encouraging members to become acquainted with one another

3. Acknowledging the contributions of each group member

15. Which are characteristics of the termination stage of group development? Select all that
apply.
1. The group evaluates the experience.
2. The real work of the group is accomplished.
3. Group interaction involves superficial conversation.
4. Group members become acquainted with each other.
5. Some structuring of group norms, roles, and responsibilities takes place.
6. The group explores members' feelings about the group and the impending separation.

o 1. The group evaluates the experience.

o 6. The group explores members' feelings about the group and the
impending separation.

16. When a client is admitted to an inpatient mental health unit with the diagnosis of anorexia
nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse
understands that which is the purpose of this approach?
1. Providing a supportive environment
2. Examining intrapsychic conflicts and past issues
3. Emphasizing social interaction with clients who withdraw
4. Helping the client to examine dysfunctional thoughts and beliefs

4. Helping the client to examine dysfunctional thoughts and beliefs

17. The nurse understands that which best describes Gestalt therapy?
1. It emphasizes self-expression, self-exploration, and self-awareness in the present.
2. It promotes the individual's comfort in the group, which then transfers to other
relationships.
3. The therapist focuses on how irrational beliefs and thoughts contribute to

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