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During admission to the psychiatric unit, a female client is extremely anxious
and states that she is worried about the sun coming up the next day. What
intervention is most important for the RN to implement during the admission
process?
A. Assist the client in developing alternative coping skills.
B. Remain calm and use a matter-of-fact approach.
C. Ask the client why she is so anxious
D. Administer a PRN sedative to help relieve her anxiety.
The RN is leading a group on the inpatient psychiatric unit. Which approach
should the RN use during the working phase of group development?
A. Establishing a rapport with group members.
B. Clarifying the nurse’s role and clients’ responsibilities.
C. Discussing ways to use new coping skills learned.
D. Helping clients identify areas of problem in their lives.
A male client with schizophrenia is demonstrating echolalia, which is
becoming annoying to other clients on the unit. What intervention is best for
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the RN to implement?
A. Isolate the client from the other clients.
B. Administer PRN sedative.
C. Avoid recognizing the
behavior. D. Escort the client
to his room.
A client is admitted for bipolar disorder and alcohol withdrawal, depressive
phase. Based on which assessment finding will the RN withhold the clonidine
(Catapres) prescription?
A. Blood pressure readings of 90/62 mmHg to 92/58 mmHg.
B. Pulse rate of 68-78 BPM.
C. Temperature of 99.5-99.7 F.
D. Respiration rate of 24 breaths per minute.
The RN on the evening shift receives report that a client is scheduled for
electroconvulsive treatment (ECT) in the morning. Which intervention should
the Rn implement the evening before the scheduled ECT?
A. Hold all bedtime medications.
B. Keep the client NPO after mid-night.
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C. Implement elopement precautions.
D. Give the client an enema at bedtime.
A female client is brought to the emergency department after police officers
found her disoriented, disorganized, and confused. The RN also determines
that the client is homeless and is exhibiting suspiciousness. The client’s plan of
care should include what priority problem?
A. Acute confusion.
B. Ineffective community coping
C. Disturbed sensory perception.
D. Self-care deficit.
The occupational health nurse is working with a female employee who was just
notified that
her child was involved in a MVA and taken to the hospital. The employee
states, “I can’t believe this. What should I do?” Which response is best for the
RN to provide in this crisis?
A. Tell me what you think should happen.
B. How serious was the collision?
C. What do you think you should do?
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D. Call for transportation to the hospital.
A client tells the RN that he has an IQ of 400+ and is a genius and an inventor.
He also reports that he is married to a female movie star and thinks that his
brother wants a sexual relationship with her. What is the priority nursing
problem for admission to the psychiatric unit?
A. Ineffective sexual patterns.
B. Impaired environmental interpretation.
C. Disturbed sensory perception.
D. Compromised family coping.
The RN is providing care for a client diagnosed with borderline personality
disorder who has self-inflicted lacerations on the abdomen. Which approach
should the RN use when
changing this client’s dressing?
A. Provide detailed thorough explanations when
cleansing wound. B. Perform the dressing change in a
non-judgmental manner.
C. Ask in a non-threatening manner why the client cut own abdomen.
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