EXAM 2023 – COMPREHENSIVE PRACTICE
EXAM (70 Questions with Rationales)
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SECTION 1: THERAPEUTIC COMMUNICATION & THE NURSE-CLIENT RELATIONSHIP (Questions 1-10) Q1. A nurse is caring for a client with major depressive disorder who states, "I'm a burden to everyone. My family would be better off without me." Which response by the nurse is the priority? • A) "You have so much to live for. Don't say that." • B) "Are you thinking about hurting or killing yourself?" • C) "Why do you feel like a burden to your family?" • D) "Let's talk about something more positive." Correct Answer: B Rationale: This statement indicates suicidal ideation. The priority is to directly assess for a suicide plan, intent, and means. Asking directly about suicide does not plant the idea and is essential for client safety. "Why" questions can feel accusatory, and false reassurance or changing the topic avoids the critical safety assessment . Q2. A client with schizophrenia tells the nurse, "The voices are telling me to jump out the window." Which response by the nurse is most appropriate? • A) "The voices aren't real. Just ignore them." • B) "What are the voices saying to you right now?" • C) "Tell the voices to stop." • D) "I don't hear any voices." Correct Answer: B Rationale: The nurse needs to assess the content of auditory hallucinations, especially for command hallucinations that direct the client to harm self or others.
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