Question: An emergency department nurse realizes that the spouse of a patient is becoming increasingly irritable while waiting. Which intervention should the nurse use to prevent escalation of anger?
Answer Choices:
A. Explain that the patient’s condition is not life threatening.
B. Periodically provide an update and progress report on the patient.
C. Explain that all patients are treated in order, based on their medical needs.
D. Suggest that the spouse return home until the patient’s treatment is completed.
Answer: B – Periodically provide an update and progress report on the patient.
Question: Confirmation of a history of what scenario from a patient’s record indicates compromised coping skills and the need for careful assessment of the risk for violence?
Answer Choices:
A. Childhood trauma
B. Family involvement
C. Academic problems
D. Daily substance abuse
Answer: D – Daily substance abuse
Question: A patient diagnosed with pneumonia has been hospitalized for 4 days. Family members describe the patient as “a difficult person who finds fault with everyone.” The patient verbally abuses nurses for providing poor care. What is the most likely explanation for this behavior?
Answer Choices:
A. Poor child-rearing that did not teach respect for others.
B. Automatic thinking, leading to cognitive distortion.
C. Personality style that externalizes problems.
D. Delusions that others wish to deliver harm.
Answer: C – Personality style that externalizes problems.
Question: A patient with a history of command hallucinations approaches the nurse, yelling obscenities. The patient mumbles and then walks away. The nurse follows. Which nursing actions are most likely to be effective in de-escalating this scenario? (Select all that apply.)
Answer Choices:
A. State the expectation that the patient will stay in control.
B. State that the patient cannot be understood when mumbling.
C. Tell the patient, “You are behaving inappropriately.”
D. Offer to provide the patient with medication to help.
E. Speak in a firm but calm, caring voice.
Answer: A – State the expectation that the patient will stay in control. D – Offer to provide the patient with medication to help. E – Speak in a firm but calm, caring voice.
Question: A nurse directs the intervention team to seclude an aggressive patient to seclusion. Other patients were removed from the area. Before approaching the patient, the nurse should ensure that which actions are taken by staff? (Select all that apply.)
Answer Choices:
A. Remove jewelry, glasses, and harmful items from the patient and staff members.
B. Appoint a person to clear a path and open, close, or lock doors.
C. Quickly approach the patient and grab the closest extremity.
D. Select the person who will communicate with the patient.
E. Move behind the patient to use the element of surprise.
Answer: A – Remove jewelry, glasses, and harmful items from the patient and staff members. B – Appoint a person to clear a path and open, close, or lock doors. D – Select the person who will communicate with the patient.
Question: Which central nervous system structures are most associated with anger and aggression? (Select all that apply.)
Answer Choices:
A. Amygdala
B. Cerebellum
C. Basal ganglia
D. Temporal lobe
E. Parietal lobe
Answer: A – Amygdala D – Temporal lobe
Question: Which behaviors are most consistent with the clinical picture of a patient who is becoming increasingly aggressive? (Select all that apply.)
Answer Choices:
A. Pacing
B. Crying
C. Withdrawn affect
D. Rigid posture with clenched jaw
E. Staring with narrowed eyes into the eyes of another
Answer: A – Pacing D – Rigid posture with clenched jaw E – Staring with narrowed eyes into the eyes of another
Question: A nurse counsels a person whose spouse recently died. The nurse uses cheer and humor to lift the person’s spirits. At one point, the widowed person smiles briefly. What analysis of this scenario is correct?
Answer Choices:
A. The nurse’s technique was effective.
B. Use of humor should be added to the plan of care.
C. This approach may prove useful in other, similar situations.
D. The nurse needs help developing therapeutic communication skills.
Answer: D – The nurse needs help developing therapeutic communication skills.
Question: After the death of a spouse, an adult repeatedly says, “I should have made him go to the doctor when he said he didn’t feel well.” What response is this individual likely experiencing?
Answer Choices:
A. Preoccupation with the image of the deceased
B. Sensations of somatic distress
C. Anger
D. Guilt
Answer: D – Guilt
Question: A person whose spouse died 2 years earlier tells friends, “I think I’m ready to start going out socially, maybe even take someone to dinner.” What does this comment best demonstrate about the individual’s state of mind?
Answer Choices:
A. Is denying the significance of the loss.
B. Is in a period of grief resolution.
C. Is actively working through grief.
D. Is experiencing intrusion.
Answer: B – Is in a period of grief resolution.
Question: After the death of his wife, a man tells the nurse, “I can’t live without her. She was my whole life.” Which is the nurse’s most therapeutic response?
Answer Choices:
A. “Each day will get a little better.”
B. “Her death is a terrible loss for you.”
C. “Remember, she’s no longer suffering.”
D. “Your friends will help you cope with this.”
Answer: B – “Her death is a terrible loss for you.”
Question: Shortly after a man’s wife dies, the man approaches the nurse who cared for his wife during her final hours of life and says angrily, “If you had given your undivided attention, she would still be alive.” Which analysis applies?
Answer Choices:
A. The husband will pursue legal action regarding the nurse’s negligence.
B. Anger is a phenomenon experienced during grieving.
C. The husband had ambivalent feelings about his wife.
D. In some cultures, grief is expressed exclusively by anger.
Answer: B – Anger is a phenomenon experienced during grieving.
Question: After her husband died of heart failure, a wife approaches the nurse who cared for her husband. In the hospital hallway, the wife shouts angrily, “He’d still be alive if you’d given him your undivided attention!” Which response should the nurse implement?
Answer Choices:
A. “I understand you’re feeling upset. Let’s go to our conference room, and I’ll stay with you until your family comes.”
B. “Your husband’s heart was severely damaged and could no longer pump. There’s nothing anyone could have done.”
C. “I will call the nursing supervisor to discuss this matter with you.”
D. “It will be all right if you cry. Crying is a normal grief response.”
Answer: A – “I understand you’re feeling upset. Let’s go to our conference room, and I’ll stay with you until your family comes.”
Question: What situation makes the mourning process more difficult for the bereaved?
Answer Choices:
A. They were relatively independent of the deceased.
B. They have experienced many previous losses.
C. They accept that death is expected for everyone.
D. They had resolved conflicts with the deceased.
Answer: B – They have experienced many previous losses.
Question: A patient newly diagnosed with pancreatic cancer says, “My father also died of pancreatic cancer. I took care of him during his illness. I can’t go through that.” Select the highest priority nursing diagnosis.
Answer Choices:
A. Anticipatory grieving
B. Ineffective coping
C. Ineffective denial
D. Risk for suicide
Answer: D – Risk for suicide
Question: A recently widowed patient tells the health care provider, “I have so much epigastric discomfort. I wonder if I have an ulcer.” Diagnostic tests are negative. What does the symptom likely demonstrate?
Answer Choices:
A. Early reorganization behavior
B. Disorganization and depression
C. Preoccupation with the deceased
D. Normal phenomenon of mourning
Answer: D – Normal phenomenon of mourning
Question: Which finding indicates the successful completion of an individual’s grieving process? a. For 2 years, a person has kept the deceased spouse’s belongings in their usual places. b. After 15 months, a widowed person realistically remembers both the pleasures and disappointments of the relationship with the spouse. c. 3 years after the death, a person talks about the spouse as if the spouse was still alive and weeps when others mention the spouse’s name. d. 18 months after the spouse’s death, a person says, “I never cry or have feelings of loss even though we were always very close.”
Answer Choices:
Answer: B – After 15 months, a widowed person realistically remembers both the pleasures and disappointments of the relationship with the spouse.