Question: A new patient immediately requires seclusion on admission. The assessment is incomplete, and the health care provider has not examined the patient. Immediately after safely secluding the patient, which action has priority?

Answer Choices: a. Provide an opportunity for the patient to go to the bathroom. b. Notify the health care provider and obtain a seclusion order. c. Notify the hospital risk manager. d. Debrief the staff.

Answer: b. Notify the health care provider and obtain a seclusion order.

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 who must take 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. Temporal lobe d. Parietal lobe

Answer: a. Amygdala c. 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: Because an intervention is required to control a patient’s aggressive behavior, a critical incident debriefing takes place. Which topics should be the focus of the discussion? (Select all that apply.)

Answer Choices: a. Patient behavior associated with the incident b. Genetic factors associated with aggression c. Intervention techniques used by staff d. Effect of environmental factors e. Review of theories of aggression

Answer: a. Patient behavior associated with the incident c. Intervention techniques used by staff d. Effect of environmental factors

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: A patient’s fiancé died in an automobile accident several days ago. The patient reports crying and experiencing feelings of guilt and anger. This behavior is characteristic of which aspect of grief?

Answer Choices: a. Reorganization b. Denial c. Development of awareness d. Preoccupation with the loss

Answer: c. Development of awareness

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 reply?

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: An adult who was widowed 18 months ago says, “I can now remember good times we shared without feeling upset. Sometimes I still feel lonely, but I’m accustomed to sleeping in our bed alone.” How is the work of mourning best characterized?

Answer Choices: a. It is beginning. b. It is progressing abnormally. c. It is at or near completion. d. It has not yet begun.

Answer: c. It is at or near completion.

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 nurse talks with a person whose spouse died suddenly while jogging. Which is the most therapeutic statement for the nurse?

Answer Choices: a. “At least your spouse did not suffer.” b. “Each day will get a little better.” c. “The loss of your spouse must be very painful for you.” d. “You’ll begin to feel better after you get over the shock.”

Answer: c. “The loss of your spouse must be very painful for you.”

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