NURS230 Ch. 7 - Client’s Response to Illness

The nurse is assessing a young school-aged child and encourages the child to express feelings through the use of toys during play. Which assessment data will the nurse obtain with the use of play for this client?

A. The child has cognitive impairment and has limited vocabulary skills.

B. The child is not intellectually stimulated and can only self-express through play.

C. The child may not have developed the language to fully describe feelings.

D. The child will not express oneself openly unless instructed to do so by the child's

parents.

C. The child may not have developed the language to fully describe feelings.

The nurse is having group therapy for a group of clients with schizophrenia. Which client does the nurse identify is at greatest risk for poor prognosis of the illness?

A. A 14-year old client that is receiving home schooling and lives with parents

B. A 72-year-old client that has received treatment for 40 years with antipsychotic medications

C. A 42-year-old married client working in health care with an adolescent child

D. A 28-year-old client that is recently diagnosed with schizophrenia starting medication

A. A 14-year old client that is receiving home schooling and lives with parents

The nurse is caring for a client with a neurological disorder that creates feelings of feeling alone due to the illness. Which action by the nurse can assist the client with sense of belonging?

A. Provide information regarding a support group for clients with the same illness.

B. Refer the client to the clergy at the facility for spiritual guidance.

C. Encourage the client to call family members to sit in the room during the stay.

D. Provide the client with diversional activities such as books and puzzles.

A. Provide information regarding a support group for clients with the same illness.

The nurse is providing education for a client to improve mental and emotional health and influence the client's response to illness. Which statement made by the client indicates that the education is effective? Select all that apply.

A. "I will take my medications as prescribed for my type I diabetes."

B. "I need to increase my exercise and start taking walks 3 times a week."

C. "It is important that I improve my nutritional intake and stop snacking on junk

food."

D. "I will follow-up with my health care provider every 6 months."

E. "I will try to set a time to go to bed and get at least 6-8 hours of sleep at night.

B. "I need to increase my exercise and start taking walks 3 times a week."

C. "It is important that I improve my nutritional intake and stop snacking on junk food."

E. "I will try to set a time to go to bed and get at least 6-8 hours of sleep at night.

The nurse is preparing to administer PRN antianxiety medication to a client deemed a poor metabolizer who is experiencing anxiety. The prescription reads, "Alprazolam 0.25 to 1.0 mg PO PRN." Which is the best dose for the nurse to give initially?

A. 0.25 mg

B. 0.5 mg

C. 0.75 mg

D. 1.0 mg

A. 0.25 mg

A client's disease prognosis is said to be good due to a high degree of self-efficacy. Which characteristics of self-efficacy does the nurse identify that contributes to this client's high degree of self-efficacy? Select all that apply.

A. Requests assistance in the recovery process from family members

B. Experiences doubt about overcoming stressors

C. Reports feelings of anxiety and depression due to the diagnosis

D. Informs the nurse of enjoying gardening when coping with stress

E. Ability to resist illness when under stress

A. Requests assistance in the recovery process from family members

D. Informs the nurse of enjoying gardening when coping with stress

A client has several stressors that predispose them to illness but demonstrates the attribute of hardiness. Which action(s) by the client contributes to the ability to resist illness with the stressors involved? Select all that apply.

A. The client remains actively involved in life activities.

B. The client has healthy responses to risky situations.

C. The client has appropriate decision making in life activities.

D. The client believes that they can cope with adverse situations.

E. The client embraces change as positive rather than an added stressor.

A. The client remains actively involved in life activities.

C. The client has appropriate decision making in life activities.

E. The client embraces change as positive rather than an added stressor.

The nurse observes behaviors from the family of a client diagnosed with terminal cancer demonstrating resiliency. Which behavior(s)s and history demonstrated by the family will lead to this conclusion? Select all that apply.

A. Family members are independent of one another.

B. The family spends time together often.

C. Family members engage in recreational activities together.

D. Family members share and take part in family rituals and traditions.

E. Family members allow individual members to develop unique daily routines.

B. The family spends time together often.

C. Family members engage in recreational activities together.

D. Family members share and take part in family rituals and traditions.

The nurse is discussing with a parent the difficulty in managing their child's attention-deficit hyperactivity disorder (ADHD). Which response by the nurse is most therapeutic?

A. "This is going to be something they just have to grow out of."

B. "The child may have to take the medication daily throughout the years."

C. "You must be supportive while your child is experiencing this behavior."

D. "The child doesn't have the understanding or ability to describe their feelings."

D. "The child doesn't have the understanding or ability to describe their feelings."

A client tells the nurse, "I feel as though I haven't been able to cope with my issues lately. Life just seems so hard." Which assessment data will determine why the client may have an inability to cope? Select all that apply.

A. The client has type II diabetes mellitus and takes insulin therapy.

B. The client reports having chronic obstructive pulmonary disease (COPD).

C. The client reports not eating well and has lost 25 lb in 2 months.

D. The client reports getting less than 4 hours of sleep at night.

E. The client states that they go to the local gym and take exercise classes.

A. The client has type II diabetes mellitus and takes insulin therapy.

B. The client reports having chronic obstructive pulmonary disease (COPD).

C. The client reports not eating well and has lost 25 lb in 2 months.

D. The client reports getting less than 4 hours of sleep at night.

A client with low self-efficacy informs the nurse about feeling depressed and fatigued most of the time. Which action(s) will the nurse employ that will develop the client's skills so that life changes will be beneficial? Select all that apply.

A. Persuade the client to believe in themselves.

B. Request that the health care provider prescribe antidepressant medications.

C. Encourage the client to find ways to reduce stress.

D. Learn how to interpret physical sensations in a positive manner.

E. Assist with devising an exercise plan to help build physical strength.

A. Persuade the client to believe in themselves.

C. Encourage the client to find ways to reduce stress.

D. Learn how to interpret physical sensations in a positive manner.

E. Assist with devising an exercise plan to help build physical strength.

The nurse is caring for a client that has experienced a traumatic event with another family member. The client is displaying depression and anxiety and the family member has been able to move past the event with no major disruption in life. Which behavior does the nurse identify the family member is displaying?

A. Hardiness

B. Resilience

C. Social skills

D. Tolerance

B. Resilience

The nurse is caring for a client that is in the process of obtaining a divorce from their partner. Which factor would be the most influential in assessing the client's response to this stressor?

A. The client's experience with stress

B. The client's perception of the stressor

C. The duration of the stressor

D. The severity of the stressor

B. The client's perception of the stressor

The client states to the nurse, "I know I can learn to cope with my family situation. By getting help here at the clinic, I'll be able to deal with them more effectively, and I won't be so stressed out all the time." Which personal characteristic does the nurse document the client is exhibiting?

A. Hardiness

B. Resilience

C. Sense of belonging

D. Self-efficacy

D. Self-efficacy

A client reports feeling like they belong among peers with whom the client shares a group home. The nurse incorporates this sense of belonging when formulating discharge plans because the nurse identifies which factor?

A. Living with a peer group often increases anxiety.

B. Peers may alienate the client from daily living activities.

C. The client will likely feel needed by peers.

D. Peer groups often do too much for each other, causing dependency.

C. The client will likely feel needed by peers.

The nurse is caring for a school-aged child who is hospitalized with a gastrointestinal virus. Which statement made by the child demonstrates successfully mastering the appropriate developmental stage according to Erikson?

A. "My parents will take care of me so that I won't hurt anymore."

B. "I am scared about my test today but I will be okay."

C. "I shouldn't have been playing with my food and spilled it on the floor."

D. "I did this puzzle all by myself. Isn't that good?"

D. "I did this puzzle all by myself. Isn't that good?"

The nurse is working with a client with diabetes to assess the client's health literacy. Which priority question will the nurse ask to ascertain this information?

A. "When were you diagnosed with diabetes, and which medications are you taking

to manage it?"

B. "Are you a member of a support group with those clients that also have diabetes?"

C. "Do you have the information that you need to take care of yourself?"

D. "Do you live in an area that is safe and you feel comfortable walking around in?"

C. "Do you have the information that you need to take care of yourself?"

The nurse is caring for a client that practices Judaism. Which action(s) will the nurse perform in order to provide culturally competent care?

A. Ask the client if they follow any particular dietary preferences or restrictions.

B. Ask the client if there is anything that can be done to help practice their beliefs.

C. Ask the client if they understood that all clients are treated the same.

D. Ask the client how they believe their illness came about.

E. Ask the client which remedies they may have used at home.

A. Ask the client if they follow any particular dietary preferences or restrictions.

B. Ask the client if there is anything that can be done to help practice their beliefs.

D. Ask the client how they believe their illness came about.

E. Ask the client which remedies they may have used at home.

The nurse is caring for clients in a large metropolitan city outpatient clinic. Which cultural phenomenon will be assessed by the nurse that includes preference such as touch and eye contact?

A. Communication

B. Social organization

C. Environmental control

D. Biologic variations

A. Communication

The nurse is caring for a culturally diverse population in an urban acute care facility. Which question will best encourage clients to disclose information that the nurse must assess to provide culturally competent care?

A. "How do you want me to help you?"

B. "Do you want me to contact your preacher?"

C. "Which special diet do you have?"

D. "Which family members do you want to receive calls from?"

A. "How do you want me to help you?"

The nurse is performing a cultural assessment for a client. Which is the most important data the nurse will obtain?

A. Generalizing the client's cultural practice from societal beliefs

B. Questioning the client and family in regards to belief and practices

C. Being aware of all cultures practices and beliefs

D. Gaining information from the family about practices and beliefs

B. Questioning the client and family in regards to belief and practices

The nurse is taking care of a client from a culture different from the nurse's culture. How might the nurse best provide culturally competent care?

A. Behave as appropriate for the nurse's culture.

B. Find out as much as possible about a client's cultural values, beliefs, and health practices.

C. Know what to expect from many cultural groups.

D. Validate knowledge about culture through continuing education.

B. Find out as much as possible about a client's cultural values, beliefs, and health practices.

An adolescent client presents to the ED along with several friends. The nurse identifies a good support system. Which key components does the nurse identify as this client's support system that indicates it is effective?

A. The collaborative information gathered from the group regarding presenting events

B. Client's perception of the support system and the responsiveness of the support system

C. The protective mechanisms shown by the support system in a matter-of-fact manner

D. Client's perception of the ED and how quickly they can be cared for

B. Client's perception of the support system and the responsiveness of the support system

A nurse is gathering information regarding discharging a client and documenting the client's support system. Which are factors the nurse identifies to assess the family support?

A. Commitment and caring

B. Concerned and inquisitive

C. Cautious of commitment

D. Available only at discharge

A. Commitment and caring

The nurse identifies a potential deficit when providing culturally competent care. Which action will the nurse take to improve the ability to provide culturally competent care?

A. Inquire about client values, beliefs, and health practices.

B. Engage other family members to get a broader perspective.

C. Open all initial visits with a firm kind hand shake.

D. Maintain good eye contact at all times during the interview.

A. Inquire about client values, beliefs, and health practices.