1. A nurse is caring for a client whose child has a terminal illness. The client requests
information about how to deal with the upcoming loss. Which of the following statements
should the nurse make
a. "It is not uncommon to feel angry toward yourself or others
Reason: Feelings of blame and anger towards oneself or others are an expected
reaction when a client is experiencing a loss.
2. A nurse is teaching a client who has bipolar disorder and a prescription for lithium. Which of
the following instructions should the nurse include in the teaching
a. "Take this medication with food
Reason: Lithium can cause GI distress and should be taken with food. Recommended
sodium intake 1500mg/day. Recommended 2000-3000ml/day fluids.
3. A nurse is planning care for four clients in a mental health facility. Which of the following
clients is at the greatest risk for injury when performing ADLs
a. A client who hassevere Alzheimer's disease
Reason: Alzheimer's clients are typically confused with memory difficulties, tend to
wander and need ADL assistance.
4. A nurse is updating the plan of care for a client who has bulimia nervosa and is 5?ove his
ideal body weight. Which of the following interventions should the nurse include in the plan
a. Identify the client'strigger foods
Reason: Nurse should identify trigger foods that initiate the client's binge and assist
the client to understand his thoughts and behavior that relate to the food
5. A nurse who works with newborns is assessing the potential for abuse or neglect. Which of
the following family groups should the nurse identify as the highest potential for future child
abuse
a. A family where one or both parents witnessed intimate partner violence in the home
as children
Reason: Parents who witnessed intimate partner violence as a child are more likely
to become abusive.
6. A nurse is performing an admission assessment on a client and notices that the client
appears withdrawn and fearful. To establish a trusting nurse-client relationship, which of the
following actions should the nurse take first
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