41. After assessing a victim of sexual assault, which terms could the nurse use in the documentation? (Select all that apply.)
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37. A client comes to the hospital for treatment of injurie…
37. A client comes to the hospital for treatment of injuries sustained during a rape. The client abruptly decides to decline treatment and return home. Before the client leaves, the nurse should provide what support?
17. A client with a history of command hallucinations appro…
17. A client with a history of command hallucinations approaches the nurse, yelling obscenities. The client 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.)
27. An adult has cared for a debilitated parent for 10 year…
27. An adult has cared for a debilitated parent for 10 years. The parent’s condition recently declined, and the health care provider recommended placement in a skilled care facility. The adult says, “I’ve always been able to care for my parents. Nursing home placement goes against everything I believe.” Successful resolution of this person’s crisis will most closely relate to what?
26. Which agency provides coordination in the event of a te…
26. Which agency provides coordination in the event of a terrorist attack?
13. A cab driver, stuck in traffic, becomes lightheaded, tr…
13. A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardic, and dyspneic. A work-up in an emergency department reveals no pathology. Which nursing diagnosis should be the nurse’s first priority?
30. A nurse at the mental health clinic plans a series of p…
30. A nurse at the mental health clinic plans a series of psychoeducational groups for persons diagnosed with schizophrenia. Which two topics would take priority? (Select all that apply.)
43. A staff nurse tells another nurse, “I evaluated a new c…
43. A staff nurse tells another nurse, “I evaluated a new client using the modified SAD PERSONS scale and got a score of 10. I’m wondering if I should send the client home.” Select the best reply by the second nurse.
55. A client with schizophrenia has recently begun a new me…
55. A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which potentially fatal side effect will the nurse teach the client about?
5. A client experiencing severe anxiety suddenly begins run…
5. A client experiencing severe anxiety suddenly begins running and shouting, “I’m going to explode!” The nurse should implement which intervention to best maximize the client’s safety?