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NCLEX-RN Exam Questions - Part 95
1. In working with a manipulative client, which of the following nursing interventions would be most appropriate?
A) Bargaining with the client as a strategy to control the behavior
B) Redirecting the client
C) Providing a consistent set of guidelines and rules
D) Assigning the client to different staff persons each day
2. Primary nursing diagnoses for the antisocial client are:
A) Alteration in perception and altered self-concept
B) Impaired social interaction, ineffective individual coping, and altered self-concept
C) Altered communication processes and altered recreational patterns
D) Altered body image and altered thought processes
3. A 25-year-old outpatient presents with a diagnosis of compulsive personality disorder. His coworkers become annoyed with his rigid, perfectionistic manner and preoccupation with trivial details and schedules. A nursing intervention appropriate for this client would include:
A) Encouraging him to engage in recreational activities
B) Avoiding discussion of his annoying behavior
C) Encouraging the client to set a time schedule and deadlines for himself
D) Contracting with him for the amount of time he will spend on the compulsive behaviors
4. The serial sevens test is often used to determine delirium and dementia. This test aids in assessing which of the following?
A) Abstract thinking
B) Ability to focus and concentrate thoughts
C) Judgment
D) Memory
5. A 14-year-old client has a history of lying, stealing, and destruction of property. Personal items of peers have been found missing. After group therapy, a peer approaches the nurse to report that he has seen the 14- year-old with some of the missing items. The best response of the nurse is to:
A) Request that he explain to the group why he took personal items from peers
B) Approach him when he is alone to inquire about his involvement in the incident
C) Imply to him that you doubt his involvement in the incident and request his denial
D) Confront him openly in group and request an apology
A) Bargaining with the client as a strategy to control the behavior
B) Redirecting the client
C) Providing a consistent set of guidelines and rules
D) Assigning the client to different staff persons each day
2. Primary nursing diagnoses for the antisocial client are:
A) Alteration in perception and altered self-concept
B) Impaired social interaction, ineffective individual coping, and altered self-concept
C) Altered communication processes and altered recreational patterns
D) Altered body image and altered thought processes
3. A 25-year-old outpatient presents with a diagnosis of compulsive personality disorder. His coworkers become annoyed with his rigid, perfectionistic manner and preoccupation with trivial details and schedules. A nursing intervention appropriate for this client would include:
A) Encouraging him to engage in recreational activities
B) Avoiding discussion of his annoying behavior
C) Encouraging the client to set a time schedule and deadlines for himself
D) Contracting with him for the amount of time he will spend on the compulsive behaviors
4. The serial sevens test is often used to determine delirium and dementia. This test aids in assessing which of the following?
A) Abstract thinking
B) Ability to focus and concentrate thoughts
C) Judgment
D) Memory
5. A 14-year-old client has a history of lying, stealing, and destruction of property. Personal items of peers have been found missing. After group therapy, a peer approaches the nurse to report that he has seen the 14- year-old with some of the missing items. The best response of the nurse is to:
A) Request that he explain to the group why he took personal items from peers
B) Approach him when he is alone to inquire about his involvement in the incident
C) Imply to him that you doubt his involvement in the incident and request his denial
D) Confront him openly in group and request an apology
1. Right Answer: C
Explanation: (A) This answer is incorrect. Bargaining is a manipulative act, which the nurse could expect from the client. (B) This answer is incorrect. Confrontation is an effective nursing strategy with manipulative behavior. Redirection is appropriate for the client who is out of touch with reality. (C) This answer is correct.Manipulative clients must abide by consistent rules. (D) This answer is incorrect. Manipulation is kept at a minimum if the same staff person is assigned to the client. Often the client will attempt to play staff persons against each other.
2. Right Answer: B
Explanation: (A) This answer is incorrect. Perception is not altered because the client is not psychotic. (B) This answer is correct. The antisocial client lacks responsibility, accountability, and social commitment; has impaired problem-solving ability; tends to overuse defense mechanisms; lies and steals; and is often grandiose concerning self. (C) This answer is incorrect. Altered communication processes do not characterize this client. The antisocial person communicates well and tends to have a charming personality. (D) This answer is incorrect. Altered thought processes refer to delusional thinking, which is bizarre and fixed, and do not characterize this client.
3. Right Answer: D
Explanation: (A) This answer is incorrect. The client will work hard at the activity instead of enjoying it. (B) This answer is incorrect. The nurse should allow the client to discuss these thoughts, within limits, not to avoid discussing them. (C) This answer is incorrect. The compulsive client tends to control time to excess. It should not be encouraged. (D) This answer is correct. A contract with the client regarding the amount of time that will be spent discussing the compulsive activities is appropriate. Time allotted should be gradually decreased.
4. Right Answer: B
Explanation: (A) This answer is incorrect. The test measures the abilities to concentrate and calculate. The use of proverbs is the most common way to test abstraction. (B)This answer is correct. The serial sevens test is a common test of calculation ability. It is difficult for the demented or delirious client to perform. (C) This answer is incorrect. The test for judgment should predict whether the individual will behave in a socially accepted manner. (D) This answer is incorrect. In testingmemory, the nurse would attempt to get the client either to recall recent events or to think about past events.
5. Right Answer: B
Explanation: (A) This answer is incorrect. There is no proof that he removed the missing items. (B) This answer is correct. Anxiety and defensiveness are lessened if the individual is approached in this manner. (C) This answer is incorrect. It is difficult for one to admit to wrongdoing with this approach. (D) This answer is incorrect.He has not yet been proved guilty. Confrontation will only increase defensiveness and anxiety.
Explanation: (A) This answer is incorrect. Bargaining is a manipulative act, which the nurse could expect from the client. (B) This answer is incorrect. Confrontation is an effective nursing strategy with manipulative behavior. Redirection is appropriate for the client who is out of touch with reality. (C) This answer is correct.Manipulative clients must abide by consistent rules. (D) This answer is incorrect. Manipulation is kept at a minimum if the same staff person is assigned to the client. Often the client will attempt to play staff persons against each other.
2. Right Answer: B
Explanation: (A) This answer is incorrect. Perception is not altered because the client is not psychotic. (B) This answer is correct. The antisocial client lacks responsibility, accountability, and social commitment; has impaired problem-solving ability; tends to overuse defense mechanisms; lies and steals; and is often grandiose concerning self. (C) This answer is incorrect. Altered communication processes do not characterize this client. The antisocial person communicates well and tends to have a charming personality. (D) This answer is incorrect. Altered thought processes refer to delusional thinking, which is bizarre and fixed, and do not characterize this client.
3. Right Answer: D
Explanation: (A) This answer is incorrect. The client will work hard at the activity instead of enjoying it. (B) This answer is incorrect. The nurse should allow the client to discuss these thoughts, within limits, not to avoid discussing them. (C) This answer is incorrect. The compulsive client tends to control time to excess. It should not be encouraged. (D) This answer is correct. A contract with the client regarding the amount of time that will be spent discussing the compulsive activities is appropriate. Time allotted should be gradually decreased.
4. Right Answer: B
Explanation: (A) This answer is incorrect. The test measures the abilities to concentrate and calculate. The use of proverbs is the most common way to test abstraction. (B)This answer is correct. The serial sevens test is a common test of calculation ability. It is difficult for the demented or delirious client to perform. (C) This answer is incorrect. The test for judgment should predict whether the individual will behave in a socially accepted manner. (D) This answer is incorrect. In testingmemory, the nurse would attempt to get the client either to recall recent events or to think about past events.
5. Right Answer: B
Explanation: (A) This answer is incorrect. There is no proof that he removed the missing items. (B) This answer is correct. Anxiety and defensiveness are lessened if the individual is approached in this manner. (C) This answer is incorrect. It is difficult for one to admit to wrongdoing with this approach. (D) This answer is incorrect.He has not yet been proved guilty. Confrontation will only increase defensiveness and anxiety.
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