A female high school teacher, who was a child of alcoholic parents, seeks counseling at the community health clinic because of depression over a student who was killed by a drunk driver. After several weeks of counseling, which client behavior is the best indicator that the client is coping well with the anxiety related to the student's death?

Becomes the faculty sponsor for Students Against Drunk Driving (SADD).

Describes alternatives to becoming depressed over the student's death.

Confronts her parents about the hurt she felt as a child of alcoholic parents.

Signs a safety contract with the nurse agreeing not to hurt herself or others.

Answer and Explanation

The Correct Answer is A

A) Becoming the faculty sponsor for Students Against Drunk Driving (SADD) is a proactive and constructive behavior that indicates the client is coping well with her anxiety related to the student’s death. This action demonstrates her ability to channel her grief into positive advocacy, suggesting that she is processing her emotions and seeking to create meaningful change, which is a strong indicator of healthy coping.

B) Describing alternatives to becoming depressed over the student’s death is a positive step, as it shows the client is engaging in cognitive strategies to manage her emotions. However, while this indicates some progress, it is less impactful than taking active steps to address the issue, like becoming involved in advocacy or community efforts.

C) Confronting her parents about the hurt she felt as a child of alcoholic parents can be a significant therapeutic step, but it may not directly relate to her current coping with the loss of her student. While this confrontation may contribute to her overall healing, it does not necessarily indicate coping specifically related to the anxiety from the recent event.

D) Signing a safety contract with the nurse indicates that there may still be significant concerns regarding self-harm or emotional distress. While this is an important safety measure, it suggests that the client is not yet fully coping well with her anxiety, as it implies she is still in a vulnerable state rather than demonstrating effective coping mechanisms.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A) Reviewing serum creatinine is the most critical laboratory finding prior to initiating lithium therapy. Lithium is primarily excreted through the kidneys, and any existing renal impairment can increase the risk of lithium toxicity. Ensuring normal kidney function is vital for safe lithium administration and monitoring throughout the treatment.

B) While blood glucose levels can be relevant in the context of overall health and any potential metabolic syndrome concerns, they are not as directly related to lithium therapy as renal function. Blood glucose levels do not significantly impact the safety or effectiveness of lithium.

C) A white blood count (WBC) can be important in assessing for potential infections or hematological disorders, but it is not the primary focus when starting lithium. Lithium does not typically have a direct effect on white blood cell levels, making this finding less critical compared to renal function.

D) Alkaline phosphatase levels are primarily related to liver function and bone health. While monitoring liver function is important in general, it is not as directly pertinent to the initiation of lithium therapy as assessing renal function through serum creatinine levels. Therefore, this laboratory finding is less of a priority in this context.

A. Schedule the client for group therapy with other bulimic clients. B. Assign the client's care to a nurse of approximately the same age. C. Assess and report the client's electrolyte status to the healthcare provider. D. Monitor the client carefully for binging activities.

Correct Answer is C

Explanation

A) Scheduling the client for group therapy with other bulimic clients can be beneficial for support and shared experiences. However, it is not the highest priority intervention at the time of admission, especially if there are immediate health concerns that need to be addressed.

B) Assigning the client's care to a nurse of approximately the same age may help with rapport and understanding, but it does not directly address the critical health risks associated with bulimia nervosa. The age of the nurse is less relevant compared to the immediate medical needs of the client.

C) Assessing and reporting the client's electrolyte status to the healthcare provider is the highest priority. Clients with bulimia nervosa often experience significant electrolyte imbalances due to behaviors such as vomiting, laxative use, or excessive exercise, which can lead to serious complications such as cardiac arrhythmias. Monitoring electrolyte levels is essential for ensuring the client’s safety and guiding further treatment.

D) Monitoring the client carefully for binging activities is an important part of care, but it is secondary to addressing any immediate medical concerns. While observation is necessary to prevent harm, it should occur alongside medical assessments, particularly for electrolyte status, to ensure comprehensive care.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider prescribes lithium carbonate for a client diagnosed with bipolar, manic depression. It is most important for the nurse to review which laboratory finding prior to beginning the drug therapy?

Correct Answer is A

Explanation

A young adult client is admitted to a psychiatric facility with a diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?

Correct Answer is C

Explanation

An employee with a history of hypertension, visits the employee clinic weekly for blood pressure checks. During the assessment the client reports being upset with coworkers and would like to shoot them. Which action should the nurse take first?

The nurse is preparing the physical environment to interview a new client for admission to the mental health unit. Which environmental setting facilitates the best outcome of the interview?

A male client with known auditory hallucinations begins talking loudly and gesturing wildly while in the unit's day room. Which action should the nurse implement first?

The nurse interacts with a client who is very depressed and slow to respond to questions. The nurse asks the client to describe current feelings, but the client looks down at the table. Which action is best for the nurse to implement?

An older adult woman who lives in a long-term mental health facility has a history of taking belongings from other clients' rooms when she becomes agitated. The client is found placing these items in the same closet on the unit. Which action should the nurse take?

A client is admitted to the psychiatric unit following aspiration of a caustic material related to a suicide attempt. Which nursing problem has the highest priority?

A young adult client is brought to the emergency department with a suspected drug overdose. Which information is most important for the nurse to obtain from the family?