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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Correct Answer is D

Explanation

A) Sitting within two feet of the client may enhance feelings of safety and security for some individuals, but for others, it could feel intrusive or overwhelming. Establishing an appropriate personal distance is essential, and too close of a proximity might create discomfort, especially in a mental health setting where clients may already feel vulnerable.

B) Dimming the lights in the room can create a calming atmosphere; however, excessive dimness might hinder visibility and affect communication. While lighting can influence mood, it’s crucial to strike a balance that allows the client to feel comfortable without compromising the ability to engage effectively during the interview.

C) Positioning a table between the client and the nurse may provide a sense of personal space, but it can also create a physical barrier that may hinder open communication and rapport-building. Establishing a connection is important in mental health interviews, and a table might inadvertently foster feelings of separation or defensiveness.

D) Reducing the noise level in the room by turning off the television and radio is the most effective approach to facilitate the interview. A quiet environment minimizes distractions, allowing both the nurse and the client to focus on the conversation. This fosters a safe and supportive atmosphere where the client feels heard and respected, which is crucial for building trust and promoting an effective therapeutic interaction.

A. It is essential not to abruptly discontinue taking the medication. B. I can report any decrease in anxiety using the 10 point scale. C. Attending individual and group therapy sessions is important. D. I should report any dizziness, light-headedness, or sedation.

Correct Answer is A

Explanation

A) The statement "It is essential not to abruptly discontinue taking the medication" indicates the client’s awareness of the critical importance of tapering off benzodiazepines like alprazolam to avoid withdrawal symptoms, which can include rebound anxiety, seizures, and other complications. This demonstrates a fundamental understanding of medication safety and the potential risks associated with abrupt discontinuation.

B) Reporting any decrease in anxiety using a 10-point scale is beneficial for monitoring progress but is not as critical as understanding the implications of stopping medication suddenly. This reflects an awareness of managing anxiety but not necessarily the highest priority in self-care.

C) Attending individual and group therapy sessions is important for comprehensive treatment of GAD. However, this statement does not reflect the most immediate self-care concern related to the medication.

D) Reporting dizziness, light-headedness, or sedation shows the client’s awareness of potential side effects, which is important, but again, it does not encompass the crucial self-care goal regarding the safe management of alprazolam.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

The nurse is preparing a client for discharge who has been taking alprazolam long-term for generalized anxiety disorder (GAD). When evaluating the client's understanding of the discharge teaching, which statement made by the client shows awareness of the most important self-care goal?

Correct Answer is A

Explanation

A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

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?

During admission to the psychiatric unit, a female client is extremely anxious and expresses that she is worried about the sun coming up the next day. Which intervention is most important for the nurse to implement during the admission process?

A client with bipolar disorder has not slept or eaten in four days. The client is pacing and becomes increasingly agitated and loud while the nurse talks to the client's spouse. Which intervention is best for the nurse to implement at this time?

The nurse is providing care for a client diagnosed with a borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the nurse use when changing this client's dressings?

A client with somatic symptom disorder reports experiencing chest pain to the nurse. Which action should the nurse take?

A client with depression is not attentive to personal hygiene, uses television watching as a means of escape from responsibilities, and describes an inability to enjoy the things that once gave them pleasure. Which coping strategy should the nurse include in the plan of care?