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 B

Explanation

A) Clarifying the nurse's role and clients' responsibilities is important but is typically more relevant during the initial stages of group development, specifically in the forming phase. By the working phase, roles should already be established.

B) Discussing ways to use new coping skills learned is the most appropriate approach during the working phase of group development. This phase is characterized by active engagement and collaboration among group members as they explore and practice the skills they’ve learned. It encourages growth and fosters a supportive environment for applying new strategies.

C) Helping clients identify areas of problem in their lives is an essential aspect of group therapy but is often emphasized during earlier phases when members are becoming familiar with each other and establishing trust. In the working phase, the focus shifts toward solutions and skill application.

D) Establishing rapport with group members is crucial in the forming phase of group development. By the working phase, rapport should be well established, allowing for deeper discussions and engagement in the therapeutic process. Therefore, focusing on new coping skills is more aligned with the goals of this phase.

A. Perform the dressing change in a non-judgmental manner. B. Provide detailed thorough explanations when cleansing the wound. C. Ask in a non-threatening manner why the client cut own abdomen. D. Request another staff member assist with the dressing change.

Correct Answer is A

Explanation

A) Performing the dressing change in a non-judgmental manner is crucial when caring for a client with borderline personality disorder. Clients with this diagnosis often have intense emotions and may feel vulnerable, so approaching the situation without judgment fosters a sense of safety and respect. This supportive attitude can help build trust and encourage open communication.

B) While providing thorough explanations when cleansing the wound can be beneficial, excessive detail may overwhelm the client or create anxiety. It is important to communicate effectively, but the focus should be on providing care in a compassionate manner rather than on the specifics of the procedure, especially given the client’s emotional state.

C) Asking the client in a non-threatening manner why they cut their abdomen could be perceived as intrusive or confrontational, potentially leading to defensiveness or escalation of emotions. This approach may not be appropriate during a dressing change; instead, it may be more effective to address the reasons for self-harm in a separate therapeutic context when the client is more stable.

D) Requesting another staff member to assist with the dressing change might be necessary in certain situations, but it could also convey a sense of fear or discomfort regarding the client’s behavior. In this case, it is essential for the nurse to manage the situation confidently and compassionately, rather than distancing themselves from the client’s needs. Fostering a supportive environment is more important than involving additional staff at this moment.

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Naxlex Comprehensive Predictor Exams

The nurse is leading a group on the inpatient psychiatric unit. Which approach should the nurse use during the working phase of group development?

Correct Answer is B

Explanation

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?

Correct Answer is A

Explanation

When responding to a call light, the nurse finds a client with aggressive behaviors pacing and restless in the room. The client shouts, "What took you so long to get in here!" Which action should the nurse implement?

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?

A female client admitted to the mental health unit starts to shout and scream at the nurse. Which is the best approach for the nurse to take?

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?

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?