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) While it is important for the family to communicate love and concern, this goal does not directly address the immediate medical needs of the adolescent. Focusing on emotional support is valuable, but it is secondary to the need for nutritional recovery.

B) The goal for the client to eat nutritious meals in the hospital cafeteria has the highest priority. Ensuring adequate nutrition is critical in the treatment of anorexia nervosa, as the client is at risk for severe physical complications due to malnutrition. This goal directly addresses the client’s immediate health needs and forms the foundation for further psychological recovery.

C) Verbalizing feelings of positive self-esteem is an important long-term goal in the treatment of anorexia nervosa; however, it cannot be effectively achieved without first addressing the client’s nutritional and physical health needs. Self-esteem often improves with physical recovery, so it should be a goal to work toward after establishing a solid nutritional foundation.

D) While regular family therapy sessions can be beneficial for the overall treatment plan, this goal does not take precedence over the need for the client to stabilize their physical health. Family involvement is important, but the immediate priority should be on the client's individual recovery and nutritional needs.

A. Disrupts group activities. B. Talks with nonsensical words. C. Refuses antipsychotic medications. D. Wanders into client's rooms.

Correct Answer is D

Explanation

A) Disrupting group activities indicates behavioral issues, but it alone does not necessarily warrant constant observation. While disruptive behavior can be concerning, it may not pose an immediate risk to the client or others.

B) Talking with nonsensical words suggests disorganized thinking or possible psychosis, which is important to note. However, this behavior does not by itself indicate that the client is in immediate danger or that they require constant observation.

C) Refusing antipsychotic medications is a significant factor, particularly in managing the client's mental health. However, refusal of medication does not automatically necessitate constant observation unless it leads to behaviors that put the client or others at risk.

D) Wandering into clients' rooms is the most concerning behavior in this context. This action can pose a risk to both the individual and other clients, potentially leading to boundary violations or safety issues. Constant observation is warranted to ensure the safety of all clients and to manage the individual's behavior effectively.

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Naxlex Comprehensive Predictor Exams

Which goal has the highest priority for an adolescent client who is hospitalized for weight loss related to anorexia nervosa?

Correct Answer is B

Explanation

A client who refuses antipsychotic medications disrupts group activities, talks with nonsensical words, and wanders into client's rooms. The nurse decides that the client needs constant observation based on which of these assessment findings?

Correct Answer is D

Explanation

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