Mr. L, who has a severe fear of needles, is hospitalized on your medical unit. The laboratory technician enters to draw blood for the routine CBC, and Mr. L begins to cry out, "Get away from me! I can't breathe! I'm having a heart attack!" What should be your first response to Mr. L?

"Relax. Take a few deep breaths. I'll stay with you."

"I'll take your vital signs and call my supervisor."

"Don't worry. She's done this many times before."

"Why do you think you're having a heart attack, Mr. L?"

Answer and Explanation

The Correct Answer is A

Choice A reason: This response is calming and supportive. It addresses Mr. L's immediate distress by providing reassurance and a directive that can help him manage his panic, which is essential in a situation where a patient is experiencing extreme anxiety.

Choice B reason: While taking vital signs is an important step, it should not be the first response. The priority is to address the patient's acute distress and provide reassurance.

Choice C reason: This response minimizes the patient's feelings and does not address his immediate fear or offer any comfort or support.

Choice D reason: Asking why he thinks he's having a heart attack could increase his anxiety. It's important to first calm the patient before attempting to rationalize the situation.

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Correct Answer is C

Explanation

Choice A reason: Vomiting can be a sign of a transfusion reaction, but it is not as specific as low back pain for an acute hemolytic reaction.

Choice B reason: Urticaria, or hives, may indicate an allergic reaction but is not specific to an acute hemolytic reaction.

Choice C reason: Low back pain is a classic symptom of an acute hemolytic reaction, which is a serious and potentially life-threatening condition that requires immediate attention.

Choice D reason: Pulmonary congestion may occur in various conditions and is not the most specific indicator of an acute hemolytic reaction.

A. Paranoid B. Dependent C. Antisocial D. Schizoid

Correct Answer is C

Explanation

Choice A reason: Paranoid personality disorder is characterized by distrust and suspicion, not the behaviors described.

Choice B reason: Dependent personality disorder involves a need to be taken care of and a fear of separation, which does not align with David's behaviors.

Choice C reason: Antisocial personality disorder includes a disregard for and violation of the rights of others, deceitfulness, and impulsivity, which aligns with David's behaviors.

Choice D reason: Schizoid personality disorder is characterized by detachment from social relationships and a restricted range of emotional expression, not matching David's behaviors.

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Mr. L, who has a severe fear of needles, is hospitalized on your medical unit. The laboratory technician enters to draw blood for the routine CBC, and Mr. L begins to cry out, "Get away from me! I can't breathe! I'm having a heart attack!" What should be your first response to Mr. L?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who is receiving a blood transfusion. The nurse should monitor for which of the following findings as an indication the client is having an acute hemolytic reaction?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

The mental health status examination includes (select all that apply):

Nursing care for people with personality disorders includes all the following except:

A patient with peripheral arterial disease (PAD) is sitting in a chair and has cool feet that are reddish-purple in color. What action should the nurse take?

Which component of the Mental Health Status Examination focuses on the way a person experiences reality?

A nurse is assisting with the plan of care for a client who is newly diagnosed with borderline personality disorder. Which of the following interventions is the nurse's priority?

The nurse is providing care for a patient after an above-the-knee amputation due to diabetes complications. Which nursing care is essential for promoting ambulation?

After positioning the patient on the surgical table and applying the safety strap, the surgical team pauses and verifies the patient and surgical information. What is this called?