The nurse is caring for a hospitalized patient who states, "I cannot sleep at night in this hospital and it's making me crazy." Which of the following should the nurse ask first?

"I can tell your family not to visit you close to bedtime."

"Would you like me to provide you with earplugs?"

"I can get you a mental health consult if you think that would help."

"Tell me why you think you may not be sleeping at night."

Answer and Explanation

The Correct Answer is D

A. "I can tell your family not to visit you close to bedtime." While this could be a consideration, it does not address the patient's immediate concerns and the possible causes of their sleep issues.

B. "Would you like me to provide you with earplugs?" This is a possible solution but does not investigate the underlying cause of the sleep issue.

C. "I can get you a mental health consult if you think that would help." A mental health consult may be helpful, but it is not the first step in understanding and addressing the immediate concern.

D. "Tell me why you think you may not be sleeping at night." This is the best initial response as it allows the nurse to understand the root cause of the patient's sleep disturbances and address specific issues, such as noise, light, or discomfort.

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Correct Answer is D

Explanation

A. The client with breast cancer who had a mastectomy. This client is facing a significant life change and physical alteration that may lead to psychosocial stressors such as body image issues and emotional distress.

B. The client with chronic obstructive pulmonary disease who requires oxygen therapy. Although this condition is challenging, the primary stressors are often physical and related to the management of the disease rather than psychosocial stressors.

C. The client with colon cancer who has a colostomy. A colostomy can affect body image and self-esteem, potentially leading to psychosocial stressors such as anxiety or social isolation.

D. The client with a left upper arm fracture who was a victim of a crime. The fracture and the trauma of being a crime victim are significant psychosocial stressors. The emotional and psychological impact of the crime can affect the client’s overall mental health.

A. Displacement B. Rationalization C. Dissociation D. Projection

Correct Answer is B

Explanation

A. Displacement: Displacement involves transferring feelings to a less threatening object or person, which is not applicable to the client’s statement.

B. Rationalization: Rationalization involves justifying behaviors or feelings with logical reasons. The client’s statement reflects an unrealistic view rather than justifying actions.

C. Dissociation: Dissociation involves a disconnection from thoughts or feelings, which is not reflected in the client's statement.

D. Projection: Projection involves attributing one’s own feelings or thoughts to others. The client is expressing their own feelings about the wheelchair rather than attributing them to others.

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The nurse is caring for a hospitalized patient who states, "I cannot sleep at night in this hospital and it's making me crazy." Which of the following should the nurse ask first?

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a group of clients for psychosocial stressors. Which of the following client's should the nurse identify as having this type of stressor?

Correct Answer is D

Explanation

The nurse is assisting a client, from the bed into a wheelchair, who had a right-side below the knee amputation one day ago. The client states, "I will not be able to do much because of this wheelchair." The client is demonstrating which of the following defense mechanisms?

Correct Answer is B

Explanation

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