Uncategorized LVN Psychosocial Integrity 2 — Questions and Answers
Question 1: A nurse is caring for a client who was recently diagnosed with a terminal illness. The client states, 'If I promise to go to church every Sunday, maybe God will let me live longer.' Which stage of KĂĽbler-Ross's grief model is the client demonstrating?
- Anger
- Bargaining (Correct answer)
- Depression
- Acceptance
Correct answer: Bargaining
Bargaining is the stage in which a person attempts to make deals—often with God or a higher power—in hopes of postponing or reversing the loss. The client's statement directly reflects this negotiation behavior.
Question 2: A nurse is communicating with a client who has schizophrenia. The client suddenly shifts from discussing a fear of snakes to talking about a recent meal to describing a childhood memory, with no logical connection between topics. The nurse recognizes this pattern as:
- Neologism
- Echolalia
- Flight of ideas
- Loose associations (Correct answer)
Correct answer: Loose associations
Loose associations (also called derailment) describe a pattern of speech in which ideas shift from one unrelated topic to another with no logical connection. Flight of ideas is similar but involves rapid, pressured speech typically seen in mania.
Question 3: A client with anorexia nervosa refuses to eat and states, 'I am fat and disgusting.' Which nursing response is MOST therapeutic?
- 'You are not fat at all — look how thin you are.'
- 'I can see you feel very upset about your body. Can you tell me more about those feelings?' (Correct answer)
- 'If you don't eat, we will have to start tube feedings.'
- 'You need to eat to stay healthy. Everyone here wants you to get better.'
Correct answer: 'I can see you feel very upset about your body. Can you tell me more about those feelings?'
Acknowledging the client's feelings and encouraging further expression is the most therapeutic approach. Arguing about body image, making threats, or giving advice dismisses the client's perception and impairs the therapeutic relationship.
Question 4: A nurse is caring for a client who has just lost a spouse. The client says, 'I keep setting the table for two every evening out of habit.' Which nursing action is MOST appropriate?
- Advise the client to rearrange the dining area to avoid the reminder.
- Explain that grief typically resolves within six months.
- Sit with the client and offer a therapeutic presence without interrupting. (Correct answer)
- Encourage the client to join a support group immediately.
Correct answer: Sit with the client and offer a therapeutic presence without interrupting.
Providing therapeutic presence—sitting quietly with the grieving client and allowing them to express emotions without interruption—is the most appropriate immediate action. It communicates empathy and support without minimizing or rushing the grief process.
Question 5: A client with obsessive-compulsive disorder (OCD) insists on washing their hands exactly 30 times before each meal. The nurse understands that the handwashing ritual primarily serves to:
- Satisfy a physical need for cleanliness
- Gain attention from nursing staff
- Temporarily reduce anxiety associated with obsessive thoughts (Correct answer)
- Demonstrate control over the hospital environment
Correct answer: Temporarily reduce anxiety associated with obsessive thoughts
Compulsive rituals in OCD are performed to neutralize the anxiety triggered by obsessive thoughts. The behavior temporarily relieves distress, which reinforces its repetition, even when the person recognizes it is excessive.
Question 6: A nurse is planning care for a client who was recently admitted after a suicide attempt. Which of the following interventions should receive the HIGHEST priority?
- Encouraging the client to verbalize feelings of hopelessness
- Assigning the client to a room near the nurses' station and removing potentially harmful objects (Correct answer)
- Scheduling the client for group therapy three times per week
- Notifying the client's family of the admission
Correct answer: Assigning the client to a room near the nurses' station and removing potentially harmful objects
Client safety is always the highest priority. Placing the client in a room near the nurses' station for close observation and removing harmful objects reduces immediate risk of self-harm, addressing the physiological and safety needs that supersede all other interventions.
Uncategorized LVN Psychosocial Integrity 2
A nurse is caring for a client who was recently diagnosed with a terminal illness.
The client states, 'If I promise to go to church every Sunday, maybe God will let me live longer.' Which stage of KĂĽbler-Ross's grief model is the client demonstrating?