1. The nurse is caring for a client recently diagnosed with cancer. The client is quietly crying and states,

PREBOARD 9

1.) The nurse is caring for a client recently diagnosed with cancer. The client is quietly crying and states, “I am not sure if I should tell my daughter.” Which statement by the nurse would be most appropriate?

• “That was how my Dad felt when he was diagnosed with cancer too.”
• “It will be okay. God will watch over you, no matter what.”
• “You seem unsure about telling your daughter.”
• “I will close the door and give you some privacy.”

2.) The nurse is caring for a client who has expressed some anxiety about an upcoming surgery. Which response by the nurse would be most therapeutic?

• “You will feel much after the surgery.”
• “Don’t thick about all the things that could go wrong. Stay positive.”
• “Tell me more about how you are feeling.”
• “You should read more about the procedure you worry.”

3.) The nurse is meeting a client for the first time. The client tells the nurse that he does not take his medication as prescribed. Which response by the nurse would be most therapeutic?

• “Tell me more about your reason for not taking the medication as prescribed.”
• “If you continue to be noncompliant, there is nothing more we can do for you.”
• “If the medication is too expensive, we can call your health insurance plan for you.”
• “You must take your medication otherwise your condition will worsen.”

4.) A client tells the nurse, “I have something very important to tell you if you promise not to tell anyone.” Which is the best response by the nurse?

• “I must document all information you tell me.”
• “I am required to report everything to your doctor.”
• “I cannot make you such a promise.”
• “That depends on what you tell me.”

5.) The nurse is caring for a female client with a body mass index of 45. Which conditions should the nurse plan to discuss with the client due to the risks associated with her weight? Select all that apply.

• Gallstones
• Coronary artery disease
• Chronic obstructive pulmonary disease
• Obstructive sleep apnea
• Breast cancer
• Hyperthyroidism

6.) A client who is believed to be homeless is brought to the emergency department by the police. The client is wearing dirty and torn clothes, has difficulty concentrating, is unable to sit still and speaks in a loud tone of voice. Which nursing intervention would be most appropriate for the client at this time?

• Place the client in a single room that is quiet and further away from others.
• Distract the client by offering snack foods and magazines to read.
• Speak with the police officers and insist that the client is taken to the local homeless shelter.
• Place the client in seclusion and begin the process of an involuntary admission.

7.) An American Indian tribal leader visits his newborn son at the hospital and performs a traditional ceremony that involves feathers and chanting or signing. Which action by the nurse is an example of cultural competence?

• The nurse silently reflects about their own biases regarding American Indians and how they

can influence how to approach the client’s parent.

• The nurse discussed the situation with a fellow nurse and decides to contact social services to

perform a home evaluation before the newborn is discharged.

• The nurse begins a discussion with the client’s parent by asking, “Can you tell me about other

traditions that your tribe uses.”

• The nurse notifies the nursing supervisor to request that the parent stop chanting or singing

because of noise concerns for other clients

8.) The palliative care nurse is developing a plan of cade for a client diagnosed with terminal cancer.Which goal should be the priority?

• Refer the client’s family to support services.
• Collaborate with the interdisciplinary team.
• Discuss the options for advance directives.
• Ensure the client is free from pain

9.) The nurse is assisting a client with substance use disorder to deal with issues of guilt. Which statement by the nurse is most appropriate?

• “You’ve caused a great deal of pain to your family. It will take time for them to forgive you.”
• “Don’t focus on the guilty feelings. These feelings will only lead to drinking and taking drugs.”
• “What do you feel most guilty about? What steps can you begin to take to help you lessen

this guilt?”

• “Don’t worry, it is a typical response due to your drinking behaviour and will eventually go

away.”

10.) The nurse is caring for a client with schizophrenia who reports seeing spiders crawling on the walls, over the bed and on the food tray, but denies feeling spiders crawling on their skin. The nurse examines the client’s room and determines that there are no spiders in the room. How should the nurse document the interaction in the client’s medical record?

• Client complains of spiders in their room. Reminded that there are no spiders present.
• Client is imagining spiders in their room. Educated about hallucinations related to

schizophrenia

• Client claims that there are spiders all over the place. Reoriented to reality and reassured that

the spiders have left.

• Client reports seeing spiders in their room. No spiders found upon inspection, Client seems to

experience visual hallucinations.

11.) The nurse is talking with a client with schizophrenia when the client abruptly says, “The moon is full.Astronauts walk on the moon. Walking is a good health habit.” Which is the best description for the client’s speech pattern?

• Loose associations
• Word salad
• Flight of ideas
• Neologisms

12.) The nurse is caring for a young adolescent client who was involved in a motor vehicle crash where several of the client’s friends died. Which initial psychologic response to the loss would the nurse expect from the client?

• Depression
• Acceptance
• Denial
• Aggression

13.) A client with a diagnosis of depression has recently been acting suicidal and is now more social and energetic than usual. Smiling, the client tells the nurse, “I’ve made some decisions about my life.” Which is the best response by the nurse?

• “I’m so glad to hear that you’ve made some decisions.”
• “You need to discuss your decisions with your therapist.”
• “I will make sure to document that in your medical record.”
• “Are you thinking about killing yourself?”

14.) The nurse is developing a plan of care for a client with a substance use disorder. Which nursing problem should be the priority?

• Disturbed self-esteem
• Impaired social relationships
• Alterations in thought processes
• At risk for injury

15.) A client of South American heritage refuses emergency treatment until a curandero is called. A curandero is a type of folk healer. What should the nurse understand about the client’s request?

• The client’s superstitious beliefs will interfere with appropriate treatment.
• The use of holistic healing practices will eliminate the need for medical treatment.
• Culturally competent care should incorporate the client’s preferences.
• The nurse must first obtain approval from the client’s health care provider.

16.) The nurse is admitting a client to the outpatient mental health unit and notices that the client is shifting positions frequently, wringing their hands and avoiding eye contact. Which intervention would be most appropriate at this time?

• Accept the behavior as a side effect of medication.
• Assess the client for auditory hallucinations.
• Ask the client what they are feeling at this moment.
• Refocus the discussion on a less anxiety-provoking topic.

17.) The nurse is caring for a female client who is a victim of domestic violence. The client tells the nurse that she told the batterer that she needs a little time away. The nurse should counsel the client to expect which most likely response from the batterer?

• With a new commitment and an opportunity to seek counselling
• With acceptance, realizing that the relationship is in trouble
• With fear of rejection, resulting in increased rage toward the client
• With relief, welcoming the separation as a means to become a better person

• An 8-year-old child is admitted to the inpatient pediatric mental health unit. After the child’s parent

leaves, the child cries unconsolably and refuses to eat dinner. Which action by the nurse is most appropriate?

• Offer to play a card game with the child.
• Tell the child that they will not be allowed to play with others if they do not eat.
• Explain that the parent will be upset if the child does not cooperate.
• Remind the child of the expectation to eat some of the dinner.

19.) The nurse in the emergency department suspects domestic violence as the cause of a client’s injuries. Which action should the nurse take first?

• Refer the client to a victim advocate.
• Ask the client if there are any old injuries.
• Photograph the specific injuries and include with documentation.
• Interview the client privately.

20.) The nurse is reviewing information about traditional Chinese medicine. Based on the Chinise cultural belief system, illness is usually attributed to which cause?

• The lack of access to traditional Chinese herbs and teas in the United States.
• The absence of recommended childhood vaccinations.
• A failure to keep physiological processes of life in balance with nature.
• The differences in cultural norms between Chinese and Western societies.

21.) The nurse is admitting a 15-year-old client with a fracture of the arm that requires surgery. The adolescent is crying and unwilling to talk. Which action by the nurse would be most appropriate at this time?

• Reassure the client that the surgery will goo fine.
• Give the client some privacy.
• Make arrangements for friends to visit.
• Try to distract the client with a computer game.

22.) The nurse is working at an adult day care program. An older adult client who has been diagnosed with a neurocognitive disorder (dementia) is crying and repeatedly saying, “I want to go home. Call my mommy to come get me.” Which intervention by the nurse is most appropriate?

• Give the client detailed information about what the client will be doing throughout the day.
• Direct the client to a group activity while reorienting them to person and place.
• Inform the client that they must wait until the program ends at 5 pm to leave.
• Engage with the client and prompt the client to join an exercise group.

23.) The nurse at a college health center is performing an assessment on a 20-year-old student. The student reports that they have legally obtained and use medical marijuana for migraine headaches.Which priority teaching should the nurse provide to the client?

• “There is a concern that marijuana impairs the structure of lung tissue.”
• “Marijuana use may decrease the body’s ability to resist infections.”
• “It is important to avoid driving while under the influence of marijuana.”
• “Frequent use of marijuana may affect your short-term memory.”

24.) A client is placed on a high-protein diet and asks the nurse to describe the role of protein in the body. Which responses by the nurse describe the role of protein? Select all that apply.