NCLEX LPN Psychosocial Integrity 1

NCLEX LPN Psychosocial Integrity 1

A client with a diagnosis of severe anxiety does not eat sufficiently and begins to lose weight. Which of these approaches by the LPN/LVN is BEST for this client?

• Serve the client's meals on a tray in client's room.
• Sit with the client during mealtime and encourage eating.
• Give the client high-calorie foods and drinks to carry.
• Set limits on the client's activities in the dining room.

(1) don't isolate the client

(2) CORRECT—provide pleasant surroundings and companionship during meals; offer more frequent feeding and favorite foods because of decreased appetite

(3) appropriate action for manic client

(4) may be required if client is manic and is manipulative

A client who has been drinking heavily for the past five years is admitted to the hospital in alcohol withdrawal. The LPN/LVN should observe for which of the following symptoms?

• Yawning, lacrimation, muscle cramps.
• Memory loss, drowsiness, diminished reflexes.
• Ataxia, nystagmus, postural hypotension.
• Increased pulse, tremors, anxiety.

(1) symptoms of narcotic withdrawal

(2) symptoms of potential alcohol intoxication

(3) ataxia and bradycardia could indicate alcohol intoxication

(4) CORRECT—symptoms occur in a client physiologically dependent on alcohol; abrupt withdrawal causes tremors, insomnia, anorexia, and alcoholic hallucinations; nursing care includes administering sedation, monitoring vital signs, seizure precautions; provide quiet, well-lighted room, don't leave hallucinating, confused client alone

When intervening with a client who is in a state of crisis, which of the following statements by the LPN/LVN is MOST appropriate?

• "Why do you feel so upset in this situation?"

• "What have you done in the past when you felt this anxious?"
• "There was no way to prevent this from happening."
• "It seems as if this situation is very stressful for you."

(1) "why" questions imply disapproval

(2) CORRECT—helps the client utilize past experience to resolve or reduce current problems

(3) LPN/LVN has no evidence to support this conclusion

(4) reflective statement; during a crisis situation, more important to determine coping methods used in past

The LPN/LVN works on an acute care psychiatric unit. The LPN/LVN understands that in a psychiatric inpatient setting, milieu therapy is BEST understood as which of the following?

• Milieu therapy provides a therapeutic physical and social environment.
• Milieu therapy manipulates the environment so the client feels at home.
• Milieu therapy establishes therapeutic communication with numerous staff members.
• Milieu therapy sets limits on behavior.

(1) CORRECT—milieu therapy provides a therapeutic social, cultural, and physical environment in which all aspects are utilized as instruments of growth to the client's benefit

(2) want to establish environment in which client feels safe and is able to work through issues

(3) not the purpose of milieu therapy

(4) not the purpose of milieu therapy

The LPN cares for a client just admitted with a diagnosis of an obsessive-compulsive disorder. The client usually performs 100 sit-ups, along with 30 minutes of aerobic exercise after eating. Because the LPN/LVN needs to administer medications and treat an open wound immediately after the client's meal, which of the following nursing actions is MOST appropriate?

• Remind the client about the routine unit policies.
• Explain that performing the activities on time is more important than an exercise

routine.

• Interrupt the client's routine activities, administer the medication, and treat the open

wound.

• Reschedule the medication administration and wound treatment.

(1) enforcing unit policies could increase client's anxiety level if performance of the ritual is interrupted; obsession is repetitive, uncontrollable thoughts, compulsion is repetitive, uncontrollable acts; accept ritualistic behavior

(2) medications likely to be more effective if anxiety-lowering ritual is not interrupted

(3) purpose of therapeutic environment is to lower anxiety; interrupting ritual can substantially increase anxiety level

(4) CORRECT—premature interruption of rituals can serve to escalate the anxiety; should schedule unit routine another time; structure environment; guide decisions; minimize choices

After an abdominal aneurysm is discovered on a client who is planning a 4-week vacation trip around the world, the client begins to sob and expresses feelings of disappointment. Which of the following actions by the LPN/LVN is the MOST appropriate?

• "Your trip can be rescheduled for this time next year."
• "An abdominal aneurysm is a very serious problem."
• "The surgeon is experienced and highly skilled."
• "You appear disappointed about missing the trip."

(1) negates client's feelings; is more concerned about the current situation; will take time to adjust

(2) not likely to reduce negative impact of disruption in client's life; is still in shock at the loss of scheduled plans; not appropriate at this time

(3) does not appear to be concerned about surgeon's skill at this time

(4) CORRECT—acknowledges client's pain; shows compassion for client's dilemma; reflective statement allows client to verbalize feelings

The LPN/LVN cares for a client in the extended care facility diagnosed with a right-sided cerebrovascular accident. The client shouts to the LPN/LVN, "I can't imagine how I am going to live my life with this disability." Which of the following responses by the LPN/LVN is BEST?

• "You will learn to cope with your disability."
• "Don't you want to keep going to your grandchildren's sporting events?"
• "Look how much more you can do now than when I first met you."
• "It sounds like you are feeling frustrated."

(1) nontherapeutic; client expressing frustration, does not believe that he will learn how to cope

(2) nontherapeutic; nurse should focus on the feelings the client is expressing

(3) nontherapeutic; avoid excessive cheeriness and pep talks; client will not believe it

(4) CORRECT client expressing feelings of frustration and depression; important that LPN/LVN allows clients to express these feelings

The LPN/LVN cares for clients in the long-term care facility. The wife of a newly admitted client paces the room and says repeatedly, "I didn't want to have to bring my husband here." Which of the following responses by the LPN/LVN is BEST?

• "You did the best that you could do."
• "Couldn't your children have helped you more?"
• "This sounds like it was a difficult decision for you."
• "We will take good care of him."

(1) nontherapeutic; negates the wife's feelings

(2) nontherapeutic; asking a yes/no question

(3) CORRECT reflects the wife's feelings and allows the wife to verbalize

(4) nontherapeutic; focus is not on the wife and her feelings

After several months of isolation, a stage performer agrees to seek treatment for a panic disorder. After the laboratory and diagnostic test results are brought to the unit, the LPN/LVN notifies the health care provider that which of the following verifies the preliminary diagnosis of an anxiety disorder?

• The client exhibits increased serum blood urea nitrogen levels.
• The client exhibits reduced serum calcium levels and decreased thalamus function.
• The client exhibits a decreased response to stimulants such as caffeine.
• MRI (magnetic resonance imaging) shows atrophy of the client's frontal lobe and

temporal lobe.

(1) renal damage is not a common complication of panic disorders

(2) could indicate renal damage as well; decreased thalamus function is not symptomatic of panic disorders

(3) tend to exhibit excessive response to caffeine

(4) CORRECT both lobes tend to exhibit decreased size in clients with panic disorders

The LPN/LVN identifies which of the following signs and symptoms as MOST representative of the signs/symptoms commonly observed in a client who has recently