1. A 16-year-old client with anorexia nervosa is on an inpatient psychiatric unit. She has a fear of gaining weight and is refusing to eat sufficient amounts to maintain body weight for her age, height, and stature. To assist with the problem of powerlessness and plan for the client to no longer need to withhold food to feel in control, the nurse uses the following strategy:
A) Establish a structured environment with routine tasks and activities. Also, serve meals at the same time each day.
B) Distract the client during meals to get her to eat because she must take in sufficient amounts to keep from starving.
C) Do frequent room checks to be sure that the client is not hiding food or throwing it away.
D) Listen attentively and participate in in-depth discussions about food, because these actions may encourage her to eat.
2. A 45-year-old male client was admitted to a chemical dependency treatment center following legal problems related to alcohol abuse. He states, 'I know that alcohol is a problem for some people, but I can stop whenever I want to. I - m never sick or miss work, and no one can complain about me.' During the initial assessment, the best response by the nurse would be:
A) 'The fact is you are an alcoholic or you wouldn - t be here.'
B) 'I understand it took strength to admit yourself to the unit, and I will do my part to help you to stay alcohol- free.'
C) 'If you can stop drinking when you want to, why don - t you stop?'
D) 'It - s good that you can stop drinking when you want to.'
3. A 79-year-old client with Alzheimer - s disease is exhibiting significant memory impairment, cognitive impairment, extremely impaired judgment in social situations, and agitation when placed in a new situation or around unfamiliar people. The nurse should include the following strategy in the client - s care:
A) Maintain routines and usual structure and adhere to schedules.
B) Encourage the client to attend all structured activities on the unit, whether she wants to or not.
C) Ask the client to go to an activity once. If she gives no response right away, change the question around, asking the same thing.
D) Give the client two or three choices to decide what she wants to do.
4. The nurse working with a client who is out of control should follow a model of intervention that includes which of the following?
A) Approach the client on a continuum of least restrictive care.
B) Challenge client - s behavior immediately with steps to prevent injury to self or others.
C) Leave the aggressive client to himself or herself, and take other clients away.
D) To ensure safety of other clients, place client in seclusion immediately when he or she begins shouting.
5. When planning care for the passive-aggressive client, the nurse includes the following goal:
A) Allow the client to use humor, because this may be the only way this client can express self.
B) Allow the client to express anger by using 'I' messages, such as 'I was angry when . . .,' etc.
C) Allow the client to have time away from therapeutic responsibilities.
D) Allow the client to give excuses if he forgets to give staff information.
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