Online Practice Test 39

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Site Title: Kozier & Erb's Fundamentals of Nursing Book Title: Kozier & Erb's Fundamentals of Nursing Location on Site: Chapter 39 > NCLEX® Review Date/Time Submitted: July 26, 2012 at 2:35 PM (UTC/GMT)

Summary of Results 60% Correct of 10 Scored items: 6 Correct:  60% 4 Incorrect:  40% More information about scoring

1.		What is an appropriate goal for a client who has low self-esteem following an automobile accident in which he killed another person while driving under the influence? Your Answer: Client will identify two personal strengths. Correct Answer: Client will make restitution to the victim's family.
		Objective: Describe ways to enhance client self-esteem. Rationale: An appropriate goal is that the client will make restitution to the victim's family. This will help the self-esteem of the client more than the other answers will. Nursing Process: Planning Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Decide what is the best action for client and situation.
2.		A group of nurses experience emotional difficulty after a sexual harassment complaint is made against a co-worker. Which comment by a nurse reflects a positive self-concept?  Your Answer: "I just acted as though I didn't hear the comments. They had nothing to do with me."
		Objective: Describe the four components of self-concept. Rationale: Positive self-concept based on one's own positive self-assessment or taking responsibility for one's ability. Answers 1, 2, and 4 contain responses that include negative self-assessment and expectations expressed by others. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
3.		A client is a survivor of domestic violence. Which action by the client indicates that the client is still having problems with intimacy? Your Answer: The client avoids social situations with couples.
		Objective: Give Erikson's explanation of the effects of psychosocial tasks on self-concept and self-esteem. Rationale: Intimacy involves interpersonal relationships. Poor eye contact is common in clients with negative self-concept or shame. Self-defense may be used to prevent intimacy, but it is more often used to increase a sense of power and control. The client living alone is not a problem. Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
4.		Which statement indicates the client is accepting of her body image following a mastectomy? Your Answer: "I don't care if I had a mastectomy, I'm still wearing a bikini."
		Objective: Describe nursing interventions designed to achieve identified outcomes for clients with altered self-concept. Rationale: "I don't care if I had a mastectomy, I'm still wearing a bikini" indicates a client is accepting of her body image. Inability to look in the mirror may indicate a problem with body image. Answer 2 reflects the husband's feelings, not the client's. The mastectomy changed the way the client wants photos taken to exclude the breasts. Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
5.		A client is three days postoperative from abdominal surgery to form a colostomy. The most effective intervention is: Your Answer: Teaching the client how to care for the colostomy, leaving the equipment in the room, and giving instructions to call when the client is ready Correct Answer: Having clients who adapted to their colostomies talk with the client about their adapting experiences
		Objective: Describe nursing interventions designed to achieve identified outcomes for clients with altered self-concept. Rationale: The most effective intervention is having clients who adapted to their colostomies talk with the client about their adapting experiences. Answers 1 and 4 facilitate avoidance. Answer 3 does not address the client's issues with body image. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Decide what is the best action for client and situation.
6.		The nurse is trying to help a 7-year-old child from an abusive home learn to tie his own shoes. The child says, "I'll never learn this because I'm not smart enough." The nurse realizes that: Your Answer: The child has a self-image of being unintelligent
		Objective: Give Erikson's explanation of the effects of psychosocial tasks on self-concept and self-esteem. Rationale: The nurse realizes that the child has a self-image of being unintelligent. There is no evidence to support Answers 1, 2, and 3 in this situation. The only information provided is the child's point of view. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Decide what is the best action for client and situation.
7.		Which question reflects assessment of personal identity? Your Answer: What would you change about yourself if you could?
		Objective: Describe the four components of self-concept. Rationale: The question that reflects assessment of personal identity is What would you change about yourself if you could? Who is important to you? assesses role performance. Have you established a relationship with a partner? assesses Erikson's Stage of Intimacy Are you comfortable discussing your appearance? reflects body image. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Decide what is the best action for client and situation.
8.		Which of the following would be most helpful during the psychosocial assessment of a 7-year-old client? Your Answer: Playing the client's favorite music Correct Answer: Creating a quiet, private environment
		Objective: Describe nursing interventions designed to achieve identified outcomes for clients with altered self-concept. Rationale: Creating a quiet, private environment would be most helpful. Playing the client's favorite music, asking the client's siblings to attend, and offering the client a snack create environments with distractions that may interfere with the interview. Nursing Process: Planning Client Need: Safe, Effective Care Environment Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
9.		Which statement by the nurse is most helpful to a client following a sexual assault? Your Answer: "This is a hard situation. You are very brave to come to the emergency room with your friend."
		Objective: Identify common stressors affecting self-concept and coping strategies. Rationale: Answer 1 does not address the immediate situation. Answer 2 does not acknowledge the client's feelings. Answer 4 blames the client by questioning her motives. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
10.		Which of the following stressors affect self-concept? (Select all that apply.) Your Answer: Declining mental, physical, or sensory abilities Relationship concerns Unrealistic ideal self Realistic Role Expectations Correct Answers: Declining mental, physical, or sensory abilities Relationship concerns Unrealistic ideal self
		Objective: Describe nursing interventions designed to achieve identified outcomes for clients with altered self-concept. Rationale: The following stressors affect self-concept: change in physical appearance, declining mental, physical, or sensory abilities, inability to achieve goals, relationship concerns, sexuality concerns, and unrealistic ideal self. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge of stress and its impact on self concept. Objective: Describe nursing interventions designed to achieve identified outcomes for clients with altered self-concept. Rationale: The following stressors affect self-concept: change in physical appearance, declining mental, physical, or sensory abilities, inability to achieve goals, relationship concerns, sexuality concerns, and unrealistic ideal self. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge of stress and its impact on self concept.