Online Practice Test 43

Your Results for: "NCLEX® Review "

Print this page

Site Title: Kozier & Erb's Fundamentals of Nursing Book Title: Kozier & Erb's Fundamentals of Nursing Location on Site: Chapter 43 > NCLEX® Review Date/Time Submitted: July 28, 2012 at 1:33 PM (UTC/GMT)

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

1.		After a nurse questions a client about relationship abuse, the client responds the she is ready to leave the abusive relationship, although past attempts were not successful due to fear, lack of support, lack of confidence, and financial considerations. She asks the nurse for help. An example of perceived loss is: Your Answer: Loss of partner Correct Answer: Loss of dreams
		Objective: Describe types and sources of losses. Rationale: Perceived loss is experienced by one person but cannot be directly verified by others. Loss of partner, residence, and lifestyle can be seen and acknowledged by others, even if they are not favorable. Dreams are something of which only the client is aware. She may have dreamed of a happier relationship that she finally acknowledge was not forthcoming, or the dream may be of a different origin. Only the client knows. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
2.		A 22-year-old client with recent paraplegia lashes out and curses at the nurse about the breakfast meal. The nurse's best response is: Your Answer: "I hear a lot of anger in your voice that is quite normal and healthy to hear. Is it a new breakfast you want or something else?"
		Objective: Discuss selected frameworks for identifying stages of grieving. Rationale: Acknowledging the client's anger and helping the client understand the source of the anger is helpful. Do not take the anger personally. Allow choices and control when possible. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
3.		The ability of an individual to cope with death is dependent upon a number of factors. Which person likely will have the most difficulty coping with a death? Your Answer: A parent whose 17-year-old child died in an auto accident the night before graduation
		Objective: Discuss factors affecting a grief response. Rationale: Many factors affect the grieving experience. These include age, significance of the loss, culture, spiritual beliefs, gender, socioeconomic status, social support systems, and the cause of the death. In our culture, the death of an older person is accepted more easily than that of a younger person. The death is more easily accepted if it is anticipated, and if the person who died did not contribute to the death. Usually, the closer the individual is to the person who died, the more difficult it is to cope with the death. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
4.		While the nurse is discussing a client's likely death with family members, one of the offspring inquires, "We plan on taking turns being here for now, but we all want to be here at the time of death. Is there any way we can tell when that time is close?" The nurse's best response is:  Your Answer: "You can expect more muscle relaxation and less movement. Breathing will become irregular and shallow, and change speed. Call me if you hear mucus in the throat. The pulse and blood pressure will decrease."
		Objective: List clinical signs of impending and actual death. Rationale: Muscles relax with decreased activity. Muscle rigidity is not a usual pattern. The gag reflex is lost, and mucus accumulates in the back of the throat. Vision is blurred. A lucid moment is not a pattern in death. It is difficult to pinpoint the exact time when death will occur, but the imminence of clinical death can be detected. Nursing Process: Evaluation Client Need: Physiological Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
5.		Following the death of a child, one of the parents begins to falsely accuse other members of the family of blaming the child's death on the parent. This leads to family members avoiding the mentioned parent for fear of the false accusation. The parent takes this as proof that the family truly believes the accusation. This sets up a destructive cycle of family dysfunction. Which nursing diagnosis is most appropriate for this family? Your Answer: Dysfunctional grieving related to loss of relationships Correct Answer: Impaired family processes related to impaired adjustment
		Objective: Describe the role of the nurse in working with families or caregivers of dying clients. Rationale: The first part of the diagnostic statement reflects the concern at hand, while the second part is the etiology or cause. There are a number of concerns present in this scenario. Following the child's death, the whole family is impaired in processing the event, adjusting, and grieving. In addition, the parent is alienating the family with false accusations, resulting in lack of support, dysfunctional grieving, and loneliness. If the parent improved adjustment to the death, family processing would improve. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
6.		A family with five children experiences a stillbirth. While intervening with the family, one member expresses a view that causes special concern for the nurse. This person is: Your Answer: A 5-year-old who cries, believing the death occurred because the child drew with magic markers on one of the baby blankets Correct Answer: A 13-year-old who assumes blame as punishment for shoplifting
		Objective: Describe the role of the nurse in working with families or caregivers of dying clients. Rationale: A child of 3 does not understand the concept of death, or its permanence. A child of 5 may associate death with unrelated actions. A 15-year-old is expected to follow similar stages of grief, including denial. Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Use nursing knowledge and the process of elimination to make a selection.
7.		A client questions the nurse about the difference between a living will and power of attorney. The nurse's best response is: Your Answer: The living will allows the client to indicate specific medical treatments to be omitted in the event of terminal illness, while durable power of attorney legally appoints another to make those decisions on the behalf of the client.
		Objective: Describe the role of the nurse in working with families or caregivers of dying clients. Rationale: A living will is a legal document that expresses an individual's decision on the use of artificial life support systems. Power of attorney is a written instrument which authorizes one person to act as another's agent or attorney Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
8.		Elizabeth Kubler-Ross’s Stages of Grieving are: __________ . Your Answer: denial, anger, bargaining, depression and acceptance Correct Answer: Denial, anger, bargaining, depression, and acceptance
		Objective: Discuss selected frameworks for identifying stages of grieving. Rationale: Kubler-Ross defined 5 stages of grieving including: denial, anger, bargaining, depression, and acceptance. Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
9.		Proper handling of the body following death is an important intervention for the client, family, and nurse. An intervention that reflects an important principle of postmortem care is: Your Answer: Preparing the body to look as clean and natural as possible
		Objective: Describe nursing measures for care of the body after death. Rationale: The body is to be handled with dignity at all times. This does not include using humor at this time. After the body is cleaned and the linen freshened, the sheet is pulled to cover the patient's shoulders. Laws and policies differ regarding the nurse's ability to declare death. Even if a physician is required to declare death, the time of death cannot be verified exactly. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
10.		While talking to adult children of a dying client, the nurse finds them tearful, with ambivalent feelings toward the client. The client often expresses beliefs of a wasted life. The children say that the client was a parent who often showed love but followed it with criticism, anger, damaging accusations, and emotional abuse. The nurse suggests an intervention that may be helpful to the client and other family members. The most likely intervention to be helpful is: Your Answer: Making a videotape of each child telling a story of a time when the client showed love, while the client tells of a special love for each child. Plan a time to watch it together.
		Objective: Describe the role of the nurse in working with families or caregivers of dying clients. Rationale: Relaxation tapes help with stress reduction, but do not help resolve problems experienced by the client and children. Staffing needs do not permit a nurse to be with one client continually, and families require privacy as well. Assurance that the past no longer matters is an assurance lacking concrete properties. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Decide what is the best action for client and situation.