PN3 EXAM 1 QUESTIONS AND ANSWERS
1. Which assessment data would prohibit the use of imagery with a client?
1. No previous history of using imagery
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2. States anxiety level of 6 on a 0–10 scale
3. Client feels reluctant to close eyes for the imagery session
4. Client has a history of psychosis
2. The nurse has determined that music therapy may be appropriate for use with a client. Which strategies should the nurse consider when choosing the music? Select all that apply.
1. Choose only music with words.
2. Choose music that is 5–7 minutes in duration.
3. Allow the client to choose music of his or her choice.
4. Encourage the client to respond to the music.
5. Ask the client not to analyze the music.
3. The nurse is using meditation with a client to help him decrease his pain. Which factor is important to consider when using this type of therapy?
1. The type of meditation is best determined by the nurse.
2. The client’s condition will influence the use of meditation.
3. Meditation is best taught when the client is in an outpatient setting.
4. A certified professional should teach the client how to perform meditation.
4. The client asks the nurse how humor therapy affects the client physiologically. Which effects should the nurse explain are attributed to laughter? Select all that apply.
1. Decreases heart rate and blood pressure
2. Increases salivary immunoglobulin A (S-IgA)
3. Produces an antagonist response to stress hormones
4. Decreases the immune response by decreasing T- lymphocytes
5. Changes temperature set point in the brain
5. The nurse decides to teach a client with hypertension the progressive relaxation technique. Which instructions should the nurse give to the client when using this relaxation method?
1. Sit in an upright position with legs crossed.
2. Place sensors on the forehead to monitor physiological activity.
3. Contract and relax the body’s muscles in groups from head to feet.
4. Monitor breathing pattern while repeating a word or phrase out loud.
6. The nurse teaches the client about massage therapy. Which statement by the client demonstrates a correct understanding of the benefits of massage? Select all that apply.
1. “Massage reduces blood clot formation.”
2. “Massage impacts lymphatic drainage.”
3. “Massage increases the lactic acid in muscle.”
4. “Massage ultimately improves blood flow.”
5. “Massage creates a sense of wakefulness.”
7. A nurse is preparing to present information to a women’s group about the cautions associated with aromatherapy. What information is appropriate to include for the audience? Select all that apply.
1. Aromatic oils are produced by a standard-quality formula. 2. The oils should be stored in dark glass containers.
3. Test for allergies by applying a small amount of oil to the skin before use.
4. Essential oils should not be used during pregnancy.
5. Production of essential oils is tightly controlled.
8. The nurse is preparing a presentation for staff about the effects of humor in nursing situations. What feedback would indicate to the nurse that the participants understand the role of humor in the healthcare setting?
1. Understanding that humor increases the social distance between people
2. Noting that humor promotes effective teaching and learning
3. Anticipating that humor fosters the expression of anger and aggression
4. Accepting that humor is ineffective as a coping mechanism
9. The nurse is evaluating the effectiveness of guided imagery for a client with preoperative anxiety. Which client statement should indicate to the nurse that the therapy has been successful?
1. “I hope that I don’t have dreams about the images we used tonight.”
2. “It is a real challenge to concentrate while I have so much on my mind.”
3. “I will need to set up some practice time for next week.”
4. “The images and exercises are selected to reduce anxiety
about the surgery.”
10. The nurse is using progressive relaxation on a client who is experiencing a great deal of stress. What nursing action is necessary in order to protect the client's safety prior to the start of the session?
1. Evaluate the client’s muscle strength.
2. Determine if the client is taking sedatives.
3. Place the client in a totally supported position.
4. Obtain information regarding client allergies.
11. The nurse is teaching the client's partner how to perform a back massage on the client. Which observation by the nurse
indicates that the partner understands how to perform the activity? Select all that apply.
1. The client is lying on the bed in his pajamas.
2. The client's back is being rubbed with large, circular motions.
3. The partner places the bottle of lotion in warm water prior to the massage.
4. The partner massages the client's back for 3–5 minutes.
5. The partner firmly massages reddened areas noted on the client.
12. The nurse taught the client about meditation. Which statement by the client demonstrates a correct understanding of this activity?
1. “Meditation is a technique used to quiet the mind and focus on the future.”
2. “Meditation involves self-reflection on my religious convictions.”
3. “Meditation is a pure concept with one clearly defined technique.”
4. “Meditation involves both relaxation and focus of attention.”
13. The nurse is performing an imagery session with a group of clients. What instruction should the nurse give the clients?
1. “Try to concentrate on your breathing, letting go of all your stress.”
2. “Imagine that your body is using its energy to heal itself.”
3. “Contract the muscles of your arm and then relax.”
4. “Listen to music of your choice and let the music take you away.”
14. A client is using aromatherapy to treat stress. Which assessment data indicates an allergic reaction in a client who has received an aromatherapy session?
1. Development of a rash
2. Increased skin turgor
3. Decreased pigmentation
4. Peripheral edema
15. The preoperative waiting area has soft instrumental music playing in the background. What purpose should the nurse recognize in regard to this utilization of music? Select all that apply.
1. Music produces a hypermetabolic state in the listener.
2. Music reduces the physiological stress, pain, and anxiety.
3. Music enhances the functions of the left hemisphere of the brain.
4. Music helps mask the normal noises found in the hospital setting.
5. Music without words more effectively enhances relaxation.
16. A client tells the nurse that walking causes right leg pain. The pain is described as muscle cramping or burning that subsides with rest. Based on the symptoms, the nurse supports the use of what herb?
1. Feverfew
2. Garlic 3. Ginkgo
4. Ginseng
17. A client is taking chlorpromazine. Based on the route of metabolism of this prescribed medication, the nurse is not surprised to learn the client uses which herb?
1. Valerian root
2. Ginger
3. Milk thistle
4. Hawthorn
18. Which therapeutic change in laboratory values would the nurse anticipate in the client taking garlic?
1. Increased platelet aggregation
2. Increased white blood cell count
3. Decreased serum cholesterol levels
4. Decreased serum glucose levels
19. The female client tells the nurse that she is planning a pregnancy soon. In providing client education about the use of herbs during pregnancy, which statement by the nurse is most appropriate?
1. “Most herbs are safe when taken as directed.”
2. “Only herbs in the topical form are safe.”
3. “Certain herbs are safe and effective when taken in lower doses.”
4. “You should discuss the use of any herbs with your healthcare provider.”
20. The client presents to the healthcare clinic with an abrasion to the left knee from a fall. After cleaning the abrasion, the nurse might support the use of which client-chosen herb as adjunct therapy to treat the abrasion?
1. Echinacea
2. Ginger
3. Valerian root
4. Feverfew
21. A client scheduled for arthroscopic knee surgery has been taking ginger for relief of arthritic pain. The client asks the nurse about postoperative use of ginger for continued relief of pain and postoperative nausea. What essential information should the nurse provide?
1. Ginger cannot be used safely postoperatively.
2. Ginger would not be effective for postsurgical pain and nausea.
3. Ginger may be repeated every 4 hours as needed.
4. Ginger may potentiate the effects of opioid medications.
22. The nurse would include which intervention when planning care for the client who is taking hawthorn?
1. Monitor blood glucose levels 2. Monitor blood pressure
3. Monitor white blood cell count
4. Monitor temperature
23. The client tells the nurse that a neighbor recommends the use of bilberry in treating simple diarrhea. The nurse supports the client's use based on knowledge of which action of bilberry?
1. Anthocynanosides in the berry decrease peristalsis.
2. The berry contains pectin, which acts as a soluble fiber.
3. Bilberry acts to counteract antimicrobial suppression of normal intestinal flora.
4. Action of the berry works to decrease bacterial or viral causes of diarrhea.
24. The nurse instructs the client taking St. John’s wort that which food preferred by the client may be safely consumed while taking this herb?
1. Chocolate
2. Aged cheeses
3. Beer
4. Vanilla ice cream
25. Which client would benefit from the therapeutic effects of garlic? Select all that apply.
1. The client with decreased blood pressure
2. The client with liver disease
3. The client with coronary artery disease
4. The client with a bleeding disorder
5. The client with peripheral vascular disease
1. While the nurse is discussing a client’s likely death with family members, one of the adult children asks, “We plan on taking turns being here for now, but we all want to be here at the time of mother’s death. How can we tell when that time is close?” What is the nurse’s best response?
1. “Often, people become more lucid for a short time about an hour before death. They become more alert with clearer eyes and focus on faces. Call the others in at that time.”
2. “I wish I could tell you that there was a way to know. It could be minutes from now or another 3 days. One just never knows.”
3. “The arms and legs become cool and more bluish in color.
Breathing becomes irregular and shallow, and you may hear mucus in the throat. Pulse and blood pressure will decrease.”
4. “You can expect muscles to become rigid, with staring eyes and mouth closed. The head is pulled back with neck rigidity. Don’t be alarmed if you hear a death rattle in the throat.”
2. A 90-year-old client expresses a wish to die at home after being told that an esophageal stricture prevents swallowing. The client refuses a feeding tube. The family fully supports this decision. What would be the most appropriate resource for the nurse to call?
1. Hospice care
2. The rabbi
3. An attorney
4. The medical examiner’s office
3. The nurse is providing postmortem care for a client. Which intervention would be appropriate prior to allowing the family to visit? Select all that apply.
1. Prepare the body to look as clean and natural as possible.
2. Keep the sheet over the client’s face until the family is comfortably seated in the room.
3. Wear sterile gloves to pack the anal canal with gauze.
4. Remove the external tubes and drains.
5. Call the healthcare provider to verify time of death before taking the body to the morgue.
4. A dying client’s partner is afraid to get a meal in the cafeteria for fear the client will die while she is gone. No other family members or visitors are present. The client is nonresponsive, has an irregular and slow pulse, and has Cheyne-Stokes respirations. What is the best course of action by the nurse?
1. Encourage the partner to eat in the cafeteria. The client is nonresponsive and won’t know the partner is gone.
2. Make arrangements for the partner to receive a meal in the client’s room.
3. Promise to call the partner if any changes occur and ask an unlicensed assistive person to sit with the client while the partner is away.
4. Refrain from saying anything that interferes with the partner’s decision.
5. The family of a client diagnosed with cancer and entering hospice care has been informed the client is not expected to live more than 2 months. Which statement made by a family member indicates to the nurse that the family understands the role of hospice care?
1. “Hospice nurses are going to help care for him at home until he gets better.”
2. “Hospice nurses are going to help care for him until we learn how to provide the care.”
3. “Hospice nurses are going to help care for him until he can take care of himself.”
4. “Hospice nurses are going to help care for him to make him more comfortable.”
6. The nurse anticipates which client newly diagnosed with a terminal illness is least likely to have difficulty facing his or her mortality?
1. A 71-year-old female whose grandson, sister, and best friend died over the past 6 months
2. A 59-year-old male who never married, is an only child, and whose parents are both healthy
3. A 70-year-old male who planned his funeral and enjoys riding a motorcycle at high speed in the desert
4. A 68-year-old female who has been an atheist for most of her life
7. A client with lung cancer is receiving total brain radiation therapy to control hand tremors due to multiple metastatic lesions. The client says, “I’m hoping this treatment will let me see my first tomatoes near the Fourth of July. It makes me want to cry to think I won’t make it till then.” The nurse concludes that this statement contains elements of which of Kübler-Ross’s stages of death and dying? Select all that apply.
1. Denial
2. Bargaining
3. Anger
4. Depression
5. Acceptance
8. The registered nurse (RN) would intervene after hearing a licensed practical/vocational nurse (LPN/LVN) make which statement about a client with severe arthritis who is also newly
diagnosed as being terminally ill with rapidly growing colorectal cancer?
1. “Even though it hurts a bit, your arthritic joints will become less stiff with gentle exercise.”
2. “If we give more pain medication, will it stop his breathing?”
3. “He has a living will that says he does not want to be resuscitated.”
4. “You have on a diaper so it’s OK if you do not make it to the bathroom.”
9. The mental health nurse is counseling a client who is grieving his father’s death. Based on Rando’s Process of Bereavement, in what order would the mental health nurse expect a client to make the following statements as he moves through the bereavement process? Place the options in correct sequence.
1. “This is the second anniversary of my father’s death.”
2. “My father had alcoholism, so during the holidays I bring coffee and chocolates to local AA groups.”
3. “It was so much fun to rummage through the antique stores together.”
4. “Since I no longer have connections to my father’s stepfamily, I visit friends on vacation.”
5. “The homestead has run down since his death. It was hard to drive past and see the lack of care in his vegetable garden.”
Fill in your answer below:
Answer: 1, 5, 3, 4, 2
10. A 46-year-old female client with a history of head and neck cancer was recently told she has multiple metastatic sites in her lung. The nurse is discussing the situation with the client and her sister. Which statement during the conversation reflects the ethical principle of justice?
1. “The staf f will do everything possible to make your sister comfortable while she is in hospice.”
2. “The healthcare provider should not have forced her into taking experimental chemotherapy. Now she is dying.”
3. “Why did I have to get this terrible disease? I just want my life back.”
4. “We will care for her at home. She has always been brave so she will probably try to use little pain medication.”
11. A 22-year-old hospitalized client with a recent diagnosis of acquired immunodeficiency syndrome (AIDS) says to the nurse, “The food on this breakfast tray is terrible. Why can’t you people do even simple things well?” What is the nurse’s best response?
1. “I know you are angry, but I cannot let you make me the object of your anger. I will send up the dietitian.”
2. “This is not about breakfast. Tell me what you are really angry about.”
3. “I understand you are angry. I’ll shut the door and let you calm down and then we can talk again.”
4. “I hear a lot of anger in your voice that is expected and healthy. Do you want a new breakfast or would you like something else?”
12. While talking to adult children of a dying man, the nurse finds them tearful, with ambivalent feelings toward the client. The client often expresses beliefs of a wasted life. The children say that their father often showed love but followed it with criticism, anger, and emotional abuse. Which intervention is most likely to be helpful at this time?
1. Suggest that the family listen to relaxation tapes before visiting each other. If negative feelings arise, listen to the tapes together.
2. Have a nurse stay in the room when a family member visits the client so the nurse can intervene with conflict resolution if problems arise.
3. Assure the client and children that what matters is the present and the future, not the past. Encourage the children to spend more time with their father.
4. Suggest they videotape each adult child speaking of a time when the father showed love, and tape the father telling of a special love for each child. Plan a time for them to watch the tape together.
13. A terminally ill client questions the nurse about the difference between a living will and power of attorney for healthcare. What is the nurse’s best response?
1. “A living will allows you to indicate treatments to be omitted, while durable healthcare power of attorney legally appoints another to make those decisions on your behalf.”
2. “A lawyer carries out a living will, while a designated family member or friend carries out advanced directives.”
3. “In a living will, you specify treatments to be carried out if you become unable to make decisions. A durable healthcare power of attorney allows you to include both treatments to be carried out and those to be omitted.”
4. “The living will indicates when you wish life support to be discontinued, while a durable [Show Less]