NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE V – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP5 Nursing Board Exam Answer Key
Nursing Board Exams Questions 41 - 55

Situation – Annie has a morbid fear of heights. She asks the nurse what desensitization therapy is:

41. The accurate information of the nurse the goal of desensitization is:

A. To help the clients relax and progressively work up a list of anxiety provoking situations through imagery

B. To provide corrective emotional experiences through a one-to-one intensive relationship

C. To help clients in a group therapy setting to take on specific roles and reenact in front of an audience, situations in which interpersonal conflict is involved.

D. To help clients cope with their problems by learning behaviors that we are more functional and be better equipped to face reality and make decisions.

42. It is essential in desensitization for the patient to:

A. Have a rapport with therapist

B. Use deep breathing or another relaxation technique

C. Assess one’s self for the need of anxiolytic drug

D. Work through unresolved unconsciousness conflicts

43. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences turned vision. Physical signs of anxiety become more pronounced.

A. Severe anxiety

B. Panic

C. Mild anxiety

D. Moderate anxiety

44. Anti-anxiety medication should be used with extreme caution because long term use can lead to.

A. Parkinsonian like syndrome

B. Hypertensive crisis

C. Hepatic failure

D. Risk of addiction

45. The nursing management of anxiety related with post traumatic stress disorder includes all of the following EXCEPT:

A. Encourage participation in recreation or sport activities

B. Reassurance client’s safety while touching client

C. Speak in calm soothing voice

D. Remain with the client while fear level is high

Situation – The nurse is often met with the following situations when clients become angry and aggressive individual, the nurse should:

46. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:

A. keep an eye contact while staring at the client

B. keep his/her hands behind his/her back or in one’s pockets

C. fold his/her arms across his/her chest

D. keep an “open” posture, e.g. Hands by sides but palms turned outwards

47. During the pre-interaction phase of the N-P relationship, the nurse recognizes thisnormal INITIAL reaction to an assaultive or potentially assaultive person.

A. To remain and cope with the incident

B. Display empathy towards the patient

C. To call for help from other members of the team

D. To stay and fight or run away

48. Which of the following is an accurate way of reporting and recording an incident?

A. “When asked about his relationship with his father, client became anxious.”

B. “When asked about his relationship with his father, client clenched his jaw/teeth, made a fist and turned away from the nurse.”

C. “When asked about his relationship with his father, client was resistant to

respond”

D. “When asked about his relationship with his father, his anger was suppressed”

49. To encourage thought, which of the following approaches is NOT therapeutic?

A. “Why do you feel angry?”

B. “When do you usually feel angry?”

C. “How do you usually express anger?”

D. What situations provoke you to be angry?”

50. A patient grabs and about to throw it. The nurse best responds saying.

A. “Stop! Put that chair down.”

B. “Don’t be silly.”

C. “Stop! The security will be here in a minute.”

D. “Calm down.”

Situation – A vehicle hit some pedestrian while waiting for a bus ride. Some of the victims suffered injuries in different part of the body. The victims were brought to the nearby hospital. One of the victims, Josephine was confirmed to have a fractured left arm. While waiting for plaster cast to be applied, Josephine appears to be anxious.

51. To reduce anxiety, the nurse teaches the procedure to the client, which of the following topics should NOT be included in the teaching plan?

A. Leave the cast uncovered to promote drying

B. Bear weight on the plaster for one hour. A stockinet will be placed

over the left arm to be placed in the cast.

C. Handle hardening cast with palm of hands.

D. Trim and reshape finish cast with knife or cutter.

52. Cast was applied on Josephine’s left arm. In assessing the neurovascular status of the client, which of the following assessment findings should be reported to the physician?

A. Pain on the left arm

B. Swelling of the fingers

C. Skin abrasion on the edges of the plaster cast

D. Nail bed capillary refill time of 10 seconds

53. One of the victims a sixty year old woman sustained hip fracture. Prior to surgery, a Buck’s extension traction is to be applied. The rationale of traction is primarily based the understanding that Buck’s extension traction:

A. Reduces muscle spasms and helps to immobilize the fracture

B. Allows reduction of the fracture site for bone healing.

C. Secures the fracture site to prevent damage to the muscle tissues

D. Secures the fracture site for rigid immobilization

54. Philip was placed in skeletal leg traction with an overbed frame. He is not allowed to move from side to side. Which of the following nursing interventions is useful in maintaining.

A. Assist the client by holding the trapeze and raising hips of the bed.

B. Check the apparatus that weights hang free and knots in the rope

are tied securely.

C. Suspend a trapeze within easy reach of the client

D. Support the affected extremity while the weights are removed.

55. To prevent complication when a child is in Buck’s traction, the nurse should:

A. Clean the extremity and keep the skin dry

B. Assess any skin and circulatory disturbances

C. Clean the pin sites as necessary

D. Provide high fiber small meals.