Question

A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

Answer 1

Correct Answers:

A room with air exhaust directly to the outdoor environment

Rationale :

🔷 Airborne precautions are essential for clients with active tuberculosis to prevent the spread of infectious droplets.

🔷 The negative pressure room with air exhaust directly to the outside ensures that contaminated air is not recirculated.

🔷 Clients with TB must be isolated from other clients, especially those with compromised immunity or non-infectious conditions.

🔷 Surgical masks are insufficient; N95 respirators are required, which aligns with placing the patient in a properly ventilated room.

🔷 This setup reduces nosocomial transmission, protecting staff and other clients from airborne pathogens like Mycobacterium tuberculosis.

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Answer 2

Correct Answers:

"Listen attentively to a client and summarize their comments"

Rationale :

🔶 Active listening is a cornerstone of therapeutic communication and includes restating or summarizing the client’s words to demonstrate understanding.

🔶 This approach fosters trust and validation, encouraging clients to continue sharing their feelings.

🔶 It promotes a nonjudgmental environment, which is essential for developing a strong nurse-client relationship.

🔶 Summarizing enhances clarity and accuracy, ensuring that the nurse correctly interprets the client’s concerns.

🔶 It reflects empathy and professionalism, both of which are crucial in mental health nursing.

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Answer 3

Correct Answers:

"Have you served time in prison?"
"Do you use drugs?"
"Are you taking antipsychotic medication?"

Rationale :

🟣 Criminal history may impact employability due to background checks, particularly in jobs requiring security clearance or working with vulnerable populations.

🟣 It helps the nurse understand barriers to employment that are not related to the client’s skills or qualifications.

🟣 Disclosure of incarceration allows for referral to supportive employment services that accommodate ex-offenders.

🟣 Substance use can impair job performance and consistency, contributing to challenges in finding or keeping a job.

🟣 Identifying substance use helps link the client with rehabilitation or counseling resources, which may improve future job prospects.

🟣 It helps differentiate between psychiatric symptoms and substance-induced behaviors.

🟣 Many antipsychotic medications have side effects like sedation or tremors that can interfere with work ability.

🟣 Medication adherence and side effects can affect the client’s functionality and readiness for employment.

🟣 This question supports a holistic evaluation of the client’s mental health management.

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Answer 4

Correct Answers:

The SE model

Rationale :

🟡The Stress-Vulnerability (SE) Model explains symptom exacerbation in schizophrenia due to increased stress or decreased coping.

🟡 The model incorporates biological vulnerability and environmental stressors, both of which influence hallucinations.

🟡 It emphasizes how nonadherence to medication, sleep deprivation, or psychosocial triggers can provoke relapse.

🟡 Educating the client on this model helps them understand relapse prevention strategies and the need for stress management.

🟡 The SE model supports the nurse’s role in psychoeducation and holistic care, bridging biology and behavior

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Answer 5

Correct Answers:

"It has been more than a year, and I still don't want to leave the house."

Rationale :

🔴 Traumatic grief is marked by persistent distress and avoidance behaviors long after the loss, as seen in prolonged isolation.

🔴 Inability to resume daily functioning more than a year post-loss is a hallmark of complicated or traumatic grief.

🔴 This response reflects impaired coping and adaptation, requiring further evaluation and intervention.

🔴 The continued avoidance of social interaction signals unresolved trauma linked to the loss.

🔴 Recognizing this pattern helps initiate referrals for trauma-focused therapy or grief counseling.

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Answer 6

Correct Answers:

Psychiatric pharmacist

Rationale :

⚫ A psychiatric pharmacist is specifically trained to understand potential drug interactions between psychiatric and medical medications.

⚫ They are the ideal professional to assess the safety and compatibility of complex regimens in clients with comorbidities like schizophrenia and diabetes.

⚫ Consulting this specialist can prevent adverse drug events, including metabolic disturbances or medication-induced side effects.

⚫ The pharmacist also ensures appropriate dosing and monitoring, particularly for high-risk medications.

⚫ Collaborating with this expert improves interprofessional coordination and patient outcomes.

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Answer 7

Correct Answers:

Temperature

Rationale :

🔵 Fever prior to transfusion may be a sign of infection or inflammation and can mimic transfusion reactions, complicating post-infusion assessments.

🔵 Establishing a baseline temperature helps differentiate between pre-existing conditions and adverse transfusion effects.

🔵 A temperature above 100°F may prompt the provider to delay the transfusion or investigate further.

🔵 Transfusion reactions often present with febrile symptoms, making this vital sign critical for early comparison.

🔵 Monitoring temperature ensures safe administration and timely recognition of transfusion complications like febrile non-hemolytic reactions.

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Answer 8

Correct Answers:

"Therapeutic communication is a key component of mental health nursing and the therapeutic nurse-client relationship that improves the emotional well-being of the client."

Rationale :

🟢 Therapeutic communication is fundamental in promoting trust, safety, and emotional healing in mental health settings.

🟢 It allows nurses to effectively assess the emotional and psychological needs of the client.

🟢 This skill enhances the nurse-client relationship, which is central to psychiatric nursing care.

🟢 Evidence shows that emotional well-being improves with empathetic listening, validation, and support.

🟢 Prioritizing therapeutic communication ensures collaborative, patient-centered care in mental health practice.

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Answer 9

Correct Answers:

"l know I am skinny."

Rationale :

🟤 Acknowledging being underweight yet showing no concern is a defining sign of anorexia nervosa.

🟤 Clients with this disorder have a distorted body image and deny the seriousness of low body weight.

🟤 This lack of insight into their condition is called anosognosia, common in eating disorders.

🟤 Statements like this reflect a disconnect between reality and perception, reinforcing the diagnosis.

🟤 Recognition of the symptom helps direct care toward nutritional support and cognitive therapy

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Answer 10

Correct Answers:

SAD PERSONS
SAFE-T

Rationale :

🟢 The PHQ-9 is a validated tool used to screen for depression and suicidal ideation, especially item 9 which asks directly about thoughts of self-harm.

🟢 It is brief, easy to administer, and widely accepted in mental health care.

🟢 Its use supports early detection and intervention.

🟢 The SAD PERSONS scale evaluates suicide risk based on ten known risk factors like age, depression, and previous attempts.

🟢 It provides a structured and reliable assessment of suicide potential.

🟢 Helps guide decisions regarding safety planning or hospitalization.

🟢 The Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) is a comprehensive clinical decision-making tool.

🟢 It assists providers in evaluating risk, protective factors, and intervention needs.

🟢 Its structured nature supports standardized documentation and safety planning.

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QLexNursing

1 :
A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

2 :
A nurse is discussing strategies to develop nurse-client therapeutic relationships with a newly licensed nurse. Which statement by the nurse accurately describes strategies for building a therapeutic relationship?

3 :
A nurse working in a community health center is speaking with a client who has a serious mental illness. The client states that they are unable to find employment and they do not understand why. Which of the following questions should the nurse ask? (Select all that apply.)

4 :
A nurse is caring for a client who has schizophrenia with an exacerbation of hallucinations. The client states, "l do not understand why the hallucinations have come back." The nurse should explain that which of the following is the reason for the exacerbation of hallucinations?

5 :
A nurse is providing care for a client who has recently returned from active combat and experienced the loss of a close friend during combat. Which of the following client statements indicates that the client is experiencing traumatic grief?

6 :
A nurse is caring for a client who has schizophrenia and diabetes mellitus. The nurse is reviewing a list of the clients prescribed medications and has questions about interactions. To which of the following members of the interprofessional team should the nurse direct their questions?

7 :
A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion?

8 :
A nurse is teaching a newly licensed nurse about the importance of therapeutic communication. Which of the following statements should the nurse include in the teaching?

9 :
A nurse is caring for a client. Which of the following client statements should the nurse identify as an indication of anorexia nervosa?

10 :
A charge nurse on a mental health unit is describing assessments for suicide risks to a group of newly licensed nurses. Which of the following tests should the nurse include? (Select All that Apply.)

QLexNursing

1 : A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

2 : A nurse is discussing strategies to develop nurse-client therapeutic relationships with a newly licensed nurse. Which statement by the nurse accurately describes strategies for building a therapeutic relationship?

3 : A nurse working in a community health center is speaking with a client who has a serious mental illness. The client states that they are unable to find employment and they do not understand why. Which of the following questions should the nurse ask? (Select all that apply.)

4 : A nurse is caring for a client who has schizophrenia with an exacerbation of hallucinations. The client states, "l do not understand why the hallucinations have come back." The nurse should explain that which of the following is the reason for the exacerbation of hallucinations?

5 : A nurse is providing care for a client who has recently returned from active combat and experienced the loss of a close friend during combat. Which of the following client statements indicates that the client is experiencing traumatic grief?

6 : A nurse is caring for a client who has schizophrenia and diabetes mellitus. The nurse is reviewing a list of the clients prescribed medications and has questions about interactions. To which of the following members of the interprofessional team should the nurse direct their questions?

7 : A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion?

8 : A nurse is teaching a newly licensed nurse about the importance of therapeutic communication. Which of the following statements should the nurse include in the teaching?

9 : A nurse is caring for a client. Which of the following client statements should the nurse identify as an indication of anorexia nervosa?

10 : A charge nurse on a mental health unit is describing assessments for suicide risks to a group of newly licensed nurses. Which of the following tests should the nurse include? (Select All that Apply.)

1 :
A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

2 :
A nurse is discussing strategies to develop nurse-client therapeutic relationships with a newly licensed nurse. Which statement by the nurse accurately describes strategies for building a therapeutic relationship?

3 :
A nurse working in a community health center is speaking with a client who has a serious mental illness. The client states that they are unable to find employment and they do not understand why. Which of the following questions should the nurse ask? (Select all that apply.)

4 :
A nurse is caring for a client who has schizophrenia with an exacerbation of hallucinations. The client states, "l do not understand why the hallucinations have come back." The nurse should explain that which of the following is the reason for the exacerbation of hallucinations?

5 :
A nurse is providing care for a client who has recently returned from active combat and experienced the loss of a close friend during combat. Which of the following client statements indicates that the client is experiencing traumatic grief?

6 :
A nurse is caring for a client who has schizophrenia and diabetes mellitus. The nurse is reviewing a list of the clients prescribed medications and has questions about interactions. To which of the following members of the interprofessional team should the nurse direct their questions?

7 :
A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion?

8 :
A nurse is teaching a newly licensed nurse about the importance of therapeutic communication. Which of the following statements should the nurse include in the teaching?

9 :
A nurse is caring for a client. Which of the following client statements should the nurse identify as an indication of anorexia nervosa?

10 :
A charge nurse on a mental health unit is describing assessments for suicide risks to a group of newly licensed nurses. Which of the following tests should the nurse include? (Select All that Apply.)