ATI Custom NUR 2711 Test 2
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Free ATI Custom NUR 2711 Test 2 Questions
A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response?
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"Crying helps us let things out and we feel better."
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"Your husband is making really good progress."
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"Did your husband say something to upset you?"
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"Tell me what is concerning you."
Explanation
Correct Answer: (D) "Tell me what is concerning you." This response uses therapeutic communication by inviting the spouse to openly express their specific concerns, demonstrating active listening and allowing the nurse to better understand and address the spouse's emotional needs.
Why the other options are incorrect:
A. "Crying helps us let things out and we feel better." offers a generalized statement rather than exploring the spouse's specific concerns. B. "Your husband is making really good progress." dismisses the spouse's expressed worry by redirecting to reassurance rather than addressing their feelings. C. "Did your husband say something to upset you?" makes an assumption about the cause of the spouse's distress rather than allowing them to share their own concerns openly.
0900 - Client appears disoriented and unable to recall the names of staff members. She repeats the same question regarding her family multiple times within the hour. Client's affect is flat, and she appears withdrawn.
Explanation
A nurse is caring for a client who is exhibiting signs of alcohol withdrawal. Which of the following medications should the nurse plan to administer?
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Methadone
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Disulfiram (Antabuse)
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Buprenorphine (Sublocade)
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Lorazepam (Ativan)
Explanation
Correct Answer: (D) Lorazepam (Ativan) Benzodiazepines such as lorazepam are the primary treatment for alcohol withdrawal because they reduce central nervous system hyperexcitability, preventing complications such as seizures and delirium tremens.
Why the other options are incorrect:
A. Methadone is used in the treatment of opioid dependence, not alcohol withdrawal. B. Disulfiram (Antabuse) is used for long-term alcohol abstinence maintenance by causing an aversive reaction when alcohol is consumed, not for managing acute withdrawal symptoms. C. Buprenorphine (Sublocade) is used to treat opioid use disorder, not alcohol withdrawal.
A nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?
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Contact the crisis counselor once a week.
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Eliminate stress and anxiety from daily life.
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Identify anxiety-producing situations.
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Try to repress feelings of anxiety.
Explanation
Helping the client identify specific anxiety-producing situations empowers them to recognize triggers and apply coping strategies proactively, supporting long-term anxiety management after discharge.
Why the other options are incorrect:
A. Contact the crisis counselor once a week. is not a realistic or necessary universal instruction, as not all clients require scheduled crisis counseling contact after discharge. B. Eliminate stress and anxiety from daily life. is an unrealistic goal, as stress and anxiety cannot be entirely eliminated from daily living. D. Try to repress feelings of anxiety. is a maladaptive coping strategy, as repression can worsen anxiety over time rather than support healthy management.
A nurse should monitor clients starting on antidepressant therapy closely for which of the following?
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Increase in suicidal thoughts
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Photosensitivity
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Anxiety
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Hallucinations
Explanation
When clients first begin antidepressant therapy, there is a well-documented and FDA black box warning risk of increased suicidal ideation, particularly in children, adolescents, and young adults. As antidepressants begin to take effect, clients may gain enough energy to act on suicidal thoughts before their mood fully improves, making close monitoring during the initial weeks of therapy critically important.
Why the other options are incorrect:
B. Photosensitivity While some antidepressants may cause mild photosensitivity, this is not the primary or most critical concern requiring close monitoring when initiating antidepressant therapy.
C. Anxiety Although anxiety can occur as a side effect, it is not the most urgent or widely recognized concern that warrants the highest level of monitoring when starting antidepressants.
D. Hallucinations Hallucinations are not a common or primary concern associated with initiating antidepressant therapy and do not carry the same level of clinical urgency as suicidal ideation.
Additional Nurses' Notes (Day 2, 0700): Client refuses to eat breakfast. Client has flat affect, wants to stay in bed and refuses to get dressed. Client states, "Everything is hopeless, I want it all to end." 12 hour intake was 230 mL, output was 260 mL. Today's weight is 39.5 kg (87 lb).
Complete the following sentence by using the lists of options.
The nurse should first address the client's [Select...] followed by the client's [Select...]
Options: oxygen saturation level, temperature, statement of hopelessness
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oxygen saturation level
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temperature
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statement of hopelessness
Explanation
Correct Answer: First — statement of hopelessness; Second — oxygen saturation level Using the safety priority framework, the client's statement "Everything is hopeless, I want it all to end" indicates active suicidal ideation and represents an immediate safety risk, so this must be addressed first with suicide precautions and further assessment. Following safety, the nurse should prioritize physiological needs using the ABC framework, addressing oxygen saturation level next since adequate oxygenation takes precedence over temperature regulation.
Why the other options are incorrect:
Temperature is an important vital sign to monitor given this client's malnutrition and risk for hypothermia, but it is a lower priority than both the client's safety and oxygenation status.
A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the client's plan of care?
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Spending time sitting with the client
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Playing a game of chess with the client
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Encouraging decision-making
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Giving the client choices of activities
Explanation
Correct Answer: (A) Spending time sitting with the client Simply spending time sitting with a client who has severe depression conveys unconditional acceptance and demonstrates the client's worth, without placing demands on them that they may not have the energy or cognitive capacity to meet.
Why the other options are incorrect:
B. Playing a game of chess with the client requires concentration and decision-making that may be too demanding for a client experiencing severe depression. C. Encouraging decision-making can be overwhelming for a client with severe depression, who often struggles with indecisiveness and low energy. D. Giving the client choices of activities similarly requires a level of cognitive engagement and decision-making that may exceed the client's current capacity during severe depression.
A nurse is caring for a client 3 days after admission for treatment of depression. The client leaves her current activity, approaches the nurse and states, "There's no reason to go on living. I just want to end it all." Which of the following actions should the nurse take?
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Recognize the attempt at manipulation and escort the client back to her activity.
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Assist the client to her room and allow her to rest before resuming activity.
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Notify the client's family and request a visitor to stay with the client until thoughts of suicide are gone.
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Ask the client if she has a plan to commit suicide.
Explanation
When a client expresses suicidal ideation, the nurse's priority is to assess the level of risk by directly asking if the client has a plan to commit suicide. This is a critical component of suicide risk assessment. Research shows that asking about suicide does not plant the idea but rather opens communication and helps determine the urgency of intervention needed.
Why the other options are incorrect:
A. Recognize the attempt at manipulation and escort the client back to her activity. Dismissing suicidal statements as manipulation is dangerous and unethical. All expressions of suicidal ideation must be taken seriously and assessed thoroughly.
B. Assist the client to her room and allow her to rest before resuming activity. Leaving a suicidal client alone is unsafe. The nurse must first conduct a proper risk assessment before any other action is taken.
C. Notify the client's family and request a visitor to stay with the client until thoughts of suicide are gone. While family support is important, notifying family is not the first priority. A thorough risk assessment must be completed first and the care team must be involved in managing the crisis.
A nurse is providing dietary teaching for a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following items requires intervention by the nurse?
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Celery sticks
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Glass of whole milk
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Salami sandwich
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Sliced apples
Explanation
Clients taking MAOIs must strictly avoid foods high in tyramine to prevent a potentially life-threatening hypertensive crisis. Salami is a cured and aged meat that is very high in tyramine content and must be completely avoided. Other high-tyramine foods to avoid include aged cheeses, smoked meats, fermented foods, red wine, and soy sauce.
Why the other options are incorrect:
A. Celery sticks Fresh vegetables such as celery are low in tyramine and are safe to consume while taking an MAOI.
B. Glass of whole milk Fresh dairy products such as whole milk are considered safe on an MAOI diet as they are not aged or fermented and contain negligible tyramine levels.
D. Sliced apples Fresh fruits such as apples are low in tyramine and are safe to consume while taking an MAOI.
A nurse is caring for a client admitted to a mental health facility who asks, "Can I refuse the electroconvulsive therapy (ECT) treatment scheduled for tomorrow?" Which of the following should be the nurse's response?
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"You can refuse it, but you won't get better."
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"You will feel better after the course of treatments."
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"You have the right to refuse even though the consent form has been signed."
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"You have given signed consent for the treatments after they were explained to you."
Explanation
Informed consent is an ongoing process and clients retain the right to withdraw consent and refuse any treatment at any time, even after a consent form has been signed. This is a fundamental principle of client autonomy and patient rights. The nurse must always advocate for and uphold the client's right to make decisions about their own care.
Why the other options are incorrect:
A. "You can refuse it, but you won't get better." This response is coercive, judgmental, and non-therapeutic. It attempts to pressure the client into treatment by making a negative prediction, which violates the client's autonomy and is ethically inappropriate.
B. "You will feel better after the course of treatments." This response dismisses the client's concern and attempts to persuade rather than inform. It does not address the client's rights and is not an appropriate therapeutic response.
D. "You have given signed consent for the treatments after they were explained to you." This response incorrectly implies that signing a consent form removes the client's right to refuse treatment. Consent is not irrevocable and clients may withdraw it at any time.
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