NUR 422 Worchester Fall at Massachusetts College of Pharmacy and Health Sciences Fall 2025
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Free NUR 422 Worchester Fall at Massachusetts College of Pharmacy and Health Sciences Fall 2025 Questions
1. A stockbroker commits suicide after being convicted of insider trading. While speaking with the family, which statement by the nurse demonstrates accurate and appropriate information sharing?
- "Your grieving will subside within 1 year; until then, I recommend antidepressants."
- "Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone."
- "The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them."
- "Support groups are available specifically for survivors of suicide, and I would be happy to help you locate one in the area."
Explanation
Families affected by suicide often experience complicated grief, guilt, shame, and social isolation. Recommending support groups provides emotional connection, reduces stigma, and offers coping strategies from others with similar experiences. This is an appropriate, therapeutic, and evidence-based resource to help them process grief and find support.
2. A client hates her mother because of childhood neglect. The nurse determines which client statement represents the use of the defense mechanism of reaction formation.
- "My mom always loved my sister more than she loved me."
- "My mother hates me."
- "I have a very wonderful mother whom I love very much."
- "I don't like to talk about my relationship with my mother."
Explanation
Reaction formation occurs when a person unconsciously replaces true unacceptable feelings with their opposite. Although the client harbors resentment and hatred due to childhood neglect, she expresses exaggerated positive feelings toward her mother. This defense mechanism protects the client from acknowledging painful emotions by adopting the opposite stance.
3. A nurse is caring for a client threatening to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which factor will guide the nurse's plan of care for the client?
- The more specific the plan is, the more likely the client will attempt suicide.
- After a brief assessment, the nurse should avoid the topic of suicide.
- Clients who threaten suicide should be observed every 15 minutes.
- Clients who talk about suicide never actually commit it.
Explanation
A detailed and specific suicide plan indicates a significantly higher level of risk. This client has both a method (hanging) and a specific means (knotted shower curtain), demonstrating intent and preparation. Clients with detailed plans require immediate and intensive safety measures, including constant observation, removal of harmful objects, and immediate intervention to reduce self-harm risk.
4. Which therapeutic communication technique is being used in this nurse-client interaction?
Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
- Giving recognition
- Making observations
- Formulating a plan of action
- Reflecting
Explanation
The nurse’s response encourages the client to identify coping alternatives, which promotes problem-solving and planning strategies for future anxiety. Asking about other methods to reduce anxiety supports the client in developing healthier coping skills and promotes autonomy in choosing alternative responses. This is an example of formulating a plan of action, a therapeutic communication technique focused on encouraging proactive planning.
5. Which of the following is a stage in the general adaptation syndrome?
- Spending time with a pet
- Adapting to and overcoming a stressor
- Primary appraisal
- Journaling thoughts and feelings
Explanation
The General Adaptation Syndrome (GAS), proposed by Hans Selye, describes the body’s physiological response to stress in three stages: alarm, resistance, and exhaustion. During the resistance stage, the body attempts to cope with and adapt to the stressor to restore balance. This phase reflects the process of adapting to and overcoming a stressor, making option B the correct choice.
6. Which of the following is the priority nursing action during the orientation (introductory) phase of the nurse-client relationship?
- Explore how thoughts and feelings may adversely impact nursing care.
- Establish rapport and develop mutually agreeable treatment goals
- Attempt to find alternative placement for the client.
- Acknowledge the client's action and generate alternative behaviors.
Explanation
During the orientation (introductory) phase, the nurse’s priority is to build trust, establish rapport, and collaboratively create treatment goals with the client. This phase sets the foundation for the therapeutic relationship by clarifying roles, expectations, and the plan of care. Establishing a safe, trusting environment encourages open communication and supports successful treatment throughout the relationship.
7. After repeated requests for a patient to unpack and get settled on the psychiatric unit, the patient states, "I have no intention of unpacking and staying on this unit." To avoid a confrontation, the nurse unpacks the patient's belongings. Which nursing behavior is exemplified?
- Aggressiveness
- Negative operant conditioning
- Assertiveness
- Positive role modeling
Explanation
Aggressiveness occurs when an individual imposes their will on another and disregards their autonomy. Although the nurse may believe they are avoiding conflict, unpacking the patient's belongings after a clear refusal violates the patient’s expressed choice. This behavior forces compliance rather than encouraging participation, undermines independence, and does not support therapeutic boundary-setting.
8. A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which utterance made by the nurse is an example of a broad opening?
- "How can we help you feel safe during your stay here?"
- "What would you like to talk about?"
- "I notice you seem uncomfortable discussing this."
- "What occurred prior to the traumatic event, and when did you go to the emergency department?"
Explanation
A broad opening allows the client to take the lead in the conversation and choose the topic, promoting autonomy and therapeutic engagement. Asking "What would you like to talk about?" invites the client to share thoughts or feelings at their own pace, which is particularly helpful for individuals with PTSD who may feel vulnerable or overwhelmed. This supports therapeutic communication and client-centered care.
9. A client diagnosed with neurocognitive disorder (NCD) has progressive memory loss, diminished cognitive functioning, and verbal aggression and is experiencing frustration. Which nursing intervention is most appropriate?
- Explaining the consequences for aggressive behaviors
- Minimizing environmental lighting
- Organizing a group activity to present reality
- Scheduling structured daily routines
Explanation
Clients with neurocognitive disorders benefit greatly from structured, predictable daily routines. Routine decreases anxiety, frustration, and confusion by providing consistency and reducing cognitive demands. Maintaining structure helps the client feel more secure and minimizes triggers for agitation and aggressive behavior. This intervention directly supports cognitive decline and behavioral symptoms seen in dementia.
10. A client diagnosed with a neurocognitive disorder (NCD) is exhibiting behavioral problems every day. At the change of shift, the client's behavior escalates from pacing to screaming and flailing. Which action would the nurse implement first?
- Anticipating the behavior and restraining when pacing begins
- Medicating the client with prn antianxiety medication
- Assessing environmental triggers and potential unmet needs
- Consulting the psychologist regarding behavior modification techniques
Explanation
When a client with a neurocognitive disorder shows escalating behaviors, the priority is to assess for possible environmental stressors and unmet needs such as pain, hunger, fatigue, overstimulation, or confusion. Change of shift can be overstimulating. Identifying and removing triggers, and addressing needs early, often prevents further escalation. Assessment and non-pharmacologic interventions are first-line before restraints or medications.
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