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
A nursing instructor is teaching about suicide in the elderly population. Which information is appropriate to include?
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Elderly men use less lethal means to commit suicide.
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Single elderly individuals are less likely to attempt and succeed at suicide.
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Suicide is the second leading cause of death among the elderly.
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The second highest rates of suicide are among those 85 years and older.
Explanation
Older adults, particularly those aged 85 and older, have some of the highest suicide rates of any age group. Increased risk is associated with social isolation, chronic illness, bereavement, functional decline, and untreated depression. This demographic often uses highly lethal means, and suicide attempts in this group are more frequently fatal, making awareness and prevention crucial.
Which of the following is the nurse's primary goal during the pre-interaction phase of the nurse-client relationship?
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Promote client change.
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Formulate a contract for intervention.
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Explore self-perceptions.
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Evaluate goal attainment.
Explanation
During the pre-interaction phase, the nurse has not yet met the client. The purpose of this phase is for the nurse to reflect on personal feelings, biases, fears, or expectations that could interfere with the therapeutic relationship. Exploring self-perceptions ensures the nurse approaches the client with self-awareness, professionalism, and emotional readiness, setting the foundation for a therapeutic and unbiased interaction.
The client is hospitalized with coronary artery disease and demonstrates other conditions often associated with diseases of adaptation, including headaches and depression. Currently, the client is demonstrating anxiety and states he is "worried" about his spouse. Which is the most appropriate nursing response to the situation?
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Ask the client if he has a pet he would like to see while in the hospital.
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Teach the client how to meditate when he is feeling anxious.
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Encourage the client to talk through his concerns about his spouse.
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Inform the client that he has to learn to cope with stressors.
Explanation
Encouraging the client to verbalize concerns is a primary therapeutic communication strategy for anxiety. Discussing worries about his spouse helps the nurse assess emotional needs, offer support, and reduce anxiety through expression. Verbalization provides emotional release and promotes coping while maintaining trust. This client is experiencing stress-related illness; exploring worries can reduce sympathetic arousal and improve adaptation.
Which client statement indicates to the nurse that the client may be experiencing a transference reaction?
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"My mother is the source of my problems. She has always told me what to do and what to say."
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"I deserve more than I am getting here. Do you know who I am and what I do? Let me talk to your supervisor."
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"I don't seem to be able to relate to people. I would rather stay in my room and be by myself."
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"I need a real nurse. You are young enough to be my daughter, and I don't want to tell you about my personal life."
Explanation
Transference occurs when a client unconsciously transfers feelings, attitudes, or expectations from a significant person in their past onto the nurse. In this statement, the client is projecting feelings associated with a daughter-figure onto the nurse based on her age and relational role. The client's refusal to engage due to this perceived relationship reflects classic transference dynamics.
A client threatens to kill himself, his wife, and their children if the wife follows through with divorce proceedings. During the pre-interaction phase of the nurse-patient relationship, which interaction should the nurse employ?
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Exploring a person's thoughts and feelings that may adversely impact the provision of care.
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Establishing rapport and development treatment goals.
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Providing community resources and aggression management.
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Acknowledging the patient's actions and encouraging alternative behaviors.
Explanation
The pre-interaction phase occurs before meeting the client and focuses on the nurse’s self-reflection, reviewing information, and addressing personal feelings or potential biases. In this scenario, the client has made violent threats, which may trigger concern or anxiety in staff. The nurse must evaluate their own emotional response and readiness to ensure safe, therapeutic care. This promotes objectivity, safety, and professional behavior when later interacting with the client.
During a one-to-one session, the client states, "Nothing will ever get better," and "Nobody can help me." Which nursing diagnosis is most appropriate for the nurse to assign at this time?
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Powerlessness related to (R/T) altered mood AEB client statements
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Hopelessness R/T altered mood AEB client statements
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Risk of suicide R/T altered mood AEB client statements
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Risk of injury R/T altered mood AEB client statements
Explanation
Hopelessness involves a subjective state where an individual feels a lack of future expectations and belief that positive outcomes are impossible. Statements like "Nothing will ever get better" and "Nobody can help me" reflect loss of hope and belief that circumstances cannot improve. This diagnosis directly fits the client's verbalizations, identifying a key emotional component requiring therapeutic intervention.
A client diagnosed with a neurocognitive disorder (NCD) due to late-stage Alzheimer's disease is incapable of performing activities of daily living (ADLs). Which intervention is the nurse's priority?
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Assisting the client with bathing and toileting
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Designing a bulletin board to represent the current season
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Labeling the client's room with name and number
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Presenting evidence of objective reality to improve cognition
Explanation
In late-stage Alzheimer's disease, the client experiences severe cognitive and functional decline, often losing the ability to perform basic ADLs such as bathing, dressing, toileting, and feeding. The priority is meeting basic physiological and self-care needs first, which ensures safety, hygiene, and comfort. Supporting ADLs promotes dignity and prevents complications like skin breakdown, incontinence-related infections, and dehydration.
A nurse's statement, "You remind me a lot of my grandmother, so I am sure we will get along very well," is an example of what?
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Sympathy
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Countertransference
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The working phase
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Transference
Explanation
Countertransference occurs when the nurse unconsciously transfers feelings or attitudes from past relationships onto the client. In this case, the nurse is associating the client with their grandmother and assuming the relationship will be positive based on that personal emotional connection. This can interfere with objective care and appropriate therapeutic boundaries, making it countertransference.
The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a general lead?
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"Can you chronologically order the events that led to your admission?"
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"Are you feeling depressed or anxious?"
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"Yes, I see. Go on."
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"Do you know why you are here?"
Explanation
Offering a general lead encourages the client to continue speaking and express thoughts without directing the conversation. Statements like "Go on" or "Tell me more" show active interest and support client expression. This therapeutic communication technique fosters exploration of feelings and experiences, and helps the nurse gather information in a client-centered, non-pressuring manner.
A 25-year-old man barely avoids a motor vehicle accident. His heart is pounding, his palms are sweaty, and his respirations are increasing. This is an example of which stage of the general adaptation syndrome?
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Stage of biological stress
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Stage of resistance
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Alarm reaction stage
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Stage of exhaustion
Explanation
The alarm reaction stage is the initial response to a stressor. The sympathetic nervous system activates the “fight-or-flight” response, causing physical changes such as increased heart rate, sweating, and rapid breathing. These immediate physiological responses prepare the body to react to danger. In this scenario, narrowly avoiding a car accident triggers those acute stress reactions, clearly demonstrating the alarm stage of the general adaptation syndrome.
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