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 suicidal client says to a nurse, "There's nothing to live for anymore." Which is the best nursing reply?
- A. "Have you considered doing volunteer work?"
- B. "It sounds like you are feeling pretty hopeless."
- C. "Things will look better to you in the morning."
- D. "Let's discuss the negative aspects of your life."
Explanation
This response reflects therapeutic communication by acknowledging and validating the client's feelings without judgment or false reassurance. It encourages the client to explore and express emotions, which is essential in suicide assessment. Validating despair demonstrates empathy and opens the door for deeper discussion regarding suicidal thoughts and safety planning.
2. What is the primary nursing goal when establishing a therapeutic relationship with a client?
- A. To develop communication skills
- B. To develop the nurse's personal identity
- C. To establish a purposeful social interaction
- D. To promote client growth
Explanation
The primary goal of a therapeutic nurse-client relationship is to promote the client’s growth, autonomy, and emotional healing. This relationship supports the client in understanding feelings, developing coping strategies, and improving mental functioning. It is purposeful and client-focused, facilitating progress toward greater self-awareness and health.
3. Which outcome does the nurse expect during the working phase of the nurse-client relationship?
- A. The client explores personal strengths and weaknesses that impact behaviors.
- B. The client and nurse establish rapport and mutually develop treatment goals.
- C. The client explores feelings related to reentering the community.
- D. The client gains insight and incorporates alternative behaviors.
Explanation
The working phase focuses on implementing the treatment plan and facilitating change. During this phase, the client confronts ineffective coping patterns, gains insight into problem behaviors and emotions, and practices healthier alternatives. This is the core therapeutic phase where real behavioral and emotional growth occurs through active participation and therapeutic interaction.
4. A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. The nurse determines the client's behaviors:
- A. Show common symptoms of grief and do not indicate mental illness
- B. Are clinically significant and indicate serious mental illness
- C. Are incongruent with cultural norms and indicate mental illness
- D. Demonstrate typical variations in daily mood, not mental illness
Explanation
The client is experiencing normal grief related to the loss of a beloved pet. The sadness is situational, occasional, and does not impair daily functioning, appetite, or sleep. Grief is a normal emotional response to loss and not indicative of mental illness unless symptoms are severe, prolonged, or significantly disrupt functioning.
5. A nurse discovers a client's suicide note that details the time, place and means to commit suicide. What is the priority nursing intervention and accompanying rationale for this action?
- A. Calling an emergency treatment team meeting because the client's threat must be addressed
- B. Establishing room restrictions because the client's threat is an attempt to manipulate the staff
- C. Placing the client on one-to-one suicide precautions because the more specific the plan, the more likely the client will attempt suicide
- D. Administering lorazepam (Ativan) as needed because the client is angry about the discovery of the note
Explanation
A suicide note that identifies time, place, and means indicates a high-lethality, high-intent situation. The strongest predictor of suicide attempt is a specific and organized plan, so the immediate priority is safety through constant one-to-one observation. This intervention ensures continuous monitoring, reduces access to means, and allows the nurse to intervene immediately if the client attempts self-harm.
6. 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?
- A. Stage of biological stress
- B. Stage of resistance
- C. Alarm reaction stage
- D. 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.
7. A nursing instructor is teaching about suicide in the elderly population. Which information is appropriate to include?
- A. Elderly men use less lethal means to commit suicide.
- B. Single elderly individuals are less likely to attempt and succeed at suicide.
- C. Suicide is the second leading cause of death among the elderly.
- D. 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.
8. Which therapeutic communication technique is being used in this nurse-client interaction?
Client: "My father spanked me often."
Nurse: "Your father was a harsh disciplinarian."
Client: "My father spanked me often."
Nurse: "Your father was a harsh disciplinarian."
- A. Accepting
- B. Offering a general lead
- C. Focusing
- D. Restating
Explanation
Restating is a therapeutic communication technique in which the nurse rephrases the client’s statement in different words to show understanding and encourage the client to continue exploring feelings. Here, the nurse paraphrases the client’s experience ("spanked me often") into an interpretation ("harsh disciplinarian"), showing active listening and inviting further discussion.
9. 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.
- A. "My mom always loved my sister more than she loved me."
- B. "My mother hates me."
- C. "I have a very wonderful mother whom I love very much."
- D. "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.
10. A client has not received what was expected for lunch and directs an angry verbal outburst at the nurse. What is an accurate description of this display of emotion?
- A. Expression of anger and aggression are closely related.
- B. Anger is a psychological arousal.
- C. Expression of anger can come under personal control.
- D. Anger is a primary emotion that is automatically experienced.
Explanation
Anger itself may arise automatically in response to frustration or unmet needs, but the expression of anger is a behavior that can be controlled. In nursing and therapeutic practice, we understand that people can learn to manage and communicate anger constructively. The client’s verbal outburst shows anger expression, not uncontrollable reflex. Teaching coping strategies and emotional regulation is part of promoting healthy anger expression.
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