when the health care provider diagnoses metastatic cancer and recommends a gastrostomy for an older female client in stable condition the son tells th

NCLEX-RN

Psychosocial Integrity NCLEX Questions Quizlet

1. When the health care provider diagnoses metastatic cancer and recommends a gastrostomy for an older female client in stable condition, the son tells the nurse that his mother must not be told the reason for the surgery because she 'can't handle' the cancer diagnosis. Which legal principle is the court most likely to uphold regarding this client's right to informed consent?

A. The family cannot provide the consent required in this situation as the older adult is capable of making decisions.
B. The son cannot waive informed consent for the client since there is no evidence of mental incompetence.
C. The court will not allow the health care provider to make the decision to withhold informed consent under therapeutic privilege.
D. If informed consent is withheld from a client, health care providers could be found guilty of negligence.

Correct answer: D

Rationale: Health care providers may be found guilty of negligence, specifically assault and battery, if they carry out a treatment without the client's consent. The client's condition is stable, so the family cannot provide consent without her involvement, making option A incorrect. There is no evidence of mental incompetence in the client, so the son cannot waive informed consent, making option B incorrect. While therapeutic privilege may have been accepted in the past, it is unlikely to be upheld by today's courts, making option C incorrect. It is crucial for health care providers to obtain informed consent from clients before proceeding with any treatment to avoid legal consequences and uphold ethical standards.

2. According to psychodynamic theory, what purpose do delusions serve?

A. Delusions are a defense against anxiety caused by real or imagined threats.
B. Magical thinking is a delusion that ensures desirable outcomes.
C. Delusions are a method of dealing with and interpreting external stimuli.
D. Subconsciously, delusions are a way to safely express anger and hostility.

Correct answer: A

Rationale: According to psychodynamic theory, delusions serve as a defense mechanism against anxiety triggered by real or perceived threats. Delusions are the individual's unconscious way of protecting themselves from overwhelming feelings of anxiety. Magical thinking, on the other hand, involves believing that one's thoughts can influence external events. This is not the same as delusions. Delusions are not a way of interpreting external stimuli but rather a defense mechanism. Expressing anger and hostility is typically associated with defense mechanisms like displacement or projection, not delusions.

3. A client who just had a bilateral mastectomy is preparing to talk about body changes. Which of the following actions of the nurse is most appropriate during this discussion?

A. Provide a room that offers minimal distractions
B. Ask closed-ended questions to allow the client to think about her situation
C. Write detailed notes during the conversation to track important information
D. Ask personal questions about the client's background to determine how the procedure has affected her self-concept

Correct answer: A

Rationale: When preparing to discuss sensitive topics such as body changes post-bilateral mastectomy, it is crucial to create a conducive environment. Providing a room with minimal distractions allows the client to feel comfortable, safe, and more likely to open up about personal feelings without interruptions. This setting fosters open communication between the nurse and client, facilitating a more empathetic and supportive interaction. Closed-ended questions (Choice B) may limit the client's ability to express emotions fully. Writing detailed notes (Choice C) during the conversation may distract the nurse from actively listening and being present for the client. Asking personal questions about the client's background (Choice D) may not be appropriate during such a vulnerable discussion and could potentially create discomfort for the client.

4. A client is receiving treatment for delusional behavior. He believes that his neighbor is purposefully poisoning his water system in an attempt to make him sick. Which of the following responses of the nurse is most appropriate?

A. Did you have the water tested to be sure?
B. Why do you feel like your neighbor is trying to poison you?
C. Let's just sit here and watch this television program.
D. Don't be silly; your neighbor would do no such thing.

Correct answer: B

Rationale: When a client presents with delusional beliefs, the nurse should avoid arguing with the client and should accept the client's initial need to hold onto the delusions. By asking the client 'Why do you feel like your neighbor is trying to poison you?' the nurse encourages the client to express his beliefs further. This open-ended question allows the client to elaborate on his delusions without feeling judged. It helps build trust between the nurse and the client, which is crucial for therapeutic communication. This approach may eventually lead to the client being more receptive to exploring and addressing his delusions. Choices A, C, and D are incorrect. Choice A may come off as dismissive and does not address the client's underlying beliefs. Choice C is a distraction and does not address the client's concerns. Choice D is confrontational and dismissive of the client's beliefs, which can damage the therapeutic relationship.

5. A seriously ill female client tells the nurse, 'I am so tired and in so much pain! Please help me to die.' Which is the best response for the nurse to provide?

A. Administer the prescribed maximum dose of pain medication.
B. Talk with the client about her feelings related to her own death.
C. Collaborate with the healthcare provider about initiating antidepressant therapy.
D. Refer the client to the ethics committee of her local healthcare facility.

Correct answer: B

Rationale: The nurse should first assess the client's feelings about her death and determine the extent to which this statement expresses her true feelings. The client may need additional pain management, but further assessment is needed before implementing option A. Option B is the correct response as it focuses on addressing the client's emotional needs and providing support. Option C is premature as initiating antidepressant therapy without a thorough assessment may not be appropriate. Option D is not the best course of action at this point; involving the ethics committee should be considered only after a comprehensive evaluation and discussion with the client.