A client with a diagnosis of passive-aggressive personality disorder is seen at the local mental health clinic. A common characteristic of persons with passive-aggressive personality disorder is:
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Solution
Answer B is correct. The client with passive-aggressive personality disorder often has underlying hostility that is exhibited as acting-out behavior. Answers A, C, and D are incorrect. Although these individuals might have a high IQ, it cannot be said that they have superior intelligence. They also do not necessarily have dependence on others or an inability to share feelings.
The client is admitted for evaluation of aggressive behavior and diagnosed with antisocial personality disorder. A key part of the care of such a client is:
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Solution
Answer A is correct. Clients with antisocial personality disorder must have limits set on their behavior because they are artful in manipulating others. Answer B is not correct because they do express feelings and remorse. Answers C and D are incorrect because it is unnecessary to minimize interactions with others or encourage them to act out rage more than they already do.
An important intervention in monitoring the dietary compliance of a client with bulimia is:
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Solution
Answer C is correct. To prevent the client from inducing vomiting after eating, the client should be observed for 1–2 hours after meals. Allowing privacy as stated in answer A will only give the client time to vomit. Praising the client for eating all of a meal does not correct the psychological aspects of the disease; thus, answer B is incorrect. Encouraging the client to choose favorite foods might increase stress and the chance of choosing foods that are low in calories and fats.
Assuming that all have achieved normal cognitive and emotional development, which of the following children is at greatest risk for accidental poisoning?
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Solution
Answer B is correct. The 4-year-old is more prone to accidental poisoning because children at this age are much more mobile and this makes them more likely to ingest poisons than the other children. Answers A, C, and D are incorrect because the 6-month-old is still too small to be extremely mobile, the 10-year-old has begun to understand risk, and the 13-year-old is also aware of the risks of poisoning and is less likely to ingest poisons than the 4-year-old.
Which of the following examples represents parallel play?
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Solution
Answer B is correct. Parallel play is play that is demonstrated by two children playing side by side but not together. The play in answers A and C is participative play because the children are playing together. The play in answer D is solitary play because the mother is not playing with Mary
The nurse is ready to begin an exam on a 9-month-old infant. The child is sitting in his mother’s lap. What should the nurse do first?
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Solution
Answer B is correct. The first action that the nurse should take when beginning to examine the infant is to listen to the heart and lungs. If the nurse elicits the Babinski reflex, palpates the abdomen, or looks in the child’s ear first, the child will begin to cry and it will be difficult to obtain an objective finding while listening to the heart and lungs. Therefore, answers A, C, and D are incorrect.
In terms of cognitive development, a 2-year-old would be expected to:
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Solution
Answer B is correct. A 2-year-old is expected only to use magical thinking, such as believing that a toy bear is a real bear. Answers A, C, and D are not expected until the child is much older. Abstract thinking, conservation of matter, and the ability to look at things from the perspective of others are not skills for small children.
Which of the following best describes the language of a 24-month-old?
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Solution
Answer C is correct. Children at age 2 can reach for objects that they desire and use simple words such as cookie to express what they want. They already understand “yes” and “no,” so answer A is incorrect. Simple language patterns begin to develop after this age, even though children at this age might understand some words; therefore, answer B is not a good choice. Later, at about age 3 or 4, they begin to ask “Why?,” making answer D incorrect.
A client who has been receiving urokinase has a large bloody bowel movement. What nursing action would be best for the nurse to take immediately?
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Solution
Answer D is correct. Urokinase is a thrombolytic used to destroy a clot following a myocardial infraction. If the client exhibits overt signs of bleeding, the nurse should stop the medication, call the doctor immediately, and prepare the antidote, which is Amicar. Answer B is not correct because simply stopping the urokinase is not enough. In answer A, vitamin K is not the antidote for urokinase, and reducing the urokinase, as stated in answer B, is not enough.
The client has a prescription for a calcium carbonate compound to neutralize stomach acid. The nurse should assess the client for:
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Solution
Answer A is correct. The client taking calcium preparations will frequently develop constipation so the client should be assessed for any problems related to bowel elimination. Answers B, C, and D are not problems related to the use of calcium carbonate.