A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching?

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Question 1 of 5

A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Altering routines may disrupt stability and increase anxiety for children. 2. Children benefit from consistency post-divorce to provide a sense of security. 3. Acknowledging children are not to blame is crucial for their emotional well-being. 4. Developing a regular visitation schedule fosters predictability and comfort. 5. Consistent limits help establish boundaries and structure for children. Therefore, statement A indicates a need for additional teaching as it could potentially harm the children's emotional well-being by disrupting their routines.

Question 2 of 5

The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find?

Correct Answer: D

Rationale: The correct answer is D because individuals with delusional disorder typically live with one or more fixed delusions for an extended period. This is a key characteristic of the disorder. Choice A is incorrect as it describes a separate condition (major depression). Choice B is incorrect as disruptive behavior patterns are not a defining feature of delusional disorder. Choice C is incorrect as delusions in this disorder are typically not bizarre but rather fixed and plausible to the individual.

Question 3 of 5

As part of a client's treatment plan for borderline personality disorder, the client is engaged in dialectical behavior therapy. As part of the therapy, the client is learning how to control and change behavior in response to events. The nurse identifies the client as learning which type of skills?

Correct Answer: D

Rationale: Rationale: Dialectical behavior therapy focuses on teaching clients skills to manage emotions, behavior, and thoughts effectively. Self-management skills involve regulating behavior in response to events, which aligns with the client's goal of controlling and changing behaviors. Emotion regulation skills focus on managing emotions, mindfulness skills involve being present in the moment, and distress tolerance skills focus on tolerating emotional distress. Therefore, self-management skills are the most appropriate choice in this scenario.

Question 4 of 5

A nurse is obtaining information about a client's sleep patterns and asks him about the total amount of sleep time compared with the amount of time spent in bed. The nurse is assessing which of the following?

Correct Answer: C

Rationale: The correct answer is C: Sleep efficiency. Sleep efficiency is the ratio of total sleep time to time spent in bed, reflecting how effectively the individual is sleeping. This assessment helps the nurse determine the quality of the client's sleep. A: Sleep latency refers to the time it takes for an individual to fall asleep, not the ratio of sleep time to time spent in bed. B: Sleep architecture pertains to the different stages of sleep (such as REM and non-REM sleep), not the ratio of sleep time to time spent in bed. D: Sleep-wake cycle refers to the body's natural circadian rhythm governing sleep and wakefulness, not the ratio of sleep time to time spent in bed.

Question 5 of 5

As part of a follow-up home visit to an 80-year-old client who has had surgery, the nurse discusses the client's risk for delirium with his family members. Which of the following would the nurse NOT include as placing the client at increased risk?

Correct Answer: B

Rationale: The correct answer is B: Hypertension. Hypertension is not a risk factor for delirium in the context of a follow-up home visit after surgery. Delirium is commonly associated with factors such as urinary tract infections (A), acute stress (C), and bone fractures (D) in elderly clients. Hypertension, although a serious condition, does not directly contribute to the development of delirium in this scenario. Delirium is often multifactorial, with underlying medical conditions, infections, and stress being key contributors. In this case, the nurse would focus on discussing the client's risk factors such as urinary tract infections, acute stress, and bone fractures with the family members to prevent delirium.

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