After leaving work, a nurse realizes documentation of administration of a PRN medication was omitted This off-duty nurse phones the nurse on duty and says, 'Please document administration of the medication for me My password is alpha' The nurse receiving the call should:

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Question 1 of 5

After leaving work, a nurse realizes documentation of administration of a PRN medication was omitted This off-duty nurse phones the nurse on duty and says, 'Please document administration of the medication for me My password is alpha' The nurse receiving the call should:

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 2 of 5

At what point in an assessment interview would a nurse ask, How does your faith help you in stressful situations? During the assessment of:

Correct Answer: D

Rationale: The question about faith relates to how a patient manages stress, making it most relevant during the assessment of coping strategies (Option D). This section explores what helps the patient handle difficulties, including spiritual resources. Options A, B, and C focus on unrelated areas—developmental history, substance use, and education—where this question would be out of context.

Question 3 of 5

A client is being evaluated for dementia. The nurse knows that a client who is able to complete very few tasks is most likely to have

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

The client spoke of a current event in the national news and described it as it relates to the client. Then the client spoke of a historical event and described it as it relates to the client. Which of the following questions might the nurse ask to determine if the client is experiencing ideas of reference?

Correct Answer: A

Rationale: Ideas of reference are the client's inaccurate interpretation that general events are personally directed to him or her, such as hearing a speech on the news and believing the message had personal meaning. 'Where were you when this happened,' would relate to the place and might give the nurse more information to validate the client's previous comments. 'Why do you think that,' may be interpreted as the nurse challenging the client. 'Are you sure,' is a closed-ended question and does not encourage the client to elaborate. 'That is unbelievable,' is a statement rather than a question and could be interpreted as the nurse's opinion of the information provided by the client.

Question 5 of 5

The client tells the nurse, 'That new TV anchor is telling the world about me.' This is an example of

Correct Answer: A

Rationale: The client's inaccurate interpretation that general events are personally directed to him or her is an example of ideas of reference. Persecutory delusions involve the client's belief that 'others' are planning to harm the client. Thought broadcasting is a delusional belief that others can hear or know what the client is thinking. Thought insertion is a delusional belief that others are putting ideas or thoughts into the client's head.

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