CSLB General Building (B) — All Questions
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A client newly diagnosed with cancer says, 'I just can't believe this is happening to me.' Which response is most therapeutic?
- a.This must be very difficult for you. Tell me what you are feeling✓
- b.At least it was caught early, so try to stay positive
- c.You should focus on your treatment plan now
- d.Many people do well with this diagnosis
Acknowledging the client's emotion and inviting them to share feelings uses empathy and open-ended communication. False reassurance and changing the focus block therapeutic dialogue.
A nurse is caring for a client with major depressive disorder who states, 'Life isn't worth living anymore.' What is the nurse's priority action?
- a.Reassure the client that things will improve
- b.Directly ask the client if they are thinking of suicide✓
- c.Change the subject to reduce the client's distress
- d.Document the statement and continue routine care
Safety is the priority. Directly asking about suicidal ideation assesses risk and does not increase the likelihood of self-harm; it opens the door to protective intervention.
A client experiencing a panic attack is hyperventilating and pacing. Which nursing action is most appropriate?
- a.Leave the client alone to calm down
- b.Provide detailed teaching about anxiety physiology
- c.Stay with the client and speak calmly using short, simple statements✓
- d.Encourage the client to describe every worry in detail
During a panic attack the nurse should stay with the client, remain calm, and use brief, clear communication. Complex teaching and detailed discussion overwhelm the client until the acute anxiety subsides.
A client with anorexia nervosa is admitted for treatment. Which finding is the priority concern?
- a.The client's distorted body image
- b.The client's refusal to discuss feelings
- c.The client's preoccupation with calories
- d.Bradycardia and electrolyte imbalance✓
Physiological instability such as bradycardia and electrolyte imbalance can be life-threatening in anorexia nervosa and takes priority over the important psychological issues.
A nurse uses therapeutic communication with a grieving client. Which technique best encourages the client to continue talking?
- a.Using silence and attentive presence✓
- b.Offering personal opinions about the loss
- c.Asking rapid closed-ended questions
- d.Reassuring the client that grief will pass quickly
Silence and attentive presence give the grieving client time to process and express feelings. Opinions, closed questions, and false reassurance interrupt therapeutic communication.
A client with schizophrenia says, 'The voices are telling me I am worthless.' Which response is most therapeutic?
- a.The voices are not real, so ignore them
- b.I do not hear the voices, but I understand they seem real and upsetting to you✓
- c.What exactly are the voices telling you to do?
- d.You should not listen to those voices
The nurse presents reality without arguing and acknowledges the client's experience and distress. Denying the client's perception or dismissing it damages trust.
A nurse is caring for a client in the manic phase of bipolar disorder. Which intervention supports the client's needs?
- a.Encourage participation in a competitive group activity
- b.Serve large meals at a communal table
- c.Provide a calm, low-stimulation environment and finger foods✓
- d.Schedule several stimulating activities back to back
During mania, clients are easily overstimulated and may not sit to eat. A low-stimulation environment and portable, high-calorie finger foods support rest and nutrition.
A client discloses a history of intimate partner violence. What is the nurse's priority action?
- a.Advise the client to leave the relationship immediately
- b.Contact the partner to discuss the situation
- c.Tell the client the abuse is not their fault and end the conversation
- d.Assess the client's immediate safety and provide resources✓
Assessing immediate safety and offering resources respects autonomy while protecting the client. Directing the client to leave or contacting the partner can increase danger.
A nurse is supporting a client through the stages of grief. A client who says, 'If I had only gone to the doctor sooner' is likely in which stage?
- a.Bargaining✓
- b.Denial
- c.Acceptance
- d.Anger
Statements involving 'if only' and attempts to undo the loss reflect the bargaining stage of grief. Recognizing the stage helps the nurse respond supportively.
A client with alcohol use disorder is 12 hours into withdrawal. Which finding requires immediate attention?
- a.Mild hand tremors
- b.Seizure activity✓
- c.Requests for a cigarette
- d.Increased appetite
Seizures during alcohol withdrawal are a medical emergency and require immediate intervention. Mild tremors are common early findings but are less urgent.
A nurse is caring for a client experiencing acute confusion (delirium). Which intervention is most appropriate?
- a.Keep the room dark and quiet at all times
- b.Restrain the client to prevent wandering
- c.Frequently reorient the client and provide familiar objects✓
- d.Rotate caregivers frequently to provide variety
Frequent reorientation, familiar objects, and consistent caregivers reduce confusion in delirium. Restraints and frequent caregiver changes can worsen agitation.
A client is angry and shouting at the nurse about a delayed procedure. Which response best de-escalates the situation?
- a.You need to lower your voice right now
- b.There is nothing I can do about the schedule
- c.If you keep yelling, I will have to leave
- d.I can see you are frustrated. Let's talk about what is upsetting you✓
Acknowledging the client's feelings and inviting discussion de-escalates anger and builds rapport. Commanding or threatening the client escalates the conflict.
A nurse is assessing a client for postpartum depression. Which finding warrants further evaluation?
- a.Persistent sadness and disinterest in the infant after three weeks✓
- b.Occasional tearfulness that resolves within two weeks
- c.Fatigue related to nighttime feedings
- d.Excitement about caring for the newborn
Persistent sadness and lack of interest in the infant beyond two weeks suggest postpartum depression rather than transient baby blues, and require further evaluation and support.
A nurse cares for a dying client's family. Which action best supports the family during end-of-life care?
- a.Limiting visiting hours to reduce fatigue
- b.Providing privacy and encouraging expression of feelings✓
- c.Avoiding discussion of the client's condition
- d.Encouraging the family to stay positive at all times
Providing privacy and encouraging the family to express feelings supports coping during end-of-life care. Restricting presence and avoiding honest discussion isolate the family.