Title RECALLS 7 - NP4 - SC ✅

Situation: You are evaluating nursing practices during an ethics audit in a tertiary hospital. Your focus is to ensure nurses understand when multiple principles overlap. 36. A nurse explains risks and benefits of a clinical trial and gives the patient time to decide. This demonstrates which principles? A. Fidelity and privacy B. Veracity and autonomy C. Justice and beneficence D. Non-maleficence and fidelity 37. A nurse refuses to share a client’s HIV status with a friend who asks. Which ethical principle is prioritized? A. Justice B. Privacy and confidentiality C. Beneficence D. Autonomy 38. A nurse positions side rails and keeps the bed in the lowest position for a confused client. Which principle is demonstrated? A. Beneficence B. Autonomy C. Justice D. Fidelity 39. During discharge teaching, the nurse notices the client is drowsy and defers teaching to a later time. This respects which principle? A. Justice B. Fidelity C. Autonomy D. Non-maleficence 40. A nurse ensures each patient gets pain medication on time, regardless of how busy the shift is. Which ethical principle is at work? A. Justice B. Autonomy C. Privacy D. Veracity Situation: You are assigned to the psychiatric unit, caring for clients with schizophrenia, mood disorders, and suicidal risk. You must prioritize safety while using therapeutic communication techniques. 41. Which therapeutic communication technique is used when a nurse says, “Tell me more about what happened before you felt anxious”? A. Giving advice B. Exploring C. Belittling feelings D. Reassuring 42. A client states, “I want to end my life.” What is the nurse’s priority? A. Ask, “Why do you feel this way?” B. Confront the client about their choices C. Ask directly if there is a specific plan D. Offer to distract the client with an activity 43. Which symptom is most associated with command auditory hallucinations? A. The client repeatedly washes hands B. The client hears voices telling them to act C. The client expresses irrational fear of strangers D. The client avoids eye contact and becomes mute 44. A client says, “The TV is sending me secret messages.” Which is the nurse’s best response? A. “That’s impossible, the TV cannot do that.” B. “It seems like you feel concerned about the messages.” C. “We need to remove the TV from your room immediately.” D. “Why do you think the TV is sending messages?” 45. Which finding is considered a negative symptom of schizophrenia? A. Hearing voices B. Flat affect C. Grandiose delusions D. Disorganized speech Situation: You are caring for clients with bipolar disorder and major depression. Your role includes medication management, suicide precautions, and client teaching. 46. Which client statement indicates understanding of lithium therapy? A. “I will double my dose if I feel manic.” B. “I need to keep my salt and fluid intake consistent.” C. “I should stop taking lithium if I feel tremors.” D. “This drug will work instantly for my mood swings.” 47. What is the therapeutic serum lithium level? A. 0.1–0.4 mEq/L B. 0.5–1.5 mEq/L C. 2.0–3.0 mEq/L D. >3.5 mEq/L 48. Which behavior is characteristic of a manic episode? A. Withdrawn, decreased energy, low self-esteem B. Flight of ideas, decreased sleep, risky behavior C. Repetitive hand-washing and counting rituals D. Tearfulness and social isolation 49. What is the primary nursing goal for a severely depressed client? A. Encourage group participation B. Promote safety and assess suicide risk C. Discuss long-term employment goals D. Teach complex coping strategies 50. Which food should a client on MAOI avoid?\ A. Fresh bananas B. Aged cheddar cheese C. Baked chicken breast D. Rice and steamed vegetables Situation: You are assigned to clients with eating disorders and mood disorders. Your priority is to recognize complications, promote safety, and reinforce therapeutic interventions. 51. A client with bulimia nervosa most likely exhibits which physical finding? A. Low BMI and lanugo hair B. Dental erosion and parotid swelling C. Amenorrhea and osteoporosis D. Hyperpigmentation and alopecia 52. A nurse encourages a depressed client to join a morning group activity. This demonstrates which therapeutic strategy? A. Confrontation B. Behavioral activation C. Cognitive reframing D. Systematic desensitization 53. Which is an expected finding in PTSD? A. Amnesia for identity and relationships B. Recurrent intrusive memories and hypervigilance C. Social detachment only D. Delusions of persecution 54. Which statement by a client taking sertraline requires further teaching? A. “I may not feel better for several weeks.” B. “I should avoid abruptly stopping the medication.” C. “It’s okay to take St. John’s Wort for added effect.” D. “I might have some sexual side effects.” 55. A nurse is using motivational interviewing with a client who abuses substances. Which statement reflects this technique? A. “You must quit now or face the consequences.” B. “Tell me what you like and dislike about your substance use.” C. “If you don’t stop, you could die.” D. “You know using is wrong, don’t you?” Situation: You are managing clients with withdrawal syndromes, suicide risk, and severe anxiety episodes. Quick recognition and immediate safety measures are essential 56. The nurse cares for a client in methamphetamine withdrawal. Which symptom is expected? A. Euphoria and hyperactivity B. Severe depression and fatigue C. Seizures and vomiting D. Violent hallucinations 57. Which is a priority outcome for a suicidal client? A. Expressing reasons for living 3 | Page
B. Demonstrating mood improvement in one week C. Verbalizing no plan for self-harm D. Participating in recreational activities 58. Which medication is most likely prescribed for acute alcohol withdrawal? A. Disulfiram B. Lorazepam C. Haloperidol D. Lithium 59. A nurse notes a client smiling while reporting sadness and hopelessness. This is known as: A. Flat affect B. Incongruent affect C. Restricted affect D. Blunted affect 60. A nurse teaching a group about stress explains that the fight-or-flight response initially causes: A. Bradycardia and pupil constriction B. Increased HR, BP, and dilated pupils C. Increased digestion and urine output D. Decreased blood glucose and muscle tension Situation: You are caring for clients with schizophrenia and psychotic disorders. Your role includes recognizing priority symptoms, preventing harm, and reinforcing medication adherence. 61. Which is the best response to a client experiencing auditory hallucinations? A. “I hear the voices too.” B. “That’s not real, ignore them.” C. “I know the voices seem real to you; what are they saying?” D. “You need to focus on reality now.” 62. Which assessment finding indicates benzodiazepine toxicity? A. Hyperreflexia and hypertension B. Respiratory depression and confusion C. Tinnitus and blurry vision D. Abdominal cramps and diarrhea 63. A client with dementia suddenly becomes more confused at night. This is called: A. Echolalia B. Perseveration C. Sundowning D. Confabulation 64. A nurse is reinforcing teaching about buspirone. Which statement indicates understanding? A. “I can take it as needed for anxiety attacks.” B. “It will start working in 1–2 days.” C. “I might feel dizzy but it’s not addictive.” D. “I need to avoid grapefruit juice.” 65. Which finding indicates serotonin syndrome? A. Hypothermia and depression B. Muscle rigidity, high fever, and confusion C. Bradycardia and excessive sleepiness D. Enlarged pupils and orthostatic hypotension Situation: You are addressing cognitive disorders and side effects of psychotropic medications, focusing on early complication detection and therapeutic approaches. 66. A nurse notices a client with dementia fabricating stories. This is known as: A. Perseveration B. Confabulation C. Flight of ideas D. Circumstantiality 67. Which therapeutic approach is best for a paranoid client refusing food? A. Offer food in sealed containers B. Force-feed for nutrition\ C. Ignore food concerns and focus on medication D. Restrict interaction until trust is gained 68. A nurse suspects neuroleptic malignant syndrome (NMS). Which symptom supports this? A. Sudden severe hypertension and headache B. High fever, muscle rigidity, altered consciousness C. Pinpoint pupils and respiratory depression D. Flushed skin and diarrhea 69. Which intervention is most appropriate for a client with moderate anxiety? A. Use a calm voice and explore feelings B. Avoid discussion until anxiety subsides C. Provide written instructions only D. Confront all irrational thoughts immediately 70. Which sign is associated with alcohol withdrawal rather than intoxication? A. Slurred speech and unsteady gait B. Bradycardia and hypotension C. Tremors and hypertension D. Pinpoint pupils and drowsiness Situation: You are assigned to clients with mood disorders, substance abuse issues, and risk for harm to self or others. Early identification and safety measures are essential. 71. A client in lithium therapy develops diarrhea, tremors, and confusion. What is the priority action? A. Document and continue monitoring B. Give an anti-diarrheal and fluids C. Hold the lithium and notify the provider D. Encourage a salty snack 72. Which behavior is expected in borderline personality disorder? A. Rigid perfectionism B. Intense, unstable relationships and fear of abandonment C. Lack of remorse for wrongdoing D. Detachment and restricted emotions 73. Which client statement reflects improved coping after depression treatment? A. “I still don’t feel like doing anything.” B. “I called a friend to go for a walk.” C. “Nothing will ever change for me.” D. “I can’t make any decisions.” 74. Which lab must be monitored for clients on valproic acid? A. Liver function tests B. Renal function C. Electrolytes D. Thyroid function tests 75. A client taking clozapine develops fever and sore throat. What is the priority action? A. Administer acetaminophen and fluids B. Hold the medication and get a CBC C. Reassure and continue treatment D. Schedule an outpatient follow-up Situation: You are working in an ICU responding to multiple cardiac arrests. Your role includes medication preparation, safe administration, and understanding their effects during code situations. 76. During a cardiac arrest, the first-line medication for asystole is: A. Epinephrine B. Amiodarone C. Atropine D. Dopamine 77. Which statement best explains the action of epinephrine during cardiac arrest? A. Increases vagal tone and decreases HR B. Enhances myocardial contractility and peripheral vasoconstriction C. Slows conduction through the AV node D. Decreases myocardial oxygen demand 78. The recommended route for epinephrine during code if IV/IO access is unavailable is: A. Oral B. Endotracheal (ET) tube C. Intramuscular deltoid D. Subcutaneous 79. What is the primary indication for atropine during a code? A. Ventricular fibrillation B. Pulseless electrical activity C. Symptomatic bradycardia D. Supraventricular tachycardia 80. Amiodarone is used during ACLS primarily for: A. Refractory VF/pulseless VT 4 | Page