Psychosocial Integrity

A licensed practical nurse (LPN) is caring for a client who recently received a terminal prognosis. As the nurse enters the room, the client suddenly becomes verbally aggressive, throws a plastic water pitcher against the wall, and yells, "Get out of here!" Which action should the nurse take first?

A client diagnosed with bipolar disorder is experiencing an acute manic episode on an inpatient psychiatric unit. The client is hyperactive, easily distractible, and repeatedly interrupts other clients' conversations. Which interventions should the practical nurse (PN) implement? (Select all that apply.)

A client with end-stage chronic obstructive pulmonary disease (COPD) is in the final days of life and has completely stopped eating and drinking. The client's spouse is visibly distressed and attempts to force the client to consume a nutritional supplement, stating, "If you do not drink this, you are going to starve to death." Which action is most appropriate for the practical nurse to take?

Match each client clinical presentation with the most appropriate therapeutic communication response that the practical nurse should utilize in that specific situation.

A terminally ill client residing in a skilled nursing facility tells the practical nurse, "I have decided to stop all treatments. I am so tired, but I haven't told my son yet because I know he will be furious." Which of the following responses by the nurse is the most therapeutic?

A client in an inpatient palliative care unit has just been pronounced deceased. The healthcare provider has documented the death, and the family has confirmed they do not wish to request an autopsy. The family members are waiting in the nearby lounge to view the body. Arrange the following post-mortem care actions performed by the practical nurse in the correct chronological order.

During an art therapy session at an intensive outpatient clinic, a client suddenly stands up, throws a chair against the wall, and begins aggressively advancing toward the group facilitator with clenched fists. Which action should the practical nurse (PN) take first?

A young adult client admitted to the behavioral health unit for severe depression stays in their room and states to the practical nurse, "I just do not see the point of trying anymore. Nobody would even notice if I were gone." Which of the following responses by the practical nurse demonstrate effective therapeutic communication? (Select all that apply.)

While completing evening rounds in a mental health facility, a practical nurse (PN) encounters an individual pacing rapidly near the locked exit doors. The individual is hyperventilating, wringing their hands, and repeatedly stating, "I cannot breathe in here, I have to get out before the walls crush me." Which action should the PN take first?

A practical nurse is assisting in a community health clinic. A client, who was just informed by the healthcare provider about a suspicious mass found on a routine screening, is pacing the examination room, wringing their hands, and speaking rapidly. The client states, 'I cannot believe this is happening. What if it is cancer? Who will take care of my children if I am gone?' Which response by the practical nurse is the most therapeutic?

A client admitted for intravenous antibiotic therapy has a documented history of bipolar disorder. Staff observe the client rapidly pacing the unit hallway, singing at a disruptive volume, and actively attempting to remove their hospital gown. Which intervention should the practical nurse implement immediately?

A practical nurse (PN) is caring for a newly admitted client diagnosed with anorexia nervosa. The PN is assisting with the client's first scheduled dinner on the inpatient eating disorders unit. Arrange the following nursing actions in the correct chronological order of implementation.

Following a visit from family members, a client diagnosed with paranoid schizophrenia begins pacing the perimeter of the dayroom, breathing heavily, and aggressively pointing at the ceiling security cameras. Which actions should the practical nurse take to manage this behavior? Select all that apply.

A practical nurse is caring for a client who underwent a traumatic below-the-knee amputation two days ago. While the nurse is preparing to change the surgical dressing, the client turns away and states, "I cannot even bear to look at my leg. Everything I planned for my life is completely ruined." Which response by the practical nurse is most therapeutic?

A client on an inpatient psychiatric unit begins pacing rapidly near the medication room, clenching their fists, and shouting loudly. In what order should the practical nurse implement the following interventions? Arrange the actions in the correct sequence, starting with the immediate priority and progressing from least restrictive to most restrictive.

A male client who observes the Islamic holy month of Ramadan is recovering from an abdominal procedure on a medical-surgical unit. The care plan requires an extensive, painful wound packing change twice daily. When the LPN/LVN brings the scheduled morning oral analgesic, the client declines the medication, explaining that his religious fasting prohibits all oral intake from dawn to sunset. What is the priority nursing action?

During the morning medication pass on an inpatient psychiatric unit, a client with schizophrenia pushes the medication cup away. The client states, "I cannot swallow those. The voices warned me that they are filled with poison." Which response by the practical nurse (PN) is most therapeutic?

An older adult resident at a skilled nursing facility is participating in a scheduled physical therapy session following a total hip arthroplasty. After struggling to complete a walking exercise, the resident abruptly pushes the walker away, shouts at the practical nurse (PN), "You are all incompetent and making me worse!" and refuses to continue. Which actions should the PN take? Select all that apply.

An individual with end-stage renal disease has elected to discontinue hemodialysis and transition to comfort measures. The client's sibling approaches the licensed practical nurse (LPN) and states, "We need to talk him into restarting the treatments. If he just pushes through this temporary depression, I know he will change his mind and fight this." Which of the following is the most therapeutic response by the LPN?

A young adult arrives at a community health clinic for a follow-up visit one week after being diagnosed with type 1 diabetes mellitus. The individual tells the practical nurse, "I did not take any insulin over the weekend. I feel perfectly healthy, and I am certain the laboratory mixed up my blood sample with someone else's." Which of the following is the most therapeutic response for the nurse to make?