Question

Which reason would the nurse include in a response to a client with rheumatoid arthritis who asks the nurse why it is necessary to inject hydrocortisone into the knee joint?

Answer 1

Correct Answers:

Reduces inflammation

Rationale :

🧪Intra-articular hydrocortisone is indicated to decrease synovial inflammation, which is a core driver of pain and swelling in rheumatoid arthritis flares.

🦵By suppressing pro-inflammatory cytokines locally, it reduces joint effusion and improves short-term range of motion.

⏱️The benefit is rapid symptom relief during an acute flare, complementing long-term DMARD therapy that treats disease activity systemically.

🎯Targeted injection limits systemic exposure, focusing the anti-inflammatory effect within the affected joint for quicker functional improvement.

📌Core Message

Local glucocorticoid injection primarily reduces synovial inflammation, providing rapid relief of pain and swelling in an RA flare.

Answer 2

Correct Answers:

Having suicidal ideation
Exhibiting tearfulness
Having poor muscle tone
Avoiding previously enjoyed activities and relationships

Rationale :

🧠Adolescent depression commonly includes suicidal ideation, reflecting profound mood disturbance and must always trigger safety assessment.

😢Frequent tearfulness is a typical affective symptom, signaling sustained sadness and impaired emotional regulation.

🚫Loss of interest and social withdrawal from previously enjoyed activities indicates anhedonia, a hallmark of major depressive episodes.

🩺These features align with diagnostic patterns of depressive disorders in youth, guiding screening, risk evaluation, and timely intervention.

📌Core Message

Adolescent depression often presents with suicidal ideation, tearfulness, and anhedonia/social withdrawal, warranting prompt risk assessment.

Answer 3

Correct Answers:

Toilet the client more frequently with supervision.

Rationale :

🛗For confused, anxious clients, scheduled and supervised toileting addresses cognitive impairment and reduces accidents.

🧭This approach is nonpunitive and supports dignity, avoiding interventions that could worsen confusion or agitation.

🔁Regular toileting is a proven behavioral strategy in continence care, adapting to impaired awareness of bodily cues.

🧼It also promotes infection prevention and unit safety, minimizing falls and exposure to contaminated surfaces.

📌Core Message

Implement scheduled, supervised toileting—a dignified, preventive strategy for confused clients to reduce accidents.

Answer 4

Correct Answers:

Warm and firm without being punitive

Rationale :

🧩Clients with antisocial traits need consistent limits with a firm, nonpunitive stance to reduce manipulation and maintain safety.

🗣️A professional warmth helps engage the client while preserving boundaries and avoiding power struggles.

📏Clear expectations and consequences delivered calmly promote accountability without shaming.

🛡️This balance supports therapeutic alliance while protecting staff and peers through structured interactions.

📌Core Message

Use a consistent, firm, yet nonpunitive approach that maintains boundaries and fosters engagement.

Answer 5

Correct Answers:

Help the client understand that the behavior is caused by maladaptive coping with increased anxiety.

Rationale :

🧠Rituals in OCD are compulsions that function as maladaptive coping to reduce anxiety from intrusive obsessions.

📚Psychoeducation linking anxiety to compulsions builds insight, a foundation for CBT strategies like exposure and response prevention.

🧭Understanding this mechanism increases motivation to practice response prevention, reducing ritual strength over time.

🛠️This intervention aligns with evidence-based care, integrating education, skills training, and therapy for sustainable change.

📌Core Message

Teach that rituals are maladaptive anxiety-coping behaviors to build insight and support CBT/ERP engagement.

Answer 6

Correct Answers:

Mild

Rationale :

📈Mild anxiety heightens alertness and attention, which facilitates learning and problem-solving.

🧠At this level, cognitive processing is sharpened rather than impaired, supporting memory and task focus.

🪙Conversely, escalating to moderate–severe anxiety narrows the perceptual field, hindering learning.

🎯Teaching is most effective when the client is at mild anxiety, leveraging optimal arousal without overwhelm.

📌Core Message

Mild anxiety enhances attention and cognition, making it the best level for learning.

Answer 7

Correct Answers:

Assisting the client in developing new coping mechanisms

Rationale :

🧠Physical symptoms under stress often reflect somatic manifestation of psychological distress, calling for coping skills training.

🧰Teaching adaptive coping (relaxation, problem-solving, cognitive reframing) reduces symptom frequency and intensity.

🧭This empowers self-management, decreasing dependence on health services while improving functioning.

🔄Skill development targets the underlying stress-response cycle, promoting long-term resilience rather than temporary relief.

📌Core Message

Build adaptive coping mechanisms to address somatization at its stress-response source.

Answer 8

Correct Answers:

Allow the behavior to continue for a specified time, letting the client help set the time limits to be imposed.

Rationale :

🕰️Time-limited allowance uses response prevention principles gradually, reducing ritual dependency without abrupt escalation of anxiety.

🤝Collaborative limit-setting enhances control and engagement, lowering distress and resistance to change.

📉Structured exposure with negotiated limits supports habit reversal and strengthens tolerance for incompleteness.

🧭This approach aligns with CBT for OCD, balancing validation of distress with behavioral shaping toward flexibility.

📌Core Message

Apply collaborative, time-limited rituals to support ERP, building tolerance and reducing compulsions.

Answer 9

Correct Answers:

Has overwhelming feelings of anxiety

Rationale :

🌊Interrupting rituals spikes anxiety, because compulsions temporarily neutralize obsessions and uncertainty.

🧠The anger reflects an acute stress response to blocked compulsive relief, not hostility toward staff.

🔗Rituals are negatively reinforced by anxiety reduction; interruption removes the reinforcer, amplifying distress.

🛟Understanding this mechanism guides supportive coaching and gradual response prevention to manage the surge.

📌Core Message

Anger after interruption stems from surging anxiety when compulsive relief is blocked.

Answer 10

Correct Answers:

"You're concerned about what other people are thinking about you."

Rationale :

🪞This statement uses reflection, a therapeutic technique that validates feelings and invites further exploration.

🧠It targets the client’s cognitive distortions about others’ judgments, opening space for reframing.

🤝Reflective listening strengthens rapport and encourages insight without minimizing the client’s experience.

🧭By naming the underlying concern, the nurse guides the client toward cognitive-behavioral work on shame and guilt.

📌Core Message

Employ reflective listening to validate feelings, address distortions, and foster insight.

1 :
Which reason would the nurse include in a response to a client with rheumatoid arthritis who asks the nurse why it is necessary to inject hydrocortisone into the knee joint?

2 :
Which characteristic is commonly associated with adolescent depression? Select all that apply.

3 :
Which action would the nurse take when a confused and anxious client voids on the floor in the sitting room of the mental health unit?

4 :
Which consistent approach would the nurse use for a client diagnosed with an antisocial personality disorder?

5 :
Which intervention would the nurse add to the plan of care for a client who engages in ritualistic behavior?

6 :
Which level of anxiety enhances the client's learning abilities?

7 :
Which nursing intervention would help a client who exhibits physical symptoms when stressed?

8 :
Which action would the nurse take for a client with an obsessive-compulsive disorder who continually walks up and down the hall, touching every other chair and becomes upset if interrupted?

9 :
Which reason would be likely for a client's anger and acting out when the nurse interrupts the hand-washing ritual of a client with obsessive-compulsive disorder?

10 :
Which response would the nurse make to a client who says, "l feel so guilty. None of this makes any sense. Everyone must really think I'm crazy," after performing a complex ritual?

1 : Which reason would the nurse include in a response to a client with rheumatoid arthritis who asks the nurse why it is necessary to inject hydrocortisone into the knee joint?

2 : Which characteristic is commonly associated with adolescent depression? Select all that apply.

3 : Which action would the nurse take when a confused and anxious client voids on the floor in the sitting room of the mental health unit?

4 : Which consistent approach would the nurse use for a client diagnosed with an antisocial personality disorder?

5 : Which intervention would the nurse add to the plan of care for a client who engages in ritualistic behavior?

6 : Which level of anxiety enhances the client's learning abilities?

7 : Which nursing intervention would help a client who exhibits physical symptoms when stressed?

8 : Which action would the nurse take for a client with an obsessive-compulsive disorder who continually walks up and down the hall, touching every other chair and becomes upset if interrupted?

9 : Which reason would be likely for a client's anger and acting out when the nurse interrupts the hand-washing ritual of a client with obsessive-compulsive disorder?

10 : Which response would the nurse make to a client who says, "l feel so guilty. None of this makes any sense. Everyone must really think I'm crazy," after performing a complex ritual?

1 :
Which reason would the nurse include in a response to a client with rheumatoid arthritis who asks the nurse why it is necessary to inject hydrocortisone into the knee joint?

2 :
Which characteristic is commonly associated with adolescent depression? Select all that apply.

3 :
Which action would the nurse take when a confused and anxious client voids on the floor in the sitting room of the mental health unit?

4 :
Which consistent approach would the nurse use for a client diagnosed with an antisocial personality disorder?

5 :
Which intervention would the nurse add to the plan of care for a client who engages in ritualistic behavior?

6 :
Which level of anxiety enhances the client's learning abilities?

7 :
Which nursing intervention would help a client who exhibits physical symptoms when stressed?

8 :
Which action would the nurse take for a client with an obsessive-compulsive disorder who continually walks up and down the hall, touching every other chair and becomes upset if interrupted?

9 :
Which reason would be likely for a client's anger and acting out when the nurse interrupts the hand-washing ritual of a client with obsessive-compulsive disorder?

10 :
Which response would the nurse make to a client who says, "l feel so guilty. None of this makes any sense. Everyone must really think I'm crazy," after performing a complex ritual?