Nursing Elites

1. Implementing counseling by the nurse specialist for the raped victim represents:

• A. assessment.
• B. crisis intervention.
• C. empathetic concern.
• D. unwarranted intrusion.

Correct answer: B

Rationale: Choice B, crisis intervention, is the correct answer. Counseling by a nurse specialist in a rape crisis situation is a form of crisis intervention, which is part of the Crisis Intervention Model. It aims to provide immediate support and help the victim cope with the traumatic event. Empathetic concern (Choice C) is important but refers more to the nurse's attitude rather than the specific action described. Assessment (Choice A) typically involves gathering information and may have already been done before counseling. Unwarranted intrusion (Choice D) is not applicable here as the counseling is provided to support the victim in a professional and caring manner.

2. The nurse wishes to decrease a client's use of denial and increase the client's expression of feelings. To do this, the nurse should:

• A. tell the client to stop using the defense mechanism of denial.
• B. positively reinforce each expression of feelings.
• C. instruct the client to express feelings.
• D. challenge the client each time denial is used.

Correct answer: B

Rationale: In the scenario provided, the nurse aims to reduce the client's use of denial and encourage the expression of feelings. Positive reinforcement for each expression of feelings is an effective approach to achieve this goal. By positively reinforcing the client's expression of feelings, the nurse encourages the desired behavior, making it more likely for the client to continue sharing their emotions. This approach creates a supportive and accepting environment for the client. In contrast, telling the client to stop using denial (Choice A) may create resistance and inhibit communication by putting pressure on the client. Instructing the client to express feelings (Choice C) is less effective as it lacks the element of reinforcement that is essential for behavior modification. Challenging the client each time denial is used (Choice D) may lead to defensiveness and hinder the therapeutic relationship, making it a less favorable option.

3. While admitting a client to an acute-care psychiatric unit, the nurse asks about substance abuse based on:

• A. psychiatric disorders' higher prevalence in addicted populations
• B. individuals with psychiatric disorders' increased susceptibility to substance abuse
• C. the importance of detecting and diagnosing substance disorders in acute-care psychiatric settings
• D. the significant impact of undetected substance problems on the treatment of psychiatric disorders

Correct answer: B

Rationale: The correct answer is 'individuals with psychiatric disorders' increased susceptibility to substance abuse.' It is crucial to inquire about substance abuse during admission to an acute-care psychiatric unit because individuals with psychiatric disorders are more prone to experiencing substance abuse issues. Addressing substance abuse is vital for effective treatment and to prevent relapse in psychiatric disorders. Option A is incorrect as it focuses on the prevalence of psychiatric illness in addicted populations rather than the relationship between psychiatric disorders and substance abuse. Option C is incorrect as it exaggerates the ease of detecting and diagnosing substance disorders in acute-care psychiatric settings. Option D is incorrect as undetected substance problems can indeed significantly impact the treatment of psychiatric disorders, but the main reason for inquiring about substance abuse is the increased susceptibility of individuals with psychiatric disorders to such issues.

4. Social support systems include all of the following except:

• A. call-in help lines
• B. emotional assistance provided by others
• C. community support groups
• D. use of coping skills and verbalization for anger management

Correct answer: D

Rationale: Social support systems involve external sources of support like call-in help lines, emotional assistance from others, and community support groups. These external resources provide individuals with assistance and comfort. Coping skills and verbalization for anger management are personal strategies that individuals use to manage emotions internally. While these skills can be beneficial, they are not considered part of external social support systems.

5. Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?

• A. "Will my retirement funds outlast me?"?
• B. "Who will handle my funeral arrangements?"?
• C. "What will become of Jonathan when I am gone?"?
• D. "How can I communicate effectively with Jonathan's physician?"?

Correct answer: C

Rationale: The most prominent concern for Mrs. Owens is likely what will happen to her son, Jonathan, after she passes away. While retirement fund sustainability is important, it is not likely to be her primary concern. Funeral arrangements, although significant, are secondary to the welfare of her son with schizophrenia. The question of how to communicate with Jonathan's physician is less likely to be a predominant concern since Mrs. Owens has likely already addressed this issue over the 38 years of managing her son's care.

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