Nursing Elites

1. Support-system enhancement includes all of the following except:

• A. determining the barriers to using support systems.
• B. discussing ways to help others who are concerned.
• C. exploring life problems of the support-team members.
• D. involving spouse, family, and friends in the care and planning.

Correct answer: C

Rationale: Support-system enhancement involves various strategies to strengthen the support system. Determining the barriers to using support systems, discussing ways to help others who are concerned, and involving spouse, family, and friends in the care and planning are all essential aspects of enhancing the support system. However, exploring the life problems of the support-team members is not directly related to enhancing the support system. This approach could potentially invade personal boundaries and may not be necessary for improving the support system, making it the correct answer in this case. Therefore, option C is the correct answer as it does not align with the appropriate methods of support-system enhancement.

2. A client reports that he is 'talking to the voices.' The nurse observes this behavior. The nurse's next action should be:

• A. touching the client to help him return to reality
• B. leaving the client alone until reality returns
• C. asking the client to describe what is happening
• D. telling the client there are no voices

Correct answer: A

Rationale: When a client reports talking to voices, the nurse should engage in a gentle touch to help the client return to reality. It is important for the nurse to acknowledge the client's experience and attempt to redirect them gently. Touch can provide grounding and connection. Asking the client to describe what is happening can be overwhelming and might exacerbate the situation. Leaving the client alone may not be safe or therapeutic as the client may need support. Telling the client there are no voices denies their reality and is not helpful in managing their experience.

3. What is a common characteristic of individuals who become batterers?

• A. Grew up in a loving, secure home.
• B. Was an only child.
• C. Was physically or psychologically abused.
• D. Admits they have a problem with anger.

Correct answer: C

Rationale: The correct answer is 'Was physically or psychologically abused.' Research indicates that many individuals who become batterers have a history of being abused themselves. This cycle of abuse can influence their behavior as adults. Choice A is incorrect because growing up in a loving home does not necessarily prevent someone from becoming a batterer. Choice B is incorrect as being an only child is not a determining factor in becoming a batterer. Choice D is incorrect because while admitting to anger issues is a positive step, it is not a common characteristic of individuals who become batterers.

4. A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares. The client reports being raped as a child. The nurse should assess the client for further signs of:

• A. generalized anxiety disorder.
• B. schizophrenia.
• C. post-traumatic stress disorder.
• D. bipolar disorder.

Correct answer: C

Rationale: Given the history of childhood sexual abuse and the presenting symptoms of difficulty concentrating, insomnia, and nightmares, the nurse should assess the client for post-traumatic stress disorder (PTSD). Childhood sexual abuse is strongly associated with adult-onset depression and an increased risk for PTSD. Individuals with PTSD may exhibit re-experiencing symptoms such as flashbacks, nightmares, and heightened reactions to trauma triggers. They may also display emotional numbing, avoidance behaviors, and increased arousal symptoms like difficulty sleeping and hypervigilance. Generalized anxiety disorder (Choice A) is characterized by excessive worry and anxiety about various events or activities, not necessarily tied to a specific trauma. Schizophrenia (Choice B) is a severe mental disorder characterized by distortions in thinking, perception, emotions, and behavior, unrelated to the traumatic event described. Bipolar disorder (Choice D) involves mood swings between depressive and manic episodes, and its symptoms differ from those typically seen in PTSD.

5. In the context of milieu therapy, what is its primary purpose?

• A. exploring the client's perception of reality
• B. enhancing social interaction abilities
• C. addressing maladaptive behaviors
• D. providing routine daily experiences

Correct answer: D

Rationale: Milieu therapy aims to provide routine daily experiences to clients. By offering a structured and predictable environment, it helps individuals feel safe and secure, reducing disruptive behaviors. Exploring the client's perception of reality (choice A) may be part of therapy but not the primary focus. Enhancing social interaction abilities (choice B) and addressing maladaptive behaviors (choice C) are important aspects of therapy but not the primary purpose of milieu therapy.

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