Nursing Elites

1. A client who has multiple sclerosis is admitted to the hospital with increasingly frequent and severe exacerbations. One day, the client's partner confides to the nurse, 'Life is getting very hard and depressing, and I am upset with myself for thinking about a nursing home.' After listening to the partner's concerns, which response would the nurse make?

• A. 'Joining a support group of people who are coping with this situation may be helpful.'
• B. 'You may be able to decrease your feelings of guilt by seeking counseling.'
• C. 'It would be helpful if you became involved in volunteer work at this time.'
• D. 'I recognize it's hard to deal with, but try to remember that this, too, shall pass.'

Correct answer: A

Rationale: Joining a support group of individuals facing similar circumstances can provide valuable support and the opportunity to share experiences, making it the most appropriate response. The response suggesting counseling to decrease feelings of guilt is premature because the partner did not directly express guilt and it may not be the most immediate need. Suggesting involvement in volunteer work at this time fails to address the partner's current emotional distress and may come across as dismissive. Offering false reassurance by stating 'this, too, shall pass' does not validate the partner's feelings and minimizes the seriousness of their concerns.

2. When developing Jerry's plan of care, which of the following would NOT be helpful to include?

• A. Limiting choices
• B. Providing structure
• C. Encouraging patient input
• D. Ensuring availability of PRN medications

Correct answer: A

Rationale: Limiting choices would not be helpful in Jerry's plan of care. Providing options, even if among limited choices, offers the patient a sense of independence rather than imposing control. Providing structure is crucial, especially in transitioning from a psychiatric to a medical-surgical unit. Encouraging patient input in identifying triggers and effective methods for managing aggressive impulses is essential for empowerment and individualized care. Ensuring the availability and prompt delivery of PRN medications gives the patient a sense of control and security, assuring access to necessary medication when needed.

3. Which defense mechanism is considered a conscious measure used to cope with anxiety?

• A. Undoing
• B. Projection
• C. Suppression
• D. Intellectualization

Correct answer: C

Rationale: The correct answer is Suppression. Suppression is a conscious defense mechanism in which an individual intentionally avoids thinking about disturbing problems, wishes, feelings, or experiences. It is a way to cope with anxiety by actively pushing aside unwanted thoughts or emotions. Undoing, on the other hand, is an unconscious defense mechanism where one uses words or behaviors to symbolically make amends for unacceptable thoughts or actions. Projection is also an unconscious defense mechanism involving falsely attributing one's own unacceptable impulses to others. Intellectualization, another unconscious defense mechanism, involves using intellect or thinking to avoid dealing with emotionally charged feelings.

4. Which is a true statement regarding stress related disorders?

• A. Stress related disorders are only caused by stress
• B. Symptoms of stress related disorders would not exist if the client was not experiencing stress
• C. Stress related disorders are also called psycho-physiologic disorders
• D. None of the above

Correct answer: C

Rationale: The correct answer is that stress related disorders are also called psycho-physiologic disorders. These disorders have a physiologic basis for their development, but stress can exacerbate the symptoms. While stress plays a significant role in these disorders, they are not solely caused by stress. Choice A is incorrect as stress is a contributing factor rather than the sole cause. Choice B is incorrect because symptoms of stress related disorders can persist even when the individual is not actively experiencing stress. Choice D is incorrect as there is a true statement among the choices, which is that stress related disorders are also known as psycho-physiologic disorders.

5. The nurse is caring for an Asian patient who is being admitted to the hospital. Which action would be most appropriate for the nurse to take when interviewing this patient?

• A. Avoid eye contact with the patient
• B. Observe the patient's use of eye contact
• C. Look directly at the patient when interacting
• D. Ask the patient's family member about the patient's cultural beliefs

Correct answer: B

Rationale: Observing the patient's use of eye contact will be most useful in determining the best way to communicate effectively with the patient. Different cultures have varying norms regarding eye contact, so by observing the patient, the nurse can adapt their communication style accordingly. Looking directly at the patient or avoiding eye contact may not be universally appropriate and could be misinterpreted. Asking a family member about the patient's cultural beliefs is not ideal as cultural beliefs can vary among individuals within the same cultural group. It is best to assess the patient directly to provide culturally sensitive care.

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