Nursing Elites

1. A fourth-grade student teases and makes jokes about a cute girl in his class. This behavior should be identified by a professional as indicative of which defense mechanism?

• A. Displacement
• B. Projection
• C. Reaction formation
• D. Sublimation

Correct answer: C

Rationale: The professional should identify that the student is using reaction formation as a defense mechanism. Reaction formation involves expressing opposite thoughts or behaviors to prevent undesirable thoughts from being expressed. In this scenario, the student's teasing and joking behavior towards the girl can be seen as a way to cover up or mask his true feelings or desires towards her. Displacement involves redirecting emotions from the original source to a substitute target; Projection involves attributing one's undesirable feelings to others; Sublimation involves channeling unacceptable impulses into socially acceptable activities. Therefore, in this case, the student's behavior aligns most closely with reaction formation.

2. A healthcare provider is assessing a client with generalized anxiety disorder (GAD). Which of the following findings should the healthcare provider expect? Select one that does not apply.

• A. Restlessness
• B. Fatigue
• C. Excessive worry
• D. Mania

Correct answer: D

Rationale: In generalized anxiety disorder (GAD), common symptoms include restlessness, fatigue, and excessive worry. These symptoms are typical in individuals with GAD due to persistent and excessive anxiety. Mania, on the other hand, is not a characteristic symptom of GAD. Mania is associated with bipolar disorder and is characterized by distinct features like elevated mood, grandiosity, and impulsivity. Therefore, the correct answer is 'D: Mania,' as it does not align with the expected findings in generalized anxiety disorder.

3. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, 'I'm here for my heart, not my head problems.' What is the nurse's best response?

• A. It's just a routine part of our assessment. All clients are asked these same questions.
• B. Why are you concerned about these types of questions?
• C. Psychological factors, like excessive stress, have been found to affect medical conditions.
• D. We can skip these questions, if you like. It isn't imperative that we complete this section.

Correct answer: C

Rationale: The nurse should educate the client about the impact of psychological factors, such as excessive stress, on medical conditions. Understanding this connection is crucial in providing holistic care. It is essential to address both physiological and psychosocial aspects during the assessment to obtain a comprehensive understanding of the client's health status and needs. Choice A is incorrect as it doesn't address the importance of psychosocial aspects on medical conditions. Choice B is not the best response as it does not provide valuable information about the connection between psychological factors and medical conditions. Choice D is incorrect because skipping these questions could lead to missing crucial information that may impact the client's overall well-being and treatment plan.

4. Which should the individual recognize as an example of the defense mechanism of repression?

• A. A student aware of the need to study for tomorrow's test goes to a movie instead.
• B. A woman whose son was killed in Iraq does not believe the military report.
• C. A man who is unhappily married goes to school to become a marriage counselor.
• D. A woman was raped when she was 12 and no longer remembers the incident.

Correct answer: D

Rationale: Repression is a defense mechanism where distressing thoughts, feelings, or memories are pushed out of conscious awareness to protect the individual from emotional pain. In this scenario, the woman's inability to recall the traumatic event of being raped at the age of 12 indicates repression in action. Choices A, B, and C do not represent repression. Choice A reflects procrastination, choice B suggests denial, and choice C indicates sublimation as the man is channeling his unhappiness into a constructive pursuit.

5. A client diagnosed with major depressive disorder is being educated by a nurse about the use of antidepressants. Which of the following statements by the client indicates a need for further teaching?

• A. I should avoid alcohol while taking this medication.
• B. It may take several weeks for the medication to take effect.
• C. I can stop taking my medication once I feel better.
• D. I should not discontinue the medication abruptly.

Correct answer: C

Rationale: The correct answer is C. The client stating, 'I can stop taking my medication once I feel better,' indicates a need for further teaching. It is crucial for clients with major depressive disorder to understand that they should continue taking their medication as prescribed even if they start feeling better. Stopping the medication prematurely can lead to a relapse of symptoms. Choices A, B, and D are correct statements. Avoiding alcohol while taking antidepressants helps prevent interactions and side effects. Understanding that it may take several weeks for the medication to show its full effect is important for managing expectations. Additionally, not discontinuing the medication abruptly is crucial to prevent withdrawal effects or a recurrence of depressive symptoms.

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