Nursing Elites

1. When a husband accuses his wife of infidelity, which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?

• A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
• B. The husband ignores the wife's continued absence from the home.
• C. The husband has already admitted to having an affair with a coworker.
• D. The husband takes out his marital frustrations through employee abuse.

Correct answer: C

Rationale: Projection is a defense mechanism where one attributes their unacceptable feelings or impulses to another person. In this scenario, the husband, by admitting to having an affair with a coworker, is projecting his infidelity onto his wife, indicating the use of the projection defense mechanism. Choice A is incorrect as it describes a different behavior, not projection. Choice B does not demonstrate projection but rather avoidance or denial. Choice D shows displacement of aggression, not projection.

2. In what order should the following goals be approached for a client being treated for alcoholism?

• A. Learning about dependence and recovery; abstinence and development of a support system; attaining physiological stabilization; developing alternative coping skills
• B. Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system
• C. Abstinence and development of a support system; attaining physiological stabilization; learning about dependence and recovery; developing alternative coping skills
• D. Abstinence and development of a support system; learning about dependence and recovery; attaining physiological stabilization; developing alternative coping skills

Correct answer: B

Rationale: When treating a client for alcoholism, it is important to follow a structured approach to maximize treatment effectiveness. The correct order of approaching goals is to first help the client in developing alternative coping skills to manage triggers and stressors without relying on alcohol. This is followed by attaining physiological stabilization, which involves addressing any physical health issues related to alcoholism. Next, the client should learn about dependence and recovery to understand the nature of their condition and the process of recovery. Finally, the goals of abstinence and developing a support system come into play to ensure long-term sobriety and a reliable network of support. Therefore, the correct order is: Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system.

3. How do epidemiological studies contribute to improvements in care for individuals with mental disorders?

• A. Providing information about effective nursing techniques.
• B. Identifying risk factors that contribute to the development of a disorder.
• C. Identifying individuals in the general population who will develop a specific disorder.
• D. Identifying which individuals will respond favorably to a specific treatment.

Correct answer: B

Rationale: Epidemiological studies play a crucial role in identifying risk factors associated with the development of mental disorders. By pinpointing these risk factors, healthcare providers can implement preventive measures and develop more effective treatments, ultimately leading to improved care for individuals with mental disorders.

4. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

• A. Projection
• B. Rationalization
• C. Regression
• D. Sublimation

Correct answer: B

Rationale: The correct answer is Rationalization. The client is using rationalization as a defense mechanism by justifying their excessive drinking as a way to relax due to working hard to provide for their family. Rationalization involves creating logical excuses to justify unacceptable feelings or behaviors. Projection involves attributing one's unacceptable feelings or thoughts to others. Regression is reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. Sublimation is the channeling of unacceptable impulses into socially acceptable activities.

5. A patient with social anxiety disorder is prescribed propranolol. The nurse understands that this medication is used primarily to:

• A. Reduce anxiety symptoms
• B. Improve mood
• C. Increase energy levels
• D. Enhance social interactions

Correct answer: A

Rationale: The correct answer is A: Reduce anxiety symptoms. Propranolol, a beta-blocker, is primarily used to reduce physical symptoms of anxiety, such as rapid heartbeat and trembling, in patients with social anxiety disorder. It does not directly affect mood, energy levels, or social interactions. Choice B is incorrect because propranolol does not target mood improvement. Choice C is incorrect because propranolol does not aim to increase energy levels. Choice D is incorrect because propranolol does not enhance social interactions; its primary role is in reducing physical symptoms of anxiety.

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