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. Which drug group requires nursing assessment for the development of abnormal movement disorders in individuals taking therapeutic dosages?

• A. SSRIs
• B. Antipsychotics
• C. Benzodiazepines
• D. Tricyclic antidepressants

Correct answer: B

Rationale: Antipsychotics are known to cause extrapyramidal symptoms, which manifest as abnormal movement disorders. Nursing assessments are crucial in monitoring patients taking antipsychotics to promptly identify and manage these potential side effects.

3. A client diagnosed with OCD spends hours bathing and grooming. During a one-on-one interaction, the client discusses the rituals in detail but avoids any feelings that the rituals generate. Which defense mechanism should the nurse identify?

• A. Dissociation
• B. Rationalization
• C. Sublimation
• D. Intellectualization

Correct answer: D

Rationale: Intellectualization is a defense mechanism where an individual focuses on rational, logical explanations to distance themselves from uncomfortable emotions. In this scenario, the client discusses the OCD rituals in a detailed and analytical manner, avoiding the emotional aspects associated with them. This behavior reflects intellectualization rather than dissociation, rationalization, or sublimation. Dissociation involves a disconnection from reality, rationalization is the attempt to justify behaviors, and sublimation is redirecting unacceptable impulses into socially acceptable activities.

4. A healthcare professional is assessing a client with obsessive-compulsive disorder (OCD). Which of the following findings shouldn't the healthcare professional expect?

• A. Recurrent, intrusive thoughts
• B. Compulsive behaviors
• C. Delusions of grandeur
• D. Avoidance of situations that trigger obsessions

Correct answer: C

Rationale: In obsessive-compulsive disorder (OCD), common findings include recurrent, intrusive thoughts (obsessions), compulsive behaviors, and avoidance of situations that trigger obsessions. Delusions of grandeur, which involve having an exaggerated sense of power, importance, or identity, are not typically associated with OCD. It is important to differentiate between the specific characteristics of OCD and other mental health conditions to provide accurate care and interventions for clients.

5. A healthcare provider is providing education to the family of a client who has been diagnosed with bipolar disorder. Which of the following instructions should the healthcare provider include?

• A. The client should avoid all stressful situations.
• B. Encourage the client to get plenty of rest.
• C. Make sure the client takes prescribed medications regularly.
• D. Provide the client with information about support groups.

Correct answer: C

Rationale: The correct answer is C: 'Make sure the client takes prescribed medications regularly.' Consistent medication adherence is crucial in managing the symptoms and stabilizing mood in individuals with bipolar disorder. Choice A is incorrect because avoiding all stressful situations is often not feasible and not the primary treatment approach for bipolar disorder. Choice B, while important, is not as critical as ensuring medication compliance. Choice D is helpful but not as essential as medication adherence for the treatment of bipolar disorder.

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