Nursing Elites

1. A new mother with class II heart disease tells the nurse that she is afraid her heart condition will prevent her from caring for her baby at home when she is discharged. How would the nurse respond?

• A. Suggest that the client arrange for help at home
• B. Ask the client to describe her concerns more fully
• C. Tell the client to speak to her primary health care provider about her concerns
• D. Recommend that the client schedule times when family members can assist her

Correct answer: B

Rationale: When a client expresses fear or concern, it is essential for the nurse to first explore and understand the client's feelings and worries. Asking the client to describe her concerns more fully allows the nurse to gather more information, which is crucial in providing appropriate support and guidance. Suggesting that the client arrange for help at home is presumptuous and may not align with the client's preferences or resources. Telling the client to speak to her primary health care provider shifts the responsibility and does not directly address the client's immediate fears. Recommending that she schedule times when family members can assist her assumes the availability and willingness of family members without addressing the client's emotional needs and fears directly.

2. Which nurse statement defines boundaries in the orientation phase of the nurse-client relationship when talking to a depressed client who has just been admitted to the psychiatric unit?

• A. ''Tell me about the relationship that you have with your mother and father.''
• B. ''Hello! I'm Nurse Andrea. I'll introduce you around and help you settle in.''
• C. ''What is the main thing that you would like to work on during therapy?'
• D. ''I understand that you have been depressed. What can you tell me about that?'

Correct answer: B

Rationale: In the orientation phase of the nurse-client relationship, setting boundaries involves establishing the nurse's role and responsibilities while maintaining a professional distance. Option B demonstrates a clear boundary by introducing the nurse and offering assistance with settling in, which is appropriate for the initial phase of building rapport with the client. Choices A, C, and D delve into personal or therapeutic topics that are more suitable for the working phase of the relationship when the client's goals and problems are being addressed. Asking about the client's family relationships (Choice A), therapy focus (Choice C), or delving into the client's depression (Choice D) would be more relevant in later stages of the therapeutic process, once trust and rapport have been established during the orientation phase.

3. Jerry is a 55-year-old veteran who has been admitted after a motor vehicle accident with multiple injuries. His friend reported that he had been using synthetic marijuana prior to the accident, and that he also sees a psychiatrist at the VA hospital for an unknown diagnosis. He stated that Jerry sometimes gets "hyper"? for no reason, starts "ranting"? and becomes violent. Of the following, which general psychiatric disorder is characterized by a pattern of aggression or violence that includes irritability, agitation, and violent behavior during manic or psychotic episodes?

• A. Schizophrenia
• B. Post-traumatic stress disorder (PTSD)
• C. Bipolar disorder
• D. Delusional disorder

Correct answer: C

Rationale: Bipolar disorder is characterized by a pattern of aggression or violence that includes irritability, agitation, and violent behavior during manic or psychotic episodes. This disorder is highly co-morbid with substance use, which can worsen the prognosis. While schizophrenia may involve aggression, it is not typically associated with mood episodes like mania that characterize bipolar disorder. Post-traumatic stress disorder (PTSD) is primarily characterized by re-experiencing traumatic events, avoidance behaviors, and hyperarousal, but not the distinct mood episodes seen in bipolar disorder. Delusional disorder is characterized by fixed false beliefs without the mood changes seen in bipolar disorder. Therefore, the correct answer is Bipolar disorder.

4. A client decides to have hospice care rather than undergo an extensive surgical procedure. Which ethical principle does the client's behavior illustrate?

• A. Justice
• B. Veracity
• C. Autonomy
• D. Beneficence

Correct answer: C

Rationale: The correct answer is 'Autonomy.' Autonomy refers to an individual's right to make decisions about their own care. In this scenario, the client is choosing hospice care over surgery, demonstrating their autonomy in making healthcare choices. Justice involves fairness and equality in the distribution of resources and services, which is not the primary ethical principle illustrated in this case. Veracity pertains to truthfulness and honesty, which is not directly related to the client's decision-making process. Beneficence refers to the duty to do good and act in the best interest of the patient, which is not the central ethical principle demonstrated by the client's decision for hospice care.

5. 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.

Similar Questions