Nursing Elites

1. During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?

• A. The client asks the nurse if they will go out to dinner together
• B. The client accuses the nurse of being controlling just like an ex-partner
• C. The client reminds the nurse of a friend who died from substance toxicity
• D. The client becomes angry and threatens to engage in self-harm

Correct answer: B

Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.

2. Which symptom is most commonly associated with social anxiety disorder?

• A. Fear of speaking in public
• B. Recurrent, intrusive thoughts
• C. Flashbacks of traumatic events
• D. Persistent low mood

Correct answer: A

Rationale: Fear of speaking in public is a hallmark symptom of social anxiety disorder. Individuals with social anxiety disorder often experience intense fear or anxiety about social situations where they may be scrutinized or judged by others, such as speaking in public. This fear can significantly impact their daily functioning and quality of life, making it a key feature in diagnosing social anxiety disorder. Recurrent, intrusive thoughts, flashbacks of traumatic events, and persistent low mood are more commonly associated with other mental health conditions, such as obsessive-compulsive disorder, post-traumatic stress disorder, and depression, respectively. Therefore, choice A is the correct answer as it aligns with the characteristic symptom of social anxiety disorder.

3. What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.

4. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?

• A. Avoiding social situations that cause anxiety
• B. Challenging and changing negative thoughts
• C. Using deep breathing exercises during social interactions
• D. Taking anti-anxiety medication before social events

Correct answer: B

Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.

5. When discharging a patient with schizophrenia on risperidone, what is an important point to include in the discharge teaching?

• A. Avoiding foods high in tyramine is essential.
• B. Getting blood levels checked regularly is necessary.
• C. Being cautious when driving due to possible drowsiness is crucial.
• D. Taking this medication on an as-needed basis is recommended.

Correct answer: B

Rationale: Regular monitoring of blood levels is crucial for patients taking risperidone to ensure the medication is at therapeutic levels and to prevent potential toxicity. This monitoring helps healthcare providers adjust the dosage as needed to optimize treatment outcomes and minimize adverse effects.

Similar Questions