Nursing Elites

1. A teenager begins to cry while talking with the nurse about the problem of not being able to make friends. Which is the correct therapeutic nursing intervention?

• A. Sitting quietly with the client
• B. Telling the client that crying is not helpful
• C. Suggesting that the client play a board game
• D. Recommending how the client can change this situation

Correct answer: A

Rationale: The correct therapeutic nursing intervention in this situation is sitting quietly with the client. This approach conveys empathy, acceptance, and a willingness to listen, which can help the teenager feel supported and understood. It is important for the nurse to create a safe space for the client to express their emotions without judgment. Telling the client that crying is not helpful dismisses their feelings and can hinder the therapeutic relationship. Suggesting a board game as a distraction may prevent the client from fully exploring and addressing their emotions about the issue. Recommending how the client can change the situation may be premature at this stage, as the priority is to provide emotional support and establish trust before delving into problem-solving.

2. A client says, 'The doctors lied about me. They said I murdered my mother. You killed her. She died before I was born.' Which psychotic feature is the client experiencing?

• A. Ideas of grandeur
• B. Confusing illusions
• C. Persecutory delusions
• D. Auditory hallucinations

Correct answer: C

Rationale: The client is experiencing persecutory delusions, as she believes that others are blaming her for negative actions. This is not about ideas of grandeur, which involve feelings of greatness or power. Confusing illusions refer to misinterpretation of stimuli, which is not present in this scenario. Auditory hallucinations involve hearing voices, which is not the case here. In this case, the client is delusional, but not hallucinating.

3. Which term describes what an adolescent client is experiencing when she says to the nurse who has been caring for her, 'You're just like my mother; I hate you'?

• A. Insight
• B. Universality
• C. Transference
• D. Identification

Correct answer: C

Rationale: Transference occurs when a client unconsciously assigns feelings and attitudes originally associated with another important person in the client's life. In this scenario, the adolescent client is projecting emotions connected to her mother onto the nurse. This client's statement does not demonstrate insight but rather reflects the mechanism of transference. Universality refers to the sense that one is not alone in any situation, which is not evident in the client's statement. Identification is a defense mechanism where an individual takes on characteristics of someone considered admirable, which is not the case in this situation.

4. Which of the following is an example of an opioid?

• A. Mescaline
• B. Diazepam
• C. Phenobarbital
• D. Methadone

Correct answer: D

Rationale: Opioids are a type of drug classified as narcotics. Nurses working with clients with substance abuse issues often encounter opioids. Opioids have the potential for addiction. Examples of opioids include methadone, codeine, morphine, and hydromorphone. Mescaline (Choice A) is a hallucinogen, not an opioid. Diazepam (Choice B) is a benzodiazepine used to treat anxiety and other conditions, not an opioid. Phenobarbital (Choice C) is a barbiturate used to treat seizures and insomnia, not an opioid.

5. Which psychosocial attribute plays an important role in the development of a healthy personality from birth to 1 year of age?

• A. Initiative versus guilt
• B. Trust versus mistrust
• C. Autonomy versus shame
• D. Industry versus inferiority

Correct answer: B

Rationale: According to Erikson's theory of psychosocial development, the first attribute that helps develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is observed at 3 to 6 years of age, when children explore their surroundings and may experience guilt if their actions conflict with parental expectations. Autonomy versus shame occurs between 1 and 3 years of age, as children develop motor skills and new activities, with shame emerging if they feel self-conscious. Industry versus inferiority is evident in children aged 6 to 12 years, where successful task completion fosters a sense of industry, while excessive expectations can lead to feelings of inferiority. Therefore, the correct attribute for a healthy personality development from birth to 1 year of age is trust versus mistrust.

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