Nursing Elites

1. During the first meeting of a therapy group, members exhibit frequent periods of silence, tense laughter, and nervous movements. Which conclusion would the nurse make?

• A. The group requires an active leader who will intervene to relieve signs of obvious stress.
• B. The group process is unhealthy and there is unwillingness to openly relate.
• C. The members are displaying expected behaviors because relationships are not yet established.
• D. The behaviors should be immediately addressed so members will not become too uncomfortable.

Correct answer: C

Rationale: During the initial stages of a therapy group, it is common for members to exhibit behaviors such as silence, tense laughter, and nervous movements. These behaviors indicate anxiety and insecurity due to the lack of established relationships and trust among the group members. This is a normal part of group development, and it does not necessarily mean that the group process is unhealthy. Intervening or addressing these behaviors immediately is not required as they are expected in the early stages of group interaction. As the group progresses and relationships are built, these behaviors are likely to diminish naturally without the need for active leader intervention. Therefore, the correct conclusion is that the members are displaying expected behaviors because relationships are not yet established. Choices A, B, and D are incorrect because active leader intervention is not necessary, the group process is not unhealthy, and addressing the behaviors immediately is not required as they are part of the early group dynamics and are expected to subside as relationships develop.

2. A client with untreatable metastasized cancer tells the nurse, 'I think they made a mistake. I don't think I have cancer. I feel too good to be dying.' Which stage of grief is the client experiencing?

• A. Anger
• B. Denial
• C. Bargaining
• D. Acceptance

Correct answer: B

Rationale: The client is experiencing the stage of denial. This is evident as the client is having difficulty accepting the reality of their diagnosis and denies the presence of cancer despite the evidence. During the anger stage, the individual expresses anger about their situation, questioning why it is happening to them. Bargaining involves attempting to negotiate for more time or a different outcome, acknowledging the reality of death but trying to delay it. Acceptance, on the other hand, is characterized by coming to terms with the inevitability of death and preparing for it peacefully. Therefore, in this scenario, the client's disbelief and refusal to accept the diagnosis align with the denial stage of grief.

3. What is the primary purpose served when an individual takes action to reduce anxiety?

• A. Reduction of tension
• B. Denial of the situation
• C. Avoidance of physical discomfort
• D. Resolution in decision-making

Correct answer: A

Rationale: The primary purpose of taking action to reduce anxiety is to alleviate emotional tension and prevent the exacerbation of anxiety symptoms. By reducing tension, anxiety levels decrease, leading to a sense of comfort, safety, and security. Denial of the situation is not the goal when addressing anxiety; rather, acknowledging and managing it is crucial. While physical discomfort may accompany anxiety, the focus is on alleviating the emotional aspect to mitigate physical manifestations. Although mild anxiety can sometimes improve decision-making skills, higher levels of anxiety typically impede cognitive functions, making resolution in decision-making less likely.

4. A 37-year-old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagia resulting in anemia. She also has depression and pelvic pain. She is crying and states, 'I don't know what to do"?my primary health care provider is recommending a hysterectomy, but I haven't had children yet!' Which response would the nurse provide?

• A. 'There are so many children up for adoption, looking for a mother.'
• B. 'This must feel so difficult for you. Children are really important to you?'
• C. This must feel so difficult for you. Although Children should not be important to you.'
• D. Believe me when I tell you that kids are so difficult to raise"?you're better off without them.'

Correct answer: B

Rationale: The correct response is to acknowledge the client's feelings and provide an open-ended question to encourage further expression. By expressing empathy and understanding, the nurse can create a supportive environment for the client. This approach allows the client to explore her emotions and concerns freely. Option A, suggesting adoption, may come across as dismissive of the client's current emotional state and may not address her immediate needs. Option D is insensitive and dismissive of the client's feelings and desires regarding having children. It is important to avoid making assumptions or judgments about the client's situation. Option C is a duplicate of Option B, and while it shows empathy, it lacks variety in communication, which may limit the depth of the conversation and the nurse's understanding of the client's needs.

5. What is a common reason why clients abuse alcohol?

• A. To blunt reality
• B. To precipitate euphoria
• C. To promote social interaction
• D. To stimulate the central nervous system

Correct answer: A

Rationale: Clients often abuse alcohol to blunt reality. Alcohol, by depressing the central nervous system and distorting or altering reality, can reduce anxiety. It is not primarily used to precipitate euphoria; instead, it may lead to mood swings, impaired judgment, and aggressive behavior. While alcohol can be used as a social lubricant, individuals with alcohol use disorder often drink in isolation. Moreover, excessive alcohol consumption can result in inappropriate and aggressive behaviors that hinder social interactions. It's important to note that alcohol is a depressant, unlike stimulants such as amphetamines and cocaine.

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