Nursing Elites

1. If the nurse who was not promoted tells another friend, "I knew I'd never get the job. The hospital administrator hates me."? If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:

• A. compensation.
• B. reaction formation.
• C. projection.
• D. denial.

Correct answer: C

Rationale: The nurse is demonstrating projection, attributing her own feelings of dislike onto the hospital administrator. This defense mechanism involves unconsciously adopting blaming behavior. Compensation involves emphasizing a strong point to make up for a perceived weakness, which is not the case here. Reaction formation is adopting behavior opposite to actual feelings, and denial involves ignoring an unpleasant reality, none of which are demonstrated in this scenario.

2. How does the ANA define the psychiatric nursing role?

• A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art
• B. assisting the therapist to relieve the symptoms of clients
• C. to solve clients' problems and give them the answers
• D. having a client committed to long-term therapy with the nurse

Correct answer: A

Rationale: The correct answer aligns with the ANA's definition of the psychiatric nursing role. According to the ANA, psychiatric nursing is a specialized area of nursing practice that incorporates theories of human behavior as its foundational science and utilizes the self as its essential art. This definition emphasizes the importance of understanding human behavior and leveraging therapeutic communication and relationships to provide effective care for individuals with mental health concerns. Choices B, C, and D are incorrect because they do not accurately represent the ANA-defined role of psychiatric nursing. Psychiatric nurses primarily focus on delivering holistic care, promoting mental health, and supporting individuals with mental health challenges using evidence-based practices and therapeutic interventions.

3. A 57-year-old woman is recently widowed. She states, "I will never be able to learn how to manage the finances. My husband did all of that."? Select the nurse's response that could help raise the client's self-esteem.

• A. "You feel inadequate because you have never learned to balance a checkbook."?
• B. "You should have insisted your husband teach you about the finances."?
• C. "You are strong and will learn how to manage your finances after a while."?
• D. "I believe in your strength to learn how to manage your finances in time."?

Correct answer: C

Rationale: The nurse should aim to boost the client's self-esteem by providing positive reinforcement. By stating, "You are strong and will learn how to manage your finances after a while,"? the nurse acknowledges the client's strength and capability, encouraging her to believe in herself. Choice A is incorrect as it focuses on the client's inadequacy rather than empowering her. Choice B places unnecessary blame on the client for not taking action in the past. Choice D, though positive, slightly alters the nurse's original phrase, making choice C the most appropriate response to uplift the client's self-esteem.

4. A successful resolution of the nursing diagnosis Negative Self-Concept (related to unrealistic self-expectations) is when the client can:

• A. report a positive self-concept.
• B. identify negative thoughts.
• C. recognize positive thoughts.
• D. give one positive cue with each negative cue

Correct answer: A

Rationale: The correct answer is to 'report a positive self-concept.' The problem statement is Negative Self-Concept, so the goal is for the client to achieve a positive self-concept. This involves helping the client recognize their worth and strengths. Choices B, C, and D do not directly address the resolution of Negative Self-Concept. Identifying negative thoughts (B) is a step towards improvement but does not represent a successful resolution. Recognizing positive thoughts (C) is positive but not the primary goal in addressing Negative Self-Concept. 'Give one positive cue with each negative cue' (D) is not as comprehensive as achieving an overall positive self-concept.

5. What significant event occurs in the orientation phase of a nurse-client relationship?

• A. establishment of roles
• B. identification of transference phenomenon
• C. placement of the client within their family structure
• D. client agreement that the nurse has the authority in the relationship

Correct answer: B

Rationale: In the orientation phase of a nurse-client relationship, the significant event is the identification of transference phenomenon. Transference phenomena are intensified in relationships with authority figures like nurses and physicians. Positive transferences may include a desire for affection and dependency, while negative transferences may involve hostility and competitiveness. It is crucial to recognize and address these transferences before progress and positive changes can be made in the working stage. The other choices are incorrect; the establishment of roles may occur in the working phase, placing the client within their family structure is not a key event in the orientation phase, and client agreement on the nurse's authority is not the primary focus during this phase.

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