Nursing Elites

1. Which client action is an example of the defense mechanism of sublimation?

• A. A woman channels her energy into a new hobby after a breakup.
• B. A man redirects his anger from work into a workout routine.
• C. A student focuses on studying to avoid thinking about a recent argument.
• D. An athlete channels competitive impulses into a successful sports career.

Correct answer: B

Rationale: Sublimation is a defense mechanism where unacceptable impulses are redirected into socially acceptable activities. In this scenario, the man redirects his anger from work into a workout routine, which is a positive and constructive way of managing his emotions. Choices A, C, and D do not fully align with sublimation as they do not involve redirecting unacceptable impulses into socially acceptable outlets, unlike the man's action in choice B.

2. Which of the following interventions should not be included in the care plan for a client with major depressive disorder?

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Discourage verbalization of feelings
• D. Monitor for suicidal ideation

Correct answer: C

Rationale: Interventions for a client with major depressive disorder should focus on promoting activities, adequate nutrition, hydration, and monitoring for suicidal ideation. Verbalizing feelings is a crucial part of therapy for clients with depression as it helps in processing emotions and seeking support. Therefore, discouraging verbalization of feelings is not appropriate and goes against therapeutic principles.

3. During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:

• A. Maternal stress
• B. Parental nurturing
• C. Appropriate stress responses in the brain
• D. Memories of the abuse

Correct answer: A

Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.

4. A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?

• A. Encourage the client to wash her hands less frequently.
• B. Set a time limit for hand washing.
• C. Teach the client relaxation techniques.
• D. Discourage the client from washing her hands.

Correct answer: B

Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.

5. A psychiatric nurse observes that a client diagnosed with schizophrenia is pacing up and down the corridor. The client is muttering to himself, and his hands are trembling. Which of the following actions should the nurse take first?

• A. Ask the client if he is hearing voices.
• B. Offer the client a PRN medication for anxiety.
• C. Encourage the client to participate in a relaxation exercise.
• D. Remove the client to a quieter environment.

Correct answer: D

Rationale: The first action the nurse should take is to remove the client to a quieter environment. This intervention aims to reduce stimuli that may be contributing to the client's agitation and help create a calmer and more supportive setting for the client. Choices A, B, and C are not the priority in this situation as addressing the environmental factors should come first before exploring symptoms, offering medication, or engaging in relaxation exercises.

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