Nursing Elites

1. Which is an example of the ego defense mechanism of regression?

• A. A mother blames the teacher for her child's failure in school.
• B. A teenager becomes hysterical after seeing a friend killed in a car accident.
• C. A woman wants to marry a man exactly like her beloved father.
• D. An adult throws a temper tantrum when he does not get his own way.

Correct answer: D

Rationale: The correct answer is D. Regression involves reverting to an earlier stage of development for comfort. In this case, an adult throwing a temper tantrum is regressing to a childlike behavior when faced with not getting their way, which is a form of seeking comfort associated with earlier development. Choices A, B, and C do not exemplify regression. Blaming the teacher, becoming hysterical after a traumatic event, or seeking a partner similar to a beloved father are not instances of reverting to earlier developmental stages to cope with stress or conflict.

2. At what point should the nurse determine that a client is at risk for developing a mental disorder?

• A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
• B. When maladaptive responses to stress are coupled with interference in daily functioning
• C. When the client communicates significant distress
• D. When the client uses defense mechanisms as ego protection

Correct answer: B

Rationale: The nurse should determine that the client is at risk for mental disorder when responses to stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that in order to be diagnosed with a mental disorder, there must be significant disturbance in cognition, emotion, regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning. These disorders are usually associated with significant distress or disability in social, occupational, or other important activities. The client's ability to communicate distress would be considered a positive attribute.

3. After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of a neurocognitive disorder due to dementia. Which statement would cause the nurse to question this diagnosis?

• A. There has been no triiodothyronine or thyroxine level evaluation ordered
• B. Neurocognitive disorders do not typically occur in African American clients
• C. The symptoms presented are more indicative of parkinsonism
• D. Dementia does not develop suddenly

Correct answer: D

Rationale:

4. Which of the following are therapeutic communication techniques that a healthcare provider can use when interacting with clients? Select one that does not apply.

• A. Using Noise
• B. Offering self
• C. Giving advice
• D. Providing reassurance

Correct answer: C

Rationale: Therapeutic communication techniques aim to promote a therapeutic relationship and client well-being. Using noise is a non-therapeutic technique that can hinder effective communication. Offering self, providing reassurance, and using silence are considered therapeutic. However, giving advice is often seen as non-therapeutic as it can diminish client autonomy and hinder problem-solving skills.

5. In a patient with bipolar disorder, which symptom would indicate a manic episode?

• A. Excessive sleeping
• B. Low self-esteem
• C. Decreased need for sleep
• D. Anhedonia

Correct answer: C

Rationale: The correct answer is C: Decreased need for sleep. A decreased need for sleep is a hallmark symptom of a manic episode in bipolar disorder. During manic episodes, individuals may experience significantly reduced sleep without feeling tired, which can lead to increased energy levels, impulsivity, and other manic symptoms. Excessive sleeping (choice A) is more indicative of depression rather than mania. Low self-esteem (choice B) and anhedonia (choice D) are also more commonly associated with depressive episodes rather than manic episodes in bipolar disorder.

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