Nursing Elites

1. What is the most significant consequence of the excessive use of defense mechanisms?

• A. Suppression of problem-solving skills.
• B. Intense experience of emotions.
• C. Enhancement of learning and growth.
• D. Limitation of problem-solving.

Correct answer: D

Rationale: The most significant consequence of the excessive use of defense mechanisms is the limitation of problem-solving skills. When individuals rely excessively on defense mechanisms to cope with stress or anxiety, they may avoid addressing underlying issues or seeking healthier coping strategies. This can lead to maladaptive behaviors, hindering their ability to effectively deal with reality, maintain healthy relationships, or perform well in various aspects of life. Choices A, B, and C are incorrect because the suppression of problem-solving skills, intense experience of emotions, and enhancement of learning and growth are not the primary consequences of excessive use of defense mechanisms.

2. A healthcare professional is assessing a client diagnosed with paranoid schizophrenia. Which of the following findings should the healthcare professional expect?

• A. Auditory hallucinations
• B. Delusions of grandeur
• C. A flat affect
• D. Disorganized speech

Correct answer: B

Rationale: The correct answer is B: Delusions of grandeur. Clients with paranoid schizophrenia often experience delusions of grandeur or persecution, auditory hallucinations, and a flat affect. However, the most characteristic finding for paranoid schizophrenia is the presence of delusions, which are fixed false beliefs that are not based in reality. Delusions of grandeur, where individuals believe they are exceptionally powerful or important, are commonly seen in paranoid schizophrenia. Choice A, auditory hallucinations, are more commonly associated with other types of schizophrenia such as paranoid or disorganized schizophrenia. Choice C, a flat affect, is a symptom that can be seen across various types of schizophrenia. Choice D, disorganized speech, is more indicative of disorganized schizophrenia.

3. A healthcare professional is planning care for a client with borderline personality disorder. Which of the following interventions should not be included in the plan of care?

• A. Set clear and consistent boundaries
• B. Encourage dependency on the healthcare professional
• C. Avoid discussing the client's feelings
• D. Use a firm, authoritative approach

Correct answer: B

Rationale: In caring for a client with borderline personality disorder, it is essential to set clear and consistent boundaries, use a firm, authoritative approach, and provide opportunities for the client to express feelings. Encouraging dependency can reinforce maladaptive behaviors, while avoiding discussing feelings can hinder therapeutic progress in addressing underlying issues. Building a sense of dependency may exacerbate the client's difficulties in developing autonomy and self-reliance, which are crucial for their progress and recovery. Therefore, encouraging dependency is not a recommended intervention in the plan of care for clients with borderline personality disorder.

4. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

• A. A client rudely complaining about limited visiting hours
• B. A client exhibiting aggressive behavior toward another client
• C. A client stating that no one cares
• D. A client verbalizing feelings of failure

Correct answer: B

Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.

5. A client is prescribed diazepam (Valium) for anxiety. Which statement by the client indicates a need for further teaching?

• A. I can drink alcohol while taking this medication.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication only when I feel anxious.
• D. I can stop taking this medication when I feel better.

Correct answer: A

Rationale: The correct answer is A because clients should avoid alcohol while taking diazepam (Valium) due to potential interactions. Alcohol can increase the sedative effects of diazepam, leading to excessive drowsiness or respiratory depression. Choice B is correct as it reflects the need to avoid alcohol. Choice C is incorrect because diazepam is usually taken regularly, not just when feeling anxious. Choice D is incorrect as abruptly stopping diazepam can lead to withdrawal symptoms and should be done gradually under medical supervision.

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