Nursing Elites

1. Which of the following statements should a healthcare provider recognize as true about defense mechanisms? Select all that apply.

• A. They are employed when there is a threat to biological or psychological integrity.
• B. They are controlled by the id and deal with primal urges.
• C. They are used in an effort to increase anxiety.
• D. They are protective devices for the superego.

Correct answer: A

Rationale: Defense mechanisms are employed by the ego, not the id or superego, in response to threats to biological or psychological integrity. They aim to relieve anxiety, not increase it. By redirecting focus, they help manage mild to moderate anxiety and are often self-deceptive in nature.

2. Which intervention would be appropriate for assisting a client diagnosed with major depressive disorder?

• A. Encourage discussion of feelings
• B. Offer family therapy sessions
• C. Discuss childhood events
• D. Teach alternate coping skills

Correct answer: B

Rationale: Offering family therapy sessions would be the most appropriate intervention for a client diagnosed with major depressive disorder. Family therapy can be beneficial as it addresses interpersonal relationships within the family system, which is crucial in managing major depressive disorder effectively. This approach aligns with Sullivan's interpersonal theory, which emphasizes the impact of interpersonal relationships on individual behavior and personality development. In contrast, encouraging discussion of feelings, discussing childhood events, or teaching alternate coping skills may not directly address the interpersonal dynamics contributing to the client's major depressive disorder.

3. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement to address this symptom?

• A. Encourage the client to discuss the voices.
• B. Tell the client that the voices are not real.
• C. Provide reality-based feedback to the client.
• D. Distract the client from the voices.

Correct answer: C

Rationale: When a client with schizophrenia is experiencing auditory hallucinations, providing reality-based feedback is a therapeutic intervention. This helps the client differentiate between what is real and what is not, aiding in reducing the impact of hallucinations. Encouraging the client to discuss the voices may validate the hallucinations, telling the client that the voices are not real dismisses their experience, and distracting the client may not address the underlying issue of the hallucinations.

4. A client has been prescribed lithium for the treatment of bipolar disorder. Which of the following instructions should the nurse include?

• A. Avoid driving until you know how the medication affects you.
• B. Take the medication with food to prevent stomach upset.
• C. You may experience mild nausea when initiating the medication.
• D. Do not double the next dose if you miss one.

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid driving until they know how the medication affects them. Lithium can lead to side effects like dizziness and drowsiness, which could impair one's ability to drive safely. Choice B is incorrect because lithium is usually taken on an empty stomach. Choice C may be true but is not as critical as the potential side effects affecting driving. Choice D is important but not as immediate as ensuring the client's safety while driving.

5. For a patient with obsessive-compulsive disorder (OCD) who spends several hours a day washing her hands, which type of therapy is most appropriate?

• A. Exposure and response prevention
• B. Dialectical behavior therapy
• C. Family therapy
• D. Interpersonal therapy

Correct answer: A

Rationale: Exposure and response prevention (ERP) is the most appropriate therapy for managing OCD. ERP involves exposing the patient to anxiety-provoking stimuli (such as touching dirty objects) and preventing the compulsive response (hand washing), thus helping the patient learn to tolerate the anxiety without performing the ritualistic behavior. Dialectical behavior therapy (DBT) focuses more on emotional regulation and interpersonal skills, making it less suitable for directly addressing OCD symptoms. Family therapy and interpersonal therapy may be beneficial for other conditions or relationship issues but are not specifically designed to target OCD symptoms like ERP.

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