Nokea
An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
- A. Encourage the graduate to use alternative coping mechanisms such as relaxation exercises.
- B. Complete the problem-solving process for the graduate.
- C. Work through the problem-solving process with the graduate.
- D. Encourage the graduate to keep a journal.
Correct Answer: C
Rationale: In situations where a client is experiencing severe anxiety and struggles with independent problem-solving, it is essential for the nurse to work through the problem-solving process together with the client. By doing so, the nurse can provide support and guidance to help the client navigate through their challenges effectively. Choice A is not the most appropriate as just encouraging alternative coping mechanisms may not address the root of the problem. Choice B of completing the problem-solving process for the graduate does not promote independence or skill development. Choice D of encouraging the graduate to keep a journal may be helpful but does not directly address the need for assistance in problem-solving during heightened anxiety.
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While assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons, how should the nurse interpret the student's reaction to her perceived problem?
- A. The problem is endangering her well-being.
- B. The problem is personally relevant to her.
- C. The problem is based on immaturity.
- D. The problem is exceeding her capacity to cope.
Correct Answer: B
Rationale: In this scenario, the student being overly concerned about not being able to afford horseback riding lessons indicates that the problem is personally relevant to her. Psychological stressors related to self-esteem and self-image are influenced by how an individual perceives a situation or event. Adolescents, in particular, place significance on self-image and feeling entitled to experiences that other adolescents have, which can lead to distress when such desires are not met. Choice A is incorrect because there is no indication that the student's physical well-being is at risk. Choice C is incorrect as it simplifies the issue by attributing it solely to immaturity. Choice D is incorrect as there is no evidence provided that the problem is beyond the student's coping abilities.
A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse include in the plan of care?
- A. Encourage the client to suppress compulsive behaviors.
- B. Set strict limits on the amount of time the client can engage in compulsive behaviors.
- C. Allow the client to perform compulsive behaviors as needed.
- D. Gradually limit the amount of time allotted for compulsive behaviors.
Correct Answer: D
Rationale: In caring for a client with OCD, it is essential to gradually limit the time allotted for compulsive behaviors. This intervention helps the client develop alternative coping mechanisms. Encouraging suppression or setting strict limits on compulsive behaviors can exacerbate the client's anxiety, making it crucial to approach the care plan with a gradual reduction strategy. Allowing the client to perform compulsive behaviors as needed does not promote progress towards managing OCD symptoms and may reinforce maladaptive patterns of behavior.
Which client should the nurse anticipate to be most receptive to psychiatric treatment?
- A. A Jewish female journalist
- B. A Baptist homeless male
- C. A Catholic black male
- D. A Protestant Swedish business executive
Correct Answer: A
Rationale: The client who is Jewish and female, a journalist, is likely to be more receptive to psychiatric treatment due to cultural factors. In Jewish culture, there is often a high value placed on preventative healthcare, including mental health. Additionally, research suggests that women are more likely than men to seek treatment for mental health issues, making this client more open to psychiatric care. Choice B, a homeless male, might face barriers to accessing and accepting psychiatric treatment due to challenges related to homelessness. Choice C, a Catholic black male, and choice D, a Protestant Swedish business executive, do not provide specific cultural or gender-related factors that would indicate higher receptiveness to psychiatric treatment than the Jewish female journalist.
During an assessment of a client with suspected substance use disorder, which of the following findings should the nurse expect? Select one that doesn't apply.
- A. Feelings of hopelessness
- B. Increased tolerance to the substance
- C. Withdrawal symptoms when not using the substance
- D. Unsuccessful attempts to cut down or control use
Correct Answer: A
Rationale: In clients with substance use disorder, common findings include increased tolerance to the substance, withdrawal symptoms when not using it, and unsuccessful attempts to cut down or control use. Feelings of hopelessness are not typically a direct manifestation of substance use disorder. Instead, feelings of hopelessness may be associated with other mental health conditions or situational factors. Therefore, the correct answer is A. Choices B, C, and D are all expected findings in clients with substance use disorder.
In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?
- A. When the individual judges the event to be benign
- B. When the individual judges the event to be irrelevant
- C. When the individual judges the resources and skills needed to deal with the event
- D. When the individual judges the event to be pleasurable
Correct Answer: C
Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.