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A client is under a great deal of stress. Which nursing recommendation would be least helpful in assisting the client in coping with stress? Select one that doesn't apply.
- A. Enjoy a pet.
- B. Spend time with a loved one.
- C. Listen to music.
- D. Focus on the stressors.
Correct Answer: D
Rationale: Focusing on the stressors can exacerbate stress levels in the client's life rather than helping to cope with it. Engaging in activities such as enjoying a pet, spending time with loved ones, and listening to music are known to be stress-relieving and can aid in coping with stress. It is essential to encourage strategies that promote relaxation and positive emotions, rather than fixating on the stressors that may worsen the client's condition. Therefore, 'Focus on the stressors' is the least helpful recommendation as it does not contribute to stress management.
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A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms should the nurse expect to observe during withdrawal? Select one that doesn't apply.
- A. Tremors
- B. Hallucinations
- C. Diaphoresis
- D. Bradycardia
Correct Answer: D
Rationale: During alcohol withdrawal, symptoms such as tremors, hallucinations, diaphoresis, and seizures are commonly observed. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia, an increased heart rate, is more commonly seen. Therefore, bradycardia is the correct answer as it is not an expected symptom during alcohol withdrawal. Tremors, hallucinations, and diaphoresis are all common manifestations of alcohol withdrawal, while bradycardia is not typically seen in this context.
During an intake assessment, a healthcare professional asks both physiological and psychosocial questions. The client angrily responds, 'I'm here for my heart, not my head problems.' What is the healthcare professional's best response?
- A. It's just a routine part of our assessment. All clients are asked these same questions.
- B. Why are you concerned about these types of questions?
- C. Psychological factors, like excessive stress, have been found to affect medical conditions.
- D. We can skip these questions, if you like. It isn't imperative that we complete this section.
Correct Answer: C
Rationale: The healthcare professional should educate the client on the negative effects of excessive stress on medical conditions. Understanding the interconnectedness of physical and mental health is crucial for providing holistic care. Choice A is incorrect because it doesn't address the importance of psychosocial aspects. Choice B is wrong as it doesn't provide relevant information about the impact of psychological factors on health. Choice D is incorrect because skipping questions would lead to an incomplete assessment, potentially missing crucial information affecting the client's overall health outcomes.
Which should the healthcare provider recognize as a DSM-5 disorder?
- A. Obesity
- B. Generalized anxiety disorder
- C. Hypertension
- D. Grief
Correct Answer: B
Rationale: The DSM-5 categorizes mental health disorders for diagnostic purposes. Generalized anxiety disorder is one of the disorders listed in the DSM-5, characterized by persistent and excessive worry about various events or activities. This disorder falls under the category of anxiety disorders, which also include panic disorder, phobias, and others. Choices A, C, and D are not DSM-5 disorders. Obesity and hypertension are medical conditions, while grief, though a significant emotional response, is not classified as a mental health disorder in the DSM-5.
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.
A new psychiatric nurse states, 'This client's use of defense mechanisms should be eliminated.' Which is a correct evaluation of this nurse's statement?
- A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
- B. Defense mechanisms are a maladaptive attempt by the ego to manage anxiety and should always be eliminated.
- C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged but not eliminated.
- D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
Correct Answer: A
Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms help individuals reduce anxiety during times of stress. It is crucial for the nurse to understand that defense mechanisms serve a purpose and can be a normal part of coping. However, if defense mechanisms significantly hinder the client's ability to develop healthy coping skills, they should be addressed and explored. Eliminating defense mechanisms entirely without considering the individual's overall coping strategies can be counterproductive and may lead to increased distress for the client. Choice B is incorrect because not all defense mechanisms are maladaptive; some can be adaptive and helpful. Choice C is incorrect because labeling individuals as having weak ego integrity based on their use of defense mechanisms is stigmatizing and oversimplified. Choice D is incorrect because fostering and encouraging defense mechanisms without differentiation can lead to maladaptive behaviors and reliance on these mechanisms instead of healthier coping strategies.