A client at a local university claims to be the president of the university. Which type of delusion is the client displaying?
- A. Somatic
- B. Grandiose
- C. Erotomanic
- D. Persecutory
Correct Answer: B
Rationale: The correct answer is 'Grandiose.' This type of delusion involves an exaggerated sense of self-importance, where the individual believes they are a prominent figure or possess special abilities. In this scenario, the client claiming to be the president of the university is displaying grandiose delusions. Somatic delusions relate to bodily functions or sensations, which are not present in this case. Erotomanic delusions involve the fixed belief that another person is in love with the individual, which is not applicable here. Persecutory delusions involve the belief that one is being targeted or conspired against, which is also not demonstrated in the given situation.
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According to Erikson's theory, which behavior would the nurse expect a preschooler to exhibit?
- A. The child develops the superego.
- B. The child plays beside other children.
- C. The child concentrates on work and play.
- D. The child becomes casual about body appearance.
Correct Answer: A
Rationale: According to Erikson's theory, a preschooler develops the superego or conscience during the initiative versus guilt stage. This stage occurs around ages 3 to 6 years old. The development of the superego is crucial for the child to start understanding and internalizing societal and parental values. Choice B is incorrect because playing beside other children typically occurs during the autonomy versus shame and doubt stage, which is seen in toddlers. Choice C is incorrect as concentrating on work and play is more characteristic of the industry versus inferiority stage, typically seen in school-aged children. Choice D is incorrect because becoming casual about body appearance is more aligned with the identity versus role confusion stage, which is seen in adolescents who have a marked preoccupation with appearance and body image.
Before discharging an anxious client, which information about anxiety would the nurse teach the family?
- A. Anxiety is a totally unique feeling and experience.
- B. Apprehension is generalized to the total environment.
- C. Fears result from conscious actions, thoughts, and wishes.
- D. Anxiety is a pattern of emotional and behavioral responses to stress.
Correct Answer: D
Rationale: Anxiety is a human response consisting of both physical and emotional changes that everyone experiences when faced with stressful situations. It is a pattern of emotional and behavioral responses to stress. Anxiety is a common experience for many individuals. Apprehension is usually related to a specific aspect of the environment rather than the total environment. Fears are not intentionally or consciously generated.
Which defense mechanism is considered a conscious measure used to cope with anxiety?
- A. Undoing
- B. Projection
- C. Suppression
- D. Intellectualization
Correct Answer: C
Rationale: The correct answer is Suppression. Suppression is a conscious defense mechanism in which an individual intentionally avoids thinking about disturbing problems, wishes, feelings, or experiences. It is a way to cope with anxiety by actively pushing aside unwanted thoughts or emotions. Undoing, on the other hand, is an unconscious defense mechanism where one uses words or behaviors to symbolically make amends for unacceptable thoughts or actions. Projection is also an unconscious defense mechanism involving falsely attributing one's own unacceptable impulses to others. Intellectualization, another unconscious defense mechanism, involves using intellect or thinking to avoid dealing with emotionally charged feelings.
Which nurse statement defines boundaries in the orientation phase of the nurse-client relationship when talking to a depressed client who has just been admitted to the psychiatric unit?
- A. Tell me about the relationship that you have with your mother and father.''
- B. Hello! I'm Nurse Andrea. I'll introduce you around and help you settle in.''
- C. What is the main thing that you would like to work on during therapy?'
- D. I understand that you have been depressed. What can you tell me about that?'
Correct Answer: B
Rationale: In the orientation phase of the nurse-client relationship, setting boundaries involves establishing the nurse's role and responsibilities while maintaining a professional distance. Option B demonstrates a clear boundary by introducing the nurse and offering assistance with settling in, which is appropriate for the initial phase of building rapport with the client. Choices A, C, and D delve into personal or therapeutic topics that are more suitable for the working phase of the relationship when the client's goals and problems are being addressed. Asking about the client's family relationships (Choice A), therapy focus (Choice C), or delving into the client's depression (Choice D) would be more relevant in later stages of the therapeutic process, once trust and rapport have been established during the orientation phase.
An adolescent reports irregularity in menses. Her mother complains that her child often fears gaining weight, has poor caloric intake, and has a distorted self-image. Which could be the reason for irregular menses?
- A. Bulimia
- B. Anorexia
- C. Orthorexia
- D. Binge eating disorder
Correct Answer: B
Rationale: The correct answer is 'Anorexia.' Anorexia is characterized by a lack of caloric intake motivated by a strong fear of gaining weight, leading to poor nutrition and potential irregular menses. Bulimia involves binge eating followed by compensatory behaviors. Orthorexia is characterized by an obsession with eating only healthy or 'pure' foods. Binge eating disorder is characterized by consuming large amounts of high-calorie food in a short period.
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