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A client comes to a psychiatric clinic, experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. What correctly written long-term outcome is realistic in addressing this clients crisis?
- A. The client will change his or her type A personality traits to more adaptive ones by week
- B. The client will completely eliminate all anxiety within 2 weeks.
- C. The client will reduce work hours from 12 to 6 hours per day immediately.
- D. The client will develop and implement a self-care routine to improve sleep and appetite within 4 weeks.
Correct Answer: D
Rationale: The correct answer is D. Developing and implementing a self-care routine to improve sleep and appetite within 4 weeks is the most realistic long-term outcome in addressing the client's crisis.
Rationale:
1. Self-care routines can positively impact sleep and appetite.
2. Improvements in sleep and appetite can help alleviate fatigue and other symptoms.
3. Realistic timeline of 4 weeks allows for gradual changes and adjustments.
4. It focuses on tangible actions the client can take to improve their well-being.
Incorrect Choices:
A: Changing personality traits is a complex and long-term process, unlikely to occur within a week.
B: Completely eliminating anxiety within 2 weeks is unrealistic and may not address the underlying causes.
C: Immediate reduction of work hours may not be feasible or necessary for addressing the client's crisis.
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An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming from severe childhood sexual abuse. Which nursing intervention takes priority?
- A. Encourage exploration of sexual abuse
- B. Encourage guided imagery
- C. Establish trust and rapport
- D. Administer antianxiety medications
Correct Answer: C
Rationale: The correct answer is C: Establish trust and rapport. This is the priority because building a therapeutic relationship is essential for effective treatment of DID. Trust and rapport are foundational for the client to feel safe and supported in exploring and processing traumatic experiences. Encouraging exploration of sexual abuse (Option A) may be overwhelming and retraumatizing without a solid therapeutic alliance. Guided imagery (Option B) might not be appropriate at this stage as the client needs to establish trust first. Administering antianxiety medications (Option D) alone does not address the root cause or provide the necessary support for the client's complex trauma history.
What is the priority nursing action during the orientation (introductory) phase of the nurseclient relationship?
- A. Acknowledge the clients actions and generate alternative behaviors.
- B. Establish rapport and develop treatment goals.
- C. Attempt to find alternative placement.
- D. Explore how thoughts and feelings about this client may adversely impact care.
Correct Answer: B
Rationale: The correct answer is B: Establish rapport and develop treatment goals. During the introductory phase of the nurse-client relationship, establishing rapport is essential to build trust and a therapeutic alliance. Developing treatment goals collaboratively with the client sets the foundation for the care plan. This action promotes client engagement and empowerment. Acknowledging client actions and generating alternative behaviors (A) is more suited for later phases. Attempting to find alternative placement (C) is not appropriate in the introductory phase. Exploring how thoughts and feelings impact care (D) is important but not the priority during the orientation phase.
A nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement would indicate a need for further follow-up instructions?
- A. I will need scheduled bloodwork in order to monitor for toxic levels of this drug.
- B. I wont stop taking this medication abruptly, because there could be serious complications.
- C. I will not drink alcohol while taking this medication.
- D. I wont take extra doses of this drug because I can become addicted.
Correct Answer: A
Rationale: The correct answer is A because the statement indicates a misunderstanding. Benzodiazepines do not require routine blood monitoring for toxicity. Benzodiazepines are typically monitored based on clinical response and potential side effects. Choices B, C, and D are all correct statements related to benzodiazepine use, emphasizing the importance of not abruptly stopping the medication, avoiding alcohol, and not taking extra doses to prevent addiction.
During a therapeutic group, two clients engage in an angry verbal exchange. The nurse leader interrupts the exchange and excuses both of the clients from the group. The nurse has demonstrated which leadership style?
- A. Autocratic
- B. Democratic
- C. Laissez-faire
- D. Bureaucratic
Correct Answer: A
Rationale: The correct answer is A: Autocratic. This leadership style is characterized by making decisions independently and enforcing them without input from the group. In this scenario, the nurse leader interrupted the exchange and made the decision to excuse both clients without consulting the group. This approach is necessary in situations requiring immediate intervention to maintain order and ensure the safety of all group members.
Summary of other choices:
B: Democratic - In a democratic leadership style, decisions are made through group discussion and input from all members. This was not demonstrated in the scenario.
C: Laissez-faire - In a laissez-faire leadership style, the leader takes a hands-off approach and allows group members to make decisions. This was not demonstrated as the nurse leader took immediate action.
D: Bureaucratic - Bureaucratic leadership involves following strict rules and procedures. The scenario did not involve following predetermined rules but rather a quick decision made by the nurse leader.
Which is the most significant consequence of the excessive use of defense mechanisms?
- A. Emotions will be experienced intensely.
- B. Problem-solving will be limited.
- C. The superego will be suppressed.
- D. Learning and the ability to grow will be enhanced.
Correct Answer: B
Rationale: The correct answer is B because excessive use of defense mechanisms can hinder problem-solving skills by avoiding facing reality and finding constructive solutions. Defense mechanisms are psychological strategies that individuals unconsciously use to cope with anxiety and protect the ego. By relying too heavily on these mechanisms, individuals may overlook important issues, leading to limited problem-solving abilities. This can result in difficulties in adapting to challenges and impede personal growth. Emotions being experienced intensely (A) is not the most significant consequence as it is a natural response to certain situations and does not directly relate to defense mechanisms. The superego being suppressed (C) is not a direct consequence of defense mechanisms but may occur as a result of unresolved conflicts. Learning and growth being enhanced (D) is incorrect as excessive defense mechanisms can actually hinder learning and personal development.