A client diagnosed with somatic symptom disorder is most likely to exhibit which personality disorder characteristics?
- A. Uses splitting and manipulation in relationships
- B. Is socially irresponsible, exploitative, and guiltless and disregards rights of others
- C. Expresses heightened emotionality, seductiveness, and strong dependency needs
- D. Uncomfortable in social situations; perceived as timid, withdrawn, cold, and strange
Correct Answer: C
Rationale: The correct answer is C because individuals with somatic symptom disorder often display characteristics of heightened emotionality, seductiveness, and strong dependency needs. These traits are consistent with histrionic personality disorder, which is commonly comorbid with somatic symptom disorder. Choice A (splitting and manipulation) is more indicative of borderline personality disorder. Choice B (socially irresponsible, exploitative) aligns with antisocial personality disorder. Choice D (uncomfortable in social situations) is more in line with schizoid or avoidant personality disorder. Thus, choice C is the most appropriate match for individuals with somatic symptom disorder.
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Which client statement may indicate a transference reaction?
- A. I need a real nurse. You are young enough to be my daughter and I dont want to tell you about my personal life.
- B. I deserve more than I am getting here. Do you know who I am and what I do? Let me talk to your supervisor.
- C. I dont seem to be able to relate to people. I would rather stay in my room and be by myself.
- D. My mother is the source of my problems. She has always told me what to do and what to say.
Correct Answer: A
Rationale: Step 1: The client's statement "I need a real nurse" suggests a desire for a particular type of nurse, implying a transfer of feelings from a significant person onto the nurse.
Step 2: The client mentioning the nurse's age and relationship dynamics ("young enough to be my daughter") indicates projection of unresolved emotions onto the nurse.
Step 3: The client's reluctance to share personal information and discomfort with the nurse's perceived identity further supports the presence of transference reactions.
Summary: Option A is correct as it demonstrates transference by projecting emotions onto the nurse based on age and personal dynamics. Other choices lack clear indications of transference and focus on different issues like entitlement, social interaction difficulties, and blaming family members.
An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?
- A. The employee assertively confronts the boss
- B. The employee leaves the staff meeting to work out in the gym
- C. The employee criticizes a coworker
- D. The employee takes the boss out to lunch
Correct Answer: C
Rationale: Displacement is a defense mechanism where emotions are redirected from the original source to a substitute target. In this case, the employee is likely to displace their anger from the boss onto a coworker by criticizing them. This behavior allows the employee to express their feelings indirectly.
A: Assertively confronting the boss does not align with displacement as it involves direct confrontation.
B: Leaving the meeting to work out in the gym is a form of avoidance and does not involve displacing emotions onto another target.
D: Taking the boss out to lunch is more of a conciliatory gesture and does not involve displacing negative emotions onto someone else.
A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, Should I seek psychiatric help for my mother? Which is an appropriate nursing reply?
- A. My mother also worries unnecessarily. I think it is part of the aging process.
- B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.
- C. From what you have told me, you should get her to a psychiatrist as soon as possible.
- D. Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.
Correct Answer: B
Rationale: The correct answer is B because it provides a clear and accurate explanation of when anxiety is considered abnormal. It states that anxiety is abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning. This response shows understanding of the situation and suggests seeking professional help based on specific criteria.
Choice A is incorrect as it dismisses the concerns as part of the aging process without addressing the possibility of abnormal anxiety. Choice C is incorrect as it jumps to the conclusion of seeking psychiatric help without evaluating the level of anxiety or impairment. Choice D is incorrect as it oversimplifies anxiety treatment by suggesting it can only be treated with medications, ignoring the importance of therapy and other interventions.
A nursing instructor is presenting content on the provisions of the Nurse Practice Act as it relates to their state. Which student statement indicates a need for further instruction?
- A. The Nurse Practice Act provides a list of definitions of important terms, including the definition of nursing.
- B. The Nurse Practice Act lists education requirements for licensure and reciprocity.
- C. The Nurse Practice Act contains detailed statements that describe the scope of practice for registered nurses (RNs).
- D. The Nurse Practice Act lists the general authority and powers of the state board of nursing.
Correct Answer: B
Rationale: The correct answer is B because education requirements for licensure and reciprocity are typically not included in the Nurse Practice Act. The Act primarily focuses on defining the scope of practice, authority of the state board, regulations, and standards for nursing practice. Education requirements are usually outlined in separate regulations or guidelines by the state board of nursing or accrediting bodies. Therefore, if a student statement mentions education requirements as part of the Nurse Practice Act, it indicates a need for further instruction as it is not accurate.
A: This statement is correct as the Nurse Practice Act often includes definitions of important terms to provide clarity and understanding.
C: This statement is correct as the Act does describe the scope of practice for registered nurses to ensure safe and competent care.
D: This statement is correct as the Act typically outlines the general authority and powers of the state board of nursing to regulate and oversee nursing practice.
A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys sympathy?
- A. You are feeling very depressed. I felt the same way when I decided to leave my husband.
- B. I can understand you are feeling depressed. It was a difficult decision. Ill sit with you.
- C. You seem depressed. It was a difficult decision to make. Would you like to talk about it?
- D. I know this is a difficult time for you. Would you like a prn medication for anxiety?
Correct Answer: A
Rationale: The correct answer is A because it shows empathy by sharing a personal experience to connect with the client emotionally. It validates the client's feelings and normalizes them. Choice B doesn't convey personal experience, and choice C lacks the personal touch. Choice D offers medication instead of emotional support, which is not therapeutic in this situation.