Nokea
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.
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During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development?
- A. Its hard for me to tell my story when Im not sure about the reactions of others.
- B. I think Joes Antabuse suggestion is a good one and might work for me.
- C. My situation is very complex, and I need professional, not peer, advice.
- D. I am really upset that you expect me to solve my own problems.
Correct Answer: B
Rationale: The correct answer is B because it shows the client actively engaging in problem-solving and considering specific strategies, indicating progress to the working phase. Choice A reflects the initial phase where trust and sharing are still developing. Choice C suggests a dependency on professional advice, not group collaboration. Choice D demonstrates resistance and a lack of ownership over personal growth, indicating an earlier phase of group development.
A client is taking chlordiazepoxide (Librium) for generalized anxiety disorder symptoms. In which situation should a nurse recognize that this client is at greatest risk for drug overdose?
- A. When the client has a knowledge deficit related to the effects of the drug
- B. When the client combines the drug with alcohol
- C. When the client takes the drug on an empty stomach
- D. When the client fails to follow dietary restrictions
Correct Answer: B
Rationale: The correct answer is B: When the client combines the drug with alcohol. Combining chlordiazepoxide with alcohol can potentiate the central nervous system depression effects, leading to respiratory depression, sedation, and potential overdose. Alcohol can enhance the sedative effects of chlordiazepoxide, increasing the risk of overdose. A, C, and D are incorrect because a knowledge deficit, taking the drug on an empty stomach, or failing to follow dietary restrictions are not directly related to increasing the risk of drug overdose in this specific scenario.
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.
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.
A nurse concludes that a restless, agitated client is manifesting a fight-or-flight response. The nurse should associate this response with which neurotransmitter?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
Correct Answer: C
Rationale: The correct answer is C, Norepinephrine. During the fight-or-flight response, the sympathetic nervous system is activated, leading to the release of norepinephrine. Norepinephrine increases heart rate, blood pressure, and alertness, preparing the body to either fight or flee from a perceived threat. Dopamine (A) is more related to reward and pleasure. Serotonin (B) is involved in regulating mood and emotions. Cortisol (D) is a stress hormone, not a neurotransmitter involved in the fight-or-flight response.