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A client is trying to explore and solve a problem. Which nursing statement would be an example of verbalizing the implied?
- A. You seem to be motivated to change your behavior.
- B. How will these changes affect your family relationships?
- C. Why dont you make a list of the behaviors you need to change.
- D. The team recommends that you make only one behavioral change at a time.
Correct Answer: A
Rationale: Step 1: A is correct as it reflects active listening and shows empathy towards the client.
Step 2: By stating "You seem to be motivated to change your behavior," the nurse acknowledges the client's feelings and encourages further exploration.
Step 3: This statement helps the client feel understood and supported in their journey towards change.
Summary:
B: Focuses on family relationships, not the client's motivation.
C: Suggests a directive approach rather than exploring the client's feelings.
D: Imposes a specific recommendation without considering the client's readiness or motivation.
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When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
- A. Hiding liquor bottles in a closet
- B. Yelling at their son for slouching in his chair
- C. Burning dinner on purpose
- D. Saying to the spouse, I dont drink too much!
Correct Answer: D
Rationale: The correct answer is D because the client is using denial as a defense mechanism to cope with the stress of being confronted about her alcohol abuse. By saying "I don't drink too much," she is refusing to acknowledge the reality of her excessive alcohol consumption. This denial allows her to avoid facing the uncomfortable truth and the need for change.
A: Hiding liquor bottles in a closet is an example of a defense mechanism called displacement, not denial.
B: Yelling at their son for slouching in his chair is an example of a defense mechanism called projection, not denial.
C: Burning dinner on purpose is an example of a defense mechanism called passive-aggression, not denial.
To promote self-reliance, how should a psychiatric nurse best conduct medication administration?
- A. Encourage clients to request their medications at the appropriate times.
- B. Refuse to administer medications unless clients request them at the appropriate times.
- C. Allow the clients to determine appropriate medication times.
- D. Take medications to the clients bedside at the appropriate times.
Correct Answer: A
Rationale: The correct answer is A because it promotes self-reliance by empowering clients to take responsibility for their own medication schedule. By encouraging clients to request their medications at the appropriate times, the nurse fosters autonomy and self-management.
Choice B is incorrect as it is too extreme and may compromise client safety by withholding medications based solely on client request. Choice C is incorrect as it puts the responsibility solely on the client without appropriate guidance from the nurse. Choice D is incorrect as it does not actively involve the client in the medication administration process.
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 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.
A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client?
- A. The client is placed in seclusion.
- B. The client is placed in a geriatric chair with tray.
- C. The client is placed in soft Posey restraints.
- D. The client is monitored by an ankle bracelet.
Correct Answer: D
Rationale: The correct answer is D - The client is monitored by an ankle bracelet. This option allows for monitoring and tracking the client's movements without physical restraint, promoting autonomy and freedom of movement. Seclusion (A) is restrictive and isolating. Placing the client in a geriatric chair with tray (B) limits mobility and can be degrading. Soft Posey restraints (C) restrict movement and can lead to physical and psychological harm. An ankle bracelet (D) is the least restrictive option as it allows for monitoring while still allowing the client some independence and mobility.