Nokea
A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client seeks out this particular nurse and imitates her mannerisms. Which defense mechanism does the nurse recognize in this client?
- A. Sublimation.
- B. Identification.
- C. Introjection.
- D. Repression.
Correct Answer: B
Rationale: Identification is the correct answer. It is a defense mechanism where an individual unconsciously models themselves after someone they admire or feel close to. In this scenario, the client is imitating the nurse's mannerisms, indicating identification. Sublimation involves channeling unacceptable impulses into socially acceptable activities. Introjection is the internalization of external attitudes or voices, while repression involves suppressing unwanted thoughts or desires.
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A client with schizophrenia is prescribed olanzapine (Zyprexa). What is the most important side effect for the nurse to monitor?
- A. Hypotension
- B. Weight gain
- C. Dry mouth
- D. Tachycardia
Correct Answer: B
Rationale: The correct answer is B: Weight gain. Olanzapine (Zyprexa) is known to cause significant weight gain in patients. This side effect is crucial to monitor because it can lead to metabolic syndrome, diabetes, and cardiovascular issues. Monitoring the client's weight regularly and providing appropriate dietary guidance is essential. Hypotension (choice A), dry mouth (choice C), and tachycardia (choice D) are not commonly associated with olanzapine use and are not the primary side effects to monitor in this case.
A client with a history of alcohol dependence tells the nurse that he has been sober for three months but has recently started drinking again. What should the nurse do next?
- A. Ask the client why he started drinking again.
- B. Provide information about support groups for sobriety.
- C. Discuss the consequences of drinking on his health.
- D. Encourage the client to express his feelings about relapse.
Correct Answer: D
Rationale: Encouraging the client to express his feelings about relapse is the most appropriate action for the nurse to take in this situation. This approach allows the nurse to address the underlying emotions and factors contributing to the relapse. Choice A, asking the client why he started drinking again, may come across as judgmental and might not be as effective in exploring the client's emotions. Choice B, providing information about support groups, is important but should come after addressing the client's current emotional state. Choice C, discussing the consequences of drinking, may be necessary at some point, but initially, the focus should be on the client's feelings and emotions surrounding the relapse.
The community health nurse talks to a male client who has bipolar disorder. The client explains that he sleeps 4 to 5 hours a night and is working with his partner to start two new businesses and build an empire. The client stopped taking his medications several days ago. What nursing problem has the highest priority?
- A. Excessive work activity.
- B. Decreased need for sleep.
- C. Medication management.
- D. Inflated self-esteem.
Correct Answer: C
Rationale: The most important nursing problem is medication management (C) because compliance with the medication regimen will help prevent hospitalization. The client is also exhibiting signs of mania, such as excessive work activity (A), decreased need for sleep (B), and inflated self-esteem (D); however, these problems do not have the priority of medication management. Managing the medications is crucial to stabilize the client's condition and prevent potential harm associated with untreated bipolar disorder.
A male client is brought to the emergency department by a police officer, who reports the client was disturbing the peace by running naked in the street, striking out at others, and smashing car windows. Which behaviors should the client demonstrate to determine if he should be evaluated for involuntary commitment?
- A. Threats to kill his friend.
- B. Disruptive behaviors in a community setting.
- C. Hears voices telling him to kill himself.
- D. Reports he has not needed a bath in 4 months.
Correct Answer: D
Rationale: The client's dangerous and disruptive behaviors, along with auditory hallucinations of self-harm, suggest a need for involuntary commitment for his safety and that of others. Involuntary commitment may be warranted based on the client's poor hygiene and self-neglect, as it indicates an inability to care for himself, which can pose a risk to his well-being.
In a mental health unit of a hospital, a LPN/LVN is leading a group psychotherapy session. What is the nurse's role in the termination stage of group development?
- A. Encourage problem solving
- B. Encourage accomplishment of the group's work
- C. Acknowledge the contributions of each group member
- D. Encourage members to become acquainted with one another
Correct Answer: C
Rationale: During the termination stage of group development in psychotherapy, the nurse's role is to acknowledge the contributions of each group member. This action helps to close the group on a positive note, reinforcing the therapeutic experience. Choice A, encouraging problem-solving, is more relevant in the earlier stages of group development. Choice B, encouraging the accomplishment of the group's work, is important throughout the group process but is not specific to the termination stage. Choice D, encouraging members to become acquainted with one another, is more aligned with the initial stages of group formation rather than the termination stage.