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A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse include in the plan of care?
- A. Encourage the client to suppress compulsive behaviors.
- B. Set strict limits on the amount of time the client can engage in compulsive behaviors.
- C. Allow the client to perform compulsive behaviors as needed.
- D. Gradually limit the amount of time allotted for compulsive behaviors.
Correct Answer: D
Rationale: In caring for a client with OCD, it is essential to gradually limit the time allotted for compulsive behaviors. This intervention helps the client develop alternative coping mechanisms. Encouraging suppression or setting strict limits on compulsive behaviors can exacerbate the client's anxiety, making it crucial to approach the care plan with a gradual reduction strategy. Allowing the client to perform compulsive behaviors as needed does not promote progress towards managing OCD symptoms and may reinforce maladaptive patterns of behavior.
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A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should the instructor include in the teaching? Select one that doesn't apply.
- A. Deep breathing exercises
- B. Progressive muscle relaxation
- C. Mindfulness meditation
- D. Cognitive restructuring
Correct Answer: D
Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique aimed at identifying and changing negative thought patterns rather than a specific relaxation technique. Therefore, cognitive restructuring does not fall under the category of relaxation techniques and is not typically used to manage anxiety.
Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?
- A. Somatic symptom disorder
- B. Grief responses
- C. Psychosis
- D. Bipolar disorder
Correct Answer: A
Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.
Which should the individual recognize as an example of the defense mechanism of repression?
- A. A student aware of the need to study for tomorrow's test goes to a movie instead.
- B. A woman whose son was killed in Iraq does not believe the military report.
- C. A man who is unhappily married goes to school to become a marriage counselor.
- D. A woman was raped when she was 12 and no longer remembers the incident.
Correct Answer: D
Rationale: Repression is a defense mechanism where distressing thoughts, feelings, or memories are pushed out of conscious awareness to protect the individual from emotional pain. In this scenario, the woman's inability to recall the traumatic event of being raped at the age of 12 indicates repression in action. Choices A, B, and C do not represent repression. Choice A reflects procrastination, choice B suggests denial, and choice C indicates sublimation as the man is channeling his unhappiness into a constructive pursuit.
A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?
- A. When an individual has limited experience managing stress
- B. When an individual inherits adaptive genes
- C. When an individual faces pre-existing conditions that worsen stress
- D. When an individual's physiological and psychological resources are depleted
Correct Answer: D
Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.
When an individual uses the defense mechanism of displacement after the boss openly disagrees with suggestions, what behavior would be expected from this individual?
- A. The individual assertively confronts the boss
- B. The individual leaves the staff meeting to work out in the gym
- C. The individual criticizes a coworker
- D. The individual takes the boss out to lunch
Correct Answer: C
Rationale: The correct answer is C. The individual using the defense mechanism of displacement would criticize a coworker after being confronted by the boss. Displacement involves transferring feelings from one target to a neutral or less-threatening target, hence the individual criticizing a coworker instead of directly confronting the boss. Choices A, B, and D are incorrect. Choice A is incorrect because the individual is not likely to assertively confront the boss when using displacement. Choice B is incorrect as leaving the meeting to work out in the gym is not a typical response when displacement is used. Choice D is incorrect as taking the boss out to lunch does not align with the concept of displacement, which involves redirecting emotions onto another target.