Nokea
A client with schizophrenia is experiencing delusions. Which of the following interventions should the nurse implement?
- A. Agree with the client's delusions to avoid confrontation.
- B. Challenge the client's delusions directly.
- C. Encourage the client to discuss their delusions in detail.
- D. Present reality and offer reassurance without reinforcing the delusions.
Correct Answer: D
Rationale: When caring for a client with schizophrenia experiencing delusions, the nurse should present reality and offer reassurance without reinforcing the client's delusions. This approach helps the client maintain a connection to reality while feeling supported. Agreeing with the delusions may perpetuate false beliefs, while directly challenging them can lead to increased distress for the client. Encouraging the client to discuss their delusions in detail may further exacerbate their symptoms or reinforce their false beliefs. Therefore, the most therapeutic intervention is to gently present reality and provide reassurance to the client.
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Which is an example of the ego defense mechanism of regression?
- A. A mother blames the teacher for her child's failure in school.
- B. A teenager becomes hysterical after seeing a friend killed in a car accident.
- C. A woman wants to marry a man exactly like her beloved father.
- D. An adult throws a temper tantrum when he does not get his own way.
Correct Answer: D
Rationale: The correct answer is D. Regression involves reverting to an earlier stage of development for comfort. In this case, an adult throwing a temper tantrum is regressing to a childlike behavior when faced with not getting their way, which is a form of seeking comfort associated with earlier development. Choices A, B, and C do not exemplify regression. Blaming the teacher, becoming hysterical after a traumatic event, or seeking a partner similar to a beloved father are not instances of reverting to earlier developmental stages to cope with stress or conflict.
The healthcare provider is preparing to provide medication instruction for a patient. Which of the following understandings about anxiety will be essential to effective instruction?
- A. Learning is best when anxiety is moderate to severe.
- B. Learning is enhanced when anxiety is mild.
- C. Panic-level anxiety helps the provider teach better.
- D. Severe anxiety is characterized by intense concentration and enhances the attention span.
Correct Answer: B
Rationale: Mild anxiety sharpens the senses, increases the perceptual field, and results in heightened awareness of the environment, which enhances learning. As anxiety increases, attention span decreases, making learning more difficult. Therefore, mild anxiety is more conducive to effective instruction compared to moderate to severe anxiety, panic-level anxiety, or severe anxiety. Choice A is incorrect because moderate to severe anxiety impairs learning. Choice C is incorrect as panic-level anxiety can be overwhelming and hinder the learning process. Choice D is incorrect because severe anxiety typically leads to impaired attention span rather than enhancing it.
A fourth-grade student teases and makes jokes about a cute girl in his class. This behavior should be identified by a professional as indicative of which defense mechanism?
- A. Displacement
- B. Projection
- C. Reaction formation
- D. Sublimation
Correct Answer: C
Rationale: The professional should identify that the student is using reaction formation as a defense mechanism. Reaction formation involves expressing opposite thoughts or behaviors to prevent undesirable thoughts from being expressed. In this scenario, the student's teasing and joking behavior towards the girl can be seen as a way to cover up or mask his true feelings or desires towards her. Displacement involves redirecting emotions from the original source to a substitute target; Projection involves attributing one's undesirable feelings to others; Sublimation involves channeling unacceptable impulses into socially acceptable activities. Therefore, in this case, the student's behavior aligns most closely with reaction formation.
When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.
- A. What coping resources have you used previously in stressful situations?
- B. Have you ever faced a similar stressful situation before?
- C. Who do you think is to blame for this situation?
- D. What do you believe led to your termination from your job?
Correct Answer: C
Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.
Which statement about the concept of neuroses is most accurate?
- A. An individual experiencing neurosis is unaware of the distress they are experiencing.
- B. An individual experiencing neurosis feels helpless to change their situation.
- C. An individual experiencing neurosis is aware of psychological causes of their behavior.
- D. An individual experiencing neurosis has a loss of contact with reality.
Correct Answer: B
Rationale: Neurosis involves feelings of distress and anxiety, but individuals experiencing neurosis are usually aware of their distress and its causes. They may recognize that their behaviors are maladaptive and are generally in contact with reality. The accurate statement about neurosis is that an individual feels helpless to change their situation. Choice A is incorrect because individuals with neurosis are usually aware of their distress. Choice C is incorrect because while individuals may be aware of psychological causes, it is not the defining characteristic of neurosis. Choice D is incorrect because a loss of contact with reality is more characteristic of psychosis, not neurosis.