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A nurse is caring for a hospitalized client who is quarrelsome and opinionated and has little regard for others. According to Sullivans interpersonal theory, the nurse should associate the clients behaviors with a previous deficit in which stage of development?
- A. Childhood
- B. Early adolescence
- C. Late adolescence
- D. Infancy
Correct Answer: A
Rationale: According to Sullivan's interpersonal theory, childhood is the stage where the foundation of interpersonal relationships is formed. Quarrelsome and opinionated behaviors with little regard for others can be associated with deficits in early childhood development. During this stage, individuals learn emotional regulation, empathy, and social skills. If these skills are not adequately developed in childhood, it can result in maladaptive behaviors in adulthood. Therefore, the correct answer is A.
Choice B, early adolescence, focuses more on identity formation and peer relationships. Choice C, late adolescence, emphasizes the transition to adulthood and independence. Choice D, infancy, is too early in development to have a significant impact on the client's current behavior.
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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- D. Uncomfortable in social situations; perceived as timid, withdrawn, cold, and strange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 female nurse is caring for a traditional Arab American male client. When planning effective care for this client, the nurse should be aware of which of the following cultural considerations? Select all that apply.
- A. Limited touch is acceptable only between members of the same sex.
- B. Conversing individuals of this culture stand far apart and do not make eye contact.
- C. Devout Muslim men may not shake hands with women.
- D. The man is the head of the household and women take on a subordinate role.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. In traditional Arab American culture, limited touch is acceptable only between members of the same sex due to modesty and respect for personal boundaries.
2. This cultural consideration is important for the nurse to provide appropriate care that respects the client's cultural beliefs and preferences.
3. Understanding this aspect helps the nurse establish trust and build rapport with the male client while upholding cultural sensitivity and respect.
Summary:
- Choice B is incorrect as Arab American individuals may stand close and make eye contact during conversations.
- Choice C is incorrect as devout Muslim men may opt for not shaking hands with women due to religious beliefs, not solely based on gender.
- Choice D is incorrect as gender roles in traditional Arab American culture can vary and may not always follow a strict hierarchical structure.
A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, Im not well enough to switch to a different nurse. What does this client response indicate to the nurse?
- A. The client is using manipulation to receive secondary gain.
- B. The client is using the defense mechanism of denial.
- C. The client is having trouble terminating the relationship.
- D. The client is using splitting as a way to remain dependent on the nurse.
Correct Answer: B
Rationale: The correct answer is B because the client's statement indicates denial of the upcoming change in nurses due to their belief that they are not well enough to switch. This defense mechanism helps the client avoid the reality of the situation. Choice A is incorrect as there is no evidence of manipulation for secondary gain. Choice C is incorrect as the client is not expressing difficulty in terminating the relationship. Choice D is incorrect as splitting involves seeing people as all good or all bad, which is not evident in the client's statement.
After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, You are incompetent! Which is the nurses best response?
- A. Do you believe that I was the cause of your blood test being canceled?
- B. I see that you are upset, but I feel uncomfortable when you swear at me.
- C. Have you ever thought about ways to express anger appropriately?
- D. Ill give you some space. Let me know if you need anything.
Correct Answer: B
Rationale: The correct answer is B: "I see that you are upset, but I feel uncomfortable when you swear at me." This response acknowledges the client's emotion while setting a boundary against inappropriate behavior. It demonstrates empathy towards the client's feelings without condoning the swearing. It also communicates the nurse's discomfort with the behavior, which can help in de-escalating the situation.
A: Choice A deflects responsibility and may come off as defensive, not addressing the client's emotions directly.
C: Choice C shifts the focus away from the client's immediate distress and may not be well-received in the heat of the moment.
D: Choice D, while giving space, doesn't address the behavior directly and may not effectively address the client's emotions or the impact of their actions on the nurse.
A nurse is interviewing a distressed client, who relates being fired after 15 years of loyal employment. Which of the following questions would best assist the nurse to determine the clients appraisal of the situation? Select all that apply.
- A. What resources have you used previously in stressful situations?
- B. Have you ever experienced a similar stressful situation?
- C. Who do you think is to blame for this situation?
- D. Why do you think you were fired from your job?
Correct Answer: A
Rationale: The correct answer is A: "What resources have you used previously in stressful situations?" This question is the best choice as it focuses on understanding the client's coping mechanisms and resilience. By asking about previous resources used, the nurse can assess the client's strengths and support systems.
Choice B is incorrect because asking if the client has experienced a similar situation does not directly address the client's current appraisal of the situation.
Choice C is incorrect as it focuses on assigning blame, which may not be helpful in understanding the client's perspective and emotions.
Choice D is also incorrect because asking why the client thinks they were fired may lead to a defensive response and may not necessarily provide insight into the client's appraisal of the situation.