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According to Eriksons developmental theory, when planning care for a 47-year-old client, which developmental task should a nurse identify as appropriate for this client?
- A. To achieve a sense of self-confidence and recognition from others
- B. To reflect back on life events to derive pleasure and meaning
- C. To achieve established life goals and consider the welfare of future generations
Correct Answer: B
Rationale: In Erikson's theory, the developmental task for a 47-year-old client aligns with the stage of Generativity vs. Stagnation. Choice B, reflecting on life events for pleasure and meaning, corresponds to this stage where individuals assess their accomplishments and seek fulfillment. This phase involves contributing to society and future generations. Choice A pertains to the earlier stage of Identity vs. Role Confusion in adolescence. Choice C aligns with the later stage of Integrity vs. Despair in older adulthood. Choice D is incomplete. Therefore, the correct answer is B as it best fits the age and developmental stage of the client in question.
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A man diagnosed with alcohol dependence experiences his first relapse. During his AA meeting, another group member states, I relapsed three times, but now have been sober for 15 years. Which of Yaloms curative group factors does this illustrate?
- A. Imparting of information
- B. Instillation of hope
- C. Catharsis
- D. Universality
Correct Answer: B
Rationale: The correct answer is B: Instillation of hope. This statement by the group member provides hope by showing that despite relapses, long-term sobriety is achievable. This aligns with Yalom's curative group factor of instillation of hope, where group members inspire and motivate each other through their own successes. The other choices are incorrect because:
A: Imparting of information focuses on sharing knowledge, not personal experiences.
C: Catharsis involves the release of emotions, not necessarily about hope for the future.
D: Universality is about realizing shared experiences, not specifically about hope for recovery.
A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, Should I seek psychiatric help for my mother? Which is an appropriate nursing reply?
- A. My mother also worries unnecessarily. I think it is part of the aging process.
- B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.
- C. From what you have told me, you should get her to a psychiatrist as soon as possible.
- D. Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.
Correct Answer: B
Rationale: The correct answer is B because it provides a clear and accurate explanation of when anxiety is considered abnormal. It states that anxiety is abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning. This response shows understanding of the situation and suggests seeking professional help based on specific criteria.
Choice A is incorrect as it dismisses the concerns as part of the aging process without addressing the possibility of abnormal anxiety. Choice C is incorrect as it jumps to the conclusion of seeking psychiatric help without evaluating the level of anxiety or impairment. Choice D is incorrect as it oversimplifies anxiety treatment by suggesting it can only be treated with medications, ignoring the importance of therapy and other interventions.
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.
During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, Im here for my heart, not my head problems. Which is the nurses best response?
- A. Its just a routine part of our assessment. All clients are asked these same questions.
- B. Why are you concerned about these types of questions?
- C. Psychological factors, like excessive stress, have been found to affect medical conditions.
- D. We can skip these questions, if you like. It isnt imperative that we complete this section.
Correct Answer: C
Rationale: The correct answer is C because it directly addresses the client's resistance by providing relevant information linking psychological factors to medical conditions. By explaining the impact of stress on health, the nurse demonstrates the importance of addressing psychosocial aspects during the assessment.
Choice A is incorrect as it does not acknowledge the client's concerns and may come off as dismissive. Choice B is also incorrect as it focuses on the client's feelings rather than providing information to address the issue. Choice D is incorrect as it offers to skip the questions, which goes against the best practice of conducting a comprehensive assessment.
Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing auditory hallucinations?
- A. My sister has the same diagnosis as you and she also hears voices.
- B. I understand that the voices seem real to you, but I do not hear any voices.
- C. Why not turn up the radio so that the voices are muted.
- D. I wouldnt worry about these voices. The medication will make them disappear.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates empathy and validation without reinforcing the hallucinations. By acknowledging the client's experience while maintaining reality orientation, the nurse can build trust and rapport. Choice A may unintentionally normalize the hallucinations. Choice C could dismiss the client's experience and avoid addressing the underlying issue. Choice D minimizes the client's distress and relies solely on medication without addressing the client's emotional needs.