Nokea
An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?
- A. The employee assertively confronts the boss
- B. The employee leaves the staff meeting to work out in the gym
- C. The employee criticizes a coworker
- D. The employee takes the boss out to lunch
Correct Answer: C
Rationale: Displacement is a defense mechanism where emotions are redirected from the original source to a substitute target. In this case, the employee is likely to displace their anger from the boss onto a coworker by criticizing them. This behavior allows the employee to express their feelings indirectly.
A: Assertively confronting the boss does not align with displacement as it involves direct confrontation.
B: Leaving the meeting to work out in the gym is a form of avoidance and does not involve displacing emotions onto another target.
D: Taking the boss out to lunch is more of a conciliatory gesture and does not involve displacing negative emotions onto someone else.
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During a therapeutic group, two clients engage in an angry verbal exchange. The nurse leader interrupts the exchange and excuses both of the clients from the group. The nurse has demonstrated which leadership style?
- A. Autocratic
- B. Democratic
- C. Laissez-faire
- D. Bureaucratic
Correct Answer: A
Rationale: The correct answer is A: Autocratic. This leadership style is characterized by making decisions independently and enforcing them without input from the group. In this scenario, the nurse leader interrupted the exchange and made the decision to excuse both clients without consulting the group. This approach is necessary in situations requiring immediate intervention to maintain order and ensure the safety of all group members.
Summary of other choices:
B: Democratic - In a democratic leadership style, decisions are made through group discussion and input from all members. This was not demonstrated in the scenario.
C: Laissez-faire - In a laissez-faire leadership style, the leader takes a hands-off approach and allows group members to make decisions. This was not demonstrated as the nurse leader took immediate action.
D: Bureaucratic - Bureaucratic leadership involves following strict rules and procedures. The scenario did not involve following predetermined rules but rather a quick decision made by the nurse leader.
A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor?
- A. Irrelevant
- B. Harm/loss
- C. Threatening
- D. Challenging
Correct Answer: D
Rationale: The correct answer is D: Challenging. The client's statement indicates a positive reframing of the job loss as an opportunity for personal growth. This suggests that the client views the situation as a challenge to adapt and pursue a new path. This perspective aligns with the concept of stress as a potential source of growth and development, known as the challenge appraisal.
Summary:
A: Irrelevant - The client's statement demonstrates relevance to his future plans, making this choice incorrect.
B: Harm/loss - The client's positive outlook does not reflect a perception of harm or loss, making this choice incorrect.
C: Threatening - The client's statement does not convey a perception of threat, making this choice incorrect.
An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming from severe childhood sexual abuse. Which nursing intervention takes priority?
- A. Encourage exploration of sexual abuse
- B. Encourage guided imagery
- C. Establish trust and rapport
- D. Administer antianxiety medications
Correct Answer: C
Rationale: The correct answer is C: Establish trust and rapport. This is the priority because building a therapeutic relationship is essential for effective treatment of DID. Trust and rapport are foundational for the client to feel safe and supported in exploring and processing traumatic experiences. Encouraging exploration of sexual abuse (Option A) may be overwhelming and retraumatizing without a solid therapeutic alliance. Guided imagery (Option B) might not be appropriate at this stage as the client needs to establish trust first. Administering antianxiety medications (Option D) alone does not address the root cause or provide the necessary support for the client's complex trauma history.
When an individuals stress response is sustained over a long period of time, which physiological effect of the endocrine system should a nurse anticipate?
- A. Decreased resistance to disease
- B. Increased libido
- C. Decreased blood pressure
- D. Increased inflammatory response
Correct Answer: A
Rationale: The correct answer is A: Decreased resistance to disease. Prolonged stress can weaken the immune system, making individuals more susceptible to illnesses. Chronic stress suppresses immune functions, leading to decreased resistance to diseases. The other choices are incorrect because increased libido (B) and decreased blood pressure (C) are not typical physiological effects of sustained stress. While stress can lead to increased inflammatory response (D), the primary concern with chronic stress is its negative impact on the immune system, making choice A the most appropriate answer in this context.
An involuntarily committed client is verbally abusive to the staff and repeatedly threatening to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit?
- A. Verbally redirect the client, and then limit one-on-one interaction.
- B. Involve the hospitals security division as soon as possible.
- C. Notify the client that documenting personal staff information is against hospital policy.
- D. Continue professional attempts to establish a positive working relationship with the client.
Correct Answer: C
Rationale: The most appropriate nursing action is to choose option C: Notify the client that documenting personal staff information is against hospital policy. This response is effective in addressing the situation because it clearly communicates boundaries to the client and informs them of the hospital's policy. By doing so, the client is made aware that their behavior is not acceptable and that there are consequences for violating the policy. This action also helps to protect the staff members' privacy and security.
Option A: Verbally redirect the client and then limit one-on-one interaction, may not effectively address the issue of the client recording personal staff information. Option B: Involve the hospital's security division as soon as possible, is a more drastic measure that may escalate the situation unnecessarily. Option D: Continue professional attempts to establish a positive working relationship with the client, is not appropriate in this scenario as the client's behavior is threatening and abusive.