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Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?
- A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
- B. It is abnormal for identical twins to react differently to similar stressors.
- C. Identical twins should share the same temperament and respond similarly to stress.
- D. Environmental influences weigh more heavily than genetic influences on reactions to stress.
Correct Answer: A
Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.
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According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?
- A. A client rudely complaining about limited visiting hours
- B. A client exhibiting aggressive behavior toward another client
- C. A client stating that no one cares
- D. A client verbalizing feelings of failure
Correct Answer: B
Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.
A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?
- A. Diagnostic blood tests
- B. Awareness of factors creating stress
- C. Relaxation exercises
- D. Identifying support systems
Correct Answer: B
Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.
Which client should the nurse anticipate to be most receptive to psychiatric treatment?
- A. A Jewish female journalist
- B. A Baptist homeless male
- C. A Catholic black male
- D. A Protestant Swedish business executive
Correct Answer: A
Rationale: The client who is Jewish and female, a journalist, is likely to be more receptive to psychiatric treatment due to cultural factors. In Jewish culture, there is often a high value placed on preventative healthcare, including mental health. Additionally, research suggests that women are more likely than men to seek treatment for mental health issues, making this client more open to psychiatric care. Choice B, a homeless male, might face barriers to accessing and accepting psychiatric treatment due to challenges related to homelessness. Choice C, a Catholic black male, and choice D, a Protestant Swedish business executive, do not provide specific cultural or gender-related factors that would indicate higher receptiveness to psychiatric treatment than the Jewish female journalist.
A healthcare professional is planning care for a client with borderline personality disorder. Which of the following interventions should not be included in the plan of care?
- A. Set clear and consistent boundaries
- B. Encourage dependency on the healthcare professional
- C. Avoid discussing the client's feelings
- D. Use a firm, authoritative approach
Correct Answer: B
Rationale: In caring for a client with borderline personality disorder, it is essential to set clear and consistent boundaries, use a firm, authoritative approach, and provide opportunities for the client to express feelings. Encouraging dependency can reinforce maladaptive behaviors, while avoiding discussing feelings can hinder therapeutic progress in addressing underlying issues. Building a sense of dependency may exacerbate the client's difficulties in developing autonomy and self-reliance, which are crucial for their progress and recovery. Therefore, encouraging dependency is not a recommended intervention in the plan of care for clients with borderline personality disorder.
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.