Nokea
If the nurse who was not promoted tells another friend, "I knew I'd never get the job. The hospital administrator hates me."? If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:
- A. compensation.
- B. reaction formation.
- C. projection.
- D. denial.
Correct Answer: C
Rationale: The nurse is demonstrating projection, attributing her own feelings of dislike onto the hospital administrator. This defense mechanism involves unconsciously adopting blaming behavior. Compensation involves emphasizing a strong point to make up for a perceived weakness, which is not the case here. Reaction formation is adopting behavior opposite to actual feelings, and denial involves ignoring an unpleasant reality, none of which are demonstrated in this scenario.
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In the United States, several definitions of death are currently being used. The definition that uses apnea testing and pupillary responses to light is termed:
- A. whole brain death.
- B. heart-lung death.
- C. circulatory death.
- D. higher brain death.
Correct Answer: A
Rationale: The correct answer is 'whole brain death.' Most protocols for determining whole brain death require two separate clinical examinations, including the induction of painful stimuli, pupillary responses to light, oculovestibular testing, and apnea testing. This comprehensive approach ensures that all functions of the brain, including the brainstem, are evaluated to confirm the absence of brain function. Choices B and D are incorrect as they do not reflect the specific tests required for determining whole brain death. Choice C, 'circulatory death,' does not involve the evaluation of brain function and is not a current definition of death in the United States.
A family member of a client with a diagnosis of Schizophrenia asks about the prognosis. The nurse's response is based on the knowledge that schizophrenia:
- A. affects both genders equally.
- B. is a chronic, deteriorating disease with periods of remission.
- C. is usually diagnosed in early adulthood.
- D. does not have a clear protective hormone effect delaying diagnosis.
Correct Answer: B
Rationale: The correct answer is B: 'is a chronic, deteriorating disease with periods of remission.' While choices A, C, and D contain some truths about schizophrenia, they do not directly address the prognosis aspect of the question. Schizophrenia can affect both men and women equally, is typically diagnosed in early adulthood, and does not have a known protective hormone effect that delays diagnosis. Choice B accurately reflects the chronic and fluctuating nature of the disease, which is essential for understanding its long-term course.
A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
- A. naloxone (Narcan).
- B. labetalol (Normodyne).
- C. neostigmine (Prostigmin).
- D. thiothixene (Navane).
Correct Answer: A
Rationale: When a client becomes extremely somnolent with respiratory depression after being given an opiate drug, the physician is likely to order the administration of naloxone (Narcan). Naloxone is an opiate antagonist that attaches to opiate receptors, blocking or reversing the action of narcotic analgesics. Choices B, C, and D are incorrect. Labetalol is a beta blocker used for hypertension, neostigmine is an anticholinesterase agent used to treat myasthenia gravis and reverse neuromuscular blockade, and thiothixene is an antipsychotic agent used for psychiatric conditions.
Tricyclics (Antidepressants) can sometimes have which of the following adverse effects on patients diagnosed with depression?
- A. Shortness of breath
- B. Fainting
- C. Large intestine ulcers
- D. Distal muscular weakness
Correct Answer: B
Rationale: The correct answer is 'Fainting.' Tricyclic antidepressants can cause fainting and hypotension as adverse effects. Shortness of breath (Choice A) is not a common side effect of tricyclics. Large intestine ulcers (Choice C) are not typically associated with tricyclic antidepressants. Distal muscular weakness (Choice D) is not a common adverse effect of tricyclics but is commonly associated with other medications.
When helping a client gain insight into anxiety, the nurse should:
- A. help the client relate anxiety to specific triggers.
- B. ask the client to describe events that precede increased anxiety.
- C. encourage the client to practice relaxation techniques.
- D. address the client's resistive behavior.
Correct Answer: B
Rationale: When assisting a client in gaining insight into anxiety, it is crucial to explore the events that lead to increased anxiety. By asking the client to describe these events, the nurse can help the client recognize patterns and triggers, leading to a better understanding of their anxiety. Option A is incorrect because it refers to triggers rather than exploring the events leading to anxiety. Option C is incorrect as it focuses on relaxation techniques rather than delving into the root causes of anxiety. Option D is inappropriate as addressing resistive behavior may not foster a supportive therapeutic environment for the client.