Nokea
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: Projection results in unconsciously adopting blaming behavior. It attributes unacceptable attributes to other people.
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The PN is caring for a client with diabetes insipidus. The nurse can expect the lab work to show:
- A. elevated urine osmolarity and elevated serum osmolarity.
- B. decreased urine osmolarity and decreased serum osmolarity.
- C. elevated urine osmolarity and decreased serum osmolarity.
- D. decreased urine osmolarity and elevated serum osmolarity.
Correct Answer: D
Rationale: In diabetes insipidus, the pituitary releases too much antidiuretic hormone (ADH) causing the client to produce a large amount of dilute (decreased osmolarity) urine and causing dehydration (elevated serum osmolarity). Choice 3 might be seen in a client with SIADH (syndrome of inappropriate ADH). Choices 1 and 2 generally don't occur- urine and serum osmolarity typically move in opposite directions.
Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?
- A. Will my retirement funds outlast me?
- B. Who will handle my funeral arrangements?
- C. What will become of Jonathan when I am gone?
- D. How can I get Jonathan's physician to talk to me?
Correct Answer: C
Rationale: The mother's most prominent concern is likely to be what becomes of her son after she dies. Choice 1 is important but is not likely to be her most prominent concern. Choice 2 is also not likely to be her primary concern because the welfare of her son with schizophrenia is more important. Choice 4 is incorrect because Mrs. Owens has likely confronted and handled concerns about getting the physician to talk to her after 38 years of managing her son's care.
The nurse can best communicate to a client that he or she has been listening by:
- A. restating the main feeling or thought the client has expressed.
- B. making a judgment about the client's problem.
- C. offering a leading question such as, 'And then what happened?'
- D. saying, 'I understand what you're saying.'
Correct Answer: A
Rationale: Restating allows the client to validate the nurse's understanding of what has been communicated. It's an active listening technique. Judgments should be suspended in a nurse-client relationship. Leading questions ask for more information rather than showing understanding. Saying 'I understand' communicates understanding, but the client has no way of measuring the understanding.
Milieu therapy is best employed to perform which activity?
- A. Investigating the client's view of the world
- B. Promoting socialization skills
- C. Focusing on inappropriate behavior
- D. Providing repetitive ordinary experiences on a daily basis
Correct Answer: D
Rationale: Milieu therapy provides repetitive ordinary experiences to minimize change, reduce disruptive behavior, and promote stability.
Incidences of child abuse appear to be higher in the African-American community and might be explained by:
- A. The increased number of African Americans viewing violence on television
- B. More single-parent households in African-American communities
- C. Stricter child-rearing practices in African-American households
- D. A higher occurrence of rage in African Americans
Correct Answer: B
Rationale: Higher child abuse rates in African-American communities correlate with socioeconomic stress and single-parent households, not violence exposure, strict practices, or inherent rage.