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Two staff nurses were considered for promotion to head nurse. The promotion is announced via a memo on the unit bulletin board. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:
- A. Conversion
- B. Regression
- C. Introjection
- D. Rationalization
Correct Answer: B
Rationale: Crying reflects regression, a return to a less mature emotional response to disappointment. Conversion involves physical symptoms, introjection is identification with another, and rationalization is justifying feelings.
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A client was involved in a motor vehicle accident in which the seat belt was not worn. The client is exhibiting crepitus, decreased breath sounds on the left, complains of shortness of breath, and has a respiratory rate of 34/min. Which of the following assessment findings should concern the nurse the most?
- A. temperature of 102°F and a productive cough
- B. arterial blood gases (ABGs) with a PaO2 of 92 and PaCO2 of 40 mmHg
- C. trachea deviating to the right
- D. barrel-chested appearance
Correct Answer: C
Rationale: A mediastinal shift is indicative of a tension pneumothorax along with the other symptoms in the question. Because the individual was involved in an MVA, assessment is targeted at acute traumatic injuries to the lungs, heart, or chest wall rather than other conditions indicated in the other choices.
James returns home from school angry and upset because his teacher gave him a low grade on an assignment. After returning home from school, he kicks the dog. This coping mechanism is known as:
- A. denial.
- B. suppression.
- C. displacement.
- D. fantasy.
Correct Answer: C
Rationale: Displacement is the transference of anger to another. Anger is displaced on the dog as a convenient object.
A female prostitute enters a clinic for treatment of a sexually transmitted disease. This disease is the most prevalent STD in the United States. The nurse can anticipate that the woman has which of the following?
- A. herpes
- B. chlamydia
- C. gonorrhea
- D. syphilis
Correct Answer: B
Rationale: Epidemiological studies indicate that chlamydia is the most prevalent sexually transmitted disease in the United States.
An appropriate question when assessing a client's self-expectations about weight loss is:
- A. What makes you think you can change your eating habits?
- B. How do you feel about losing weight?
- C. How important is it that you lose weight?
- D. What do you think is a realistic weekly weight loss for you?
Correct Answer: D
Rationale: Nurses should assist clients to evaluate themselves and make behavior changes. Listening to clients, supporting clients' strengths, assisting clients to look at themselves in totality, and encouraging clients to set attainable goals should be part of the nurse-client relationship.
What is the reason for a contract between nurse and client?
- A. Contracts state the roles the participants take.
- B. Contracts are indicative of the feeling tone established between participants.
- C. Contracts are binding and prevent either party from ending the relationship prematurely.
- D. Contracts spell out the participation and responsibilities of both parties.
Correct Answer: D
Rationale: A contract emphasizes that the nurse works with the client, rather than doing something for the client. Working with suggests that each party is expected to participate and share responsibility for outcomes. Contracts do not, however, stipulate roles or feeling tone, nor is premature termination expressly forbidden.