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When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.
- A. What coping resources have you used previously in stressful situations?
- B. Have you ever faced a similar stressful situation before?
- C. Who do you think is to blame for this situation?
- D. What do you believe led to your termination from your job?
Correct Answer: C
Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.
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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.
A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?
- A. Determine the risks and benefits for each alternative.
- B. Formulate goals for resolution of the problem.
- C. Evaluate the outcome of the implemented alternative.
- D. Assess the facts of the situation.
Correct Answer: D
Rationale: In this scenario, the nurse's initial step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances, the nurse can better understand the problem and make informed decisions moving forward. This foundational assessment is crucial before proceeding to formulate goals, evaluate outcomes, or consider risks and benefits. Options A, B, and C involve steps that should follow the initial assessment of the situation, making them less suitable as the initial action in this context.
A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?
- A. When an individual has limited experience managing stress
- B. When an individual inherits adaptive genes
- C. When an individual faces pre-existing conditions that worsen stress
- D. When an individual's physiological and psychological resources are depleted
Correct Answer: D
Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.
A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?
- A. Projection
- B. Rationalization
- C. Regression
- D. Sublimation
Correct Answer: B
Rationale: The nurse should recognize that the client is using rationalization, a common defense mechanism. Rationalization involves creating logical reasons to justify unacceptable feelings or behaviors. In this scenario, the client is justifying excessive drinking by linking it to hard work and the need for relaxation, masking the true underlying issue of alcohol abuse. Projection involves attributing one's thoughts or feelings to others, regression involves reverting to an earlier stage of development, and sublimation involves channeling unacceptable impulses into socially acceptable activities, none of which are demonstrated in the client's statement.
Which of the following symptoms should a healthcare provider expect to assess in a client diagnosed with generalized anxiety disorder (GAD)? Select one that doesn't apply.
- A. Excessive worry
- B. Muscle tension
- C. Increased energy
- D. Restlessness
Correct Answer: C
Rationale: Symptoms of generalized anxiety disorder include excessive worry, muscle tension, restlessness, and irritability. Increased energy is not typically associated with GAD; clients often experience fatigue instead. This heightened energy level is more commonly seen in conditions like mania or hypomania, rather than in GAD. Therefore, the correct answer is 'Increased energy.' Choices A, B, and D are all symptoms commonly observed in individuals with generalized anxiety disorder.