Which behavior by the client exhibits denial after a recent diagnosis?
- A. Attempts to minimize the illness
- B. Lacks an emotional response to the illness
- C. Refuses to discuss the condition with the client's spouse
- D. Expresses displeasure with the prescribed activity program
Correct Answer: A
Rationale: The correct answer is 'Attempts to minimize the illness.' This behavior is a classic sign of denial, where the individual tries to downplay the seriousness of the illness to cope with it. By minimizing the illness, the client avoids facing the reality of the situation, which is characteristic of denial. Lacking an emotional response to the illness suggests suppression of emotions rather than denial. Refusing to discuss the condition with the spouse may stem from other issues like relationship strain or fear of causing distress, but it doesn't directly indicate denial. Expressing displeasure with the prescribed activity program typically reflects displaced anger, not denial of the illness.
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A client who is newly diagnosed with multiple sclerosis is obviously upset and asks, 'Am I going to die?' Which response would the nurse make?
- A. Most individuals with your disease live a normal life span.
- B. Is your family here? I would like to explain your disease to all of you.
- C. The prognosis varies, as most individuals have remissions and exacerbations.
- D. Why don't you speak with your health care provider to get more details?
Correct Answer: C
Rationale: The most appropriate response to the client's question regarding their prognosis is to acknowledge the variable nature of multiple sclerosis by stating that 'The prognosis varies, as most individuals have remissions and exacerbations.' This response provides realistic information while offering some hope. Choice A ('Most individuals with your disease live a normal life span.') gives false reassurance as repeated exacerbations may affect life span. Choice B ('Is your family here? I would like to explain your disease to all of you.') does not directly address the client's question and involves the family unnecessarily. Choice D ('Why don't you speak with your health care provider to get more details?') deflects the responsibility and does not address the client's immediate concerns about their prognosis.
Which psychosocial attribute plays an important role in the development of a healthy personality from birth to 1 year of age?
- A. Initiative versus guilt
- B. Trust versus mistrust
- C. Autonomy versus shame
- D. Industry versus inferiority
Correct Answer: B
Rationale: According to Erikson's theory of psychosocial development, the first attribute that helps develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is observed at 3 to 6 years of age, when children explore their surroundings and may experience guilt if their actions conflict with parental expectations. Autonomy versus shame occurs between 1 and 3 years of age, as children develop motor skills and new activities, with shame emerging if they feel self-conscious. Industry versus inferiority is evident in children aged 6 to 12 years, where successful task completion fosters a sense of industry, while excessive expectations can lead to feelings of inferiority. Therefore, the correct attribute for a healthy personality development from birth to 1 year of age is trust versus mistrust.
The client has a new colostomy. Which client outcome is most important for achievement of long-range goals associated with adjusting to a new colostomy?
- A. Mastery of colostomy care techniques
- B. Readiness to accept an altered body function
- C. Awareness of community resources available
- D. Understanding necessary dietary modifications
Correct Answer: B
Rationale: The most crucial client outcome for successful adjustment to a new colostomy is the readiness to accept an altered body function. Acceptance of changes in body image and function is essential to facilitate mastery of colostomy care techniques and optimal utilization of community resources. Without readiness to accept the altered body function, the client may not be open to learning and adopting necessary changes, hindering the achievement of long-term goals. Understanding dietary modifications, while important, is secondary to the fundamental acceptance of the altered body function in the process of adjusting to a new colostomy.
Which behavior would the nurse recognize as developmentally atypical in preschoolers?
- A. Thumb sucking during stress
- B. Feeling guilty for behaving inappropriately
- C. Feeling happy if there is a newborn in the family
- D. Curiosity about their surroundings
Correct Answer: C
Rationale: The correct answer is feeling happy if there is a newborn in the family. Preschoolers are more likely to exhibit feelings of stress and jealousy rather than happiness with the arrival of a new baby in the family. Thumb sucking and bed-wetting are common behaviors displayed by preschoolers during times of stress. Guilt typically arises in children when they perceive that they have not behaved appropriately. Preschoolers are known to be naturally curious about their surroundings, showing an interest in exploring and learning about the environment around them. Therefore, feeling happy with the birth of a new baby is developmentally atypical for preschoolers.
In the care of a withdrawn, reclusive psychotic client, which goal is the priority?
- A. Establish trust
- B. Increase feelings of self-worth
- C. Solidify sense of identity
- D. Improve ability to socialize
Correct Answer: A
Rationale: The priority goal in the care of a withdrawn, reclusive psychotic client is to establish trust. Trust is fundamental in building a therapeutic relationship, which is essential for effective care. Without trust, the client may not engage in therapy or interventions. Once trust is established, the nurse can then assess the client's feelings of self-worth, sense of identity, and ability to socialize. While these other goals are important in the overall care of the client, establishing trust forms the foundation for further progress in the therapeutic relationship and treatment.