Nokea
Which client statement may indicate a transference reaction?
- A. I need a real nurse. You are young enough to be my daughter and I dont want to tell you about my personal life.
- B. I deserve more than I am getting here. Do you know who I am and what I do? Let me talk to your supervisor.
- C. I dont seem to be able to relate to people. I would rather stay in my room and be by myself.
- D. My mother is the source of my problems. She has always told me what to do and what to say.
Correct Answer: A
Rationale: Step 1: The client's statement "I need a real nurse" suggests a desire for a particular type of nurse, implying a transfer of feelings from a significant person onto the nurse.
Step 2: The client mentioning the nurse's age and relationship dynamics ("young enough to be my daughter") indicates projection of unresolved emotions onto the nurse.
Step 3: The client's reluctance to share personal information and discomfort with the nurse's perceived identity further supports the presence of transference reactions.
Summary: Option A is correct as it demonstrates transference by projecting emotions onto the nurse based on age and personal dynamics. Other choices lack clear indications of transference and focus on different issues like entitlement, social interaction difficulties, and blaming family members.
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A nurse is caring for a hospitalized client who is quarrelsome and opinionated and has little regard for others. According to Sullivans interpersonal theory, the nurse should associate the clients behaviors with a previous deficit in which stage of development?
- A. Childhood
- B. Early adolescence
- C. Late adolescence
- D. Infancy
Correct Answer: A
Rationale: According to Sullivan's interpersonal theory, childhood is the stage where the foundation of interpersonal relationships is formed. Quarrelsome and opinionated behaviors with little regard for others can be associated with deficits in early childhood development. During this stage, individuals learn emotional regulation, empathy, and social skills. If these skills are not adequately developed in childhood, it can result in maladaptive behaviors in adulthood. Therefore, the correct answer is A.
Choice B, early adolescence, focuses more on identity formation and peer relationships. Choice C, late adolescence, emphasizes the transition to adulthood and independence. Choice D, infancy, is too early in development to have a significant impact on the client's current behavior.
A client comes to a psychiatric clinic, experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. What correctly written long-term outcome is realistic in addressing this clients crisis?
- A. The client will change his or her type A personality traits to more adaptive ones by week
- B. The client will completely eliminate all anxiety within 2 weeks.
- C. The client will reduce work hours from 12 to 6 hours per day immediately.
- D. The client will develop and implement a self-care routine to improve sleep and appetite within 4 weeks.
Correct Answer: D
Rationale: The correct answer is D. Developing and implementing a self-care routine to improve sleep and appetite within 4 weeks is the most realistic long-term outcome in addressing the client's crisis.
Rationale:
1. Self-care routines can positively impact sleep and appetite.
2. Improvements in sleep and appetite can help alleviate fatigue and other symptoms.
3. Realistic timeline of 4 weeks allows for gradual changes and adjustments.
4. It focuses on tangible actions the client can take to improve their well-being.
Incorrect Choices:
A: Changing personality traits is a complex and long-term process, unlikely to occur within a week.
B: Completely eliminating anxiety within 2 weeks is unrealistic and may not address the underlying causes.
C: Immediate reduction of work hours may not be feasible or necessary for addressing the client's crisis.
A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, Im not well enough to switch to a different nurse. What does this client response indicate to the nurse?
- A. The client is using manipulation to receive secondary gain.
- B. The client is using the defense mechanism of denial.
- C. The client is having trouble terminating the relationship.
- D. The client is using splitting as a way to remain dependent on the nurse.
Correct Answer: B
Rationale: The correct answer is B because the client's statement indicates denial of the upcoming change in nurses due to their belief that they are not well enough to switch. This defense mechanism helps the client avoid the reality of the situation. Choice A is incorrect as there is no evidence of manipulation for secondary gain. Choice C is incorrect as the client is not expressing difficulty in terminating the relationship. Choice D is incorrect as splitting involves seeing people as all good or all bad, which is not evident in the client's statement.
From an interpersonal theory perspective, which intervention would a nurse use to assist a client diagnosed with major depressive disorder?
- A. Offer family therapy sessions
- B. Discuss childhood events
- C. Teach alternate coping skills
- D. Encourage discussion of feelings
Correct Answer: A
Rationale: The correct answer is A because family therapy sessions can help address underlying family dynamics contributing to the client's depression. This intervention aligns with interpersonal theory, which focuses on improving relationships and communication within the client's social network. Family therapy can enhance support systems and promote healthier interactions.
Option B is incorrect as discussing childhood events may not directly address current interpersonal difficulties. Option C, teaching coping skills, is helpful but may not target the interpersonal issues specific to major depressive disorder. Option D, encouraging discussion of feelings, is important but may not address the broader interpersonal dynamics impacting the client's condition.
A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client?
- A. The client is placed in seclusion.
- B. The client is placed in a geriatric chair with tray.
- C. The client is placed in soft Posey restraints.
- D. The client is monitored by an ankle bracelet.
Correct Answer: D
Rationale: The correct answer is D - The client is monitored by an ankle bracelet. This option allows for monitoring and tracking the client's movements without physical restraint, promoting autonomy and freedom of movement. Seclusion (A) is restrictive and isolating. Placing the client in a geriatric chair with tray (B) limits mobility and can be degrading. Soft Posey restraints (C) restrict movement and can lead to physical and psychological harm. An ankle bracelet (D) is the least restrictive option as it allows for monitoring while still allowing the client some independence and mobility.