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Which of the following considerations should have the most influence in the nurse's choice of the treatment for the client?
- A. The client's feelings and perceptions about his or her situation
- B. The nurse's beliefs about the theories of psychosocial development
- C. The nurse's familiarity with the type of treatment
- D. Any approach to treatment should work with any client.
Correct Answer: A
Rationale: The client's feelings and perceptions are critical in tailoring effective therapeutic interventions, ensuring they align with the client's needs and expectations.
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A patient is blaming his impending divorce on the fact that his wife goes out frequently with her girlfriends. If using reality therapy, the nurse would help the patient with which of the following responses?
- A. If you really love her, she should love you as well.
- B. What does being divorced mean for you?
- C. How do you feel about your marriage ending?
- D. What role do you think you have played in the end of your marriage?
Correct Answer: D
Rationale: Reality therapy encourages clients to examine their own behaviors and their impact on life goals, such as taking responsibility for their role in the divorce.
A college student decides to go to a party the night before a major exam instead of studying. After receiving a low score on the exam, the student tells a fellow student, 'I have to work too much and don't have time to study. It wouldn't matter anyway because the teacher is so unreasonable.' The defense mechanisms the student is using are
- A. Denial and displacement
- B. Rationalization and projection
- C. Reaction formation and resistance
- D. Regression and compensation
Correct Answer: B
Rationale: The student uses rationalization by excusing poor performance with external factors (work) and projection by blaming the teacher's unreasonableness for the outcome.
A nurse is meeting with a crisis support group. In efforts to help patients identify with one another, the nurse explains which of the following about the crisis experience?
- A. Even happy events can cause a crisis if the stress is overwhelming.
- B. Only people who have unfortunate life events will experience a crisis.
- C. A person has no control over how a crisis will affect him or her.
- D. People can prevent all crises if they develop good coping skills early.
Correct Answer: A
Rationale: Crises can arise from both positive and negative events, like marriage or loss, when stress overwhelms coping abilities. Not all crises stem from negative events, individuals have some control through coping, and not all crises can be prevented.
A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks for a bed bath, and makes many demands of the nurses. He also yells that they are lazy and incompetent. The nurse recognizes this behavior as which of the following defense mechanisms?
- A. Introjection
- B. Projection
- C. Rationalization
- D. Reaction formation
Correct Answer: B
Rationale: Projection involves attributing one's own unacceptable thoughts or feelings, such as laziness, to others, as seen in the client's accusations toward the nurses.
A nurse is assisting a patient who is working on the technique of systematic desensitization. When the patient feels anxious, the nurse can best use the principles of this technique by stating.
- A. Use the deep breathing techniques we practiced yesterday.
- B. What is the worst that will happen if you confront this fear?
- C. Tell me how you are feeling right now.
- D. I can see you are anxious. Let's stop for a minute.
Correct Answer: A
Rationale: Systematic desensitization involves using learned relaxation techniques, like deep breathing, to manage anxiety during exposure to fear-inducing stimuli.