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Which of the following interventions should a nurse include in the care plan for a client with major depressive disorder? Select one that is not appropriate.
- A. Encourage participation in activities
- B. Promote adequate nutrition and hydration
- C. Discourage verbalization of feelings
- D. Monitor for suicidal ideation
Correct Answer: C
Rationale: Interventions for a client with major depressive disorder should focus on encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discouraging verbalization of feelings goes against the therapeutic approach as expressing and discussing feelings is crucial in the treatment of major depressive disorder. Clients with major depressive disorder often benefit from talking about their emotions and experiences, as it can help in processing their feelings and promoting recovery. Therefore, discouraging verbalization of feelings would hinder the client's progress and is not an appropriate intervention.
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In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?
- A. When the individual judges the event to be benign
- B. When the individual judges the event to be irrelevant
- C. When the individual judges the resources and skills needed to deal with the event
- D. When the individual judges the event to be pleasurable
Correct Answer: C
Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.
A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms should the nurse expect to observe during withdrawal? Select one that doesn't apply.
- A. Tremors
- B. Hallucinations
- C. Diaphoresis
- D. Bradycardia
Correct Answer: D
Rationale: During alcohol withdrawal, symptoms such as tremors, hallucinations, diaphoresis, and seizures are commonly observed. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia, an increased heart rate, is more commonly seen. Therefore, bradycardia is the correct answer as it is not an expected symptom during alcohol withdrawal. Tremors, hallucinations, and diaphoresis are all common manifestations of alcohol withdrawal, while bradycardia is not typically seen in this context.
Which medication is commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD)?
- A. Haloperidol
- B. Fluoxetine
- C. Methylphenidate
- D. Clozapine
Correct Answer: C
Rationale: Methylphenidate is a stimulant medication commonly prescribed to manage symptoms of attention-deficit/hyperactivity disorder (ADHD). It works by affecting certain chemicals in the brain to improve focus, attention span, and impulse control. Haloperidol, fluoxetine, and clozapine are not typically used as first-line treatments for ADHD. Haloperidol is an antipsychotic, fluoxetine is an antidepressant, and clozapine is an atypical antipsychotic, each with different mechanisms of action and primary indications.
When an individual uses the defense mechanism of displacement after the boss openly disagrees with suggestions, what behavior would be expected from this individual?
- A. The individual assertively confronts the boss
- B. The individual leaves the staff meeting to work out in the gym
- C. The individual criticizes a coworker
- D. The individual takes the boss out to lunch
Correct Answer: C
Rationale: The correct answer is C. The individual using the defense mechanism of displacement would criticize a coworker after being confronted by the boss. Displacement involves transferring feelings from one target to a neutral or less-threatening target, hence the individual criticizing a coworker instead of directly confronting the boss. Choices A, B, and D are incorrect. Choice A is incorrect because the individual is not likely to assertively confront the boss when using displacement. Choice B is incorrect as leaving the meeting to work out in the gym is not a typical response when displacement is used. Choice D is incorrect as taking the boss out to lunch does not align with the concept of displacement, which involves redirecting emotions onto another target.
When a husband accuses his wife of infidelity, which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?
- A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
- B. The husband ignores the wife's continued absence from the home.
- C. The husband has already admitted to having an affair with a coworker.
- D. The husband takes out his marital frustrations through employee abuse.
Correct Answer: C
Rationale: Projection is a defense mechanism where one attributes their unacceptable feelings or impulses to another person. In this scenario, the husband, by admitting to having an affair with a coworker, is projecting his infidelity onto his wife, indicating the use of the projection defense mechanism. Choice A is incorrect as it describes a different behavior, not projection. Choice B does not demonstrate projection but rather avoidance or denial. Choice D shows displacement of aggression, not projection.