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Which scenario best demonstrates an example of eustress?
- A. An individual loses a beloved family pet.
- B. prepares to take a vacation to a tropical island with a group of close friends.
- C. receives a bank notice that there were insufficient funds in his/her account for a recent rent payment.
- D. receives notification that his/her current employer is experiencing financial problems and some workers will be terminated.
Correct Answer: B
Rationale: Eustress is beneficial stress; it motivates people to develop skills they need to solve problems and meet personal goals. Positive life experiences produce eustress. Going on a tropical vacation is an exciting, relaxing experience and is an example of eustress. Losing the family pet, worrying about employment security, and having financial problems are examples of distress, a negative experience that drains energy and can lead to significant emotional problems.
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A medical-surgical nurse works with a patient diagnosed with a somatic symptom disorder. Care planning is facilitated by understanding that the patient will probably
- A. readily seek psychiatric counseling.
- B. be resistant to accepting psychiatric help.
- C. attend psychotherapy sessions without encouragement.
- D. be eager to discover the true reasons for physical symptoms.
Correct Answer: B
Rationale: Patients with somatic symptom disorders go from one health care provider to another trying to establish a physical cause for their symptoms. When a psychological basis is suggested and a referral for counseling offered, these patients reject both.
A nurse asks a patient, 'If you had fever and vomiting for 3 days, what would you do?' Which aspect of the mental status examination is the nurse assessing?
- A. Behavior
- B. Cognition
- C. Affect and mood
- D. Perceptual disturbances
Correct Answer: B
Rationale: Assessing cognition involves determining a patient's judgment and decision making. In this case, the nurse would expect a response of 'Call my doctor' if the patient's cognition and judgment are intact. If the patient responds, 'I would stop eating' or 'I would just wait and see what happened,' the nurse would conclude that judgment is impaired. The other options refer to other aspects of the examination.
During a one-on-one interaction with the nurse, a patient frequently looks nervously at the door. Select the best comment by the nurse regarding this nonverbal communication.
- A. I notice you keep looking toward the door.'
- B. This is our time together. No one is going to interrupt us.'
- C. It looks as if you are eager to end our discussion for today.'
- D. If you are uncomfortable in this room, we can move someplace else.'
Correct Answer: A
Rationale: Making observations and encouraging the patient to describe perceptions are useful therapeutic communication techniques for this situation. The other responses are assumptions made by the nurse.
A nurse is developing a discharge plan for a client who is in a detoxification unit. The nurse should include which of the following in the client's relapse prevention plan?
- A. Limit partying with former friends to once weekly, lock up substances in the home, and turn over finances to another person.
- B. Find a support person or sponsor, identify triggers, and develop new coping skills.
- C. Isolate at home, take leave of absence from job, and limit social contacts.
- D. Solicit a support person to transport to meetings, live in the home with client, and prevent them from using the substance.
Correct Answer: B
Rationale: A relapse prevention plan should include finding a support person or sponsor, identifying triggers, and developing new coping skills. These strategies help the client maintain sobriety and manage potential triggers.
An advanced practice nurse observes a novice nurse expressing irritability regarding a patient with a long history of alcoholism and suspects the new nurse is experiencing countertransference. Which comment by the new nurse confirms this suspicion?
- A. This patient continues to deny problems resulting from drinking.
- B. My parents were alcoholics and often neglected our family.
- C. The patient cannot identify any goals for improvement.
- D. The patient said I have many traits like her mother.
Correct Answer: B
Rationale: Countertransference involves the nurse’s past influencing their reaction, as in Option B, linking irritability to personal history. Options A and C are objective observations, and Option D suggests patient transference.