Nokea
Which should the nurse recognize as an example of the defense mechanism of repression?
- A. A woman whose son was killed in Iraq does not believe the military report.
- B. A man who is unhappily married goes to school to become a marriage counselor.
- C. A woman was raped when she was 12 and no longer remembers the incident.
Correct Answer: C
Rationale: The correct answer is C because repression is a defense mechanism in which traumatic memories are unconsciously blocked from awareness. In this scenario, the woman's inability to remember the rape incident at age 12 is a classic example of repression. She has pushed the memory out of consciousness to avoid the emotional distress associated with it.
Choice A is incorrect as it describes denial, where the woman refuses to accept the truth. Choice B is incorrect as it reflects sublimation, where the man channels his unhappiness into a positive pursuit. Choice D is incomplete, making it impossible to evaluate.
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A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation?
- A. Everyone diagnosed with OCD needs to control their ritualistic behaviors.
- B. It is important for you to discontinue these ritualistic behaviors.
- C. Why are you asking for help if you wont participate in unit therapy?
- D. Lets figure out a way for you to attend unit activities and still wash your hands.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the client's need to wash their hands due to OCD while also addressing the issue of missing unit activities. By suggesting finding a way for the client to attend activities while still accommodating their need to wash hands, it promotes a collaborative approach and respects the client's autonomy. Option A is incorrect as not everyone with OCD can completely control their behaviors. Option B is too directive and may increase resistance. Option C is confrontational and may discourage the client from seeking help.
Neurological tests have ruled out pathology in a clients sudden lower-extremity paralysis. Which nursing care should be included for this client?
- A. Deal with physical symptoms in a detached manner.
- B. Challenge the validity of physical symptoms.
- C. Meet dependency needs until the physical limitations subside.
- D. Encourage a discussion of feelings about the lower-extremity problem.
Correct Answer: D
Rationale: The correct answer is D because focusing on the client's emotional response is crucial when physical pathology is ruled out. By encouraging a discussion of feelings, the nurse can provide emotional support, assess coping mechanisms, and address any psychosocial factors contributing to the paralysis. This approach promotes holistic care and aids in the client's emotional well-being.
Choice A is incorrect as dealing with physical symptoms in a detached manner may neglect the client's emotional needs. Choice B is incorrect as challenging the validity of physical symptoms can invalidate the client's experience and hinder therapeutic rapport. Choice C is incorrect as meeting dependency needs may not address the emotional impact of sudden paralysis.
A nurse directs the client interaction and plans for interventions to achieve client goals. According to Peplaus framework for psychodynamic nursing, what therapeutic role is this nurse assuming?
- A. The role of technical expert
- B. The role of resource person
- C. The role of teacher
- D. The role of leader
Correct Answer: D
Rationale: The correct answer is D: The role of leader. In Peplau's framework, the nurse in this scenario is assuming the therapeutic role of a leader because they are directing client interactions and planning interventions to achieve client goals. This role involves guiding and facilitating the therapeutic process, fostering a collaborative relationship with the client, and empowering them to make decisions and progress towards their goals.
A: The role of technical expert is incorrect because it focuses more on providing specialized knowledge and skills rather than leading and directing client interactions.
B: The role of resource person is incorrect as it typically involves providing information and support, but not necessarily directing client interactions and planning interventions.
C: The role of teacher is incorrect because while education and guidance are important in nursing, it does not fully capture the leadership and direction involved in the scenario described.
An involuntarily committed client is verbally abusive to the staff and repeatedly threatening to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit?
- A. Verbally redirect the client, and then limit one-on-one interaction.
- B. Involve the hospitals security division as soon as possible.
- C. Notify the client that documenting personal staff information is against hospital policy.
- D. Continue professional attempts to establish a positive working relationship with the client.
Correct Answer: C
Rationale: The most appropriate nursing action is to choose option C: Notify the client that documenting personal staff information is against hospital policy. This response is effective in addressing the situation because it clearly communicates boundaries to the client and informs them of the hospital's policy. By doing so, the client is made aware that their behavior is not acceptable and that there are consequences for violating the policy. This action also helps to protect the staff members' privacy and security.
Option A: Verbally redirect the client and then limit one-on-one interaction, may not effectively address the issue of the client recording personal staff information. Option B: Involve the hospital's security division as soon as possible, is a more drastic measure that may escalate the situation unnecessarily. Option D: Continue professional attempts to establish a positive working relationship with the client, is not appropriate in this scenario as the client's behavior is threatening and abusive.
A female nurse is caring for a traditional Arab American male client. When planning effective care for this client, the nurse should be aware of which of the following cultural considerations? Select all that apply.
- A. Limited touch is acceptable only between members of the same sex.
- B. Conversing individuals of this culture stand far apart and do not make eye contact.
- C. Devout Muslim men may not shake hands with women.
- D. The man is the head of the household and women take on a subordinate role.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. In traditional Arab American culture, limited touch is acceptable only between members of the same sex due to modesty and respect for personal boundaries.
2. This cultural consideration is important for the nurse to provide appropriate care that respects the client's cultural beliefs and preferences.
3. Understanding this aspect helps the nurse establish trust and build rapport with the male client while upholding cultural sensitivity and respect.
Summary:
- Choice B is incorrect as Arab American individuals may stand close and make eye contact during conversations.
- Choice C is incorrect as devout Muslim men may opt for not shaking hands with women due to religious beliefs, not solely based on gender.
- Choice D is incorrect as gender roles in traditional Arab American culture can vary and may not always follow a strict hierarchical structure.