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Nursing Elites

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1. A client with obsessive-compulsive disorder (OCD) spends several hours a day washing his hands. What is the best nursing intervention?

Correct answer: B

Rationale: Encouraging the client to discuss their compulsions is the best nursing intervention when caring for a client with OCD who spends excessive time on hand-washing. This approach can help the client identify underlying anxieties and triggers associated with the compulsive behavior. Restricting access to soap and water (Choice A) can lead to increased anxiety and worsen the obsession. Allowing the client to continue the behavior (Choice C) can perpetuate the compulsive cycle. Scheduling distracting activities (Choice D) may provide temporary relief but does not address the root cause of the behavior.

2. A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client seeks out this particular nurse and imitates the nurse's mannerisms. The nurse knows that the client is using which defense mechanism?

Correct answer: B

Rationale: The correct answer is (B) Identification. In this scenario, the client is imitating the nurse's mannerisms, which is a form of identification, a defense mechanism where an individual adopts the characteristics or behaviors of someone they admire or view as powerful. (A) Sublimation involves channeling unacceptable impulses into socially acceptable actions, not imitation. (C) Introjection is the internalization of external qualities or attributes, not imitation. (D) Repression is the unconscious exclusion of painful thoughts or memories from awareness, which is not demonstrated in this case.

3. At a support meeting of parents of a teenager with polysubstance dependency, a parent states, 'Each time my son tries to quit taking drugs, he gets so depressed that I'm afraid he will commit suicide.' The nurse's response should be based on which information?

Correct answer: D

Rationale: The priority is to teach the parents that their son will need monitoring and support during withdrawal to ensure that he does not attempt suicide. Option A is incorrect because addiction can be managed and treated effectively with appropriate interventions. Option B is incorrect as tolerance to drugs causing depression is not the primary concern in this scenario. Option C is incorrect as while depression can be a risk factor for drug abuse, in this case, the focus is on the son's safety during withdrawal.

4. A 30-year-old sales manager tells the nurse, 'I am thinking about a job change. I don't feel like I am living up to my potential.' Which of Maslow's developmental stages is the sales manager attempting to achieve?

Correct answer: A

Rationale: The correct answer is A: Self-Actualization. Self-actualization is the highest level of Maslow's development stages, characterized by the desire to fulfill one's full potential and achieve personal growth. In this scenario, the sales manager's statement indicates a need for personal fulfillment and reaching his highest aspirations, aligning with the concept of self-actualization. Choice B, Loving and Belonging, refers to the need for social relationships and support systems. Choice C, Basic Needs, represents the foundation level of Maslow's hierarchy, encompassing physiological needs like food and shelter. Choice D, Safety and Security, pertains to the need for physical and emotional safety.

5. The LPN/LVN is caring for a client with post-traumatic stress disorder (PTSD). Which intervention is most appropriate for the nurse to implement?

Correct answer: B

Rationale: Assisting the client in developing coping strategies is an appropriate intervention for managing PTSD. This approach helps the client build resilience and learn how to effectively cope with symptoms. Choice A, encouraging the client to talk about the traumatic event, may not be appropriate as it can potentially re-traumatize the client. Referring the client to a PTSD support group, as in choice C, can be beneficial but may not be the most immediate intervention. Administering medications, as in choice D, is important in some cases, but focusing on coping strategies should be prioritized as a holistic approach to managing PTSD.

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