Nursing Elites

1. Which of the following coping mechanisms protects an individual from anxiety?

• A. denial and fantasy
• B. rationalization and suppression
• C. regression and displacement
• D. reaction formation and projection

Correct answer: A

Rationale: The correct answer is 'denial and fantasy.' Denial involves blocking external events from awareness to avoid anxiety, while fantasy is escaping to a more comfortable, less threatening place. These mechanisms can protect individuals from anxiety by providing temporary relief or distraction. Choices B, C, and D are incorrect. Rationalization and suppression do not directly protect individuals from anxiety. Regression and displacement involve reverting to earlier developmental stages or redirecting emotions to a substitute target, which do not directly shield individuals from anxiety. Reaction formation and projection entail behaving in the opposite way to one's impulses or attributing one's feelings to others respectively, which do not directly protect individuals from anxiety.

2. The nurse is developing a care plan for a client with severe anxiety. An appropriate outcome for the client is that within 4 days the client should:

• A. Have decreased anxiety.
• B. Talk to the nurse for 10 minutes.
• C. Sit quietly for 30 minutes.
• D. Develop an adaptive coping mechanism.

Correct answer: B

Rationale: When developing outcome criteria for a client with severe anxiety, it is crucial for the goals to be specific, measurable, and realistic. In this scenario, the most appropriate outcome is for the client to talk to the nurse for 10 minutes within 4 days. This goal is specific (talking for a defined duration), measurable (10 minutes), and realistic given the client's condition. Expecting a severely anxious client to sit quietly for 30 minutes is not realistic and may even exacerbate their anxiety. While developing an adaptive coping mechanism is important, it is a broader long-term goal and may not be achievable within the specified timeframe. Having decreased anxiety is a desirable outcome, but it lacks specificity and measurability, making it less suitable as an immediate goal.

3. When medications have an additive, synergistic, or antagonistic effect on a tissue, a ________ reaction has occurred.

• A. pharmaceutical
• B. pharmacodynamic
• C. pharmacokinetic
• D. drug incompatibility

Correct answer: B

Rationale: The correct answer is 'pharmacodynamic.' Pharmacodynamics pertain to the effect of a drug on receptors, explaining how drugs affect tissues. Pharmaceutical reactions refer to chemical reactions between drugs before administration or absorption, not their effect on tissues. Pharmacokinetic reactions involve how the body affects the drug, not the tissue. Drug incompatibilities are essentially pharmaceutical reactions, not the specific effects on tissues seen in pharmacodynamic reactions.

4. What should the charge nurse do after overhearing the patient care assistant speaking harshly to the client with dementia?

• A. Change the patient care assistant's assignment
• B. Explore the interaction with the patient care assistant
• C. Discuss the matter with the client's family
• D. Initiate a group session with the patient care assistant

Correct answer: B

Rationale: The best action for the charge nurse to take is to explore the interaction with the patient care assistant. This step allows for clarification of the situation and direct addressing of the issue. Changing the patient care assistant's assignment (choice A) might be necessary, but understanding the situation should come first. Discussing the matter with the client's family (choice C) as an initial step could escalate the situation. Initiating a group session with the patient care assistant (choice D) could be considered later as a preventive measure to avoid similar incidents in the future.

5. Lidocaine is a medication frequently ordered for the client experiencing

• A. Atrial tachycardia
• B. Ventricular tachycardia
• C. Heart block
• D. Ventricular bradycardia

Correct answer: B

Rationale: Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electrical stimulation threshold of the ventricles without depressing the force of ventricular contractions. It is not used for atrial arrhythmias; thus, answer A is incorrect. Answers C and D are incorrect because lidocaine does not slow the heart rate, so it is not used for heart block or bradycardia.

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