Nursing Elites

1. A fourth-grade student teases and makes jokes about a cute girl in his class. This behavior should be identified by a professional as indicative of which defense mechanism?

• A. Displacement
• B. Projection
• C. Reaction formation
• D. Sublimation

Correct answer: C

Rationale: The professional should identify that the student is using reaction formation as a defense mechanism. Reaction formation involves expressing opposite thoughts or behaviors to prevent undesirable thoughts from being expressed. In this scenario, the student's teasing and joking behavior towards the girl can be seen as a way to cover up or mask his true feelings or desires towards her. Displacement involves redirecting emotions from the original source to a substitute target; Projection involves attributing one's undesirable feelings to others; Sublimation involves channeling unacceptable impulses into socially acceptable activities. Therefore, in this case, the student's behavior aligns most closely with reaction formation.

2. When developing a care plan for a client with generalized anxiety disorder (GAD), which of the following interventions should not be included?

• A. Encourage the client to avoid anxiety-provoking situations.
• B. Teach the client relaxation techniques.
• C. Encourage the client to express their feelings.
• D. Provide a structured daily routine.

Correct answer: A

Rationale: When caring for a client with generalized anxiety disorder (GAD), it is essential to consider therapeutic interventions. Encouraging the client to avoid anxiety-provoking situations is not recommended as it can reinforce their anxiety. Teaching relaxation techniques, encouraging the expression of feelings, and providing a structured daily routine are beneficial strategies in managing generalized anxiety disorder by promoting coping skills and emotional expression while fostering stability and predictability.

3. In the treatment of a patient with bipolar disorder experiencing a depressive episode, which medication is commonly prescribed?

• A. Valproic acid
• B. Risperidone
• C. Fluoxetine
• D. Lithium

Correct answer: C

Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a commonly prescribed antidepressant, is used to manage depressive episodes in bipolar disorder. It helps alleviate symptoms of depression by increasing the levels of serotonin in the brain, which can improve mood and reduce feelings of sadness and hopelessness. While mood stabilizers like lithium are often used in bipolar disorder, for depressive episodes, antidepressants like fluoxetine are preferred to address the specific symptoms associated with depression. Valproic acid is a mood stabilizer often used in bipolar disorder to manage manic episodes. Risperidone is an atypical antipsychotic that may be used in bipolar disorder to help control manic episodes or as an adjunctive treatment, but it is not a first-line medication for depressive episodes.

4. A client is experiencing panic attacks. Which intervention should the nurse implement to help the client manage anxiety?

• A. Encourage the client to avoid situations that trigger anxiety.
• B. Encourage the client to practice deep breathing exercises.
• C. Encourage the client to take anti-anxiety medication as prescribed.
• D. Encourage the client to engage in regular physical activity.

Correct answer: B

Rationale: During panic attacks, deep breathing exercises can help the client manage anxiety effectively by promoting relaxation and reducing the intensity of symptoms. Encouraging the client to practice deep breathing can provide a quick and accessible strategy to cope with the immediate distress of a panic attack. Choices A, C, and D are incorrect because avoiding triggering situations may reinforce avoidance behavior, anti-anxiety medication is not the first-line intervention during a panic attack, and engaging in physical activity may not be feasible or effective during an acute episode of panic.

5. An individual who has survived incest and is receiving treatment at the mental health clinic feels relief upon understanding that her anxiety and depression are:

• A. Going to be eradicated with treatment
• B. Normal and will soon pass
• C. Abnormal but will pass
• D. A normal reaction to posttraumatic events

Correct answer: D

Rationale: It is important to recognize that anxiety and depression are common responses to traumatic events like incest. Understanding that these feelings are normal reactions can help validate the individual's experiences and reduce stigma. By acknowledging that anxiety and depression are expected outcomes of posttraumatic events, the mental health clinic can provide appropriate support and treatment to help the survivor cope and heal. Therefore, option D is the correct choice as it reflects a compassionate and informed approach to addressing the survivor's emotional struggles.

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