Nursing Elites

1. When a husband accuses his wife of infidelity, which situation would indicate to the nurse the husband's use of the ego defense mechanism of projection?

• A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
• B. The husband ignores the wife's continued absence from the home.
• C. The husband has already admitted to having an affair with a coworker.
• D. The husband takes out his marital frustrations through employee abuse.

Correct answer: C

Rationale: Projection is a defense mechanism where one attributes their unacceptable feelings or impulses to another person. In this scenario, the husband, by admitting to having an affair with a coworker, is projecting his infidelity onto his wife, indicating the use of the projection defense mechanism. Choice A is incorrect as it describes a different behavior, not projection. Choice B does not demonstrate projection but rather avoidance or denial. Choice D shows displacement of aggression, not projection.

2. A client has been prescribed sertraline (Zoloft) and is receiving education from a healthcare provider. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at the same time every day.
• B. It may take several weeks for this medication to be effective.
• C. I should take this medication on an empty stomach.
• D. I should avoid eating aged cheeses and processed meats.

Correct answer: B

Rationale: The correct answer is B. Sertraline (Zoloft) may take several weeks to be effective, so it is important for the client to be informed about this timeframe. This medication does not need to be taken on an empty stomach, but it can be taken with or without food. Choice A is a good practice for many medications but not specifically related to sertraline (Zoloft). Choice D is not directly related to sertraline (Zoloft) but pertains to dietary restrictions when taking MAOIs due to potential interactions with tyramine.

3. Which medication is commonly prescribed for the treatment of panic disorder?

• A. Haloperidol
• B. Clonazepam
• C. Lithium
• D. Fluoxetine

Correct answer: B

Rationale: Clonazepam, a benzodiazepine, is commonly prescribed for the treatment of panic disorder due to its anxiolytic properties. It helps reduce the frequency and intensity of panic attacks by acting on the central nervous system to produce a calming effect. Haloperidol is an antipsychotic medication, lithium is primarily used for bipolar disorder, and fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used for depression and some anxiety disorders, but not as a first-line treatment for panic disorder.

4. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

• A. Projection
• B. Rationalization
• C. Regression
• D. Sublimation

Correct answer: B

Rationale: The nurse should recognize that the client is using rationalization, a common defense mechanism. Rationalization involves creating logical reasons to justify unacceptable feelings or behaviors. In this scenario, the client is justifying excessive drinking by linking it to hard work and the need for relaxation, masking the true underlying issue of alcohol abuse. Projection involves attributing one's thoughts or feelings to others, regression involves reverting to an earlier stage of development, and sublimation involves channeling unacceptable impulses into socially acceptable activities, none of which are demonstrated in the client's statement.

5. When using therapeutic communication with a withdrawn patient who has major depression, an effective method of managing the silence is to:

• A. Engage in a quiet meditation
• B. Ask simple questions even if the patient will not answer
• C. Use the technique of making observations
• D. Simply sit quietly and leave when the patient falls asleep

Correct answer: C

Rationale: Using the technique of making observations is an effective method of managing silence when communicating with a withdrawn patient who has major depression. This approach can encourage the patient to engage and feel understood without the pressure to respond, fostering a therapeutic connection and helping the patient open up at their own pace.

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