Nursing Elites

1. During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?

• A. The client asks the nurse if they will go out to dinner together
• B. The client accuses the nurse of being controlling just like an ex-partner
• C. The client reminds the nurse of a friend who died from substance toxicity
• D. The client becomes angry and threatens to engage in self-harm

Correct answer: B

Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.

2. A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

• A. Restricting the patient from washing hands
• B. Setting strict limits on the patient's hand washing
• C. Allowing the patient to wash hands at specified times
• D. Ignoring the patient's behavior

Correct answer: C

Rationale: Allowing the patient to wash hands at specified times is the most appropriate nursing intervention for a patient with OCD who repetitively performs hand washing. This intervention provides structure by allowing the patient to engage in the behavior at designated times, helping to reduce the compulsion gradually. Restricting or setting strict limits may increase anxiety and worsen the condition, while ignoring the behavior does not address the underlying issue of OCD.

3. After Natasha's husband passed away two months ago, she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?

• A. Depression often begins after a major loss. Losing dad was a major loss.
• B. Bereavement and depression are the same problem.
• C. Mourning is pathological and not normal behavior.
• D. Antidepressant medications will not help this type of depression.

Correct answer: A

Rationale: It is common for major depressive disorder to be triggered by significant life events, such as the sudden loss of a loved one. Therefore, Nadia's statement that 'Depression often begins after a major loss' is correct. Bereavement and major depressive disorder are related but distinct conditions, and while mourning can be intense, it is generally considered a normal response to loss. Antidepressant medications can be beneficial in treating depression, including cases triggered by a significant loss.

4. What medication is frequently prescribed for patients with generalized anxiety disorder (GAD)?

• A. Fluoxetine
• B. Sertraline
• C. Buspirone
• D. Diazepam

Correct answer: C

Rationale: Buspirone is a medication commonly prescribed for generalized anxiety disorder (GAD) due to its effectiveness and lower risk of dependency compared to benzodiazepines like diazepam. While fluoxetine and sertraline are selective serotonin reuptake inhibitors (SSRIs) often used for various anxiety disorders, buspirone is specifically indicated for GAD.

5. A community mental health nurse is planning care to address the issue of depression among older adult clients in the community. Which of the following interventions should the nurse implement as a method of tertiary prevention?

• A. Educating clients on health promotion techniques to reduce the risk of depression
• B. Performing screenings for depression at community health programs
• C. Establishing rehabilitation programs to decrease the effects of depression
• D. Providing support groups for clients at risk for depression

Correct answer: C

Rationale: Establishing rehabilitation programs to decrease the effects of depression is a method of tertiary prevention.

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