Nursing Elites

1. According to psychodynamic theory, what purpose do delusions serve?

• A. Delusions are a defense against anxiety caused by real or imagined threats.
• B. Magical thinking is a delusion that ensures desirable outcomes.
• C. Delusions are a method of dealing with and interpreting external stimuli.
• D. Subconsciously, delusions are a way to safely express anger and hostility.

Correct answer: A

Rationale: According to psychodynamic theory, delusions serve as a defense mechanism against anxiety triggered by real or perceived threats. Delusions are the individual's unconscious way of protecting themselves from overwhelming feelings of anxiety. Magical thinking, on the other hand, involves believing that one's thoughts can influence external events. This is not the same as delusions. Delusions are not a way of interpreting external stimuli but rather a defense mechanism. Expressing anger and hostility is typically associated with defense mechanisms like displacement or projection, not delusions.

2. A terminally ill client repeatedly talks about her son's upcoming wedding and how much she wants to attend. Which stage of the K�bler-Ross theory of death and dying is the client displaying?

• A. Anger
• B. Denial
• C. Bargaining
• D. Acceptance

Correct answer: C

Rationale: The client is displaying the stage of bargaining in the K�bler-Ross theory of death and dying. During the bargaining stage, individuals attempt to negotiate for more time or a different outcome in the face of impending death. In this scenario, the client expressing a desire to attend her son's wedding and discussing it frequently reflects a form of bargaining for additional time to be present for the event. Anger, on the other hand, involves extreme expressions of emotion ranging from irritation to rage. Denial is characterized by an inability to accept the reality of the situation. Acceptance signifies coming to terms with the circumstances and may lead to decreased interest in people and surroundings.

3. What is the primary purpose served when an individual takes action to reduce anxiety?

• A. Reduction of tension
• B. Denial of the situation
• C. Avoidance of physical discomfort
• D. Resolution in decision-making

Correct answer: A

Rationale: The primary purpose of taking action to reduce anxiety is to alleviate emotional tension and prevent the exacerbation of anxiety symptoms. By reducing tension, anxiety levels decrease, leading to a sense of comfort, safety, and security. Denial of the situation is not the goal when addressing anxiety; rather, acknowledging and managing it is crucial. While physical discomfort may accompany anxiety, the focus is on alleviating the emotional aspect to mitigate physical manifestations. Although mild anxiety can sometimes improve decision-making skills, higher levels of anxiety typically impede cognitive functions, making resolution in decision-making less likely.

4. While reviewing the side effects of a newly prescribed medication, a 72-year-old client notes that one of the side effects is a reduction in sexual drive. Which is the best response by the nurse?

• A. How will this affect your present sexual activity?
• B. How active is your current sex life?
• C. How has your sex life changed as you have become older?
• D. Tell me about your sexual needs as an older adult.

Correct answer: A

Rationale: The best response in this scenario is option A, 'How will this affect your present sexual activity?' This response directly addresses the client's concern and allows them to express their thoughts and feelings. Option B does not directly address the client's worry about the medication's side effect. Options C and D deviate from the client's immediate concern and are not as relevant in this situation.

5. When performing sterile wound care in the acute care setting, the nurse obtains a bottle of normal saline from the bedside table that is labeled 'opened' and dated 48 hours prior to the current date. Which is the best action for the nurse to take?

• A. Discard the saline solution and obtain a new unopened bottle.
• B. Obtain a new sterile syringe to draw up the labeled saline solution.
• C. Use the saline solution and then relabel the bottle with the current date.
• D. Use the normal saline solution once more and then discard.

Correct answer: A

Rationale: Solutions labeled as opened within 24 hours may be used for clean procedures, but only newly opened solutions are considered sterile. This solution is not newly opened and is out of date, so it should be discarded. Options B and C are incorrect as they involve using the expired solution. Option A is incorrect as reusing the solution after it has been opened for more than 24 hours poses a risk of contamination. Therefore, the best course of action is to discard the expired solution and obtain a new unopened bottle for sterile wound care.

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