Nursing Elites

1. When an individual uses the defense mechanism of displacement after the boss openly disagrees with suggestions, what behavior would be expected from this individual?

• A. The individual assertively confronts the boss
• B. The individual leaves the staff meeting to work out in the gym
• C. The individual criticizes a coworker
• D. The individual takes the boss out to lunch

Correct answer: C

Rationale: The correct answer is C. The individual using the defense mechanism of displacement would criticize a coworker after being confronted by the boss. Displacement involves transferring feelings from one target to a neutral or less-threatening target, hence the individual criticizing a coworker instead of directly confronting the boss. Choices A, B, and D are incorrect. Choice A is incorrect because the individual is not likely to assertively confront the boss when using displacement. Choice B is incorrect as leaving the meeting to work out in the gym is not a typical response when displacement is used. Choice D is incorrect as taking the boss out to lunch does not align with the concept of displacement, which involves redirecting emotions onto another target.

2. Gilbert, age 19, is described by his parents as a moody child with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: The scenario describes Gilbert as having an early and slow onset of schizophrenia, which typically indicates a less positive prognosis. Individuals with such presentations may experience more severe symptoms and difficulties in functioning, leading to a poorer long-term outcome. In Gilbert's case, his challenges with completing tasks, social withdrawal, and fixation on security measures suggest a more challenging prognosis. Early detection and intervention are crucial in managing schizophrenia, but the described symptoms and onset pattern are concerning for a less favorable outcome.

3. Which client action is an example of the defense mechanism of sublimation?

• A. A woman channels her energy into a new hobby after a breakup.
• B. A man redirects his anger from work into a workout routine.
• C. A student focuses on studying to avoid thinking about a recent argument.
• D. An athlete channels competitive impulses into a successful sports career.

Correct answer: B

Rationale: Sublimation is a defense mechanism where unacceptable impulses are redirected into socially acceptable activities. In this scenario, the man redirects his anger from work into a workout routine, which is a positive and constructive way of managing his emotions. Choices A, C, and D do not fully align with sublimation as they do not involve redirecting unacceptable impulses into socially acceptable outlets, unlike the man's action in choice B.

4. In a client's history, a significant indicator suggesting marginal coping skills and the need for careful risk assessment for violence is a history of

• A. childhood trauma.
• B. family involvement.
• C. academic problems.
• D. chemical dependence.

Correct answer: D

Rationale: A history of chemical dependence is a critical factor indicating marginal coping skills and the need for assessing the risk of violence. Substance abuse can impair judgment, increase impulsivity, and escalate the likelihood of violent behavior. It is essential to thoroughly evaluate and address substance abuse issues in clients to enhance treatment outcomes and ensure safety.

5. Which statement made by the nurse demonstrates the best understanding of nonverbal communication?

• A. The patient's verbal and nonverbal communication is often different.
• B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
• C. If a patient is slumped in the chair, I can be sure he's angry or depressed.
• D. It's easier to understand verbal communication than nonverbal communication.

Correct answer: B

Rationale: Checking for congruence between verbal and nonverbal communication helps validate the patient's response.

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