Nursing Elites

1. What behavior is expected of members of Alcoholics Anonymous (AA)?

• A. Speaking at and participating in weekly meetings
• B. Promising to attend at least 12 meetings yearly
• C. Maintaining controlled drinking after 6 months
• D. Acknowledging an inability to control the drinking

Correct answer: D

Rationale: A fundamental aspect of Alcoholics Anonymous (AA) is the acceptance of one's inability to control their drinking behavior. This acknowledgment is crucial for individuals seeking recovery from alcohol abuse issues. While speaking at and participating in meetings is encouraged, it is not a strict requirement for AA members. Similarly, there is no specific mandate on the number of meetings to attend yearly, as long as the individual finds the support they need. Maintaining controlled drinking after 6 months is not aligned with AA principles, as the group emphasizes complete abstinence from alcohol to support long-term sobriety.

2. According to Erikson's theory, which behavior would the nurse expect a preschooler to exhibit?

• A. The child develops the superego.
• B. The child plays beside other children.
• C. The child concentrates on work and play.
• D. The child becomes casual about body appearance.

Correct answer: A

Rationale: According to Erikson's theory, a preschooler develops the superego or conscience during the initiative versus guilt stage. This stage occurs around ages 3 to 6 years old. The development of the superego is crucial for the child to start understanding and internalizing societal and parental values. Choice B is incorrect because playing beside other children typically occurs during the autonomy versus shame and doubt stage, which is seen in toddlers. Choice C is incorrect as concentrating on work and play is more characteristic of the industry versus inferiority stage, typically seen in school-aged children. Choice D is incorrect because becoming casual about body appearance is more aligned with the identity versus role confusion stage, which is seen in adolescents who have a marked preoccupation with appearance and body image.

3. A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of "suppression"?

• A. "I don't remember anything about what happened to me."
• B. "I'd rather not talk about it right now."
• C. "It's the other guy's fault! He was going too fast."
• D. "My mother is heartbroken about this."

Correct answer: A

Rationale: The correct answer is "I don't remember anything about what happened to me." This statement indicates the use of suppression, which is the willful act of putting an unacceptable thought or feeling out of one's mind. In this case, the client is deliberately excluding memories of the traumatic event to protect their self-esteem. The other choices do not reflect suppression: Choice B shows avoidance or deflection, Choice C demonstrates blame shifting, and Choice D indicates empathy towards another individual.

4. 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.

5. Urinary catheterization is prescribed for a postoperative female client who has been unable to void for 8 hours. The nurse inserts the catheter, but no urine is seen in the tubing. What should the nurse do next?

• A. Clamp the catheter and recheck it in 60 minutes.
• B. Pull the catheter back 3 inches and redirect upward.
• C. Leave the catheter in place and reattempt with another catheter.
• D. Notify the healthcare provider of a possible obstruction.

Correct answer: C

Rationale: When no urine is seen in the tubing after inserting a catheter in a female client who has not voided for 8 hours, it is possible that the catheter is in the vagina rather than the bladder. Leaving the initial catheter in place can help locate the meatus for the second attempt. The client should have at least 240 mL of urine output after 8 hours, indicating the need for catheterization. Clamping the catheter (Option A) does not address the issue of incorrect catheter placement. Pulling the catheter back and redirecting it (Option B) is not effective unless the catheter is completely removed, requiring a new catheter. There is no indication of a urinary tract obstruction to notify the healthcare provider (Option D) as the catheter could be inserted easily.

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