Nursing Elites

1. What is the most significant consequence of the excessive use of defense mechanisms?

• A. Suppression of problem-solving skills.
• B. Intense experience of emotions.
• C. Enhancement of learning and growth.
• D. Limitation of problem-solving.

Correct answer: D

Rationale: The most significant consequence of the excessive use of defense mechanisms is the limitation of problem-solving skills. When individuals rely excessively on defense mechanisms to cope with stress or anxiety, they may avoid addressing underlying issues or seeking healthier coping strategies. This can lead to maladaptive behaviors, hindering their ability to effectively deal with reality, maintain healthy relationships, or perform well in various aspects of life. Choices A, B, and C are incorrect because the suppression of problem-solving skills, intense experience of emotions, and enhancement of learning and growth are not the primary consequences of excessive use of defense mechanisms.

2. When caring for a client with anorexia nervosa in a psychiatric unit, which intervention should the nurse implement to address the client's nutritional needs?

• A. Provide small, frequent meals throughout the day.
• B. Monitor the client's weight daily.
• C. Offer a liquid supplement if the client refuses solid food.
• D. Encourage the client to choose from a variety of food options.

Correct answer: A

Rationale: Providing small, frequent meals throughout the day is a crucial intervention when caring for a client with anorexia nervosa. This approach helps in gradually increasing caloric intake and meeting the client's nutritional needs. Offering large meals can be overwhelming and may contribute to anxiety in these clients. By providing small, frequent meals, the nurse supports the client in establishing a healthier eating pattern and aids in the restoration of adequate nutrition levels. Monitoring the client's weight daily (Choice B) may exacerbate anxiety related to body image and weight, which are common concerns in anorexia nervosa. Offering a liquid supplement if the client refuses solid food (Choice C) may not address the underlying issues related to food aversion and may not provide the necessary nutrients in a balanced way. Encouraging the client to choose from a variety of food options (Choice D) may be overwhelming for someone with anorexia nervosa and could lead to increased anxiety around food choices.

3. A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse implement? Select one that does not apply.

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Monitor for suicidal ideation
• D. Discourage verbalization of feelings

Correct answer: D

Rationale: Interventions for a client with bipolar disorder experiencing a depressive episode include encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discussing feelings is an essential part of therapy for clients with bipolar disorder, thus discouraging verbalization of feelings is not therapeutic and should not be implemented. Choice D is incorrect because it goes against the principles of therapeutic communication and emotional expression, which are crucial in managing bipolar disorder.

4. When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?

• A. Weight gain
• B. Suicidal ideation
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.

5. 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.

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