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. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient is an uncommon initial biological response to stress?

• A. Constricted pupils
• B. Watery eyes
• C. Palpitations
• D. Increased heart rate

Correct answer: A

Rationale: Increased lacrimal secretions, palpitations, and increased heart rate are common initial biological responses to stress. Constricted pupils are not typical in the initial response to stress and are more associated with the opposite response, the Rest and Digest system. Watery eyes, palpitations, and increased heart rate are indicative of the body's fight or flight response to stress. Unusual food cravings are not a typical biological response to stress.

3. Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?

• A. Restating
• B. Encouraging description of perception
• C. Summarizing
• D. Asking 'why' questions

Correct answer: D

Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.

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. A patient with obsessive-compulsive disorder (OCD) is prescribed paroxetine. The nurse should educate the patient about which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Sexual dysfunction
• D. Hypertension

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Paroxetine, an SSRI commonly prescribed for OCD, can lead to sexual dysfunction as a side effect. Patients should be educated about this potential adverse effect to ensure they are aware and can seek appropriate management if needed. Choices A, B, and D are incorrect because insomnia, weight loss, and hypertension are not typically associated with paroxetine use as common side effects in patients with OCD.

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