Nursing Elites

1. Which of the following therapies is considered the most effective for treating phobias?

• A. Cognitive-behavioral therapy
• B. Psychoanalysis
• C. Medication management
• D. Group therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is widely recognized as the most effective treatment for phobias. CBT helps individuals identify and change negative thought patterns and behaviors associated with their phobias, leading to long-lasting improvement and symptom reduction. Unlike psychoanalysis, which focuses on exploring unconscious conflicts, CBT provides practical strategies to address phobias directly. Medication management may be used in conjunction with therapy but is not typically considered a standalone treatment for phobias. Group therapy can be beneficial for some individuals, but CBT is specifically tailored to target and alleviate phobia symptoms effectively.

2. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?

• A. Meditation
• B. Problem-solving training
• C. Relaxation
• D. Journaling

Correct answer: B

Rationale: In this scenario, the student is dealing with conflicting priorities of attending college or working to support the family financially. Problem-solving training is the most appropriate coping strategy to recommend. It can help the student objectively assess the situation, identify potential solutions, and make informed decisions. Problem-solving training provides structure and guidance, empowering the student to navigate the conflicting priorities effectively and choose the best course of action. Meditation, relaxation, and journaling may be beneficial for stress relief but may not directly address the decision-making process required in this situation.

3. A client is diagnosed with obsessive-compulsive disorder (OCD). Which of the following interventions should the nurse include in the care plan? Select one that does not apply.

• A. Allow the client to perform rituals initially
• B. Set limits on the time allowed for rituals
• C. Encourage the client to verbalize feelings
• D. Provide a structured schedule of activities

Correct answer: A

Rationale: Interventions for a client with OCD should include allowing the client to perform rituals initially, setting limits on the time allowed for rituals, encouraging the client to verbalize feelings, and providing a structured schedule of activities. Allowing the client to perform rituals is an essential part of managing OCD and should not be restricted in the initial stages of care. Setting limits on the time for rituals helps prevent excessive engagement in them. Encouraging the client to verbalize feelings promotes emotional expression and processing. Providing a structured schedule of activities helps establish routine and predictability, which can be beneficial for individuals with OCD.

4. A new psychiatric nurse states, 'This client's use of defense mechanisms should be eliminated.' Which is a correct evaluation of this nurse's statement?

• A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
• B. Defense mechanisms are a maladaptive attempt by the ego to manage anxiety and should always be eliminated.
• C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged but not eliminated.
• D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

Correct answer: A

Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms help individuals reduce anxiety during times of stress. It is crucial for the nurse to understand that defense mechanisms serve a purpose and can be a normal part of coping. However, if defense mechanisms significantly hinder the client's ability to develop healthy coping skills, they should be addressed and explored. Eliminating defense mechanisms entirely without considering the individual's overall coping strategies can be counterproductive and may lead to increased distress for the client. Choice B is incorrect because not all defense mechanisms are maladaptive; some can be adaptive and helpful. Choice C is incorrect because labeling individuals as having weak ego integrity based on their use of defense mechanisms is stigmatizing and oversimplified. Choice D is incorrect because fostering and encouraging defense mechanisms without differentiation can lead to maladaptive behaviors and reliance on these mechanisms instead of healthier coping strategies.

5. A healthcare provider is assessing a client diagnosed with antisocial personality disorder. Which of the following behaviors should the provider expect the client to exhibit?

• A. A lack of remorse for wrongdoing
• B. A fear of gaining weight
• C. A need for constant reassurance
• D. A willingness to take responsibility for actions

Correct answer: A

Rationale: Individuals with antisocial personality disorder typically exhibit a lack of remorse for their actions. They may disregard the rights of others, engage in deceitful and manipulative behaviors, and show a consistent pattern of irresponsibility and disregard for social norms. This behavior is a key characteristic of this disorder. Choices B, C, and D are incorrect because they do not align with the typical behaviors associated with antisocial personality disorder. Fear of gaining weight is more indicative of an eating disorder rather than antisocial personality disorder. Needing constant reassurance is not a common trait of individuals with antisocial personality disorder. Additionally, individuals with this disorder often avoid taking responsibility for their actions.

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