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?

Correct Answer: B

Rationale: Given the situation where the student is facing conflicts related to attending college or working to support their family financially, recommending problem-solving training would be the most appropriate coping strategy. Problem-solving training involves teaching individuals how to identify and assess problems, generate possible solutions, evaluate those solutions, and implement the best course of action. This training can help the student develop practical skills to address the conflicting demands they are facing. It allows them to approach their challenges in a systematic and structured way, potentially leading to more effective decision-making and problem resolution. Meditation, relaxation, and journaling are valuable coping strategies for managing stress and enhancing overall well-being, but in this particular context of conflicting responsibilities, problem-solving training would offer more targeted support for the student's specific situation.

Correct Answer: B

Rationale: The most appropriate nursing response is B: How you reacted to past experiences influences how you feel now. This response highlights the concept of cognitive appraisal, where an individual's interpretation of past experiences can influence their current stress levels. By acknowledging the role of past experiences and reactions, the nurse can help the client understand the connection between their thoughts, emotions, and stress responses. This response empowers the client to explore their coping mechanisms and cognitive patterns to better manage stress in the future. It also opens up the opportunity for further discussion and guidance on healthier coping strategies and stress management techniques.

Correct Answer: D

Rationale: The nurse should interpret the client's behaviors as demonstrating no functional impairment, indicating no mental illness. The client is experiencing occasional feelings of sadness, which can be considered a normal reaction to the recent death of a beloved pet. The fact that the client's appetite, sleep patterns, and daily routine have not changed suggests that the client is still able to function effectively in their daily life. It is important for the nurse to assess the situation holistically and consider the context of the client's grief before jumping to conclusions about mental illness.

Correct Answer: A

Rationale: Defense mechanisms are psychological strategies that individuals unconsciously use to cope with stress, anxiety, and threats to their self-esteem. It is not necessary to eliminate defense mechanisms entirely, as they can serve as adaptive responses to protect oneself in certain situations. While some defense mechanisms can be maladaptive or harmful if used excessively, it is essential to understand that addressing the root causes of the underlying issues that trigger the use of defense mechanisms is more important than simply trying to eradicate them. Encouraging healthy coping mechanisms and providing appropriate support and interventions can help individuals develop resilience and better ways of managing stress without completely eliminating all defense mechanisms.

Correct Answer: A

Rationale: In the DSM-5, somatic symptom disorders are identified as psychoneurotic responses to severe anxiety. These disorders involve physical symptoms that are either very distressing or result in significant disruption of daily life. Examples of somatic symptom disorders include somatic symptom disorder, illness anxiety disorder, and conversion disorder. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses in the DSM-5.