A forty-year-old client in the therapist's office coughs and makes awkward sounds when the therapist chooses to talk about his childhood sexual abuse. Where does this reflexive behavior stem from?

Correct Answer: A

Rationale: The correct answer is A because the id, according to Freudian psychology, is the part of the psyche that operates on the pleasure principle, seeking immediate gratification without considering consequences. In this scenario, the client's coughing and awkward sounds stem from an unconscious defense mechanism triggered by the uncomfortable topic of childhood sexual abuse. This reflexive behavior is a way for the client's mind to protect itself from the distressing emotions associated with the discussion. Choices B, C, and D are incorrect because they do not address the underlying psychological mechanism driving the client's behavior and do not align with the principles of Freudian theory.

Correct Answer: C

Rationale: The correct answer is C because the child expressing sadness and having trouble sleeping may indicate underlying emotional or mental health issues. This information can help the nurse assess the child's well-being and provide appropriate support. Incorrect Answers: A: "I can't get along with my parents" - This statement may suggest conflict in the parent-child relationship but does not directly indicate the child's emotional state. B: "I yell at my parents a lot" - This statement implies behavioral issues rather than emotional distress. D: "I refuse to do what my parents tell me to" - This statement indicates defiance or disobedience but does not necessarily reflect the child's emotional well-being. In summary, choice C is correct as it provides valuable insight into the child's emotional state, whereas the other choices focus on different aspects of the parent-child relationship or behavior.

Correct Answer: B

Rationale: The correct answer is B because presenting information in a calm manner using simple language helps the patient with moderate anxiety better understand preoperative information. This approach acknowledges the patient's anxiety and promotes effective communication. Choice A is incorrect because it addresses postoperative care rather than preoperative information. Choice C is incorrect as it focuses on recovery rather than addressing the patient's anxiety and understanding of preoperative information. Choice D is incorrect because it encourages expression of feelings rather than directly addressing the patient's understanding of preoperative information.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient for a history of renal problems. Elevated BUN and creatinine levels indicate possible renal dysfunction, which can manifest as psychiatric symptoms. By assessing the patient for a history of renal problems, the nurse can gather important information to help determine the underlying cause of the symptoms. This step is crucial in identifying and addressing any potential medical issues contributing to the psychiatric presentation. Incorrect choices: A: Reporting the findings to the health care provider is important, but assessing the patient for a history of renal problems should be done first. C: Assessing the patient's family history for cardiac problems is not relevant to the elevated BUN and creatinine levels. D: Hospitalization on the psychiatric unit may not address the underlying medical issue causing the symptoms; assessing for renal problems is more appropriate.

Correct Answer: A

Rationale: Solution-focused brief therapy differs from other cognitive therapies by focusing on the functional aspects of the patient rather than solely on problems. This approach emphasizes strengths and solutions, aiming to help clients identify and build on their existing resources to achieve their goals. By focusing on the positive and functional aspects, solution-focused brief therapy promotes a forward-looking and goal-oriented approach. In contrast, other therapies may focus more on challenging the existence of problems (choice B), recognizing change as constant (choice C), or delving into past experiences (choice D).