A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which of the following as representing the psychoanalytic theory for this disorder?

Correct Answer: D

Rationale: The correct answer is D: Unresolved unconscious conflicts. According to the psychoanalytic theory, generalized anxiety disorder (GAD) stems from unresolved unconscious conflicts that manifest as excessive worry and anxiety. Sigmund Freud proposed that anxiety is a result of repressed emotions and unresolved conflicts from childhood. Individuals with GAD may be experiencing inner conflicts or unresolved issues that are causing them to feel anxious. The other choices are incorrect because they do not align with the psychoanalytic perspective, which focuses on internal conflicts rather than external stressors or neurological explanations like kindling.

Correct Answer: C

Rationale: The correct answer is C: alteration in attention. Delirium is characterized by acute onset and fluctuating course, leading to prominent deficits in attention. In contrast, dementia typically presents with gradual memory decline over months or years. Choices A and B are more indicative of dementia, as alterations developing over months and memory deficits are common in dementia. Choice D, no alteration in baseline, is not specific to either delirium or dementia, as both conditions can have alterations in baseline functioning.

Correct Answer: C

Rationale: The correct answer is C because it demonstrates empathy and a desire to understand the patient's feelings. By addressing the patient by name and expressing a willingness to talk about their emotions, the nurse is acknowledging the patient's distress and showing a therapeutic approach. This can help de-escalate the situation and establish a trusting relationship. Option A is incorrect because it does not show empathy or offer support. Option B is inappropriate as it is demanding and may escalate the situation further. Option D is also incorrect as it is directive and does not address the patient's emotional state. Overall, option C is the best choice as it focuses on building rapport and understanding the patient's perspective.

Correct Answer: D

Rationale: The correct answer is D: Ineffective coping. The patient is exhibiting intense anger, acting out behaviors, and expressing negative emotions, indicating a maladaptive response to stress. Ineffective coping addresses the inability to manage stressors and emotions effectively. A: Disturbed thought processes typically involve cognitive impairments or disorganized thinking, which is not the primary issue presented here. B: Low self-esteem focuses on negative self-perception, which may not be the root cause of the patient's current distress. C: Hopelessness pertains to a sense of despair and pessimism about the future, which may not be the main concern in this case. In summary, the patient's behaviors and statements suggest a lack of effective coping mechanisms, making "Ineffective coping" the most appropriate nursing diagnosis.

Correct Answer: B

Rationale: The correct answer is B because a victim of physical abuse may give a far-fetched explanation not logically connected to their injuries to protect their abuser or out of fear. In this scenario, the student requesting aspirin for back pain could potentially provide a vague or unrelated reason to explain the injuries if he is being abused. Choice A is incorrect because most victims of abuse are hesitant to report their abusers directly. Choice C is incorrect because it assumes the sister would give a similar explanation, which may not be the case. Choice D is incorrect because it presents a rationalization for abuse rather than a potential indicator of abuse. In summary, the correct answer, B, aligns with the behavior of abuse victims who may give inconsistent or illogical explanations to conceal the abuse.

Correct Answer: B

Rationale: The correct answer is B: Switching to a longer acting preparation. By switching to a longer-acting preparation of methylphenidate, the child will receive a sustained release of the medication throughout the day, which can help control symptoms more effectively. This would prevent the dip in medication effectiveness before lunch. A: Giving the second dose at 1 PM or later may not be as effective in maintaining symptom control throughout the school day. C: Splitting the early morning dose in half may not provide consistent symptom control throughout the day. D: Switching to another class of medication is not necessary if the child is responding well to methylphenidate, and a longer-acting preparation of the same medication can be a more appropriate solution.

Correct Answer: B

Rationale: The correct answer is B because contracts in a therapeutic setting are meant to clearly outline the roles and responsibilities of both the nurse and the patient. By establishing expectations and boundaries, a contract helps ensure mutual understanding and agreement on the treatment process. Choice A is incorrect because contracts are not just about what the nurse will do, but also about the patient's responsibilities. Choice C is incorrect as contracts focus on the practical aspects rather than the emotional dynamics. Choice D is incorrect because while contracts provide structure, they do not prevent parties from ending the relationship if necessary.

Correct Answer: A

Rationale: The correct answer is A: "How much sleep do you usually get each night?" This question directly relates to circadian rhythms, which regulate the sleep-wake cycle and impact overall quality of life. Sleep patterns are influenced by circadian rhythms, and inadequate sleep can have negative effects on health. Choices B, C, and D do not directly address circadian rhythms or their impact on quality of life. B is related to cardiac issues, C to infections, and D to urinary problems. Therefore, A is the most relevant question to assess the effects of circadian rhythms on quality of life.

Correct Answer: C

Rationale: The correct answer is C: Brahmans. In Hinduism, Brahmans are considered the highest caste due to their traditional role as priests and scholars who perform religious rituals and preserve sacred knowledge. They are tasked with upholding spiritual and moral values in society. Kshatriyas are the warrior caste, Vaisyas are the merchant and farmer caste, and Untouchables are considered outside the caste system and historically faced discrimination. Brahmans hold the highest social status and are respected for their spiritual knowledge and leadership in religious practices.