A patient says, 'I will never be happy until I'm as successful as my older sister.' The nurse asks the patient to reassess this statement and reframe it. Which reframed statement by the patient is most likely to promote coping?

Correct Answer: B

Rationale: Finding contentment within one's own work, even when it does not involve success as others might define it, is likely to lead to a reduced sense of distress about achievement level. It speaks to finding satisfaction and happiness without measuring the self against another person. Focusing on salary is simply a more specific way of being as successful as the sister, which would not promote coping. Expecting others to treat her as they do her sister is beyond her control. Dismissing the sister's cleverness as unimportant indicates that the patient continues to feel inferior to the sibling.

Correct Answer: A

Rationale: Reaction formation is an unconscious mechanism that keeps unacceptable feelings out of awareness by using the opposite behavior. Instead of expressing hatred for the other person, the individual gives praise. Denial operates unconsciously to allow an anxiety-producing idea, feeling, or situation to be ignored. Projection involves unconsciously disowning an unacceptable idea, feeling, or behavior by attributing it to another. Repression involves unconsciously placing an idea, feeling, or event out of awareness.

Correct Answer: B

Rationale: In the context of managing aggressive behavior related to ritualistic hand washing, encouraging the patient to participate in social activities (Option B) is the most appropriate action to help the patient develop more effective coping mechanisms. Encouraging social activities helps the patient to engage in meaningful interactions, improve social skills, reduce isolation, and shift focus away from the compulsive behavior of hand washing. Social engagement can provide emotional support, distraction, and a sense of belonging, which are crucial in managing anxiety and compulsive behaviors. Option A, allowing the patient to set a hand-washing schedule, may reinforce the compulsive behavior rather than addressing the underlying issues causing the behavior. Option C, encouraging the patient to discuss hand-washing routines, may not actively involve the patient in alternative coping strategies. Option D, focusing on the patient's symptoms rather than the patient, neglects the holistic approach needed to address the underlying psychological factors contributing to the behavior. In an educational context, understanding the rationale behind choosing social activities as an intervention can help nurses develop a comprehensive care plan for patients exhibiting aggressive behaviors. By prioritizing social engagement and exploring alternative coping mechanisms, nurses can better support patients in managing their symptoms and improving their overall well-being.

Correct Answer: A

Rationale: The patient in a dissociative fugue state relocates and lacks recall of his life before the fugue began. Often fugue states follow traumatic experiences and sometimes involve assuming a new identity. Such persons at some point find themselves in their new surroundings, unable to recall who they are or how they got there. A feeling of detachment from one's body or from the external reality is an indication of depersonalization disorder. Losing track of several minutes when highly anxious is not an indication of a dissociative disorder and is common in states of elevated anxiety. Finding evidence of having bought clothes or gone to restaurants without any explanation for these is suggestive of dissociative identity disorder, particularly when periods are "lost" to the patient (blackouts).

Correct Answer: B

Rationale: The correct answer is option B) "We spend daily family time talking about experiences and feelings." This option demonstrates support for the development of resilience and effective stress management in young children by promoting open communication within the family. By encouraging children to express their experiences and feelings, parents create a supportive environment where children can learn to cope with stress, build emotional intelligence, and develop resilience. Option A is incorrect because simply allowing children to make their own decisions without guidance or support may not necessarily promote effective stress management or resilience. Option C is incorrect as the educational qualifications of babysitters do not directly correlate with teaching children resilience or stress management skills. Option D is incorrect because stating differences in parenting strategies without indicating how they support resilience or stress management does not provide a clear demonstration of effective support for children's development in these areas. In an educational context, it is important for parents and caregivers to understand the significance of fostering resilience and effective stress management in children. By creating a nurturing and open environment where children feel comfortable expressing their emotions and experiences, parents can help children develop the skills they need to cope with challenges and bounce back from adversity. Communication, emotional support, and active listening are key components in promoting resilience and effective stress management in young children.