While leading a group, a nurse leader says to a patient, 'This is the fourth time that you've changed the subject when we have talked about child abuse. Is something going on?' The nurse is using which technique?

Correct Answer: B

Rationale: The correct answer is B: Confrontation. In this scenario, the nurse leader directly addresses the patient's behavior of changing the subject, which is a key aspect of confrontation technique. Confrontation is used to address discrepancies or inconsistencies in a nonjudgmental manner to promote self-awareness and insight. This technique encourages the patient to explore their thoughts and behaviors. Incorrect Choices: A: Support - Support involves providing empathy, understanding, and validation to the patient. The nurse in the scenario is not offering support, but rather challenging the patient's behavior. C: Summarizing - Summarizing involves restating key points to ensure understanding and facilitate communication. The nurse's statement does not summarize but rather confronts the patient's behavior. D: Clarification - Clarification is used to ensure mutual understanding by seeking clarification on unclear statements. The nurse's statement is not seeking clarification but rather addressing a specific behavior pattern.

Correct Answer: C

Rationale: The child counting backward from 10 to 0 demonstrates conservation of numbers and reversibility, characteristics of the concrete operational stage. In this stage, children can engage in logical thought processes, manipulate information mentally, and understand conservation. This ability is typically developed around ages 7 to 11. A: Sensorimotor stage focuses on sensory experiences and object permanence, typically occurring from birth to age 2. B: Formal operational stage involves abstract thinking and hypothetical reasoning, usually from age 12 and beyond. D: Preoperational stage includes egocentrism and lack of conservation, typical for children aged 2 to 7. Therefore, the child counting backward is in the concrete operational stage due to their ability to think logically and understand conservation.

Correct Answer: A

Rationale: Correct Answer: A: Limiting amounts of evening snacks and beverages Rationale: 1. Limiting evening snacks and beverages can help regulate patients' sleep patterns by reducing stimulants that may interfere with sleep. 2. Nutrition plays a role in sleep quality, and avoiding heavy meals close to bedtime can promote better sleep. 3. This intervention addresses a common issue in psychiatric patients without imposing strict rules or physical activity. 4. It focuses on a holistic approach to improving sleep quality by considering dietary factors. Summary: B: Involving patients in a volleyball game immediately before bedtime - This choice is incorrect as vigorous physical activity before bedtime can be stimulating and may disrupt sleep. C: Enforcing the rule that all patients be in bed with lights out by 10:30 PM - This choice is incorrect as it is too rigid and may not address the underlying causes of sleep disturbances. D: Encouraging patients to take short naps in the afternoons - This choice is incorrect as daytime

Correct Answer: A

Rationale: Correct Answer: A: Ability to survive in the midst of severe stress Rationale: 1. The patient is under severe stress due to caring for her mother with Alzheimer's disease. 2. Adaptation to stress involves the ability to survive and cope with challenging situations. 3. Surviving severe stress indicates the patient's resilience and ability to endure difficult circumstances. 4. This choice best reflects the patient's capacity to manage and withstand the stress she is facing. Summary: B: Acceptance of others' help in caring for her mother - This choice focuses on receiving help from others, which may not directly relate to the patient's ability to adapt to stress. C: Success at being able to solve problems - While problem-solving skills are valuable, adaptation to stress goes beyond just solving problems. D: Capability in setting reasonable personal goals - Setting goals is important but may not directly address the patient's adaptation to severe stress.

Correct Answer: C

Rationale: The correct answer is C because assuming a relaxed posture and leaning toward the client demonstrates active listening by showing empathy and interest in what the client is saying. This nonverbal behavior encourages the client to continue expressing their feelings. A: Agreeing with the client can shut down communication and invalidate the client's emotions. B: Repeating everything the client says may come across as robotic and not conducive to building rapport. D: Expressing sorrow and sadness, while empathetic, may shift the focus from the client to the nurse's emotions. In summary, actively listening involves nonverbal cues that show understanding and support without interjecting personal opinions or emotions.

Correct Answer: C

Rationale: The correct answer is C: Reports of the same symptoms repeatedly. In complex somatic symptom disorder, individuals often report persistent physical symptoms with no clear medical explanation. By repeatedly reporting the same symptoms, the client demonstrates a key characteristic of this disorder. Choices A, B, and D do not directly align with the diagnostic criteria for complex somatic symptom disorder. Expressions of concern about psychological problems (A) could indicate other mental health conditions. Indications that parents were always in 'good health' (B) and evidence of a need for social support from friends (D) are not specific to complex somatic symptom disorder.

Correct Answer: C

Rationale: The correct answer is C: Superego. The superego is responsible for internalizing societal norms, values, and moral standards. By rewarding and praising the child for positive behaviors such as helping a sibling and using good manners, the parent is reinforcing these moral values, which are then internalized by the child through the development of the superego. The superego acts as the conscience and strives for perfection based on societal expectations. Option A (Id) is incorrect because the Id is the instinctual and impulsive part of the personality driven by the pleasure principle. Option B (Ego) is incorrect as the Ego mediates between the Id and the external world, dealing with reality. Option D (Preconscious) is incorrect as it refers to the part of the mind that contains thoughts and memories that are not currently in awareness but can be easily accessed.

Correct Answer: C

Rationale: The correct answer is C because focusing on the patient's feelings developed towards the therapist is consistent with psychoanalytic therapy. This approach allows the therapist to explore transference and countertransference dynamics, which are central in understanding the patient's inner conflicts and relational patterns. By addressing these feelings, the therapist can help the patient gain insight into unresolved issues from their past that are influencing their current behavior. Choice A is incorrect because while it can be beneficial in therapy, it is more aligned with a strengths-based or humanistic approach rather than psychoanalytic therapy. Choice B is also incorrect because praising the patient for describing feelings of isolation does not directly address the deeper unconscious processes that psychoanalytic therapy aims to explore. Choice D is incorrect because providing psychoeducation and emphasizing medication adherence are more commonly associated with cognitive-behavioral or medication-focused therapies, rather than psychoanalytic therapy.

Correct Answer: A

Rationale: The correct answer is A because as a psychiatric nurse, it is important to ensure the safety of the patient, especially those with anorexia nervosa who may have harmful items in their belongings. Going through the patient's belongings allows the nurse to assess and remove any potential risks. This action aligns with the duty of care and ensures the patient's well-being. Choice B is incorrect because using a scale can trigger anxiety and reinforce unhealthy behaviors related to weight monitoring in patients with anorexia nervosa. Choice C is incorrect as stating a specific number of meals may not be suitable for every individual and could create unnecessary pressure on the patient. Choice D is incorrect because the structure of care should be based on evidence-based practices and clinical guidelines, not solely on the patient’s desire to eat.