A nurse in a long-term care facility is assessing an older adult client for depression. Which of the following findings should the nurse expect?
Rambling speech
Insomnia
Rapid mood swings
Sundowning
The Correct Answer is B
A. Rambling speech
Rambling speech is not a typical finding associated with depression. It may indicate other conditions or issues.
B. Insomnia
Insomnia, or difficulty sleeping, is a common symptom of depression. Many individuals with depression experience trouble falling asleep, staying asleep, or both.
C. Rapid mood swings
Rapid mood swings are not typically associated with depression. Depression often involves persistent low mood rather than rapid fluctuations.
D. Sundowning
Sundowning refers to a state of confusion and restlessness that occurs in the late afternoon and evening, often seen in individuals with dementia. While it can be related to mood disturbances, it's not specific to depression.
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Correct Answer is C
Explanation
A. Reaction Formation:
Reaction formation is a defense mechanism where an individual expresses feelings or behaviors that are the opposite of their true feelings or impulses. For example, someone who harbors unconscious aggressive feelings might display exaggerated friendliness and kindness. In the given scenario, the behavior of the newly licensed nurse is not contradictory to their true feelings; they are imitating the charge nurse willingly.
B. Suppression:
Suppression is a conscious effort to push down or hide certain thoughts or feelings. Unlike repression (which is unconscious), suppression involves a deliberate choice not to think about or dwell on certain emotions or thoughts. In the scenario, the behavior of the newly licensed nurse is not an example of suppression because they are not consciously trying to hide their actions.
C. Identification:
Identification is a defense mechanism where an individual unconsciously models their behavior, feelings, or attitudes after those of someone else, especially someone they perceive as powerful or significant. In this scenario, the newly licensed nurse is imitating the behaviors of the charge nurse, which is an example of identification.
D. Compensation:
Compensation is a defense mechanism where an individual consciously or unconsciously covers up weaknesses, frustrations, or feelings of inadequacy by emphasizing strengths or seeking to excel in other areas. It involves making up for a perceived lack by putting extra effort into another aspect of life. The scenario does not describe the newly licensed nurse compensating for any perceived weakness; they are simply imitating the charge nurse's behavior.
Correct Answer is A
Explanation
A. Reassure staff members that the debriefing is confidential:
Explanation: This step is crucial in establishing trust among the participants. Reassuring confidentiality encourages individuals to express their feelings and experiences openly. It helps create a safe environment where people can share their emotions without fear of judgment or repercussions.
B. Have staff members discuss their involvement in the event:
Explanation: After establishing confidentiality, it might be appropriate to encourage participants to discuss their involvement in the event. This allows individuals to share their perspectives and experiences, helping others understand the situation from different angles. Sharing experiences can provide insights into how different people were affected and how they coped.
C. Ask staff members to describe their most traumatic memories of the event:
Explanation: While it might be a natural inclination to immediately delve into the most traumatic memories, it's generally not the first step in a critical incident stress debriefing. Encouraging participants to share their most traumatic memories right away could be overwhelming and retraumatizing. The process usually begins with establishing trust and then progresses to discussing individual experiences, gradually leading to more specific and potentially distressing details.
D. Provide stress-management exercises to the staff members:
Explanation: Stress-management exercises are valuable and often an essential part of the debriefing process. However, introducing stress-management techniques usually comes after participants have had the opportunity to express their feelings and experiences. These exercises can include relaxation techniques, breathing exercises, or mindfulness practices, which help individuals manage their stress and anxiety effectively.
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