Brian is seeking treatment for PTSD following his tour of duty in a combat zone. He reports to the assessment nurse that he has been smoking marijuana and drinking alcohol daily for the past 4 days because he just can't stand feeling depressed all the time. Which of these assessments is the nurse's highest priority?

Suicide risk assessment

Neurological assessment

Amount of current cannabis use

Marital status

Answer and Explanation

The Correct Answer is A

Choice A reason: Given Brian's recent substance use and expression of not being able to tolerate depressive feelings, a suicide risk assessment is the highest priority to ensure his immediate safety.

Choice B reason: While a neurological assessment may be relevant, it is not the highest priority when there is a potential risk of suicide.

Choice C reason: Assessing the amount of current cannabis use is important but secondary to evaluating the risk of suicide.

Choice D reason: Marital status may inform social support but is not the highest priority in the context of potential self-harm.

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Correct Answer is B

Explanation

Choice A reason: Conversion involves expressing psychological distress through physical symptoms, which is not indicated in this scenario.

Choice B reason: Projection is a defense mechanism where an individual attributes their own unacceptable thoughts or feelings to someone else. In this case, the student is projecting their feelings of inadequacy or frustration onto the teacher and the course.

Choice C reason: Undoing is a defense mechanism where an individual attempts to take back an unconscious behavior or thought that is unacceptable or hurtful. This is not demonstrated by the student's behavior.

Choice D reason: Regression is a return to earlier stages of development and abandoned forms of gratification belonging to them, induced by stress. Berating the teacher does not indicate a regression but rather a projection of the student's feelings.

A. "I will start basing my decisions and actions on reality." B. "I am going to have to learn to trust other people." C. "I will be able to differentiate when my suspicions are true." D. "I understand the origins of my paranoid thinking."

Correct Answer is A

Explanation

Choice A reason: This statement reflects an understanding of the need to ground perceptions in reality, which is a key step in managing paranoid personality disorder.

Choice B reason: While learning to trust others is important, it does not directly indicate that the client has learned to validate their ideas before acting.

Choice C reason: Being able to differentiate true suspicions can be part of managing the disorder, but it does not demonstrate an understanding of the need to validate ideas with others.

Choice D reason: Understanding the origins of paranoid thinking is insightful, but it does not show that the client has learned to validate their ideas before taking action.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanisms?

Correct Answer is B

Explanation

The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action. Which statement made by the client indicates that the teaching is effective?

Correct Answer is A

Explanation

The nurse is working with another nurse in the emergency department (ED) when a client comes in stating they have been raped during a date. Which statement made by the other nurse privately requires immediate correction?

A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?

A client has a history of excessive fear of water. Which term should the nurse use to describe this specific phobia, and under what subtype is this phobia identified?

The nurse should frequently assess a client with a depressive disorder for lethality risk related to suicidal ideation. Which questions should the nurse include? (Select all that apply.)

The nurse is educating a client about their diagnosis of somatization disorder prior to the termination phase of the nurse-client relationship. Which statement by the client indicates a need for additional teaching?

A client and their spouse come to talk with the nurse about their suspicion that the client may have intermittent explosive disorder after researching it on the internet. Which behaviors reported by the spouse indicate that the client may be experiencing this disorder? (Select all that apply.)

A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and observes that the client engages in constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following?