Nursing Elites

1. A client with depression is experiencing anhedonia. Which statement by the client reflects this symptom?

• A. I feel so anxious all the time.
• B. I don't enjoy the things I used to love.
• C. I can't concentrate on anything.
• D. I have trouble sleeping through the night.

Correct answer: B

Rationale: Anhedonia is the inability to experience pleasure from activities usually found enjoyable. The statement 'I don't enjoy the things I used to love' directly reflects this symptom as the client is expressing a lack of pleasure from previously enjoyable activities. Choices A, C, and D do not specifically relate to anhedonia but rather indicate symptoms of anxiety, concentration difficulties, and sleep disturbances, respectively.

2. A client diagnosed with generalized anxiety disorder (GAD) is receiving education from a healthcare provider. Which of the following statements by the client indicates a need for further teaching? Select all that apply.

• A. I should avoid caffeine because it can increase my anxiety.
• B. I can stop taking my medication once I feel better.
• C. Practicing deep breathing exercises can help reduce my anxiety.
• D. I should gradually face situations that cause me anxiety.

Correct answer: B

Rationale: The correct answer is B. The statement 'I can stop taking my medication once I feel better' indicates a need for further teaching. It is crucial for individuals with generalized anxiety disorder to continue taking their medication as prescribed even when they start feeling better. Discontinuing medication abruptly can lead to a recurrence of symptoms. It is essential to emphasize the importance of following the prescribed treatment plan and regularly consulting with a healthcare provider to assess the need for medication adjustments.

3. Gilbert, age 19, is described by his parents as a moody child with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: The scenario describes Gilbert as having an early and slow onset of schizophrenia, which typically indicates a less positive prognosis. Individuals with such presentations may experience more severe symptoms and difficulties in functioning, leading to a poorer long-term outcome. In Gilbert's case, his challenges with completing tasks, social withdrawal, and fixation on security measures suggest a more challenging prognosis. Early detection and intervention are crucial in managing schizophrenia, but the described symptoms and onset pattern are concerning for a less favorable outcome.

4. Which of the following statements should a healthcare provider recognize as true about defense mechanisms? Select all that apply.

• A. They are employed when there is a threat to biological or psychological integrity.
• B. They are controlled by the id and deal with primal urges.
• C. They are used in an effort to increase anxiety.
• D. They are protective devices for the superego.

Correct answer: A

Rationale: Defense mechanisms are employed by the ego, not the id or superego, in response to threats to biological or psychological integrity. They aim to relieve anxiety, not increase it. By redirecting focus, they help manage mild to moderate anxiety and are often self-deceptive in nature.

5. A healthcare provider is caring for a client diagnosed with schizophrenia. Which intervention is most appropriate to address the client's delusions?

• A. Challenge the client's delusions directly.
• B. Provide evidence to disprove the delusions.
• C. Acknowledge the client's feelings without reinforcing the delusions.
• D. Ignore the client's delusions.

Correct answer: C

Rationale: When caring for a client with schizophrenia experiencing delusions, the most appropriate intervention is to acknowledge the client's feelings without reinforcing the delusions. This approach helps maintain trust and communication, fostering a therapeutic relationship. Challenging the delusions directly can lead to increased distress and resistance from the client. Providing evidence to disprove the delusions may not be effective due to the deeply ingrained nature of the client's beliefs. Ignoring the delusions may make the client feel dismissed or unheard, which can hinder the therapeutic process.

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