Nursing Elites

1. A healthcare provider is assessing a client who has been diagnosed with conversion disorder. Which of the following findings should the provider expect?

• A. Paralysis of a limb
• B. Auditory hallucinations
• C. Dissociative amnesia
• D. Compulsive behaviors

Correct answer: A

Rationale: Conversion disorder is characterized by the development of neurological symptoms, such as paralysis of a limb, that cannot be explained by medical evaluation. The paralysis is typically due to a psychological conflict or stress rather than a physical issue. Auditory hallucinations, dissociative amnesia, and compulsive behaviors are not commonly associated with conversion disorder, making them incorrect choices. Therefore, the healthcare provider should expect to find paralysis of a limb in a client with conversion disorder.

2. A client diagnosed with major depressive disorder is prescribed an SSRI. Which side effect should the nurse monitor for in the initial weeks of treatment?

• A. Weight loss
• B. Increased risk of suicide
• C. Hypertension
• D. Photosensitivity

Correct answer: B

Rationale: When a client is prescribed an SSRI for major depressive disorder, the nurse should closely monitor for an increased risk of suicide, especially in younger patients, during the initial weeks of treatment. SSRIs may initially increase energy levels before improving mood, which can lead to a higher risk of suicide in some individuals. Weight loss is not a common side effect of SSRIs and may actually be a concern for some patients with major depressive disorder who experience appetite changes. Hypertension is not typically associated with SSRIs, and photosensitivity is not a common side effect of this class of medications.

3. A patient with agoraphobia is unable to leave home. Which intervention should the nurse prioritize?

• A. Teach the patient relaxation techniques.
• B. Gradual exposure to feared situations.
• C. Encourage the patient to attend social gatherings.
• D. Provide education about the disorder.

Correct answer: B

Rationale: For a patient with agoraphobia, the priority intervention should be gradual exposure to feared situations. This approach helps the patient confront and gradually overcome their fear of leaving home, a common challenge in agoraphobia. By exposing the patient to feared situations in a step-by-step manner, they can learn to manage their anxiety and increase their confidence in leaving home. Teaching relaxation techniques (Choice A) can be beneficial but may not address the core issue of avoidance behavior. Encouraging the patient to attend social gatherings (Choice C) can be overwhelming and counterproductive at the initial stage of treatment. Providing education about the disorder (Choice D) is important but should come after addressing the immediate need for exposure therapy.

4. How does emotional trauma typically affect individuals physically?

• A. Emotional trauma is a distinct category and unrelated to physical symptoms.
• B. Physical manifestations of emotional trauma are usually temporary.
• C. Emotional trauma is often manifested as physical symptoms.
• D. Patients are more aware of physical problems caused by trauma.

Correct answer: C

Rationale: Emotional trauma can often manifest as physical symptoms, such as headaches, stomachaches, and other somatic complaints. These physical manifestations can be long-lasting and impact the individual's overall well-being.

5. A client diagnosed with borderline personality disorder has been admitted to the psychiatric unit after a suicide attempt. Which of the following actions should the nurse take first?

• A. Encourage the client to express feelings about the suicide attempt.
• B. Place the client on one-to-one observation.
• C. Discuss the client's feelings about the suicide attempt.
• D. Encourage the client to participate in group therapy.

Correct answer: B

Rationale: The initial priority for the nurse is to ensure the safety of the client. Placing the client on one-to-one observation allows for constant monitoring and intervention if there are any signs of self-harm or a worsening condition. This immediate intervention is crucial to prevent further harm. Options A, C, and D involve therapeutic communication and interventions, which are important but should come after ensuring the client's safety.

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