Nursing Elites

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

• A. Intentional production of false symptoms
• B. Lack of concern about symptoms
• C. Fear of gaining weight
• D. Unintentional production of false symptoms

Correct answer: A

Rationale: Individuals with factitious disorder deliberately fabricate or exaggerate symptoms to assume the sick role and garner attention. They may show a lack of concern about their symptoms, a phenomenon known as la belle indifférence. Fear of gaining weight is not typically associated with factitious disorder. Therefore, the correct behavior to expect in a client with factitious disorder is the intentional production of false symptoms. Choices B, C, and D are incorrect as lack of concern about symptoms and fear of gaining weight are not characteristic of factitious disorder. Additionally, factitious disorder involves the intentional, not unintentional, production of false symptoms.

2. When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?

• A. Change of shift reports
• B. Admission interviews
• C. One-to-one conversations with patients
• D. Conversations with patient families

Correct answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

3. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to talk about their feelings.
• B. Provide a quiet and calm environment.
• C. Encourage the client to exercise vigorously.
• D. Encourage the client to participate in group activities.

Correct answer: B

Rationale: During severe anxiety, it is essential to create a quiet and calm environment to help the client feel safe and reduce anxiety levels. Loud or stimulating environments can exacerbate anxiety symptoms, so providing a serene setting can promote relaxation and a sense of security.

4. A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?

• A. Avoid foods high in sodium.
• B. Avoid foods high in calcium.
• C. Avoid foods high in tyramine.
• D. Avoid foods high in potassium.

Correct answer: C

Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.

5. When caring for a client with major depressive disorder, what is the most appropriate short-term goal for the client?

• A. The client will report a decrease in depressive symptoms.
• B. The client will establish a sleep routine.
• C. The client will improve social interactions.
• D. The client will set realistic goals for the future.

Correct answer: A

Rationale: The most appropriate short-term goal for a client with major depressive disorder is for them to report a decrease in depressive symptoms. This goal is specific, measurable, and achievable, focusing on the primary symptoms of the disorder. By monitoring and assessing the client's self-reported improvement in depressive symptoms, the healthcare team can track progress and adjust interventions accordingly.

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