Nursing Elites

1. A client has been diagnosed with paranoid personality disorder. Which of the following behaviors should the nurse expect?

• A. Distrust of others
• B. Reluctance to confide in others
• C. Suspiciousness of others
• D. Jealousy of others

Correct answer: A

Rationale: Individuals with paranoid personality disorder commonly display a pervasive distrust of others. They often interpret benign actions of others as hostile or malicious, leading to suspicion and a belief that others have malevolent intentions. While choices B, C, and D may be present in individuals with different personality disorders or issues, distrust of others is a hallmark feature of paranoid personality disorder, making it the correct behavior to expect in these clients.

2. In assessing a client with major depressive disorder, which of the following findings shouldn't the nurse expect?

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is typically associated with bipolar disorder during manic episodes, not major depressive disorder.

3. A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

• A. The client identifies and challenges negative thoughts.
• B. The client reports an increase in suicidal thoughts.
• C. The client experiences an increase in anxiety.
• D. The client shows no change in behavior.

Correct answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

4. In managing a patient with anorexia nervosa, which initial treatment goal is most important?

• A. Addressing distorted body image
• B. Restoring nutritional status
• C. Resolving family conflicts
• D. Increasing social interactions

Correct answer: B

Rationale: The most crucial initial treatment goal for anorexia nervosa is restoring nutritional status. This is essential to prevent life-threatening complications associated with severe malnutrition, such as organ damage and cardiac issues. Addressing distorted body image, resolving family conflicts, and increasing social interactions are important aspects of treatment, but they are secondary to the critical need of restoring the patient's nutritional status to ensure their physical well-being and recovery.

5. A healthcare professional is assessing a client diagnosed with anorexia nervosa. Which of the following findings shouldn't the professional expect?

• A. Amenorrhea
• B. Lanugo
• C. Hypotension
• D. Hyperkalemia

Correct answer: D

Rationale: When assessing a client diagnosed with anorexia nervosa, healthcare professionals should expect findings such as amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa; instead, hypokalemia, which is low potassium levels, is more commonly seen in these individuals due to malnutrition and other factors.

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