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. A patient being treated for insomnia is prescribed ramelteon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for this particular patient?

• A. Obsessive-compulsive disorder
• B. Generalized anxiety disorder
• C. Persistent depressive disorder
• D. Substance use disorder

Correct answer: D

Rationale: The correct answer is D, Substance use disorder. Ramelteon is preferred for patients with substance use disorder because it lacks abuse potential. This makes it a safer choice for individuals with a history of substance misuse. Choosing a medication with a lower risk of abuse in this population is crucial to prevent potential misuse or dependence issues.

3. A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, 'I know she wants me.' This statement reflects which defense mechanism?

• A. Displacement
• B. Projection
• C. Rationalization
• D. Sublimation

Correct answer: B

Rationale: The correct answer is B: Projection. The nurse should determine that the client's statement reflects the defense mechanism of projection. Projection involves attributing one's unacceptable feelings or impulses to another person. By projecting these feelings onto someone else, the individual reduces their own anxiety. Displacement involves transferring feelings from one target to another, not attributing them to another person. Rationalization involves making excuses to justify behavior, not attributing feelings to others. Sublimation involves channeling unacceptable drives or impulses into more constructive and acceptable activities, not attributing feelings to another person.

4. 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.

5. A healthcare professional is providing education to the family of a client who has been diagnosed with schizophrenia. Which of the following instructions should the healthcare professional include?

• A. Encourage the client to participate in daily activities.
• B. Encourage the client to express their feelings.
• C. Encourage the client to avoid caffeine.
• D. Encourage the client to spend time alone.

Correct answer: A

Rationale: Encouraging the client to participate in daily activities is crucial in managing schizophrenia. Engaging in activities can enhance the quality of life and reduce symptoms by providing structure, routine, and social interaction, which are beneficial for individuals with schizophrenia. Choices B, C, and D are not the most appropriate instructions for managing schizophrenia. While expressing feelings can be helpful, daily activities have a more significant impact on managing the condition. Avoiding caffeine and spending time alone are not directly related to managing schizophrenia and may not be the most beneficial strategies.

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