Nursing Elites

1. A healthcare professional is assessing a client diagnosed with paranoid schizophrenia. Which of the following findings should the healthcare professional expect?

• A. Auditory hallucinations
• B. Delusions of grandeur
• C. A flat affect
• D. Disorganized speech

Correct answer: B

Rationale: The correct answer is B: Delusions of grandeur. Clients with paranoid schizophrenia often experience delusions of grandeur or persecution, auditory hallucinations, and a flat affect. However, the most characteristic finding for paranoid schizophrenia is the presence of delusions, which are fixed false beliefs that are not based in reality. Delusions of grandeur, where individuals believe they are exceptionally powerful or important, are commonly seen in paranoid schizophrenia. Choice A, auditory hallucinations, are more commonly associated with other types of schizophrenia such as paranoid or disorganized schizophrenia. Choice C, a flat affect, is a symptom that can be seen across various types of schizophrenia. Choice D, disorganized speech, is more indicative of disorganized schizophrenia.

2. Which medication would the nurse least likely use to provide immediate intervention for an angry psychotic client?

• A. Lithium
• B. Alprazolam
• C. Diphenhydramine
• D. Haloperidol

Correct answer: B

Rationale: Alprazolam is a benzodiazepine commonly used for anxiety disorders. While it may help calm an individual, it is not typically the first-line choice for managing acute agitation in a psychotic client. Haloperidol, on the other hand, is a typical antipsychotic medication often used for immediate intervention in psychiatric emergencies involving aggression or psychosis.

3. A client with schizophrenia is prescribed risperidone. Which statement by the client indicates a need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. I need to avoid drinking alcohol while taking this medication.
• C. I should take this medication with food to avoid stomach upset.
• D. This medication may cause weight gain.

Correct answer: A

Rationale: The correct answer is A. Risperidone should be taken consistently as prescribed and should not be stopped abruptly. It is essential to educate the client that discontinuing the medication without medical advice can lead to a worsening of symptoms or potential relapse. Choices B, C, and D demonstrate understanding of important considerations when taking risperidone, such as avoiding alcohol, taking it with food to reduce stomach upset, and being aware of the potential side effect of weight gain. Choice A suggests a misconception that the medication can be discontinued once the client feels better, which is incorrect and requires further clarification to ensure treatment adherence and effectiveness.

4. A nurse is providing education to a client diagnosed with generalized anxiety disorder (GAD). Which of the following statements by the client indicates a need for further teaching? Select one that does not 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: Statements indicating a need for further teaching include stopping medication once feeling better and believing that medication will always be needed. Medication should be continued as prescribed, and the need for it should be regularly re-evaluated by a healthcare provider.

5. Which is an example of the ego defense mechanism of regression?

• A. A mother blames the teacher for her child's failure in school.
• B. A teenager becomes hysterical after seeing a friend killed in a car accident.
• C. A woman wants to marry a man exactly like her beloved father.
• D. An adult throws a temper tantrum when he does not get his own way.

Correct answer: D

Rationale: The correct answer is D. Regression involves reverting to an earlier stage of development for comfort. In this case, an adult throwing a temper tantrum is regressing to a childlike behavior when faced with not getting their way, which is a form of seeking comfort associated with earlier development. Choices A, B, and C do not exemplify regression. Blaming the teacher, becoming hysterical after a traumatic event, or seeking a partner similar to a beloved father are not instances of reverting to earlier developmental stages to cope with stress or conflict.

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