Nursing Elites

1. A client is experiencing occasional feelings of sadness due to the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How should the nurse interpret the client's behaviors?

• A. The client's behaviors demonstrate mental illness in the form of depression.
• B. The client's behaviors are extensive, indicating the presence of mental illness.
• C. The client's behaviors are not congruent with cultural norms.
• D. The client's behaviors demonstrate no functional impairment, indicating no mental illness.

Correct answer: D

Rationale: In this scenario, the nurse should interpret the client's behaviors as not indicative of mental illness. The client is experiencing normal feelings of sadness following the loss of a pet, and the fact that the client's appetite, sleep patterns, and daily routine remain unchanged suggests no functional impairment. It is essential to recognize that experiencing occasional feelings of sadness in response to a significant life event, such as the death of a pet, does not necessarily signify mental illness, especially when there is no significant impairment in daily functioning. Choices A, B, and C are incorrect because they incorrectly suggest that the client's behaviors indicate mental illness, which is not the case in this context.

2. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

• A. If only we could have tried again, things might have worked out.
• B. I am so mad that the children and I had to put up with him as long as we did.
• C. Yes, it was a difficult relationship, but I think I have learned from the experience.
• D. I still don't have any appetite and continue to lose weight.

Correct answer: C

Rationale: The nurse should recognize that the client is in the acceptance stage of grief based on the statement 'Yes, it was a difficult relationship, but I think I have learned from the experience.' In this statement, the client is acknowledging the difficulty of the relationship but also expressing personal growth and learning from the experience, indicating acceptance. Choices A, B, and D do not reflect the acceptance stage of grief. Choice A shows a sense of regret and a wish for things to have turned out differently. Choice B demonstrates lingering anger towards the ex-husband. Choice D suggests ongoing physical manifestations of grief like loss of appetite and weight loss, which are more indicative of earlier stages of grief.

3. Which of the following symptoms shouldn't one expect to assess in a client diagnosed with major depressive disorder?

• A. Loss of interest or pleasure
• B. Decreased ability to concentrate
• C. Significant weight loss or gain
• D. Increased energy

Correct answer: D

Rationale: Symptoms commonly associated with major depressive disorder include a loss of interest or pleasure, decreased ability to concentrate, significant weight loss or gain, and feelings of worthlessness or excessive guilt. Increased energy is not a typical symptom of major depressive disorder; individuals with this condition often experience fatigue rather than increased energy.

4. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, 'Last night, demons came to my room and tried to rape me.' Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we'll check on you at night and you'll be safe.

Correct answer: C

Rationale: Response C is the most therapeutic as it shows empathy and encourages the patient to express their feelings and share more about their experience. By actively listening and inviting the patient to talk, the nurse creates a supportive environment that can help the patient feel heard and understood, which is essential in building trust and rapport in therapeutic communication with individuals experiencing schizophrenia.

5. In addition to antianxiety agents, which classification of drugs is commonly prescribed to treat anxiety and anxiety disorders?

• A. Antipsychotics
• B. Mood stabilizers
• C. Antidepressants
• D. Cholinesterase inhibitors

Correct answer: C

Rationale: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are frequently used in the treatment of anxiety disorders. These medications help alleviate symptoms by affecting neurotransmitters in the brain associated with mood regulation and anxiety.

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