Nursing Elites

1. A healthcare professional is assessing a client with bipolar disorder who is experiencing a depressive episode. Which of the following findings should the healthcare professional expect? Select one that does not apply.

• A. High energy
• B. Feelings of hopelessness
• C. Insomnia or hypersomnia
• D. Decreased appetite

Correct answer: A

Rationale: During a depressive episode in bipolar disorder, clients typically exhibit low energy levels, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. High energy levels are more commonly seen in manic episodes of bipolar disorder.

2. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist in determining the client's appraisal of the situation? Select all that apply.

• A. What caused the stressful situation?
• B. Have you ever experienced a similar stressful situation?
• C. Who do you think is to blame for this situation?
• D. Why do you think you were fired from your job?

Correct answer: B

Rationale: The question 'Have you ever experienced a similar stressful situation?' is the most appropriate as it assesses the client's coping resources and encourages reflection on past experiences. This question can help the client consider alternative ways to deal with stress. Asking about the cause of the stressful situation may provide insight into the current situation but does not directly assess coping abilities. Inquiring about blame does not focus on coping strategies but may encourage negative thinking and a sense of victimization. Questioning why the client was fired is a nontherapeutic approach that can hinder communication by putting the client on the defensive.

3. A client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. The nurse recognizes these as classic signs of which condition?

• A. Delirium
• B. Mania
• C. Parkinsonism
• D. Alzheimer’s

Correct answer: D

Rationale: The client's presentation of progressive memory changes, poor judgment, and attention deficits align with classic signs of Alzheimer's disease. Alzheimer's is a neurodegenerative disorder characterized by cognitive decline that significantly impacts daily functioning. While delirium and mania may present with cognitive changes, Alzheimer's is specifically associated with progressive memory loss and cognitive impairment over time.

4. A nurse is assessing a client who has been diagnosed with persistent depressive disorder (dysthymia). Which of the following findings should the nurse expect?

• A. Episodes of hypomania
• B. Periods of elevated mood
• C. Lack of interest in activities
• D. Feelings of detachment from one's body

Correct answer: C

Rationale: The correct finding the nurse should expect in a client diagnosed with persistent depressive disorder (dysthymia) is a lack of interest in activities. This disorder is characterized by a chronic depressive mood lasting for at least two years, alongside symptoms such as changes in appetite, fatigue, low self-esteem, and difficulty concentrating. Clients with dysthymia do not typically experience hypomania, periods of elevated mood, or feelings of detachment from one's body, which are more commonly associated with other mood disorders. Therefore, options A, B, and D are incorrect findings for a client with persistent depressive disorder.

5. Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?

• A. Restating
• B. Encouraging description of perception
• C. Summarizing
• D. Asking 'why' questions

Correct answer: D

Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.

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