Nursing Elites

1. A healthcare professional is assessing a client with obsessive-compulsive disorder (OCD). Which of the following findings shouldn't the healthcare professional expect?

• A. Recurrent, intrusive thoughts
• B. Compulsive behaviors
• C. Delusions of grandeur
• D. Avoidance of situations that trigger obsessions

Correct answer: C

Rationale: In obsessive-compulsive disorder (OCD), common findings include recurrent, intrusive thoughts (obsessions), compulsive behaviors, and avoidance of situations that trigger obsessions. Delusions of grandeur, which involve having an exaggerated sense of power, importance, or identity, are not typically associated with OCD. It is important to differentiate between the specific characteristics of OCD and other mental health conditions to provide accurate care and interventions for clients.

2. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?

• A. The client is experiencing severe distress and is at risk for physical and psychological illness.
• B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
• C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
• D. The client may view these losses as challenges and perceive them as opportunities.

Correct answer: C

Rationale: The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client's life. However, susceptibility to stress-related physical or psychological illness cannot be accurately estimated without considering the individual's coping resources and available support systems. Positive coping mechanisms and strong social support can mitigate the risk of stress-related illnesses even in the face of significant life changes and losses. Choice A is incorrect because it makes a definitive statement about the client's state without considering individual coping mechanisms and support. Choice B is incorrect because a score of 110 does not necessarily mean no threat of stress-related illness, as individual factors play a crucial role. Choice D is incorrect as it assumes a positive outlook without acknowledging the potential impact of the experienced losses on stress levels.

3. A patient with obsessive-compulsive disorder (OCD) is prescribed paroxetine. The nurse should educate the patient about which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Sexual dysfunction
• D. Hypertension

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Paroxetine, an SSRI commonly prescribed for OCD, can lead to sexual dysfunction as a side effect. Patients should be educated about this potential adverse effect to ensure they are aware and can seek appropriate management if needed. Choices A, B, and D are incorrect because insomnia, weight loss, and hypertension are not typically associated with paroxetine use as common side effects in patients with OCD.

4. Which of the following is an uncommon symptom of schizophrenia?

• A. Delusions
• B. Fatigue
• C. Disorganized speech
• D. Catatonia

Correct answer: B

Rationale: Common symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and catatonia. Fatigue is not typically considered a direct symptom of schizophrenia. It is important to focus on symptoms directly related to the disorder when identifying schizophrenia.

5. A healthcare professional is assessing a client who has been diagnosed with schizophrenia and is exhibiting negative symptoms. Which of the following is an example of a negative symptom?

• A. Hallucinations
• B. Delusions
• C. Apathy
• D. Disorganized speech

Correct answer: C

Rationale: Apathy is a negative symptom of schizophrenia characterized by a lack of interest or motivation. Negative symptoms involve a decrease or absence of normal functions, such as emotions, motivation, or socialization, rather than the presence of abnormal behaviors like hallucinations or delusions. Hallucinations (choice A) and delusions (choice B) are positive symptoms, which involve the presence of abnormal behaviors. Disorganized speech (choice D) is an example of a disorganized symptom, not a negative symptom.

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