Nursing Elites

1. When assessing a patient with schizophrenia who exhibits flat affect and social withdrawal, these symptoms are classified as:

• A. Positive symptoms
• B. Negative symptoms
• C. Cognitive symptoms
• D. Mood symptoms

Correct answer: B

Rationale: Flat affect and social withdrawal are characteristic of negative symptoms in schizophrenia. Negative symptoms involve disruptions to normal emotions and behaviors, such as reduced emotional expression (flat affect) and social withdrawal. These symptoms reflect a decrease or absence of normal functions. Positive symptoms, on the other hand, involve the presence of abnormal behaviors or experiences, such as hallucinations and delusions, which are added to a person’s experiences. Cognitive symptoms relate to difficulties with thinking, memory, and processing information, impacting cognition. Mood symptoms involve disturbances in mood regulation, which is distinct from the flat affect seen in negative symptoms.

2. When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?

• A. Change of shift reports
• B. Admission interviews
• C. One-to-one conversations with patients
• D. Conversations with patient families

Correct answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

3. In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?

• A. When the individual judges the event to be benign
• B. When the individual judges the event to be irrelevant
• C. When the individual judges the resources and skills needed to deal with the event
• D. When the individual judges the event to be pleasurable

Correct answer: C

Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.

4. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?

• A. A client rudely complaining about limited visiting hours
• B. A client exhibiting aggressive behavior toward another client
• C. A client stating that no one cares
• D. A client verbalizing feelings of failure

Correct answer: B

Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.

5. Which should the healthcare provider recognize as a DSM-5 disorder?

• A. Obesity
• B. Generalized anxiety disorder
• C. Hypertension
• D. Grief

Correct answer: B

Rationale: The DSM-5 categorizes mental health disorders for diagnostic purposes. Generalized anxiety disorder is one of the disorders listed in the DSM-5, characterized by persistent and excessive worry about various events or activities. This disorder falls under the category of anxiety disorders, which also include panic disorder, phobias, and others. Choices A, C, and D are not DSM-5 disorders. Obesity and hypertension are medical conditions, while grief, though a significant emotional response, is not classified as a mental health disorder in the DSM-5.

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