Nursing Elites

1. A nurse is assessing a patient with schizophrenia who is experiencing delusions. Which intervention is most appropriate?

• A. Agree with the patient's delusions to avoid confrontation.
• B. Encourage the patient to explore the basis of the delusions.
• C. Engage the patient in reality-based activities.
• D. Ask the patient to explain the delusions in detail.

Correct answer: C

Rationale: The most appropriate intervention when assessing a patient with schizophrenia experiencing delusions is to engage the patient in reality-based activities. This intervention helps distract the patient from the delusions and reorients them to the present, promoting grounding in reality. Choice A is incorrect because agreeing with delusions can reinforce them and hinder treatment. Choice B may exacerbate the delusions by delving deeper into their basis. Choice D may not be beneficial as it focuses solely on the delusions without addressing the need to ground the patient in reality.

2. Which of the following characteristics is not a feature of borderline personality disorder?

• A. Intense fear of abandonment
• B. Unstable relationships
• C. Impulsivity
• D. Grandiosity

Correct answer: D

Rationale: Borderline personality disorder is characterized by an intense fear of abandonment, unstable relationships, impulsivity, and chronic feelings of emptiness. Grandiosity, which involves an inflated sense of self-importance, is typically associated with narcissistic personality disorder rather than borderline personality disorder.

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. When explaining one of the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse mention?

• A. Symptoms of the two diagnoses are essentially the same, making it difficult to differentiate between them.
• B. People with narcolepsy awaken from a nap feeling rested and replenished.
• C. People with obstructive sleep apnea syndrome can experience temporary paralysis during naps.
• D. Naps are contraindicated for clients with narcolepsy due to their association with catatonia.

Correct answer: B

Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep, while obstructive sleep apnea syndrome involves the obstruction of the upper airway during sleep. One of the main differences is that people with narcolepsy often experience refreshing naps, feeling rested and replenished upon waking, which is not the case for obstructive sleep apnea syndrome. This distinction is important for healthcare providers to understand as it helps differentiate between these two sleep disorders.

5. A client diagnosed with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects should the nurse monitor for? Select one that doesn't apply.

• A. Tardive dyskinesia
• B. Muscle tension
• C. Orthostatic hypotension
• D. Hyperglycemia

Correct answer: B

Rationale: Side effects of antipsychotic medications commonly include tardive dyskinesia, orthostatic hypotension, and hyperglycemia. Muscle tension is not typically associated with antipsychotic medication use. Tardive dyskinesia is characterized by involuntary movements, orthostatic hypotension refers to a drop in blood pressure upon standing, and hyperglycemia indicates high blood sugar levels. Monitoring these side effects is crucial for early detection and management, but muscle tension is not a typical side effect of antipsychotic medications.

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