Nursing Elites

1. A client diagnosed with borderline personality disorder tells the nurse, 'You are the only one who understands me. The other nurses don't care about me.' Which of the following responses should the nurse make?

• A. Why do you feel that way?
• B. The other nurses care about you too.
• C. You shouldn't say things like that.
• D. I think you are overreacting.

Correct answer: B

Rationale: The correct response is to acknowledge the client's feelings and provide support while also emphasizing that all staff members care about the client's well-being. Choice A does not acknowledge the client's emotions and may come across as dismissive. Choice C invalidates the client's feelings and may make the client feel misunderstood. Choice D minimizes the client's emotions, which can lead to a breakdown in therapeutic communication. Therefore, option B is the most appropriate response as it validates the client's feelings while reinforcing the idea that the entire healthcare team is supportive.

2. A client has been prescribed lithium for the treatment of bipolar disorder. Which of the following instructions should the nurse include?

• A. Avoid driving until you know how the medication affects you.
• B. Take the medication with food to prevent stomach upset.
• C. You may experience mild nausea when initiating the medication.
• D. Do not double the next dose if you miss one.

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid driving until they know how the medication affects them. Lithium can lead to side effects like dizziness and drowsiness, which could impair one's ability to drive safely. Choice B is incorrect because lithium is usually taken on an empty stomach. Choice C may be true but is not as critical as the potential side effects affecting driving. Choice D is important but not as immediate as ensuring the client's safety while driving.

3. Which of the following are therapeutic communication techniques that a healthcare professional can use when interacting with clients? Select one that doesn't apply.

• A. Using silence
• B. Offering self
• C. Giving advice
• D. Providing reassurance

Correct answer: C

Rationale: Therapeutic communication techniques aim to promote understanding and trust between the professional and the client. Using silence allows the client to process thoughts, feelings, and information. Offering self involves making oneself available and showing empathy. Providing reassurance helps instill confidence. However, giving advice can sometimes be non-therapeutic as it may undermine the client's autonomy and decision-making process.

4. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.

• A. What coping resources have you used previously in stressful situations?
• B. Have you ever faced a similar stressful situation before?
• C. Who do you think is to blame for this situation?
• D. What do you believe led to your termination from your job?

Correct answer: C

Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.

5. A student finds that they come down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?

• A. Alarm reaction stage
• B. Stage of resistance
• C. Stage of exhaustion
• D. Fight-or-flight stage

Correct answer: C

Rationale: The student is most likely experiencing the stage of exhaustion. In this stage, the body's exposure to stress has been prolonged, and adaptive energy has been depleted. As a result, diseases of adaptation, such as the recurrent sinus infection in this case, are more likely to occur. The alarm reaction stage is the initial stage of the stress response, where the body perceives a threat and activates the fight-or-flight response. The stage of resistance is when the body tries to adapt and cope with the stressor. The fight-or-flight response is the immediate reaction to a perceived threat, involving physiological changes to prepare the body to either fight the stressor or flee from it.

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