Nursing Elites

1. A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?

• A. A client in an acute care mental health facility who has fallen several times while running down the hallway
• B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
• C. A client in a day treatment program who reports increasing anxiety during group therapy
• D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months

Correct answer: B

Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.

2. Gilbert, age 19, is described by his parents as a 'moody child' with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: Individuals with an early and slow onset of schizophrenia typically have a less positive outcome or prognosis. This is because early onset schizophrenia is often associated with a more severe form of the illness and can lead to greater functional impairment in various aspects of life, including academic and social functioning. Therefore, the prognosis for Gilbert, given his presentation and age of onset, would be considered to have a less positive outcome.

3. Which symptom is most indicative of obsessive-compulsive disorder (OCD)?

• A. Flashbacks of traumatic events
• B. Persistent, intrusive thoughts
• C. Frequent mood swings
• D. Auditory hallucinations

Correct answer: B

Rationale: Persistent, intrusive thoughts are a hallmark symptom of obsessive-compulsive disorder. Individuals with OCD experience persistent and unwanted thoughts or obsessions that are intrusive and cause significant distress. These thoughts often lead to repetitive behaviors or compulsions to try to alleviate the anxiety or distress caused by the obsessions. Flashbacks of traumatic events (Choice A), frequent mood swings (Choice C), and auditory hallucinations (Choice D) are not typical symptoms of OCD. Flashbacks are more commonly associated with post-traumatic stress disorder, mood swings can be seen in mood disorders, and auditory hallucinations are more characteristic of psychotic disorders.

4. Which of the following is an example of a mood stabilizer used to treat bipolar disorder?

• A. Fluoxetine
• B. Lithium
• C. Haloperidol
• D. Lorazepam

Correct answer: B

Rationale: Lithium is a widely recognized mood stabilizer used in the treatment of bipolar disorder. It helps to control mood swings, prevent manic episodes, and reduce the risk of suicidal behavior in individuals with bipolar disorder. Fluoxetine is an antidepressant, Haloperidol is an antipsychotic, and Lorazepam is a benzodiazepine used for anxiety and insomnia, none of which are primary mood stabilizers for bipolar disorder.

5. A healthcare provider decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The healthcare provider’s actions are an example of which of the following torts?

• A. Invasion of privacy
• B. False imprisonment
• C. Assault
• D. Battery

Correct answer: B

Rationale: The correct answer is B: False imprisonment. False imprisonment occurs when an individual is intentionally restricted in their freedom of movement without consent and without lawful justification. In this scenario, placing the client in seclusion overnight due to staffing shortages and behavioral issues constitutes false imprisonment as the client is confined against their will. Choice A, invasion of privacy, does not apply as the situation is about physical confinement, not privacy violation. Assault (choice C) involves the threat of harm, which is not the case here. Battery (choice D) refers to the intentional harmful or offensive touching of another person, which is not happening in this scenario.

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