Nursing Elites

1. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?

• A. A client who received a burn on the arm while using a hot iron at home
• B. A client who requests a change of antipsychotic medication due to new adverse effects
• C. A client who reports hearing a voice saying that life is not worth living anymore
• D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview

Correct answer: C

Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.

2. A patient with schizophrenia is being educated about the significance of medication adherence. Which statement by the patient indicates understanding?

• A. I will take my medication only when I feel symptoms returning.
• B. I understand that taking my medication regularly is important to manage my symptoms.
• C. I can stop taking my medication once I feel better.
• D. I should take my medication on an as-needed basis.

Correct answer: B

Rationale: The correct answer is B because acknowledging the importance of consistently taking medication is crucial for effectively managing symptoms of schizophrenia. It is essential for patients with schizophrenia to adhere to their medication regimen to stabilize their condition and prevent symptom exacerbation. Waiting for symptoms to return before taking medication, stopping medication once feeling better, or taking medications on an as-needed basis are not recommended practices for managing schizophrenia effectively.

3. In dissociative identity disorder, a patient exhibits different personalities, each with distinct behaviors and memories. The nurse recognizes that this fragmentation of identity serves as a coping mechanism for:

• A. Current stressors
• B. Developmental issues
• C. Traumatic experiences
• D. Family dynamics

Correct answer: C

Rationale: In dissociative identity disorder, the fragmentation of identity serves as a coping mechanism for traumatic experiences. Individuals may develop different identities to help them manage and cope with overwhelming and traumatic events from their past. These distinct personalities often emerge as a way to protect the individual from the emotional pain associated with their traumatic experiences. Choices A, B, and D are incorrect because dissociative identity disorder is primarily associated with coping mechanisms related to past traumatic experiences, rather than current stressors, developmental issues, or family dynamics.

4. In schizophrenia, a patient is experiencing negative symptoms. Which of the following is a negative symptom?

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

Correct answer: C

Rationale: In schizophrenia, negative symptoms refer to deficits in normal emotional responses or other thought processes. Apathy is a negative symptom characterized by a lack of interest, enthusiasm, or concern. Hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), and disorganized speech are positive symptoms, which involve the presence of abnormal behaviors or thoughts.

5. Which medication is often prescribed for patients with bipolar disorder to help stabilize mood?

• A. Sertraline
• B. Lithium
• C. Haloperidol
• D. Diazepam

Correct answer: B

Rationale: Lithium is the medication frequently prescribed to stabilize mood in patients with bipolar disorder. It helps to reduce the frequency and severity of manic episodes, making it a cornerstone in the treatment of bipolar disorder. Sertraline is an antidepressant commonly used for depression, while haloperidol and diazepam are not typically first-line treatments for bipolar disorder.

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