Nursing Elites

1. 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.

2. 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.

3. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?

• A. Complains of persistent and excessive worry.
• B. Frequently fidgets and has difficulty sitting still.
• C. Exhibits ritualistic behaviors.
• D. Reports periods of derealization.

Correct answer: A

Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.

4. What is a common side effect of benzodiazepines prescribed for anxiety?

• A. Weight gain
• B. Insomnia
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Benzodiazepines, commonly prescribed for anxiety, often cause drowsiness as a side effect due to their sedative properties. This can lead to impairments in cognitive and motor skills, making it important for individuals on these medications to exercise caution when performing tasks that require alertness, such as driving or operating machinery. Choices A, B, and D are incorrect because weight gain, insomnia, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more commonly reported side effects.

5. What principle should guide a nurse's fear about 'saying the wrong thing' to a patient in nurse-patient communication?

• A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
• B. The patient is more interested in talking to you than listening to what you have to say and is not likely to be offended.
• C. Considering the patient's history, there is little chance that the comment will do any actual harm.
• D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.

Correct answer: A

Rationale: Effective nurse-patient communication is guided by the principle that patients value sincere and respectful interactions. A nurse's well-meaning approach that conveys acceptance, respect, and concern helps establish trust and rapport with patients, even if the nurse is apprehensive about making mistakes. It is essential for the nurse to focus on genuine intent and respect for the patient's situation rather than being consumed by the fear of saying something wrong.

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