Nursing Elites

1. A patient with borderline personality disorder is admitted to the psychiatric unit. Which behavior is most characteristic of this disorder?

• A. Avoiding social interactions due to fear of rejection.
• B. Engaging in impulsive and self-destructive behaviors.
• C. Having a grandiose sense of self-importance.
• D. Exhibiting a pattern of unstable relationships.

Correct answer: B

Rationale: Borderline personality disorder is characterized by impulsivity and self-destructive behaviors, such as substance abuse, reckless driving, and self-harm. These behaviors are often used to cope with intense emotional distress and are a key feature of this disorder. While individuals with borderline personality disorder may also struggle with unstable relationships, the hallmark feature that sets it apart is the impulsivity and self-destructive behaviors. Avoiding social interactions due to fear of rejection is more characteristic of avoidant personality disorder. Having a grandiose sense of self-importance is a feature of narcissistic personality disorder.

2. Which of the following is a common symptom of borderline personality disorder?

• A. Obsessive-compulsive behaviors
• B. Fear of social situations
• C. Grandiose sense of self-importance
• D. Impulsive and self-destructive behaviors

Correct answer: D

Rationale: Individuals with borderline personality disorder often exhibit impulsive and self-destructive behaviors. These behaviors can include reckless driving, substance abuse, self-harm, and suicidal gestures. These actions are often attempts to cope with intense emotional pain or to avoid feelings of emptiness and abandonment. It is crucial for healthcare professionals to recognize and address these symptoms when diagnosing and treating borderline personality disorder.

3. A patient with major depressive disorder is struggling to cope. Which intervention is most appropriate to help the patient develop better coping skills?

• A. Encouraging the patient to express their feelings through art
• B. Providing the patient with information about their diagnosis
• C. Encouraging the patient to keep a journal of their thoughts and feelings
• D. Providing the patient with a structured daily routine

Correct answer: D

Rationale: Providing a patient with major depressive disorder a structured daily routine can help them establish a sense of stability, which is crucial for coping with their condition. Routine provides predictability and helps in organizing activities, promoting a sense of accomplishment and control, which can be especially beneficial for individuals struggling with depression.

4. A client in an acute mental health facility is being discharged and requires supervision due to a severe mental illness. The client’s partner works all day but is home by late afternoon. Which of the following strategies should the nurse suggest for follow-up care?

• A. Receiving daily care from a home health aide
• B. Having a weekly visit from a nurse case worker
• C. Attending a partial hospitalization program
• D. Visiting a community mental health center on a daily basis

Correct answer: C

Rationale: For clients requiring supervision due to severe mental illness, attending a partial hospitalization program provides structured care and support while allowing the client to return home in the evenings, making it a suitable option for follow-up care. The other choices are less appropriate: A home health aide may not provide the necessary level of care and supervision, a weekly visit from a nurse case worker may not be sufficient for the client's needs, and visiting a community mental health center on a daily basis may not offer the structured support required for someone with a severe mental illness.

5. A patient with schizophrenia is prescribed risperidone. Which statement by the patient indicates understanding of the medication?

• A. I should take this medication at the same time every day.
• B. I can stop taking this medication once I feel better.
• C. I should avoid drinking alcohol while taking this medication.
• D. I should take this medication on an as-needed basis.

Correct answer: A

Rationale: The correct answer is A because taking the medication at the same time every day helps maintain consistent blood levels and effectiveness. Consistency in dosing is crucial for the medication to work optimally in managing symptoms of schizophrenia. Option B is incorrect because stopping the medication abruptly can lead to a worsening of symptoms. Option C is important as alcohol can interact with the medication and cause adverse effects. Option D is incorrect because risperidone is typically taken regularly, not on an as-needed basis, to manage symptoms effectively.

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