Nursing Elites

1. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?

• A. Teenagers! They don't know a thing about real stress.
• B. Stress occurs only when there is a loss.
• C. When you are in poor physical condition, you can't experience psychological well-being.
• D. Stress can be psychological. A threat to self-esteem may result in high stress levels.

Correct answer: D

Rationale: The correct answer is D. Stress can manifest as physical or psychological. A perceived threat to self-esteem can be as stressful as a physiological change. Choice A is dismissive of the teenager's concerns and does not address the issue professionally. Choice B is incorrect as stress can result from various factors, not just loss. Choice C oversimplifies the relationship between physical condition and psychological well-being, neglecting the impact of mental stressors on overall health.

2. A client is experiencing alcohol withdrawal. Which symptom should the nurse identify as a priority to address?

• A. Tremors
• B. Nausea and vomiting
• C. Increased blood pressure
• D. Insomnia

Correct answer: C

Rationale: During alcohol withdrawal, increased blood pressure is a critical symptom that requires immediate attention. Elevated blood pressure can lead to serious complications such as cardiovascular events or stroke. Monitoring and managing blood pressure in clients experiencing alcohol withdrawal is crucial to prevent adverse outcomes. Tremors, nausea and vomiting, and insomnia are common symptoms of alcohol withdrawal, but they are not as immediately life-threatening as increased blood pressure. Therefore, addressing increased blood pressure takes precedence in the management of a client experiencing alcohol withdrawal.

3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?

• A. I've found that avoiding contact with others helps me cope.
• B. I really enjoy journaling; it's my private time.
• C. I signed up for a yoga class this week.
• D. I made an appointment to meet with a therapist.

Correct answer: A

Rationale: The correct answer is A. Reliance on social isolation as a coping mechanism is maladaptive and can hinder the development of appropriate coping skills and access to support systems. It may indicate a lack of healthy coping strategies and social connections, which are important for managing stress effectively. Choice B is a positive coping strategy that promotes self-reflection and emotional expression. Choice C reflects a proactive approach to managing stress through physical activity. Choice D shows a willingness to seek professional help, which is a healthy coping mechanism.

4. Which of the following are common side effects of selective serotonin reuptake inhibitors (SSRIs)? Select one that does not apply.

• A. Nausea
• B. Insomnia
• C. Weight loss
• D. Sexual dysfunction

Correct answer: C

Rationale: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include nausea, insomnia, weight gain, and sexual dysfunction. Weight loss is not a common side effect associated with SSRIs. Therefore, the correct answer is C. While some individuals may experience weight changes while taking SSRIs, weight loss is less common compared to weight gain as a side effect of these medications.

5. A patient is being educated about the difference between mental health and mental illness. Which statement by the patient reflects an accurate understanding of mental health?

• A. Mental health is the absence of any stressors.
• B. Mental health is successful adaptation to stressors in the internal and external environment.
• C. Mental health is incongruence between thoughts, feelings, and behavior.
• D. Mental health is a diagnostic category in the DSM-5.

Correct answer: B

Rationale: The correct answer is B. Mental health is defined as the successful adaptation to stressors in the internal and external environment. This includes having thoughts, feelings, and behaviors that are age-appropriate and congruent with cultural and societal norms. Mental health is not solely the absence of stressors or incongruence between thoughts, feelings, and behavior, nor is it a specific diagnostic category in the DSM-5. Choice A is incorrect because mental health is not just the absence of stressors but the ability to adapt to them. Choice C is wrong as mental health involves congruence, not incongruence, between thoughts, feelings, and behaviors. Choice D is inaccurate as mental health is a broader concept than a specific diagnostic category in the DSM-5.

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