Nursing Elites

1. An individual who has survived incest and is receiving treatment at the mental health clinic feels relief upon understanding that her anxiety and depression are:

• A. Going to be eradicated with treatment
• B. Normal and will soon pass
• C. Abnormal but will pass
• D. A normal reaction to posttraumatic events

Correct answer: D

Rationale: It is important to recognize that anxiety and depression are common responses to traumatic events like incest. Understanding that these feelings are normal reactions can help validate the individual's experiences and reduce stigma. By acknowledging that anxiety and depression are expected outcomes of posttraumatic events, the mental health clinic can provide appropriate support and treatment to help the survivor cope and heal. Therefore, option D is the correct choice as it reflects a compassionate and informed approach to addressing the survivor's emotional struggles.

2. A client has been prescribed diazepam (Valium) for the treatment of anxiety. Which of the following instructions should the nurse include in the discharge teaching?

• A. Avoid drinking alcohol while taking this medication.
• B. Take the medication with food to avoid stomach upset.
• C. Stop taking the medication if you feel better.
• D. Double the dose if you miss a dose.

Correct answer: A

Rationale: The correct instruction is to avoid drinking alcohol while taking diazepam (Valium) as it can potentiate the sedative effects and increase the risk of side effects such as drowsiness and dizziness. Taking the medication with food may help reduce stomach upset, but avoiding alcohol is crucial to ensure safe and effective use of diazepam. Choice B is partially correct, as taking the medication with food can indeed help with stomach upset, but it is not as crucial as avoiding alcohol. Choice C is incorrect because abruptly stopping diazepam can lead to withdrawal symptoms and should only be done under medical supervision. Choice D is incorrect as doubling the dose is dangerous and should never be done without healthcare provider approval.

3. In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?

• A. When the individual judges the event to be benign
• B. When the individual judges the event to be irrelevant
• C. When the individual judges the resources and skills needed to deal with the event
• D. When the individual judges the event to be pleasurable

Correct answer: C

Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.

4. How do psychiatrists determine which diagnosis to give a patient?

• A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• B. Hospital policy dictates how psychiatrists diagnose mental disorders.
• C. Psychiatrists assess the patient and identify diagnoses based on the patient's symptoms and contributing factors.
• D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine which diagnosis to give a patient. The DSM-5 is a comprehensive manual published by the American Psychiatric Association (APA) that outlines specific criteria for diagnosing mental disorders. It aims to ensure accurate and consistent diagnosis and treatment. Choices B and D provide inaccurate information. Hospital policy does not dictate psychiatric diagnoses, and the American Medical Association does not provide diagnostic labels for mental disorders. Choice C, although mentioning the assessment of patients, does not highlight the specific criteria and guidelines provided by the DSM-5 that psychiatrists use to assign diagnoses.

5. In a patient with bipolar disorder, which symptom would indicate a manic episode?

• A. Excessive sleeping
• B. Low self-esteem
• C. Decreased need for sleep
• D. Anhedonia

Correct answer: C

Rationale: The correct answer is C: Decreased need for sleep. A decreased need for sleep is a hallmark symptom of a manic episode in bipolar disorder. During manic episodes, individuals may experience significantly reduced sleep without feeling tired, which can lead to increased energy levels, impulsivity, and other manic symptoms. Excessive sleeping (choice A) is more indicative of depression rather than mania. Low self-esteem (choice B) and anhedonia (choice D) are also more commonly associated with depressive episodes rather than manic episodes in bipolar disorder.

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