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. During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:

• A. Major depression
• B. Normal grieving
• C. Adjustment disorder
• D. Posttraumatic stress disorder

Correct answer: C

Rationale: The widow's symptoms align more closely with an adjustment disorder rather than major depression, normal grieving, or posttraumatic stress disorder. The widow's prolonged struggle in coping with the loss, characterized by emptiness, loss of self, difficulty envisioning the future, and anger towards her deceased husband, indicates an inability to adapt to the loss. These symptoms are indicative of an adjustment disorder, which typically arises in response to a significant life stressor and persists beyond what is considered a normal grieving process. Bereavement counseling can help the widow navigate her emotions and coping strategies during this challenging period.

3. A client diagnosed with schizophrenia is receiving discharge teaching. Which of the following instructions should the healthcare provider include? Select one that does not apply.

• A. Continue taking medications as prescribed
• B. Avoid all social interactions
• C. Report any side effects of medications to the healthcare provider
• D. Develop a daily routine

Correct answer: B

Rationale: Discharge instructions for a client diagnosed with schizophrenia should focus on promoting medication adherence, monitoring and reporting any medication side effects, and establishing a structured daily routine to support stability and well-being. Encouraging the client to avoid all social interactions is not appropriate as social support can be beneficial for individuals with schizophrenia. Social interactions can help reduce feelings of isolation, improve overall well-being, and provide emotional support. Therefore, advising the client to avoid all social interactions would not be in the best interest of their recovery and management of the condition.

4. Which therapeutic approach is most effective for managing borderline personality disorder?

• A. Dialectical behavior therapy
• B. Cognitive-behavioral therapy
• C. Psychoanalysis
• D. Supportive therapy

Correct answer: A

Rationale: Dialectical behavior therapy (DBT) is considered the most effective therapeutic approach for managing borderline personality disorder. DBT is a specialized form of cognitive-behavioral therapy that focuses on providing skills to cope with intense emotions, improve relationships, and regulate behavior. It has been extensively studied and shown to be effective in reducing self-harm, suicidal behaviors, and improving overall functioning in individuals with borderline personality disorder. Cognitive-behavioral therapy (Choice B) is a common and effective treatment for many mental health conditions but is not as specifically tailored to address the core symptoms of borderline personality disorder as DBT. Psychoanalysis (Choice C) is a more intensive and long-term therapy that focuses on exploring unconscious patterns and early life experiences, which may not be as practical or effective for the impulsive and emotional dysregulation seen in borderline personality disorder. Supportive therapy (Choice D) provides emotional support but lacks the structured skills training and strategies that are essential in managing borderline personality disorder.

5. When assessing a client diagnosed with post-traumatic stress disorder (PTSD), which finding should the nurse expect?

• A. Hypervigilance
• B. Insomnia
• C. Flashbacks
• D. Suicidal ideation

Correct answer: A

Rationale: Clients with PTSD commonly exhibit symptoms such as hypervigilance, insomnia, flashbacks, difficulty concentrating, and increased irritability. Hypervigilance refers to an enhanced state of awareness and alertness, often seen in individuals with PTSD as they are constantly on guard for potential threats. Insomnia is a common sleep disturbance associated with PTSD, where individuals may have trouble falling or staying asleep. Flashbacks involve re-experiencing the traumatic event as if it is occurring in the present moment. Suicidal ideation, while a serious concern in mental health, is not a hallmark symptom specifically associated with PTSD. Therefore, the correct finding that the nurse should expect when assessing a client diagnosed with PTSD is hypervigilance.

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