Nursing Elites

1. At what point should the nurse determine that a client is at risk for developing a mental disorder?

• A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
• B. When maladaptive responses to stress are coupled with interference in daily functioning
• C. When the client communicates significant distress
• D. When the client uses defense mechanisms as ego protection

Correct answer: B

Rationale: The nurse should determine that the client is at risk for mental disorder when responses to stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that in order to be diagnosed with a mental disorder, there must be significant disturbance in cognition, emotion, regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning. These disorders are usually associated with significant distress or disability in social, occupational, or other important activities. The client's ability to communicate distress would be considered a positive attribute.

2. Which of the following are therapeutic communication techniques that a healthcare provider can use when interacting with clients? Select one that does not apply.

• A. Using Noise
• B. Offering self
• C. Giving advice
• D. Providing reassurance

Correct answer: C

Rationale: Therapeutic communication techniques aim to promote a therapeutic relationship and client well-being. Using noise is a non-therapeutic technique that can hinder effective communication. Offering self, providing reassurance, and using silence are considered therapeutic. However, giving advice is often seen as non-therapeutic as it can diminish client autonomy and hinder problem-solving skills.

3. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?

• A. Has no memory of the physical abuse he endured.
• B. Using both alcohol and marijuana.
• C. Often reports being unaware of surroundings.
• D. Reports feelings of 'not really being here.'

Correct answer: B

Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.

4. A patient with major depressive disorder is being treated with electroconvulsive therapy (ECT). The nurse should monitor the patient for which common side effect?

• A. Memory loss
• B. Hypertension
• C. Weight gain
• D. Hyperglycemia

Correct answer: A

Rationale: Memory loss, especially short-term memory loss, is a common side effect associated with electroconvulsive therapy (ECT). During ECT treatment, the electrical currents passed through the brain can disrupt short-term memory formation. This side effect is usually temporary, but patients should be closely monitored for any changes in memory function during and after the treatment. Choices B, C, and D are incorrect because they are not commonly associated with ECT. Hypertension, weight gain, and hyperglycemia are not typically observed as side effects of ECT.

5. A nursing instructor is discussing diseases of adaptation with students and when they are likely to occur. Which student response indicates that learning has occurred?

• A. When an individual has limited experience managing stress
• B. When an individual inherits adaptive genes
• C. When an individual faces pre-existing conditions that worsen stress
• D. When an individual's physiological and psychological resources are depleted

Correct answer: D

Rationale: The correct answer is D. During the stage of exhaustion in the general adaptation syndrome, an individual's physiological and psychological resources become depleted, leading to a reduced capacity to adapt effectively. This depletion of resources is when diseases of adaptation, such as stress-related disorders, are more likely to occur. Choices A, B, and C do not reflect an accurate understanding of diseases of adaptation. Limited experience managing stress, inheriting adaptive genes, and facing pre-existing conditions that worsen stress do not directly relate to the concept of physiological and psychological resource depletion leading to diseases of adaptation.

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