Nursing Elites

1. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

• A. If only we could have tried again, things might have worked out.
• B. I am so mad that the children and I had to put up with him as long as we did.
• C. Yes, it was a difficult relationship, but I think I have learned from the experience.
• D. I still don't have any appetite and continue to lose weight.

Correct answer: C

Rationale: The nurse should recognize that the client is in the acceptance stage of grief based on the statement 'Yes, it was a difficult relationship, but I think I have learned from the experience.' In this statement, the client is acknowledging the difficulty of the relationship but also expressing personal growth and learning from the experience, indicating acceptance. Choices A, B, and D do not reflect the acceptance stage of grief. Choice A shows a sense of regret and a wish for things to have turned out differently. Choice B demonstrates lingering anger towards the ex-husband. Choice D suggests ongoing physical manifestations of grief like loss of appetite and weight loss, which are more indicative of earlier stages of grief.

2. A client diagnosed with borderline personality disorder tells the nurse, 'You are the only one who understands me. The other nurses don't care about me.' Which of the following responses should the nurse make?

• A. Why do you feel that way?
• B. The other nurses care about you too.
• C. You shouldn't say things like that.
• D. I think you are overreacting.

Correct answer: B

Rationale: The correct response is to acknowledge the client's feelings and provide support while also emphasizing that all staff members care about the client's well-being. Choice A does not acknowledge the client's emotions and may come across as dismissive. Choice C invalidates the client's feelings and may make the client feel misunderstood. Choice D minimizes the client's emotions, which can lead to a breakdown in therapeutic communication. Therefore, option B is the most appropriate response as it validates the client's feelings while reinforcing the idea that the entire healthcare team is supportive.

3. When assessing a client diagnosed with anorexia nervosa, which of the following findings should the nurse expect? Select one that does not apply.

• A. Amenorrhea
• B. Lanugo
• C. Hypotension
• D. Hyperkalemia

Correct answer: D

Rationale: In a client diagnosed with anorexia nervosa, expected findings include amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa; instead, hypokalemia, which is low potassium levels, is more common. Hypokalemia can result from decreased intake of potassium-rich foods or excessive purging behaviors commonly seen in individuals with anorexia nervosa.

4. Which medication is commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD)?

• A. Haloperidol
• B. Fluoxetine
• C. Methylphenidate
• D. Clozapine

Correct answer: C

Rationale: Methylphenidate is a stimulant medication commonly prescribed to manage symptoms of attention-deficit/hyperactivity disorder (ADHD). It works by affecting certain chemicals in the brain to improve focus, attention span, and impulse control. Haloperidol, fluoxetine, and clozapine are not typically used as first-line treatments for ADHD. Haloperidol is an antipsychotic, fluoxetine is an antidepressant, and clozapine is an atypical antipsychotic, each with different mechanisms of action and primary indications.

5. A nurse is assessing a client who has been diagnosed with persistent depressive disorder (dysthymia). Which of the following findings should the nurse expect?

• A. Episodes of hypomania
• B. Periods of elevated mood
• C. Lack of interest in activities
• D. Feelings of detachment from one's body

Correct answer: C

Rationale: The correct finding the nurse should expect in a client diagnosed with persistent depressive disorder (dysthymia) is a lack of interest in activities. This disorder is characterized by a chronic depressive mood lasting for at least two years, alongside symptoms such as changes in appetite, fatigue, low self-esteem, and difficulty concentrating. Clients with dysthymia do not typically experience hypomania, periods of elevated mood, or feelings of detachment from one's body, which are more commonly associated with other mood disorders. Therefore, options A, B, and D are incorrect findings for a client with persistent depressive disorder.

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