Nursing Elites

1. Based on what criteria do most cultures label behavior as mental illness?

• A. Incomprehensibility and cultural relativity
• B. Strength of character and ethics
• C. Goal directedness and high energy
• D. Creativity and good coping skills

Correct answer: A

Rationale: The correct answer is A: Incomprehensibility and cultural relativity. Incomprehensibility and cultural relativity are the main criteria used across cultures to define behavior as mental illness. When behavior is incomprehensible and significantly deviates from cultural norms, it is more likely to be classified as a mental illness. Choices B, C, and D are incorrect. Strength of character, ethics, goal directedness, high energy, creativity, and good coping skills are typically associated with positive mental health rather than mental illness.

2. A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?

• A. Projection
• B. Rationalization
• C. Regression
• D. Sublimation

Correct answer: B

Rationale: The nurse should recognize that the client is using rationalization, a common defense mechanism. Rationalization involves creating logical reasons to justify unacceptable feelings or behaviors. In this scenario, the client is justifying excessive drinking by linking it to hard work and the need for relaxation, masking the true underlying issue of alcohol abuse. Projection involves attributing one's thoughts or feelings to others, regression involves reverting to an earlier stage of development, and sublimation involves channeling unacceptable impulses into socially acceptable activities, none of which are demonstrated in the client's statement.

3. What information should the nurse provide in patient education for a patient prescribed sertraline for major depressive disorder?

• A. Take the medication with food.
• B. It may take several weeks to feel the full effect.
• C. Avoid consuming grapefruit while taking this medication.
• D. Regular blood tests are necessary to monitor levels.

Correct answer: B

Rationale: Patients prescribed sertraline for major depressive disorder should be educated that it may take several weeks before experiencing the full therapeutic effects of the medication. This delay in onset of action is common with antidepressants like sertraline, and patients need to be aware of this to manage their expectations and continue with the treatment regimen. It's important for the patient to understand that consistent adherence to the prescribed dosage is crucial, even if the full effects are not immediately apparent. Choices A, C, and D are incorrect because taking the medication with food, avoiding grapefruit, and regular blood tests are not specific education points related to the expected timeframe for therapeutic effects of sertraline.

4. A patient with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?

• A. Encourage the patient to ignore the voices.
• B. Provide a structured and safe environment.
• C. Engage the patient in a debate about the reality of the voices.
• D. Ask the patient to describe the content of the hallucinations.

Correct answer: D

Rationale: The most appropriate nursing intervention when a patient with schizophrenia is experiencing auditory hallucinations is to ask the patient to describe the content of the hallucinations. This intervention helps assess the risk associated with the hallucinations and provides valuable insight into the patient's condition, aiding in developing an effective care plan. Encouraging the patient to ignore the voices (Choice A) may not address the underlying issues or risks associated with the hallucinations. Providing a structured and safe environment (Choice B) is important but does not directly address the hallucinations. Engaging the patient in a debate about the reality of the voices (Choice C) may worsen the situation by invalidating the patient's experiences.

5. Which of the following are potential side effects of electroconvulsive therapy (ECT)? Select one that does not apply.

• A. Short-term memory loss
• B. Headache
• C. Confusion
• D. Tardive dyskinesia

Correct answer: D

Rationale: Potential side effects of ECT include short-term memory loss, headache, confusion, and nausea. Tardive dyskinesia is not a side effect of ECT; it is associated with long-term use of antipsychotic medications, particularly antipsychotics that block dopamine receptors over time. ECT is primarily used for severe depression, bipolar disorder, and certain psychotic disorders. The other choices, short-term memory loss, headache, and confusion, are known side effects of ECT and are usually short-term and manageable.

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