Nursing Elites

1. Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas's nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co-occur along with:

• A. Generally good health despite the mental illness.
• B. An aversion to drinking fluids.
• C. Anxiety and depression.
• D. The ability to express his needs.

Correct answer: C

Rationale: Individuals with schizophrenia often turn to excessive alcohol consumption as a way to manage symptoms of anxiety and depression. This maladaptive coping mechanism can exacerbate the challenges associated with schizophrenia and may hinder effective treatment outcomes. Recognizing the presence of anxiety and depression alongside alcohol abuse is crucial for providing holistic care and support to individuals with schizophrenia.

2. A patient with schizophrenia is experiencing hallucinations. Which intervention is most appropriate?

• A. Encourage the patient to ignore the voices.
• B. Engage the patient in a reality-based activity.
• C. Provide a quiet environment to reduce stimulation.
• D. Ask the patient to describe the hallucinations in detail.

Correct answer: B

Rationale: Engaging the patient in a reality-based activity is the most appropriate intervention for a patient with schizophrenia experiencing hallucinations. This intervention can help distract the patient from the hallucinations and reorient them to the present, promoting a connection with reality and potentially reducing distress associated with the hallucinations. Choice A, encouraging the patient to ignore the voices, may not be effective as it can be challenging for the patient to dismiss the hallucinations. Choice C, providing a quiet environment, is helpful but may not directly address the hallucinations. Choice D, asking the patient to describe the hallucinations in detail, may increase the patient's focus on the hallucinations, potentially worsening distress.

3. A client experiencing alcohol withdrawal is being cared for by a nurse. Which symptom should the nurse identify as a priority to address?

• A. Insomnia
• B. Nausea and vomiting
• C. Increased heart rate
• D. Tremors

Correct answer: C

Rationale: Increased heart rate is a critical symptom to address in a client experiencing alcohol withdrawal as it can indicate potential cardiovascular complications. Monitoring and managing the increased heart rate promptly is essential to prevent adverse outcomes.

4. When assessing a patient with generalized anxiety disorder (GAD), which symptom would the nurse most likely observe?

• A. Flashbacks
• B. Excessive worry
• C. Hallucinations
• D. Compulsive behaviors

Correct answer: B

Rationale: Excessive worry is a characteristic feature of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their life, such as work, health, or family, even when there is little or no reason for concern. This chronic worrying can significantly impact their daily functioning and quality of life. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical in conditions like schizophrenia, while compulsive behaviors are seen in obsessive-compulsive disorder (OCD). Therefore, in the context of GAD, excessive worry is the symptom that the nurse is most likely to observe.

5. A nurse is providing education to the family of a client who has been diagnosed with major depressive disorder. Which of the following instructions should the nurse include?

• A. Encourage the client to avoid caffeine.
• B. Encourage the client to participate in physical activity.
• C. Encourage the client to express their feelings.
• D. Encourage the client to avoid isolation.

Correct answer: D

Rationale: The nurse should instruct the family to encourage the client to avoid isolation. Social support and interaction are crucial for individuals with major depressive disorder as it can help in improving mood, reducing feelings of loneliness, and providing a sense of belonging and support. Choices A, B, and C are not the most appropriate instructions for a client with major depressive disorder. While avoiding caffeine can be beneficial for some individuals with anxiety or sleep issues, it is not a primary intervention for major depressive disorder. Encouraging physical activity and expressing feelings are important aspects of managing depression, but avoiding isolation is more critical to address first.

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