Nursing Elites

1. When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should one anticipate?

• A. Decreased resistance to disease
• B. Increased libido
• C. Decreased blood pressure
• D. Increased inflammatory response

Correct answer: A

Rationale: When stress is prolonged, the body reaches the stage of exhaustion in the general adaptation syndrome, where compensatory mechanisms fail, and diseases of adaptation may occur. One physiological effect includes a decreased immune response, leading to decreased resistance to disease. Therefore, the correct answer is A. Increased libido (choice B) is not a typical physiological effect related to prolonged stress. Decreased blood pressure (choice C) is not commonly associated with sustained stress. Increased inflammatory response (choice D) may occur in the short term due to stress, but over a prolonged period, the immune system's function weakens, leading to decreased resistance to disease.

2. A healthcare professional is assessing a client diagnosed with body dysmorphic disorder. Which of the following findings should the healthcare professional expect?

• A. Preoccupation with a perceived physical defect
• B. Fear of gaining weight
• C. Excessive worry about physical symptoms
• D. Persistent depressive mood

Correct answer: A

Rationale: The correct answer is A: Preoccupation with a perceived physical defect. Individuals with body dysmorphic disorder exhibit an obsessive preoccupation with a perceived flaw in their physical appearance, which is often minor or not noticeable to others. This preoccupation causes distress and leads to repetitive behaviors like mirror checking or seeking reassurance about their appearance. Choices B, C, and D are incorrect because fear of gaining weight is more characteristic of an eating disorder, excessive worry about physical symptoms may be seen in somatic symptom disorder, and persistent depressive mood aligns more with depressive disorders rather than body dysmorphic disorder.

3. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?

• A. Teenagers! They don't know a thing about real stress.
• B. Stress occurs only when there is a loss.
• C. When you are in poor physical condition, you can't experience psychological well-being.
• D. Stress can be psychological. A threat to self-esteem may result in high stress levels.

Correct answer: D

Rationale: The most appropriate response is D: 'Stress can be psychological. A threat to self-esteem may result in high stress levels.' This response acknowledges the psychological aspect of stress and how a perceived threat to self-esteem can be just as stressful as a physiological change. Choices A, B, and C are incorrect because they do not address the client's concerns or provide a therapeutic response to the situation.

4. 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.

5. Which of the following statements should a healthcare provider recognize as true about defense mechanisms? Select all that apply.

• A. They are employed when there is a threat to biological or psychological integrity.
• B. They are controlled by the id and deal with primal urges.
• C. They are used in an effort to increase anxiety.
• D. They are protective devices for the superego.

Correct answer: A

Rationale: Defense mechanisms are employed by the ego, not the id or superego, in response to threats to biological or psychological integrity. They aim to relieve anxiety, not increase it. By redirecting focus, they help manage mild to moderate anxiety and are often self-deceptive in nature.

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