Nursing Elites

1. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

• A. Medications provided are ineffective.
• B. Nurses are trying to control their minds.
• C. The medications will make them sick.
• D. They are not actually ill.

Correct answer: D

Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.

2. Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes?

• A. I know you say you hear voices, but I cannot hear them.
• B. Stop listening to the voices, they are NOT real.
• C. You say you hear voices, what are they telling you?
• D. Please tell the voices to leave you alone for now.

Correct answer: C

Rationale: Asking about the content of the voices helps understand the patient's experience and assess risk.

3. When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?

• A. Encourage the client to avoid stressful situations.
• B. Encourage the client to participate in daily activities.
• C. Encourage the client to express their feelings.
• D. Encourage the client to develop a daily routine.

Correct answer: D

Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.

4. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?

• A. Meditation
• B. Problem-solving training
• C. Relaxation
• D. Journaling

Correct answer: B

Rationale: In this scenario, the student is dealing with conflicting priorities of attending college or working to support the family financially. Problem-solving training is the most appropriate coping strategy to recommend. It can help the student objectively assess the situation, identify potential solutions, and make informed decisions. Problem-solving training provides structure and guidance, empowering the student to navigate the conflicting priorities effectively and choose the best course of action. Meditation, relaxation, and journaling may be beneficial for stress relief but may not directly address the decision-making process required in this situation.

5. Which approach involves surgically implanting electrodes into specific areas of the brain to stimulate regions identified as underactive in depression?

• A. Transcranial magnetic stimulation
• B. Deep brain stimulation
• C. Vagus nerve stimulation
• D. Electroconvulsive therapy

Correct answer: B

Rationale: Deep brain stimulation is a treatment approach that involves the surgical implantation of electrodes into specific areas of the brain to stimulate regions identified as underactive in depression. This method aims to modulate brain activity and has shown effectiveness in treating certain cases of depression.

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