Nursing Elites

1. Which characteristic is most commonly associated with dissociative identity disorder?

• A. Frequent nightmares
• B. Auditory hallucinations
• C. Multiple distinct personalities
• D. Chronic fatigue

Correct answer: C

Rationale: Dissociative identity disorder, commonly known as multiple personality disorder, is characterized by the presence of two or more distinct personality states within an individual. These distinct personalities may have their own way of perceiving and interacting with the world, often leading to gaps in memory and a sense of detachment. Frequent nightmares, auditory hallucinations, and chronic fatigue are not primary characteristics of dissociative identity disorder. Option C, multiple distinct personalities, is the hallmark feature of this disorder, making it the correct choice.

2. In dissociative identity disorder, a patient exhibits different personalities, each with distinct behaviors and memories. The nurse recognizes that this fragmentation of identity serves as a coping mechanism for:

• A. Current stressors
• B. Developmental issues
• C. Traumatic experiences
• D. Family dynamics

Correct answer: C

Rationale: In dissociative identity disorder, the fragmentation of identity serves as a coping mechanism for traumatic experiences. Individuals may develop different identities to help them manage and cope with overwhelming and traumatic events from their past. These distinct personalities often emerge as a way to protect the individual from the emotional pain associated with their traumatic experiences. Choices A, B, and D are incorrect because dissociative identity disorder is primarily associated with coping mechanisms related to past traumatic experiences, rather than current stressors, developmental issues, or family dynamics.

3. A client has a new prescription for disulfiram for the treatment of alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting when alcohol is consumed. Which of the following types of treatment is this method an example of?

• A. Aversion therapy
• B. Flooding
• C. Biofeedback
• D. Dialectical behavior therapy

Correct answer: A

Rationale: Aversion therapy is a form of behavioral therapy that aims to create a negative response to a stimulus, in this case, alcohol consumption. Disulfiram is used in aversion therapy to induce unpleasant effects when alcohol is consumed, such as nausea and vomiting, to deter the individual from drinking. Therefore, the use of disulfiram in this context exemplifies aversion therapy. Flooding involves exposing an individual to a feared object or situation to overcome anxiety; biofeedback teaches self-regulation techniques, and dialectical behavior therapy is a type of cognitive-behavioral therapy focusing on acceptance and change strategies, which are not directly related to the use of disulfiram for alcohol use disorder.

4. What is the most effective initial intervention for a patient experiencing a panic attack?

• A. Encourage the patient to discuss their feelings.
• B. Provide a quiet environment and stay with the patient.
• C. Administer prescribed medication immediately.
• D. Teach the patient relaxation techniques.

Correct answer: B

Rationale: During a panic attack, the most effective initial intervention is to provide a quiet environment and stay with the patient. This approach can help the patient feel safe and supported, which may help reduce the intensity and duration of the panic attack. Encouraging the patient to discuss their feelings may not be helpful during the acute phase of a panic attack as it can be overwhelming. Administering prescribed medication immediately is not typically the first-line intervention for panic attacks. Teaching relaxation techniques is beneficial in the long term but may not be the most effective immediate intervention during a panic attack.

5. A client tells a nurse, 'Don’t tell anyone, but I hid a sharp knife under my mattress to protect myself from my threatening roommate.' Which of the following actions should the nurse take?

• A. Keep the client’s communication confidential, but talk to the client daily using therapeutic communication to convince them to admit to hiding the knife
• B. Keep the client’s communication confidential, but watch the client and their roommate closely
• C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others
• D. Report the incident to the health care team but do not inform the client of the intention to do so

Correct answer: C

Rationale: In this scenario, the nurse must prioritize the safety of the client and others. The client's disclosure of hiding a sharp knife under the mattress poses a significant risk. It is crucial for the nurse to inform the health care team about this situation to ensure immediate intervention and prevent any harm. Confidentiality is important in nursing care, but in cases where there is a clear threat to safety, the duty to protect overrides the duty of confidentiality. Reporting the incident to the health care team is essential to address the safety concerns and provide appropriate support and intervention for the client. Choices A and B are incorrect because while confidentiality is important, the immediate safety concern outweighs keeping the client's communication confidential or simply monitoring the situation. Choice D is incorrect as it does not involve informing the client, which can impact the therapeutic relationship and trust between the nurse and the client.

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