Nursing Elites

1. Which consideration is the most accurate when applying the principles of mental health?

• A. Emotionally ill individuals may initially reject psychological support from family or others.
• B. People with emotional illnesses may experience challenges in problem-solving.
• C. Mental illness is not solely characterized by signs and symptoms of socially inappropriate behavior.
• D. Emotional health is promoted when there is a sense of mastery of self and the environment.

Correct answer: D

Rationale: Emotional health is enhanced when an individual feels a sense of control over themselves and their surroundings, fostering security, reducing anxiety, and promoting optimal functioning. While some emotionally ill individuals may reject help initially, many are in distress and acknowledge the need for psychological support. Some seek care based on positive past experiences or the attention received. Additionally, individuals with excellent cognitive function may face challenges in problem-solving due to emotional or psychological barriers. Not all individuals with mental illness exhibit socially inappropriate behavior; it is a misconception that mental illness is solely characterized by such signs and symptoms. Therefore, the most accurate consideration among the choices is that emotional health thrives when there is a feeling of mastery over oneself and the environment.

2. The client believes that the illness is a punishment for sins. Which cultural health belief is the client communicating?

• A. Yin/Yang balance
• B. Biomedical belief
• C. Determinism belief
• D. Magicoreligious belief

Correct answer: D

Rationale: The client is communicating a magicoreligious belief by attributing the illness to punishment for sins. In this belief system, illness is seen as caused by supernatural forces or hexes, often related to spiritual or religious beliefs. The yin/yang balance belief system does not view illness as punishment but rather as an imbalance of opposing forces. Biomedical belief focuses on physical and biochemical processes as the cause of health and illness. Determinism belief revolves around outcomes being preordained and unchangeable, not related to punishment for sins.

3. The health care provider has changed a client's prescription from the PO to the IV route of administration. The nurse should anticipate which change in the pharmacokinetic properties of the medication?

• A. The client will experience increased tolerance to the drug's effects and may need a higher dose.
• B. The onset of action of the drug will occur more rapidly, resulting in a more rapid effect.
• C. The medication will be more highly protein-bound, increasing the duration of action.
• D. The therapeutic index will be increased, placing the client at greater risk for toxicity.

Correct answer: B

Rationale: When changing the route of administration from PO to IV, the absorption process is bypassed, leading to a more rapid onset of action of the medication and consequently a quicker effect. Choices A, C, and D are incorrect. Increased drug tolerance and higher doses are not typical outcomes of changing the route of administration. Protein binding does not increase with a change to IV administration; rather, it is the bioavailability and onset of action that are affected. Moreover, an increased therapeutic index reduces the risk of drug toxicity, contrary to what is stated in choice D.

4. When assessing an older adult, which vital sign changes would the nurse recognize as occurring with aging?

• A. Increase in pulse rate
• B. Widened pulse pressure
• C. Increase in body temperature
• D. Decrease in diastolic blood pressure

Correct answer: B

Rationale: When assessing an older adult, the nurse should be aware that with aging, systolic blood pressure tends to increase, resulting in widened pulse pressure. While in many older individuals both systolic and diastolic pressures increase, the pulse rate and body temperature typically do not increase with aging. Therefore, the correct answer is widened pulse pressure. Choices A, C, and D are incorrect because pulse rate does not necessarily increase with age, body temperature generally remains stable, and diastolic blood pressure may increase instead of decreasing in many older adults.

5. A client with generalized anxiety disorder presents with restlessness and fatigue. Which additional clinical manifestation would the nurse monitor for?

• A. Hoarding
• B. Panic attacks
• C. Excessive worry
• D. Fear of leaving the house

Correct answer: C

Rationale: The nurse would monitor for excessive worry. Generalized anxiety disorder is characterized by physical and cognitive symptoms of chronic or excessive anxiety and worry. Excessive worry is a core feature of generalized anxiety disorder. Hoarding is a symptom of hoarding disorder, not generalized anxiety disorder. Panic attacks are typical of panic disorder, not generalized anxiety disorder. Fear of leaving the house is a characteristic of agoraphobia, which is distinct from generalized anxiety disorder.

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