Nursing Elites

1. Which statement about the concept of neuroses is most accurate?

• A. An individual experiencing neurosis is unaware of the distress they are experiencing.
• B. An individual experiencing neurosis feels helpless to change their situation.
• C. An individual experiencing neurosis is aware of psychological causes of their behavior.
• D. An individual experiencing neurosis has a loss of contact with reality.

Correct answer: B

Rationale: Neurosis involves feelings of distress and anxiety, but individuals experiencing neurosis are usually aware of their distress and its causes. They may recognize that their behaviors are maladaptive and are generally in contact with reality. The accurate statement about neurosis is that an individual feels helpless to change their situation. Choice A is incorrect because individuals with neurosis are usually aware of their distress. Choice C is incorrect because while individuals may be aware of psychological causes, it is not the defining characteristic of neurosis. Choice D is incorrect because a loss of contact with reality is more characteristic of psychosis, not neurosis.

2. Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states:

• A. I understand that imaginary friends are abnormal.
• B. I understand that imaginary friends are a maladaptive behavior.
• C. I understand that imaginary friends are a coping mechanism.
• D. I understand that we should tell the child that imaginary friends are unacceptable.

Correct answer: C

Rationale: Imaginary friends can serve as a coping mechanism for children, especially those who have experienced trauma. They can provide comfort and a sense of control in challenging situations. Acknowledging and supporting the child's imaginary friend can be beneficial in their emotional healing and development.

3. Which of the following is a common side effect of electroconvulsive therapy (ECT)?

• A. Memory loss
• B. Weight gain
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Memory loss, particularly short-term memory loss, is a common side effect of electroconvulsive therapy (ECT). ECT can affect memory due to its impact on brain function during and after treatment. While the memory issues are often temporary and tend to improve over time, they are important considerations when discussing the risks and benefits of ECT with patients. Choices B, C, and D are incorrect as weight gain, insomnia, and increased appetite are not common side effects of ECT.

4. A healthcare professional is assessing a client with obsessive-compulsive disorder (OCD). Which of the following findings should the professional expect? Select one that does not apply.

• A. Recurrent, intrusive thoughts
• B. Compulsive behaviors
• C. Delusions of grandeur
• D. Avoidance of situations that trigger obsessions

Correct answer: C

Rationale: Obsessive-compulsive disorder (OCD) is characterized by recurrent, intrusive thoughts (obsessions), compulsive behaviors, and avoidance of situations that trigger obsessions. Delusions of grandeur, which involve inflated beliefs about one's own importance or abilities, are not typically associated with OCD. Therefore, the presence of delusions of grandeur would not be an expected finding in a client with OCD. Choices A, B, and D are all typical features of OCD and would be expected findings during the assessment of a client with this disorder.

5. A client diagnosed with borderline personality disorder tells the nurse, 'You are the only one who understands me. The other nurses don't care about me.' Which of the following responses should the nurse make?

• A. Why do you feel that way?
• B. The other nurses care about you too.
• C. You shouldn't say things like that.
• D. I think you are overreacting.

Correct answer: B

Rationale: The correct response is to acknowledge the client's feelings and provide support while also emphasizing that all staff members care about the client's well-being. Choice A does not acknowledge the client's emotions and may come across as dismissive. Choice C invalidates the client's feelings and may make the client feel misunderstood. Choice D minimizes the client's emotions, which can lead to a breakdown in therapeutic communication. Therefore, option B is the most appropriate response as it validates the client's feelings while reinforcing the idea that the entire healthcare team is supportive.

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