Nursing Elites

1. Which of the following individuals is at the highest risk of experiencing intimate partner violence?

• A. A 36-year-old woman who is recently divorced
• B. A 22-year-old man who is unemployed but living with friends
• C. A 20-year-old woman who grew up with a psychologically abusive father
• D. A 40-year-old man diagnosed with schizophrenia

Correct answer: C

Rationale: Intimate partner violence is a serious issue encompassing physical, psychological, or sexual abuse within an intimate relationship. Individuals who have experienced psychological abuse in their upbringing are at a higher risk of becoming victims themselves due to the normalization of abusive behaviors. While factors such as age, mental health conditions, and social support can contribute to vulnerability, growing up in an abusive environment can significantly heighten the risk of intimate partner violence. The other options, such as recent divorce (A), unemployment (B), and schizophrenia diagnosis (D), do not directly correlate with the same level of increased risk associated with a history of psychological abuse.

2. A client who exhibits blurred and double vision and muscular weakness is informed of the diagnosis of multiple sclerosis (MS). The client becomes visibly upset. Which response would the nurse make?

• A. That must have shocked you. Tell me what the health care provider told you about it.
• B. You should see a psychiatrist who will help you cope with this overwhelming news.
• C. Don't worry; early treatment often alleviates the symptoms of the disease.
• D. You should be glad that we caught it early so you can be cured.

Correct answer: A

Rationale: The response 'That must have shocked you. Tell me what the health care provider told you about it' acknowledges the effect of the diagnosis on the client and explores what is known. This response shows empathy and encourages the client to share their understanding. There is no evidence of ineffective coping, so a referral to a psychiatrist is not necessary at this initial stage. The statement 'Don't worry; early treatment often alleviates symptoms of the disease' provides false reassurance as the course of MS varies for each individual and may not always respond well to treatment. The statement 'You should be glad we caught it early so it can be cured' does not address the client's current emotional state and is inaccurate; MS is a chronic autoimmune disease that currently has no cure.

3. The healthcare provider is assessing several clients before surgery. Which factor in a client's history poses the greatest threat for complications during surgery?

• A. Taking birth control pills for the past 2 years
• B. Taking anticoagulants for the past year
• C. Recently completing antibiotic therapy
• D. Having taken laxatives PRN for the last 6 months

Correct answer: B

Rationale: The correct answer is taking anticoagulants for the past year. Anticoagulants increase the risk of bleeding during surgery, which can lead to complications. It is crucial for the healthcare provider to be aware of this medication. While clients taking birth control pills (option A) may be more prone to developing blood clots, these issues typically arise after surgery. Clients who recently completed antibiotic therapy (option C) or have taken laxatives PRN for the last 6 months (option D) are at lower risk compared to those taking anticoagulants (option B) during surgery.

4. Which behavior is most typical for clients with borderline personality disorder?

• A. Arrogant
• B. Eccentric
• C. Impulsive
• D. Dependent

Correct answer: C

Rationale: The correct answer is 'Impulsive.' Clients with borderline personality disorder often exhibit impulsive, potentially self-damaging behaviors. Arrogance is more characteristic of narcissistic personality disorder, eccentric behavior aligns with schizotypal personality disorder, and dependent behavior is typical of dependent personality disorder. Therefore, the key feature of borderline personality disorder is impulsivity.

5. Which term or description would the nurse use for a client who repeatedly performs ritualistic behaviors throughout the day to limit anxious feelings?

• A. Obsessions
• B. Compulsions
• C. Under personal control
• D. Related to rebelliousness

Correct answer: B

Rationale: The correct answer is 'Compulsions.' A compulsion is an uncontrollable, persistent urge to perform an act repetitively to relieve anxiety. In this scenario, the client's repetitive ritualistic behaviors are indicative of compulsions. Obsessions, on the other hand, are persistent ideas, thoughts, or impulses that cannot be eliminated with logical reasoning. The behavior is not under personal control because avoiding it increases anxiety, making it a defense mechanism. It is not related to rebelliousness; instead, clients engage in these behaviors to reduce anxiety.

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