Nursing Elites

1. Which of the following interventions should a nurse include in the care plan for a client with major depressive disorder? Select one that is not appropriate.

• A. Encourage participation in activities
• B. Promote adequate nutrition and hydration
• C. Discourage verbalization of feelings
• D. Monitor for suicidal ideation

Correct answer: C

Rationale: Interventions for a client with major depressive disorder should focus on encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discouraging verbalization of feelings goes against the therapeutic approach as expressing and discussing feelings is crucial in the treatment of major depressive disorder. Clients with major depressive disorder often benefit from talking about their emotions and experiences, as it can help in processing their feelings and promoting recovery. Therefore, discouraging verbalization of feelings would hinder the client's progress and is not an appropriate intervention.

2. Gilbert, age 19, is described by his parents as a moody child with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

• A. Favorable with medication
• B. In the relapse stage
• C. Improvable with psychosocial interventions
• D. To have a less positive outcome

Correct answer: D

Rationale: The scenario describes Gilbert as having an early and slow onset of schizophrenia, which typically indicates a less positive prognosis. Individuals with such presentations may experience more severe symptoms and difficulties in functioning, leading to a poorer long-term outcome. In Gilbert's case, his challenges with completing tasks, social withdrawal, and fixation on security measures suggest a more challenging prognosis. Early detection and intervention are crucial in managing schizophrenia, but the described symptoms and onset pattern are concerning for a less favorable outcome.

3. A client has been diagnosed with histrionic personality disorder. Which of the following behaviors should the nurse expect?

• A. Attention-seeking behavior
• B. Dramatic expressions of emotion
• C. Seductive behavior
• D. Dependency on others

Correct answer: A

Rationale: Individuals with histrionic personality disorder often display attention-seeking behaviors as a way to draw focus and validation from others. This behavior may manifest as exaggerated emotions and dramatic expressions to maintain the spotlight. While seductive behavior and dependency on others are potential characteristics of histrionic personality disorder, attention-seeking behavior is the hallmark trait. Therefore, the correct answer is attention-seeking behavior (Choice A). Dramatic expressions of emotion (Choice B) can be a feature of histrionic personality disorder, but it is not as characteristic as attention-seeking behavior. Seductive behavior (Choice C) may also be present in individuals with histrionic personality disorder, but it is not the primary behavior to expect. Dependency on others (Choice D) is not a core feature of histrionic personality disorder, although individuals with this disorder may seek attention and validation from others.

4. A client prescribed sertraline for depression is receiving discharge instructions. Which statement by the client indicates an accurate understanding of the medication?

• A. I should take this medication at bedtime to avoid nausea.
• B. I should avoid drinking alcohol while taking this medication.
• C. I should take this medication with food to avoid stomach upset.
• D. It may take several weeks for this medication to be effective.

Correct answer: D

Rationale: The correct answer is D because sertraline, used for depression, typically takes several weeks to become effective. It is important for clients to understand this delayed onset of action to manage their expectations and continue taking the medication as prescribed despite not seeing immediate results.

5. How does emotional trauma typically affect individuals physically?

• A. Emotional trauma is a distinct category and unrelated to physical symptoms.
• B. Physical manifestations of emotional trauma are usually temporary.
• C. Emotional trauma is often manifested as physical symptoms.
• D. Patients are more aware of physical problems caused by trauma.

Correct answer: C

Rationale: Emotional trauma can often manifest as physical symptoms, such as headaches, stomachaches, and other somatic complaints. These physical manifestations can be long-lasting and impact the individual's overall well-being.

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