Nursing Elites

1. Which of the following mental health situations is considered a psychiatric emergency?

• A. Seasonal Affective Disorder (SAD)
• B. Depression with melancholic features
• C. Major depressive episode with psychotic features
• D. Bipolar depression

Correct answer: C

Rationale: A major depressive episode with psychotic features is considered a psychiatric emergency because it poses a significant risk to the individual's safety. Psychotic features in depression can include hallucinations, delusions, or other severe symptoms that require immediate intervention. While Seasonal Affective Disorder (SAD) and depression with melancholic features are serious conditions, they do not inherently represent an acute emergency that necessitates immediate hospitalization. Bipolar depression, although severe, does not inherently involve psychotic symptoms that would classify it as a psychiatric emergency requiring immediate intervention. It's crucial to recognize the urgency and severity of major depressive episodes with psychotic features to ensure appropriate and timely treatment.

2. Which intervention should the nurse use for a client who hallucinates, yells, and curses throughout the day?

• A. Ignore the client's behavior if the client is not harming anyone.
• B. Isolate the client until the behavior decreases or stops.
• C. Explain how the behavior affects other people on the unit.
• D. Seek to understand what the behavior means to the client.

Correct answer: D

Rationale: When a client experiences hallucinations, yells, and curses, it is essential to seek to understand the underlying meaning of their behavior. All behavior has significance, and understanding the client's perspective can guide appropriate interventions. Ignoring the behavior may exacerbate the situation and isolating the client could lead to increased anxiety and further acting out. Explaining the impact on others is not helpful in this scenario as the client is not intentionally hallucinating; yelling and cursing are responses to the hallucinations.

3. What psychodynamic process is suggested by a client calling the emergency department during a suicide attempt?

• A. A cry for help
• B. A need for attention
• C. Ambivalence about dying
• D. An inability to stick to a decision

Correct answer: C

Rationale: The correct answer is 'Ambivalence about dying.' When a client calls the emergency department during a suicide attempt, it suggests conflicting feelings about living and dying. This act can indicate an unconscious desire to be stopped from dying, showing ambivalence between the wish to die and the wish to live. It is not primarily a cry for attention or a need to punish others. The client's intention of suicide alongside seeking help demonstrates the struggle between life and death, making ambivalence the key psychodynamic process at play.

4. The client with cholecystitis is being instructed about dietary choices. Which meal best meets the dietary needs of this client?

• A. Steak, baked beans, and a salad
• B. Broiled fish, green beans, and an apple
• C. Pork chops, macaroni and cheese, and grapes
• D. Avocado salad, milk, and angel food cake

Correct answer: B

Rationale: Clients with cholecystitis, which is inflammation of the gallbladder, should follow a low-fat diet to reduce symptoms. Broiled fish, green beans, and an apple (Option B) is the most suitable choice as it is low in fat. Steak, baked beans, and a salad (Option A) provide a high amount of fat and protein, which may exacerbate symptoms of cholecystitis. Pork chops, macaroni and cheese, and grapes (Option C) and avocado salad, milk, and angel food cake (Option D) contain high-fat foods that are not recommended for individuals with cholecystitis. Therefore, Option B is the most appropriate choice for a client with cholecystitis.

5. According to the CDC, which of the following age groups is most likely to meet the criteria for major depression?

• A. 18-24 years
• B. 25-34 years
• C. 35-44 years
• D. 45-64 years

Correct answer: D

Rationale: According to the CDC, individuals aged 45-64 years are most likely to meet the criteria for major depression. While patients in the 18-24 year age group are more likely to report symptoms of depression, when it comes to major depression, the prevalence is higher in the 45-64 year age group. Choices A, B, and C are incorrect because the CDC indicates that major depression is most prevalent in the 45-64 year age group.

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