Nursing Elites

1. Which individual is likely experiencing symptoms of derealization?

• A. I just feel like I’m looking at life through a fog and that can’t be my face in the mirror.
• B. I cannot recall why I’m living in this town or how I got here.
• C. There are just too many people living in my head now.
• D. I feel like I’m going to die, I’m having a heart attack.

Correct answer: A

Rationale: The individual describing feeling like they are looking at life through a fog and questioning their reflection in the mirror is likely experiencing symptoms of derealization. Derealization involves feelings of detachment from one's surroundings, which can manifest as a sense of unreality or distortion of the environment. Choice B describes dissociative amnesia, which involves memory loss related to personal information or traumatic events. Choice C suggests dissociative identity disorder (DID), where a person experiences two or more distinct identities or personality states. Choice D indicates symptoms of a panic attack, such as fearing imminent death and physical sensations like a heart attack.

2. When a patient with schizophrenia is taking haloperidol, what is a priority assessment for the nurse?

• A. Assessing for signs of tardive dyskinesia
• B. Monitoring for signs of neuroleptic malignant syndrome
• C. Checking for signs of depression
• D. Monitoring for changes in appetite

Correct answer: B

Rationale: Monitoring for signs of neuroleptic malignant syndrome is crucial for patients taking haloperidol. Neuroleptic malignant syndrome is a rare but serious side effect that can occur with antipsychotic medications like haloperidol. It presents with symptoms such as high fever, unstable blood pressure, confusion, muscle rigidity, and autonomic dysfunction. Early detection and intervention are essential to prevent serious complications.

3. A healthcare provider is educating a patient about the side effects of selective serotonin reuptake inhibitors (SSRIs). Which side effect should the provider emphasize?

• A. Weight gain
• B. Increased libido
• C. Nausea
• D. Insomnia

Correct answer: C

Rationale: When educating patients about SSRIs, it is crucial to emphasize the common side effect of nausea. Nausea is a frequently reported side effect of SSRIs that can impact adherence to treatment. By highlighting this side effect, patients can be better prepared and informed about what to expect when taking these medications. Choices A, B, and D are incorrect as weight gain, increased libido, and insomnia are not typically associated with SSRIs as common side effects. Nausea is a more relevant and prevalent side effect to address with patients.

4. After a severe automobile accident, Mr. and Mrs. Johnson were brought to the hospital. Mrs. Johnson is unable to remember anything about the accident or the two days preceding it. The nurse recognizes this as:

• A. Generalized amnesia
• B. Localized amnesia
• C. Selective amnesia
• D. Continuous amnesia

Correct answer: B

Rationale: Localized amnesia refers to an inability to recall specific events, often traumatic, within a particular time frame. In this case, Mrs. Johnson's memory loss about the accident and the preceding two days aligns with the characteristics of localized amnesia. Generalized amnesia involves a more extensive memory loss, often encompassing a person's entire life, which is not the case here. Selective amnesia involves forgetting specific details but not a whole chunk of time like in this scenario. Continuous amnesia is not a recognized term in psychology.

5. When the caregiver of a child asks the nurse for reassurance about their child’s condition, which of the following responses should the nurse make?

• A. “I think your child is getting better. What have you noticed?”
• B. “I’m sure everything will be okay. It just takes time to heal.”
• C. “I’m not sure what’s wrong. Have you asked the doctor about your concerns?”
• D. “I understand you’re concerned. Let’s discuss what concerns you specifically.”

Correct answer: D

Rationale: When providing reassurance to a caregiver about their child’s condition, it's essential to acknowledge their concern and address it specifically. Response D demonstrates empathy and a willingness to discuss the caregiver's specific concerns, which can help in providing accurate information and support to them. Choices A and B provide general reassurance without addressing the caregiver's specific concerns, which may not alleviate their worries effectively. Choice C deflects the question back to the caregiver and suggests consulting the doctor without directly engaging with the caregiver's worries, which may not offer the needed support and reassurance.

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