Nursing Elites

1. 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.

2. Which client action is an example of the defense mechanism of sublimation?

• A. A woman channels her energy into a new hobby after a breakup.
• B. A man redirects his anger from work into a workout routine.
• C. A student focuses on studying to avoid thinking about a recent argument.
• D. An athlete channels competitive impulses into a successful sports career.

Correct answer: B

Rationale: Sublimation is a defense mechanism where unacceptable impulses are redirected into socially acceptable activities. In this scenario, the man redirects his anger from work into a workout routine, which is a positive and constructive way of managing his emotions. Choices A, C, and D do not fully align with sublimation as they do not involve redirecting unacceptable impulses into socially acceptable outlets, unlike the man's action in choice B.

3. What should the nurse include in patient education for a patient starting on bupropion for major depressive disorder?

• A. Avoid consuming alcohol while taking this medication.
• B. Take the medication in the morning to prevent insomnia.
• C. It may cause significant weight gain.
• D. It is used as a first-line treatment for anxiety.

Correct answer: A

Rationale: Patients prescribed bupropion should be educated to avoid consuming alcohol while on this medication to reduce the risk of seizures. Bupropion lowers the seizure threshold, and alcohol can further increase this risk. It is important for patients to understand the potential consequences of combining bupropion with alcohol to ensure their safety and treatment effectiveness. Choices B, C, and D are incorrect. Taking bupropion in the morning does not prevent insomnia; it is not associated with significant weight gain; and it is not a first-line treatment for anxiety.

4. Kyle, a patient with schizophrenia, began taking the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay, he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select one that does not apply.

• A. Hold his medication and contact his prescriber.
• B. Wipe him with a washcloth wet with cold water or alcohol.
• C. Administer a medication such as benztropine IM to correct this dystonic reaction.
• D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass.

Correct answer: C

Rationale: The patient's symptoms, including stiffness, diaphoresis, inability to respond verbally, and vital sign abnormalities, are indicative of neuroleptic malignant syndrome (NMS), a serious and potentially life-threatening side effect of antipsychotic medications. Administering a medication such as benztropine intramuscularly is the priority to address the dystonic reaction associated with NMS. This intervention can help alleviate symptoms and prevent further complications. Holding the medication and contacting the prescriber may be necessary but addressing the acute symptoms takes precedence. Wiping the patient with a cold washcloth or alcohol would not address the underlying medical emergency. Reassuring the patient about tardive dyskinesia is irrelevant and not the immediate concern in this scenario.

5. Which statement is an example of reflection?

• A. I think this feeling will pass.
• B. So you are saying that life has no meaning.
• C. I'm not sure I understand what you mean.
• D. You look sad.

Correct answer: B

Rationale: The correct answer is B. Reflection involves restating the patient's words or feelings to show understanding and encourage further discussion. Choice B restates the patient's statement, demonstrating active listening and empathy.

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