Nursing Elites

1. Which statement made by the nurse demonstrates the best understanding of nonverbal communication?

• A. The patient's verbal and nonverbal communication is often different.
• B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
• C. If a patient is slumped in the chair, I can be sure he's angry or depressed.
• D. It's easier to understand verbal communication than nonverbal communication.

Correct answer: B

Rationale: Checking for congruence between verbal and nonverbal communication helps validate the patient's response.

2. During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:

• A. Major depression
• B. Normal grieving
• C. Adjustment disorder
• D. Posttraumatic stress disorder

Correct answer: C

Rationale: The widow's symptoms align more closely with an adjustment disorder rather than major depression, normal grieving, or posttraumatic stress disorder. The widow's prolonged struggle in coping with the loss, characterized by emptiness, loss of self, difficulty envisioning the future, and anger towards her deceased husband, indicates an inability to adapt to the loss. These symptoms are indicative of an adjustment disorder, which typically arises in response to a significant life stressor and persists beyond what is considered a normal grieving process. Bereavement counseling can help the widow navigate her emotions and coping strategies during this challenging period.

3. A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?

• A. Avoid foods high in sodium.
• B. Avoid foods high in calcium.
• C. Avoid foods high in tyramine.
• D. Avoid foods high in potassium.

Correct answer: C

Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.

4. Which of the following symptoms shouldn't a healthcare professional expect to assess in a client diagnosed with generalized anxiety disorder (GAD)?

• A. Excessive worry
• B. Muscle tension
• C. Increased energy
• D. Restlessness

Correct answer: C

Rationale: In generalized anxiety disorder (GAD), common symptoms include excessive worry, muscle tension, restlessness, and irritability. Increased energy is not typically associated with GAD; instead, clients often experience fatigue due to the persistent anxiety and worry that characterize the disorder.

5. A healthcare professional is assessing a client who is experiencing severe anxiety. Which of the following is an appropriate intervention?

• A. Encourage the client to talk about their feelings.
• B. Provide a quiet and calm environment.
• C. Encourage the client to exercise vigorously.
• D. Encourage the client to participate in group activities.

Correct answer: B

Rationale: During severe anxiety, it is essential to create a quiet and calm environment to help the client feel safe and reduce anxiety levels. Loud or stimulating environments can exacerbate anxiety symptoms, so providing a serene setting can promote relaxation and a sense of security.

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