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. Pablo is a homeless adult who has no family connection. Pablo passed out on the street, and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select one that doesn't apply.

• A. Intermittent supervision is available in inpatient settings.
• B. He requires stabilization of multiple symptoms.
• C. How do you feel about talking to a mental health counselor?
• D. Medication adherence will be mandated.

Correct answer: D

Rationale: The correct answer is D because medication adherence being mandated is not a primary rationale for inpatient treatment. The main reasons for recommending inpatient treatment in this scenario include the need for stabilization of multiple symptoms, addressing nutritional and self-care needs, and ensuring safety due to the imminent danger of self-harm. Inpatient settings provide a more intensive level of care and supervision to address these complex issues effectively.

3. Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states:

• A. I understand that imaginary friends are abnormal.
• B. I understand that imaginary friends are a maladaptive behavior.
• C. I understand that imaginary friends are a coping mechanism.
• D. I understand that we should tell the child that imaginary friends are unacceptable.

Correct answer: C

Rationale: Imaginary friends can serve as a coping mechanism for children, especially those who have experienced trauma. They can provide comfort and a sense of control in challenging situations. Acknowledging and supporting the child's imaginary friend can be beneficial in their emotional healing and development.

4. In assessing a client with major depressive disorder, which of the following findings shouldn't the nurse expect?

• A. Anhedonia
• B. Hypersomnia
• C. Fatigue
• D. Flight of ideas

Correct answer: D

Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is typically associated with bipolar disorder during manic episodes, not major depressive disorder.

5. Based on what criteria do most cultures label behavior as mental illness?

• A. Incomprehensibility and cultural relativity
• B. Strength of character and ethics
• C. Goal directedness and high energy
• D. Creativity and good coping skills

Correct answer: A

Rationale: The correct answer is A: Incomprehensibility and cultural relativity. Incomprehensibility and cultural relativity are the main criteria used across cultures to define behavior as mental illness. When behavior is incomprehensible and significantly deviates from cultural norms, it is more likely to be classified as a mental illness. Choices B, C, and D are incorrect. Strength of character, ethics, goal directedness, high energy, creativity, and good coping skills are typically associated with positive mental health rather than mental illness.

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