Nursing Elites

1. A client diagnosed with OCD spends hours bathing and grooming. During a one-on-one interaction, the client discusses the rituals in detail but avoids any feelings that the rituals generate. Which defense mechanism should the nurse identify?

• A. Dissociation
• B. Rationalization
• C. Sublimation
• D. Intellectualization

Correct answer: D: Intellectualization

Rationale: Intellectualization is a defense mechanism where an individual focuses on rational, logical explanations to distance themselves from uncomfortable emotions. In this scenario, the client discusses the OCD rituals in a detailed and analytical manner, avoiding the emotional aspects associated with them. This behavior reflects intellectualization rather than dissociation, rationalization, or sublimation. Dissociation involves a disconnection from reality, rationalization is the attempt to justify behaviors, and sublimation is redirecting unacceptable impulses into socially acceptable activities.

2. How do psychiatrists determine which diagnosis to give a patient?

• A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• B. Hospital policy dictates how psychiatrists diagnose mental disorders.
• C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
• D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: The correct answer is A. Psychiatrists use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) to determine diagnoses. The DSM-5 provides standardized criteria for the classification of mental disorders, ensuring accurate and reliable diagnosis and treatment. Choices B and D are inaccurate as hospital policy does not dictate psychiatric diagnoses, and the American Medical Association is not responsible for psychiatric diagnostic criteria. Choice C describes a more general approach to assessment and does not specifically address the standardized criteria used in psychiatric diagnosis.

3. Which of the following is not a symptom of a panic attack?

• A. Chest pain
• B. Shortness of breath
• C. Dizziness
• D. Hot flashes

Correct answer: A

Rationale: Symptoms of a panic attack include shortness of breath, dizziness, and hot flashes. Chest pain is not a common symptom of a panic attack but can be present in some cases. Euphoria is not typically associated with panic attacks.

4. A healthcare professional is providing education to the family of a client who has been diagnosed with schizophrenia. Which of the following instructions should the healthcare professional include?

• A. Encourage the client to participate in daily activities.
• B. Encourage the client to express their feelings.
• C. Encourage the client to avoid caffeine.
• D. Encourage the client to spend time alone.

Correct answer: A

Rationale: Encouraging the client to participate in daily activities is crucial in managing schizophrenia. Engaging in activities can enhance the quality of life and reduce symptoms by providing structure, routine, and social interaction, which are beneficial for individuals with schizophrenia. Choices B, C, and D are not the most appropriate instructions for managing schizophrenia. While expressing feelings can be helpful, daily activities have a more significant impact on managing the condition. Avoiding caffeine and spending time alone are not directly related to managing schizophrenia and may not be the most beneficial strategies.

5. A healthcare professional is assessing a client who has been diagnosed with schizoid personality disorder. Which of the following behaviors should the healthcare professional expect?

• A. Preference for solitary activities
• B. Detachment from social relationships
• C. Indifference to praise or criticism
• D. Anxiety in social situations

Correct answer: C

Rationale: The correct behavior that the healthcare professional should expect in an individual with schizoid personality disorder is indifference to praise or criticism. While it is true that individuals with this disorder often exhibit a preference for solitary activities and detachment from social relationships, the key defining characteristic is their emotional detachment and lack of response to external feedback, which includes being indifferent to praise or criticism. Anxiety in social situations is not a typical feature of schizoid personality disorder.

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