Nursing Elites

1. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?

• A. The client is experiencing severe distress and is at risk for physical and psychological illness.
• B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
• C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
• D. The client may view these losses as challenges and perceive them as opportunities.

Correct answer: C

Rationale: The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client's life. However, susceptibility to stress-related physical or psychological illness cannot be accurately estimated without considering the individual's coping resources and available support systems. Positive coping mechanisms and strong social support can mitigate the risk of stress-related illnesses even in the face of significant life changes and losses. Choice A is incorrect because it makes a definitive statement about the client's state without considering individual coping mechanisms and support. Choice B is incorrect because a score of 110 does not necessarily mean no threat of stress-related illness, as individual factors play a crucial role. Choice D is incorrect as it assumes a positive outlook without acknowledging the potential impact of the experienced losses on stress levels.

2. Which statement reflects an accurate understanding of the concepts of mental health and mental illness?

• A. The concepts are rigid and religiously based.
• B. The concepts are multidimensional and culturally defined.
• C. The concepts are universal and unchanging.
• D. The concepts are unidimensional and fixed.

Correct answer: B

Rationale: Understanding mental health and mental illness as multidimensional and culturally defined is essential for healthcare professionals. Mental health varies across cultures and is influenced by various dimensions such as biological, psychological, social, and spiritual factors. Recognizing these differences helps in providing culturally competent care and understanding the diverse expressions of mental health and illness. Choice A is incorrect because mental health and mental illness are not rigid or solely based on religion. Choice C is incorrect because mental health and mental illness are not universally experienced in the same way and can change over time. Choice D is incorrect because mental health and mental illness are not unidimensional; they involve various factors and are not fixed in nature.

3. After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?

• A. Do you believe that I was the cause of your blood test being canceled?
• B. I see that you are upset, but I feel uncomfortable when you swear at me.
• C. Have you ever thought about ways to express anger appropriately?
• D. I'll give you some space. Let me know if you need anything.

Correct answer: B

Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.

4. Which of the following is a common side effect of benzodiazepines prescribed for anxiety?

• A. Insomnia
• B. Weight gain
• C. Drowsiness
• D. Increased appetite

Correct answer: C

Rationale: Drowsiness is a common side effect of benzodiazepines prescribed for anxiety. Benzodiazepines work by depressing the central nervous system, which can lead to drowsiness as a side effect. This sedative effect is often desired in the treatment of anxiety disorders, but individuals should be cautious when engaging in activities that require alertness, such as driving, while taking these medications. Insomnia, weight gain, and increased appetite are not typically associated with benzodiazepines; instead, drowsiness and sedation are more common side effects.

5. A patient with obsessive-compulsive disorder (OCD) is prescribed paroxetine. The nurse should educate the patient about which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Sexual dysfunction
• D. Hypertension

Correct answer: C

Rationale: The correct answer is C, 'Sexual dysfunction.' Paroxetine, an SSRI commonly prescribed for OCD, can lead to sexual dysfunction as a side effect. Patients should be educated about this potential adverse effect to ensure they are aware and can seek appropriate management if needed. Choices A, B, and D are incorrect because insomnia, weight loss, and hypertension are not typically associated with paroxetine use as common side effects in patients with OCD.

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