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 neurotransmitter is primarily implicated in the development of schizophrenia?

• A. Serotonin
• B. Norepinephrine
• C. Dopamine
• D. Acetylcholine

Correct answer: C

Rationale: The correct answer is dopamine. Dopamine dysregulation is a key factor in the development of schizophrenia. Excess dopamine activity in certain brain regions is associated with positive symptoms of schizophrenia, such as hallucinations and delusions. Dopaminergic medications that reduce dopamine levels are often used to manage these symptoms, further supporting the role of dopamine in schizophrenia. Serotonin (Choice A) is more commonly associated with mood regulation and is implicated in depression and anxiety disorders. Norepinephrine (Choice B) is involved in the body's 'fight or flight' response and is linked to conditions like anxiety and PTSD. Acetylcholine (Choice D) plays a role in muscle movement and memory but is not primarily implicated in schizophrenia.

3. When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?

• A. Change of shift reports
• B. Admission interviews
• C. One-to-one conversations with patients
• D. Conversations with patient families

Correct answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

4. A client has been prescribed escitalopram (Lexapro) for depression. Which instruction should the nurse include in the discharge teaching?

• A. Take the medication at bedtime to prevent daytime drowsiness.
• B. Avoid consuming alcohol while taking this medication.
• C. Take the medication with food to prevent stomach upset.
• D. Discontinue the medication if you start feeling better.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the discharge teaching is to advise the client to avoid consuming alcohol while taking escitalopram (Lexapro). Alcohol can potentiate side effects such as drowsiness and dizziness when combined with this medication. Choice A is incorrect because escitalopram is usually taken in the morning due to its potential to cause insomnia if taken at bedtime. Choice C is incorrect because taking the medication with or without food does not significantly affect its absorption or side effects. Choice D is incorrect because it is essential for the client to continue taking the medication even if they start feeling better, as abruptly stopping an antidepressant can lead to withdrawal symptoms and a relapse of depression.

5. Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?

• A. Somatic symptom disorder
• B. Grief responses
• C. Psychosis
• D. Bipolar disorder

Correct answer: A

Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.

Similar Questions