Nursing Elites

1. A client undergoing presurgical testing before a total abdominal hysterectomy says to the nurse, 'After I have this surgery I know my husband will never come near me again.' Which response would the nurse give?

• A. You're underestimating how your husband will respond to your surgery.
• B. You're concerned about the effect on your sexual relations.
• C. You're worried that the surgery will change how others see you.
• D. You're concerned about how your husband will respond to your surgery.

Correct answer: D

Rationale: The correct response acknowledges the client's expressed concern about her husband's reaction to the surgery, encouraging further discussion without imposing the nurse's assumptions. Choice A reframes the client's concern to focus on the husband's response, aligning more closely with the client's stated worry. Choice B makes an assumption about the client's concerns regarding sexual relations, which may not be the primary focus of her statement. Choice C shifts the attention to how others perceive the client, deviating from the client's specific reference to her husband's reaction, thus not addressing the client's main concern.

2. Which of the following is an advantage of working with psychiatric clients in a group setting?

• A. Clients assist each other through therapeutic interventions with the support of a nurse
• B. Clients can receive peer support and feedback in a safe and controlled environment
• C. Clients can share experiences and coping strategies while maintaining confidentiality
• D. Clients learn from others when their behaviors are inappropriate in a safe and trusting environment

Correct answer: D

Rationale: Group therapy is a valuable approach in mental health treatment. Working with psychiatric clients in a group setting offers various benefits. Clients in a group setting can learn from others when their behaviors are inappropriate in a safe and trusting environment. This environment allows individuals to express thoughts and feelings without fear of judgment or criticism, fostering a supportive atmosphere. Through interactions with peers, clients can gain insight into their own behaviors and learn alternative ways of coping. Choice A is incorrect as the presence and support of a nurse are typically important in group therapy sessions. Choice B is incorrect as group settings provide structure and rules to ensure a safe space for clients to express themselves. Choice C is incorrect as maintaining confidentiality is crucial in group therapy to build trust and encourage open sharing.

3. A seriously ill female client tells the nurse, 'I am so tired and in so much pain! Please help me to die.' Which is the best response for the nurse to provide?

• A. Administer the prescribed maximum dose of pain medication.
• B. Talk with the client about her feelings related to her own death.
• C. Collaborate with the healthcare provider about initiating antidepressant therapy.
• D. Refer the client to the ethics committee of her local healthcare facility.

Correct answer: B

Rationale: The nurse should first assess the client's feelings about her death and determine the extent to which this statement expresses her true feelings. The client may need additional pain management, but further assessment is needed before implementing option A. Option B is the correct response as it focuses on addressing the client's emotional needs and providing support. Option C is premature as initiating antidepressant therapy without a thorough assessment may not be appropriate. Option D is not the best course of action at this point; involving the ethics committee should be considered only after a comprehensive evaluation and discussion with the client.

4. Which of the following mental health situations is considered a psychiatric emergency?

• A. Seasonal Affective Disorder (SAD)
• B. Depression with melancholic features
• C. Major depressive episode with psychotic features
• D. Bipolar depression

Correct answer: C

Rationale: A major depressive episode with psychotic features is considered a psychiatric emergency because it poses a significant risk to the individual's safety. Psychotic features in depression can include hallucinations, delusions, or other severe symptoms that require immediate intervention. While Seasonal Affective Disorder (SAD) and depression with melancholic features are serious conditions, they do not inherently represent an acute emergency that necessitates immediate hospitalization. Bipolar depression, although severe, does not inherently involve psychotic symptoms that would classify it as a psychiatric emergency requiring immediate intervention. It's crucial to recognize the urgency and severity of major depressive episodes with psychotic features to ensure appropriate and timely treatment.

5. What feeling is likely to result from withdrawn behavior?

• A. Anger
• B. Paranoia
• C. Loneliness
• D. Boredom

Correct answer: C

Rationale: Withdrawn behavior involves avoiding social interactions and isolating oneself. This isolation can lead to feelings of loneliness as the individual lacks connection and companionship. While anger or paranoia may contribute to withdrawal, loneliness is a common emotional consequence of prolonged social isolation. Boredom may also arise from withdrawal if meaningful activities and social engagements are reduced.

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