Nursing Elites

1. After a client with major depressive disorder undergoes electroconvulsive therapy (ECT), which of the following is a priority assessment for the nurse?

• A. Monitoring for signs of infection
• B. Monitoring for signs of respiratory distress
• C. Monitoring for signs of hypotension
• D. Monitoring for signs of bleeding

Correct answer: B

Rationale: The priority assessment for the nurse after a client undergoes electroconvulsive therapy (ECT) is monitoring for signs of respiratory distress. This is crucial due to the potential risk of complications from anesthesia, such as airway compromise or respiratory depression. Prompt identification and intervention in case of respiratory distress are essential to ensure the client's safety and well-being. Monitoring for signs of infection (Choice A) is important but not the priority immediately post-ECT. Hypotension (Choice C) and bleeding (Choice D) are also potential concerns but assessing respiratory distress takes precedence due to the immediate risk it poses to the client's well-being.

2. Which of the following is a common side effect of electroconvulsive therapy (ECT)?

• A. Memory loss
• B. Weight gain
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Memory loss, particularly short-term memory loss, is a common side effect of electroconvulsive therapy (ECT). ECT can affect memory due to its impact on brain function during and after treatment. While the memory issues are often temporary and tend to improve over time, they are important considerations when discussing the risks and benefits of ECT with patients. Choices B, C, and D are incorrect as weight gain, insomnia, and increased appetite are not common side effects of ECT.

3. A client has been diagnosed with histrionic personality disorder. Which of the following behaviors should the nurse expect?

• A. Attention-seeking behavior
• B. Dramatic expressions of emotion
• C. Seductive behavior
• D. Dependency on others

Correct answer: A

Rationale: Individuals with histrionic personality disorder often display attention-seeking behaviors as a way to draw focus and validation from others. This behavior may manifest as exaggerated emotions and dramatic expressions to maintain the spotlight. While seductive behavior and dependency on others are potential characteristics of histrionic personality disorder, attention-seeking behavior is the hallmark trait. Therefore, the correct answer is attention-seeking behavior (Choice A). Dramatic expressions of emotion (Choice B) can be a feature of histrionic personality disorder, but it is not as characteristic as attention-seeking behavior. Seductive behavior (Choice C) may also be present in individuals with histrionic personality disorder, but it is not the primary behavior to expect. Dependency on others (Choice D) is not a core feature of histrionic personality disorder, although individuals with this disorder may seek attention and validation from others.

4. In a patient with schizophrenia, which of the following symptoms would indicate a poor prognosis?

• A. Auditory hallucinations
• B. Paranoia
• C. Flat affect
• D. Delusions of grandeur

Correct answer: C

Rationale: A flat affect, characterized by a lack of emotional expression, is often linked to a poorer prognosis in schizophrenia. It can hinder social interactions and affect the individual's ability to engage in therapy or express emotions, thereby impacting the overall treatment outcomes. Auditory hallucinations (Choice A) and delusions of grandeur (Choice D) are common symptoms in schizophrenia but may not always indicate a poor prognosis. Paranoia (Choice B) can also vary in its impact on prognosis depending on the individual and the severity of the symptom.

5. Which of the following are cultural aspects of mental illness? Select one that doesn't apply.

• A. Local or cultural norms define pathological behavior.
• B. The higher the social class the greater the recognition of mental illness behaviors.
• C. Psychiatrists typically see patients when the family can no longer deny the illness.
• D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

Correct answer: D

Rationale: The fewer ties that a group has with mainstream society, the greater the likelihood of a negative response by society to mental illness. Coercive treatments and involuntary hospitalizations are more common in this population.

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